Definition: An ectopic pregnancy occurs when a fertilized egg implants somewhere other than the main cavity of the uterus, most commonly in the Fallopian tubes.
Background:
First descriptions of ectopic pregnancy in England dates back to 1731 when Gifford described implantation of a pregnancy outside the uterine cavity.
Charles Meigs provided particularly vivid descriptions of severe cases of ectopic pregnancy in the mid-nineteenth century, when ectopic pregnancy was considered to be a rare, but universally
fatal condition.
With the improvements in surgical techniques at the turn of the twentieth century ectopic pregnancy became curable . However, it was still considered a very serious problem with high mortality rates. This perception has changed only recently with the increased ability to establish the diagnosis of ectopic pregnancy non-invasively in women with minimal clinical symptoms.
Although there has been a massive increase in the incidence of ectopic pregnancy in recent years, the
mortality of the disease has been static . Therefore the main challenge in modern clinical practice is to identify and treat as early as possible cases of ectopic pregnancy with the potential to cause serious morbidity and death, and at the same time to minimize interventions in those destined to be resolved without causing any harm.
Risk Factors For Ectopic pregnancy:
A number of factors have been identified, which increase individual risk of ectopic implantation.
An association between increased maternal age and ectopic pregnancy has been well documented in the past. The incidence of ectopic pregnancy is three times higher in women aged 35–44 in comparison to those in the age group 15–24.
A past history of sexually transmitted disease also increases the risk of ectopic pregnancy.
A list of the risk factors associated with increased chances of ectopic pregnancy is given below:
- History of previous ectopic pregnancy
- (IUCD) or sterlization failure
- Pelvic inflammatory disease
- Chlamydia infection
- Early age of intercourse and multiple partners
- History of infertility
- Previous pelvic surgery
- Increased maternal age
- Cigarette smoking
- Strenuous physical exercise
- In utero DES exposure
