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16 Dec

Ectopic pregnancy is the result of a flaw in human reproductive physiology that allows the conceptus to implant and mature outside the endometrial cavity (see the image below), which ultimately ends in the death of the fetus. Unfortunately, only about 50% of patients present with all 3 symptoms.

Without timely diagnosis and treatment, ectopic pregnancy can become a life-threatening situation. Patients may present with other symptoms common to early pregnancy (eg, nausea, breast fullness).

Ectopic pregnancy can lead to massive hemorrhage, infertility, or death (see the images below).

(See Etiology and Prognosis.) A 12-week interstitial gestation, which eventually resulted in a hysterectomy.

Many risk factors affect both events; for example, a history of major tubal infection decreases fertility and increases abnormal implantation.

Reflecting this, most ectopic pregnancies are located in the fallopian tube; the most common site is the ampullary portion of the tube, where over 80% of ectopic pregnancies occur.In theory, anything that hampers or delays the migration of the fertilized ovum (blastocyst) to the endometrial cavity can predispose a woman to ectopic gestation.The following risk factors have been linked to ectopic pregnancy: The most logical explanation for the increasing frequency of ectopic pregnancy is previous pelvic infection; however, most patients presenting with an ectopic pregnancy have no identifiable risk factor. (A) Ampullary, 80%; (B) Isthmic, 12%; (C) Fimbrial, 5%; (D) Cornual/Interstitial, 2%; (E) Abdominal, 1.4%; (F) Ovarian, 0.2%; and (G) Cervical, 0.2%.The following symptoms have also been reported: In a normal pregnancy, the β-HCG level doubles every 48-72 hours until it reaches 10,000-20,000m IU/m L.