Ectopic pregnancy risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Moises Romo M.D.

Overview

Ectopic pregnancy usually occurs in women with fallopian tube dysfunction. There are a number of risk factors for ectopic pregnancies, among them pelvic inflammatory disease, infertility, DES exposure, tubal surgery, smoking, previous ectopic pregnancy, multiple sexual partners, current IUD use, tubal ligation, and previous abortion. The most potent risk factor in the development of ectopic pregnancy is tubal surgery.

Risk Factors

Common risk factors in the development of ectopic pregnancies may be occupational, environmental, genetic, and viral. The folowing table summarizes these risks and its odds ratio:

Risk Factors Odds Ratios for Ectopic Pregnancy
Risk Factor	Odds Ratio
Tubal surgery	21
Tubal ligation	9.3
Previous ectopic pregnancy	8.3
In-utero DES exposure	5.6
IUD	4.2 – 45
Documented tubal pathology	3.8 – 21
Infertility	2.5 – 21
Previous STD	2.5 – 3.7
Multiple sexual partners	2.1
Prior pelvic / abd surgery	0.9 – 3.8
Cigarette smoking	2.3 – 2.5
Vaginal douching	1.1 – 3.1
1st intercourse < 18 years old	1.6

Common Risk Factors

• Tubal surgery.
• Tubal ligation. Although tubal ligation is highly effective in preventing pregnancies, if a pregnancy does occur, it is more likely to be ectopic.
• Previous ectopic pregnancy. Same as having a previous ectopic pregnancy increases the risk for further ectopic pregnancies, having a intrauterine pregnancy decreases this risk.
• In-utero DES exposure. The usage causes a loss of fimbriae and stenosis of fallopian tubes, which may increase up to 3 times the risk of ectopic pregnancy as compared to unexposed women.
• IUD
• Documented tubal pathology

Less common Risk Factors

• Infertility. Treatment of infertility, such as in vitro fertilization is associated with a 2 – 3 % increased risk compared with the general population.
• Previous STD
• Multiple sexual partners
• Prior pelvic / abd surgery
• Cigarette smoking
• Vaginal douching
• 1st intercourse < 18 years old
• Advanced age.
• Vaginal douching. It is thought by some to increase ectopic pregnancies.