Recurrence of ectopic pregnancy: the role of salpingitis

Article Abstract:

Occasionally the fertilized embryo abnormally becomes implanted some place other than the uterus (such as in the fallopian tubes). Women who have already had such an ectopic pregnancy have a higher risk for having another one in subsequent fertilizations. Women who have had salpingitis, an inflammation of the fallopian tubes, are also at higher risk for ectopic pregnancy. This study examined the risk for recurrence of ectopic pregnancy in women who had both an ectopic pregnancy previously and who had salpingitis prior to or following the first ectopic pregnancy. Women who were examined for acute pelvic inflammatory disease during a 25-year period in a Swedish hospital were followed-up for pregnancies and their outcomes following initial examination. Of the 2,503 women examined, 1,540 became pregnant for a total of 2,901 pregnancies. Data were available for 2,899 pregnancies. Episodes of salpingitis and their severity were also evaluated. Results showed that 193 (6.7 percent) of the pregnancies were ectopic. Such pregnancies were more likely to occur in women who were older, who had prior episodes of salpingitis, and who had more severe cases of salpingitis. Ectopic pregnancies occurred in 2.2 percent of cases where there had been no prior salpingitis, 5.0 percent of cases where there had been mild previous salpingitis, 7.7 percent where there had been moderate salpingitis, and 14.1 percent where there had been severe salpingitis. Ectopic pregnancies occurred in 6.8 percent of first pregnancies and in 21.7 percent of second pregnancies following an ectopic first pregnancy. Ectopic pregnancies were more likely when there was a history of salpingitis and the previous pregnancy was uterine. The history of salpingitis did not increase the risks in women who had already had an ectopic pregnancy. These results indicate that prior history of salpingitis and prior history of ectopic pregnancy are both risk factors for ectopic pregnancy, but the risks from each factor are not additive. Salpingitis is only a risk factor for a first ectopic pregnancy but does not increase the risk once an ectopic pregnancy has occurred beyond the increased risk associated with having had an ectopic pregnancy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Risk factors, Salpingitis

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Transabdominal and transvaginal ultrasonography in the diagnosis of ectopic pregnancy: a comparative study

Article Abstract:

Ultrasonography is a diagnostic tool that uses high frequency sound to visualized internal structures. The transducer that transmits the ultrasound can be placed on the surface of the abdomen (transabdominal) or through a probe inserted into the vagina (transvaginal). Ultrasonographic imaging can be used to diagnose ectopic pregnancies, in which embryos implant in areas outside of the uterus. Since ectopic pregnancies are potentially life-threatening, early diagnosis is essential. The diagnostic accuracy of transvaginal and abdominal ultrasound was compared in 34 women with a suspected ectopic pregnancy. No embryonic sac was identified within the uterus in all 34 patients, who had positive pregnancy tests. Twenty-four patients had surgery 24 hours after ultrasound confirmation of an ectopic pregnancy located within the fallopian tubes (tubal pregnancy). Of these confirmed cases, 68 percent were suspected on the basis of transabdominal ultrasound, while 84 percent were identified by transvaginal ultrasound. An embryonic sac was clearly visualized in the fallopian tubes by transabdominal ultrasound in 32 percent of the cases and by transvaginal ultrasound in 64 percent of the cases. The one ectopic pregnancy identified by transabdominal ultrasound but not transvaginal ultrasound was found to be attached to the uterine wall and was out of the visual field of the transvaginal probe. The high-resolution image produced by transvaginal ultrasound appears to have a much greater ability to detect ectopic pregnancies than transabdominal ultrasound. The earlier an ectopic pregnancy is diagnosed, the better the chances are of saving the fallopian tube and maintaining reproductive integrity for future fertility. Transvaginal ultrasound identified tubal pregnancies more frequently than did transabdominal ultrasound. (Consumer Summary produced by Reliance Medical Information, Inc.)

Innovations, Prenatal ultrasonography, Ultrasonics in obstetrics, Adnexa uteri

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Ectopic tubal pregnancy treated by operative laparoscopy

Article Abstract:

Ectopic tubal pregnancies, when the fertilized egg is implanted in the fallopian tubes rather than the uterus, is one of the leading causes of maternal death. Laparoscopy, a surgical technique where a tube is inserted into a small opening in the abdomen to visualize internal structures, can be used to remove these fetal tissues. Hospital stays and operating times are less than those of exploratory abdominal surgery. The laparoscopic method of treating ectopic tubal pregnancy is therefore preferred.

Usage, Patient outcomes, Mortality, Infant mortality, Mothers, Maternal mortality, Perinatal death, Laparoscopy

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