Ectopic pregnancy

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Ectopic pregnancy on right fallopian tube (laparoscopic image)

Ectopic pregnancy is the implantation of the embryo to an extra-uterine cavity, most usually in the fallopian tubes, or the cervix. It can happen after natural conception at a rate of 1-1.5%. The rate is slightly higher in IVF programs.

Depending on the site of implantation:

  • Fallopian tube pregnancy
  • Ovarian pregnancy
  • Peritoneal pregnancy
  • Cervical pregnancy
  • Concomitant uterine and ectopic

It is diagnosed at early stages (6th week of gestation) as the first ultrasound that is performed 14 days after the positive pregnancy test can accurately identify the location of embryo development.

In the past, diagnosis of an ectopic pregnancy was based on on symptoms before the rupture of the fallopian tube and included delay of menstruation, pelvic pain and vaginal bleeding, and symptoms after the rupture of the fallopian tube that included intense pain and sites of internal bleeding. Today its diagnosis is facilitated using the levels of hCG combined with transvaginal ultrasound.

Ectopic pregnancies are treated using laparoscopic surgery, which is the method of choice. The traditional laparotomy with removal of the tube is athing of the past. Surgical treatment of an ectopic pregnancy be performed using:

  • Preservation of the fallopian tube (salpingostomy)
  • Removal of the fallopian tube (salgingectomy)