Certain factors are associated with increased risk of ectopic pregnancy.
|
Risk |
Risk Factor |
Odds Ratio |
|
high risk |
tubal surgery |
21.0 |
|
|
sterilization |
9.3 |
|
|
previous ectopic pregnancy |
8.3 |
|
|
in-utero exposure to diethylstilbesterol |
5.6 |
|
|
use of intrauterine device (IUD) |
4.2-45.0 |
|
|
documented tubal pathology |
3.8-21.0 |
|
moderate risk |
infertility, especially if pregnancy occurs during infertility treatment |
2.5-21.0 |
|
|
previous genital infections |
2.5-3.7 |
|
|
multiple sexual partners |
2.1 |
|
slight risk |
previous pelvic or abdominal surgery |
0.9-3.8 |
|
|
cigarette smoking |
2.3-2.5 |
|
|
vaginal douching |
1.1-3.1 |
|
|
early age at first intercourse (< 18 years) |
1.6 |
(from Table 1, page 1115. Single value odds ratios from homogenous studies; value range for odds ratio if heterogeneous studies)
Risk after sterilization:
(1) if pregnancy occurs after tubal sterilization, then an ectopic location should be suspected
(2) risk highest after electrocoagulation procedures
Tubal pathology associated with ectopic pregnancy:
(1) following pelvic infection
(2) endometriosis
(3) previous surgery
Risk in women with previous ectopic pregnancy:
(1) risk is increased in women with a previous ectopic pregnancy, and the risk increases in proportion to the number of previous ectopic pregnancies
(2) risk of recurrence decreases with subsequent intrauterine pregnancies after the initial ectopic pregnancy
Heterotopic pregnancy is the coexistence of an intrauterine and ectopic gestation:
(1) very rare in spontaneous pregnancies
(2) occurs in 1-3% of pregnancy with fertility treatments involving superovulatory drugs or in-vitro fertilization, especially if the woman has concomitant tubal damage
(3) 50% of patients are diagnosed after tubal rupture
Specialty: Obstetrics & Gynecology
