Ectopic Pregnancy

Posted by e-Medical PPT Wednesday, September 8, 2010
An ectopic pregnancy is one in which the fertilized egg implants in tissue outside of the uterus and the placenta and fetus begin to develop there.
The most common site of occurrence is within a fallopian tube, however, ectopic pregnancies can occur in the ovary, the abdomen and in the lower portion of the uterus (the cervix).Ectopic Pregnancy is a common, life–threatening condition affecting one in 100 pregnancies
As the pregnancy grows it causes pain and bleeding. If it is not treated quickly enough it can rupture and cause abdominal bleeding, which can lead to maternal cardiovascular collapse and death.




Risk Factors for Ectopic Pregnancy
  • Pelvic inflammatory disease (PID) or Salpingitis → 6 -10 times higher risk. Mainly invasion of gonorrhea or chlamydia from the cervix up to the uterus and tubes and infection in these tissues causes an intense inflammatory response and scar tissue adhesions in the tube and may damage the cilia of the fallopian tube
  • Endometriosis
  • History of IUD use
  • Progesterone–only contraceptive pill (mini–pill) → alters tubal motility
  • Pregnancy after tubal ligation or coagulation
  • Previous tubal surgery
  • Ovulation induction or ovarian stimulation
  • In vitro fertilization → 2-5% of pregnancies are conected with IVF
  • Advancing age
  • Previous ectopic → about 10-20% of women attempting pregnancy after one ectopic will have another
  • Salpingitis Isthmica Nodosa → uncommon diverticulae in the proximal (isthmic) portion of the tube that enhance tubal implantation of the early developing embryo
  • Pelvic adhesions, pelvic tumors
  • Atrophic endometrium
  • Septate uterus
  • Zygote abnormalities (chromosomal abnormatity, neural tube defects, abnormal spermatozoa)

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