Ectopic Pregnancy

Ectopic pregnancy is a complication of pregnancy in which the embryo attaches outside the uterus.

Signs and symptoms classically include abdominal pain and vaginal bleeding, but fewer than 50 percent of affected women have both of these symptoms.

Signs and symptoms of ectopic pregnancy include

  • Increased HCG
  • Vaginal bleeding (in varying amounts)
  • Sudden lower abdominal pain
  • Pelvic pain
  • A tender cervix
  • An adnexal mass, or adnexal tenderness
  • Rupture of an ectopic pregnancy can lead to symptoms such as

There are a number of risk factors for ectopic pregnancies. However, in as many as one-third to one-half no risk factors can be identified.

  • Pelvic Inflammatory Disease
  • Infertility
  • Use Of An Intrauterine Device (Iud)
  • Previous Exposure To Diethylstilbestrol (Des)
  • Tubal Surgery
  • Intrauterine Surgery (E.G. D&C)
  • Smoking
  • Previous Ectopic Pregnancy
  • Endometriosis
  • Tubal Ligation

High: Tubal sterilization, IUD, prior ectopic, PID (pelvic inflammatory disease), SIN (salpingitis isthmica nodosa)

Moderate: Smoking, having more than 1 partner, infertility, chlamydia

Low: Douching, age greater than 35, age less than 18, GIFT (gamete intrafallopian transfer)

There's no way to prevent an ectopic pregnancy, but here are some ways to decrease your risk.

  • Limiting the number of sexual partners and using a condom during sex helps to prevent sexually transmitted infections and may reduce the risk of pelvic inflammatory disease.
  • Don't smoke

How is it diagnosed?

An ultrasound showing a gestational sac with fetal heart in the fallopian tube has a very high specificity of ectopic pregnancy.

How is it treated?

Most women with a PUL are followed up with serum hCG measurements and repeat TVS examinations until a final diagnosis is confirmed.[4] Low-risk cases of PUL that appear to be failing pregnancies may be followed up with a urinary pregnancy test after two weeks and get subsequent telephone advice. For nontubal ectopic pregnancy, evidence from randomised clinical trials in women with CSP is uncertain regarding treatment success, complications and side effects of methotrexate compared with surgery (uterine arterial embolization or uterine arterial chemoembolization). Surgeons use laparoscopy or laparotomy to gain access to the pelvis and can either incise the affected Fallopian and remove only the pregnancy (salpingostomy) or remove the affected tube with the pregnancy (salpingectomy).

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