On March 21, 2018 | All, Obstetrics & Gynaecology

By Dr. Suhasini Inamdhar

An ectopic pregnancy is an early pregnancy that occurs outside of the normal location (uterine lining) for a developing pregnancy. The vast majority of ectopic pregnancies are so-called tubal pregnancies and occur in the Fallopian tube. An ectopic pregnancy occurs in about one in 1%-2% of all pregnancies.

These other places can be:

1) Fallopian tubes
2) Ovaries
3) Cervix
4) Cornua of uterus
5) Abdominal Cavity

The major health risk of ectopic pregnancy is rupture leading to internal bleeding. Before the 19th century, the mortality rate (death rate) from ectopic pregnancies exceeded 50%. Statistics suggest that with current advances in early detection, the mortality rate has improved to less than five in 10,000. The survival rate from ectopic pregnancies is improving even though the incidence of ectopic pregnancies is also increasing. The major reason for a poor outcome is failure to seek early medical attention. Ectopic pregnancy remains the leading cause of pregnancy-related death in the first trimester of pregnancy.

Causes of Ectopic pregnancy:
1)LAZY EMBRYO

The embryo does not travel till the cavity of uterus, but gets attached in the ovary, tube or cornua of uterus .
2) PELVIC INFLAMMATORY DISEASE (PID) :  infection because of :

1) chlamydia,
2) bacteria
3) acute appendicitis
4) recurrent D & C/ MTP
5) pelvic surgery

inflammation of the pelvis sets in and the fallopian tubes get damaged, form adhesions, get partially /completely blocked and impede the movement of embryo. This makes embryo to get settled in the tube.

3) ENDOMETRIOSIS
Here the anatomy of Fallopian Tubes and Pelvis gets distorted and tubes do not function to the full potential.

4) TUBAL LIGATION OR REVERSAL OF THE SAME
Family planning procedure where the tubes are tied sometimes fails and this can lead to partial blockage of tubes.
5) IUCD
It is sometimes the cause of genital tract infection and can lead to damaged tubes.

6) PREVIOUS ECTOPIC PREGNANCY

7) EMERGENCY CONTRACEPTIVE PILL
Here the egg is already fertilised and it’s movement is hampered because of change in the hormonal miluea
8) PROGESTERONE ONLY PILL (MINI PILL)
Here the mucus membrane of tubes gets altered and the motility of tube also is affected
9)CIGARETTE SMOKING
It is known to increase the level of protein PROKR1 in the fallopian tube and this protein is known to help in implantation of embryo.
Please remember: ectopic pregnancy is not your fault and it just happens, one needs to be vigilant and aware.

By,
Suhasini Inamdar

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