Ectopic pregnancy is the implantation of the pregnancy outside the uterine cavity. The fallopian tubes are the most common site of implantation, with rates of about 90%.
Causes of ectopic pregnancy
In a normally progressing pregnancy, the fertilised egg travels down the fallopian tubes and implants in the uterine cavity. Various pathological conditions can lead to implantation in organs other than the endometrium. The most common cause is adhesions inside the fallopian tubes, which prevent the transport of the fertilised egg into the uterine cavity. That is why the fallopian tubes are the most common site of an ectopic pregnancy. It can also be found in other sites, for example the ovaries, the peritoneum, the abdominal cavity or even the cervix.
Diagnosis of ectopic pregnancy
In the early stages, the diagnosis is usually made by chance, when an ultrasound is performed to confirm a possible pregnancy. In these cases the gestational sac is found outside the uterus. At a later gestational age, the symptom that appears is lower abdominal pain. It increases in intensity as the hours pass and is due to rupture of the ectopic pregnancy. What matters here is differential diagnosis from other conditions that may be confused with ectopic pregnancy. For this reason, history, clinical examination, laboratory tests and ultrasound are all necessary to make a definitive diagnosis.
Treatment of ectopic pregnancy
Ectopic pregnancy is treated mainly surgically. Laparoscopic surgery is now the most appropriate method. Drug treatment has a place in the management of ectopic pregnancy; however, this requires strict fulfilment of certain criteria, which make this approach safe and effective for the patient.