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| {{Ectopic pregnancy}} | | {{Ectopic pregnancy}} |
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| === Cilial damage and tube occlusion ===
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| Hair-like [[cilia]] located on the internal surface of the Fallopian tubes carry the fertilized egg to the uterus. Damage to the cilia or blockage of the Fallopian tubes is likely to lead to an ectopic pregnancy. Women with [[pelvic inflammatory disease]] (PID) have a high occurrence of ectopic pregnancy. This results from the build-up of [[scar|scar tissue]] in the Fallopian tubes, causing damage to cilia. If however both tubes were occluded by PID, pregnancy would not occur and this would be protective against ectopic pregnancy. Tubal surgery for damaged tubes might remove this protection and increase the risk of ectopic pregnancy. [[Tubal ligation]] can predispose to ectopic pregnancy. Seventy percent of pregnancies after tubal cautery are ectopic, while 70% of pregnancies after tubal clips are intrauterine. Reversal of tubal sterilization ([[Tubal reversal]]) carries a risk for ectopic pregnancy. This is higher if more destructive methods of tubal ligation (tubal cautery, partial removal of the tubes) have been used than less destructive methods (tubal clipping). A history of ectopic pregnancy increases the risk of future occurrences to about 10%. This risk is not reduced by removing the affected tube, even if the other tube appears normal. The best method for diagnosing this is to do an early ultrasound.
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| === Association with infertility ===
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| Infertility treatments are highly variable and specific to individual patients. [[In vitro fertilization]] is used for patients with damaged tubes, which are an inherent risk factor for ectopic pregnancy. Ectopic pregnancies have been seen with [[in vitro fertilization]], but this is an uncommon complication and quickly diagnosed by the early ultrasounds that these intensively surveyed patients undergo.
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| ===Hysterectomy===
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| Ectopic pregnancy occasionally occurs in women who have had a [[hysterectomy]]. Rather than implanting in the absent uterus, the fetus implants in the abdomen, and must be delivered via [[caesarean section]].[http://www.dailyprincetonian.com/archives/2002/05/08/opinion/5154.shtml] <ref>[http://content.nejm.org/cgi/content/full/329/16/1174 SA Carson, JE Buster, Ectopic Pregnancy. New Engl J Med 329:1174-1181]</ref>
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| === Other ===
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| Patients are at higher risk for ectopic pregnancy with advancing age. Also, it has been noted that [[Tobacco smoking|smoking]] is associated with ectopic risk. Vaginal douching is thought by some to increase ectopic pregnancies; this is speculative. Women exposed to [[diethylstilbestrol]] (DES) in utero (aka "DES Daughters") also have an elevated risk of ectopic pregnancy, up to 3 times the risk of unexposed women.
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| ==References== | | ==References== |
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| {{WS}} | | {{WS}} |
| | [[Category:Needs content]] |
| [[Category:Disease]] | | [[Category:Disease]] |
| [[Category:Emergency medicine]] | | [[Category:Emergency medicine]] |
| [[Category:Obstetrics]] | | [[Category:Obstetrics]] |