Ectopic pregnancy concurrent with induced abortion: incidence and mortality

Article Abstract:

Ectopic pregnancy occurs when the embryo implants and grows in an area outside of the uterus. Symptoms of an ectopic pregnancy include pain, nausea, vomiting, vaginal bleeding, fever, shock and constipation. A diagnosis of an ectopic pregnancy may be missed in women undergoing elective abortions because symptoms are often masked by symptoms that normally follow an abortion procedure. An undiagnosed ectopic pregnancy is life-threatening. The incidence of ectopic pregnancy in women undergoing an induced abortion and the number of resultant deaths were studied. There were 5,797 women diagnosed with an ectopic pregnancy and induced abortion between 1972 and 1985, for a ratio of 1.35 ectopic pregnancies per 1,000 induced abortions. This compared with 13.6 ectopic pregnancies per 1,000 pregnancies not associated with abortions (induced or spontaneous). There were 24 deaths among women with an ectopic pregnancy coinciding with an induced abortion. The death rate was 1.3 times higher than the death rate among women having an ectopic pregnancy not undergoing an abortion. Many abortion clinics send the tissue obtained during the abortion to a laboratory to examine for the products of conception. A missed ectopic pregnancy can be reduced if the practitioner performing the abortion examines for products of conception immediately after the abortion rather than waiting for laboratory result, which could dangerously delay the diagnosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Patient outcomes, Mortality, Diagnosis, Abortion

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Contraception and ectopic pregnancy risk

Article Abstract:

Ectopic pregnancies, in which the fertilized egg fails to locate in the uterus, have become increasingly more common. This may be related to improved diagnosis, increased frequency of pelvic inflammatory disease, and delay of pregnancy to older ages, when ectopic pregnancy is more common. It is unclear whether contraceptive methods, particularly the IUD (intrauterine device), are associated with the occurrence of ectopic pregnancies, and this is partly due to methodological difficulties in studies of this issue. The rate of ectopic pregnancy per 1,000 woman-years of use was estimated for six contraceptive methods and no contraceptive use by evaluating data obtained in two large studies. The results were calculated from values of the incidence rate of pregnancy per contraceptive method and the proportion of pregnancies implanted outside the uterus per contraceptive method. The calculation method may have been somewhat biased toward overstating the risk among contraceptive users relative to nonusers. The frequency of ectopic pregnancy was lowest among users of oral contraceptives or those whose partners were vasectomized, and increased in frequency, in order, for users of condoms, diaphragms, tubal sterilization, the IUD, and for those who did not use contraception. Further research should clarify some of the uncertainties in the estimates. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Contraception

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Delayed care of pelvic inflammatory disease as a risk factor for impaired fertility

Article Abstract:

Women who delay seeking treatment for pelvic inflammatory disease may have a higher risk of infertility or an ectopic pregnancy than those who seek immediate treatment. Pelvic inflammatory disease is any pelvic infection that affects the upper female genital tract above the cervix. An ectopic pregnancy is a pregnancy that occurs outside the uterus. Among 443 women who had had one episode of pelvic inflammatory disease, 76 were infertile or had an ectopic pregnancy and 367 women had a normal pregnancy. The risk of infertility or an ectopic pregnancy was three times higher among the women who delayed seeking treatment for pelvic inflammatory disease than among those who immediately sought treatment. This risk was especially high for women with pelvic inflammatory disease caused by a Chlamydia infection who delayed seeking treatment.

Causes of, Infertility, Pelvic inflammatory disease

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