Sexually transmitted diseases and tubal pregnancy

Article Abstract:

The risk of tubal pregnancy (fetal development within the fallopian tubes) has been reported to be associated with, and consequent to, venereal diseases, genital herpes, genital warts, and trichomoniasis. The possible association of Chlamydia trachomatis infection and a previous clinical history of other venereal infections with tubal pregnancy was the basis of this study. Female patients over 18 years of age, participating in a group health program during 1981 to 1986, with a history of tubal pregnancy were identified from the program records. A total of 715 controls, matched only for age and county of residence, were studied with the 264 patients selected for evaluation. In general, controls and patients were demographically alike. More patients than controls had prior histories of multiple marriages, multiple sexual partners, and venereal disease infections. Unfortunately, in many of the cases the venereal diseases were identified from interview data rather than from clinical assessment. A previous history of gonorrhea correlated with positive test for Chlamydia in both patients and controls. There was a two-fold greater risk for tubal pregnancy in patients who were positive for Chlamydial antibodies. In summary, the evidence suggests the likelihood of a history of sexually transmitted disease, as well an the association of infection with Chlamydia trachomatis, as a risk factor for tubal pregnancy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Sexually transmitted diseases, Chlamydia infections

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Previous abdominal surgery and tubal pregnancy

Article Abstract:

An ectopic pregnancy occurs when the products of conception implant in areas outside of the uterus. The most common location for an ectopic pregnancy is in one of the fallopian tubes, which is called a tubal pregnancy. Studies investigating whether previous abdominal surgery increases the risk for tubal pregnancy have yielded conflicting results. The possible role of abdominal surgery in subsequent tubal pregnancy was studied by examining the medical, reproductive and sexual histories of 337 women with tubal pregnancy and 893 women without a history of a tubal pregnancy, who served as controls. Women who had surgery involving the fallopian tubes themselves were excluded from the study. After adjusting for age and number of previous pregnancies, there was no increased risk for tubal pregnancy after the following types of abdominal surgery: cesarean section, ovarian surgery, and removal of an unruptured appendix. Women who had surgery for a ruptured appendix were 1.8 times more likely to have a tubal pregnancy, however, this increase was within the limits of chance. In conclusion, there is a slim possibility that surgery for a ruptured appendix increases the risk of having a tubal pregnancy, but it is more likely that a history of abdominal surgery (excluding that of the fallopian tubes) is not associated with an increased risk of subsequent tubal pregnancy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surgery, Postoperative complications, Abdomen, Laparotomy, Appendectomy

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Tubal sterilization and subsequent ectopic pregnancy: a case-control study

Article Abstract:

Ectopic pregnancy occurs when the fertilized egg implants outside the uterus, and may be fatal if not treated promptly with surgery. Between 1970 and 1985 the rate of ectopic pregnancy more than tripled. During that time the proportion of women who underwent tubal sterilization more than doubled, but whether tubal sterilization is implicated in the increased incidence (number of cases) of ectopic pregnancy is not known. To determine the relation between tubal sterilization and ectopic pregnancy, 241 women who had an ectopic pregnancy were matched with 835 women of childbearing age who did not. Those who had undergone tubal sterilization were divided into two groups based on whether sterilization had been performed during the month of a previous delivery (postpartum sterilization) or at another time (interval sterilization). Electrocoagulation (use of electric current to destroy part of the fallopian tube) is more likely to result in an incomplete tubal blockage. The results indicate that this technique may increase the likelihood of ectopic pregnancy. Women who had undergone postpartum sterilization, which is more often done by ligation (tying), and those who had interval sterilization by ligation had a lower risk of ectopic pregnancy. The advantages and disadvantages of the research design and alternatives are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Cases, Oral contraceptives, Tubal sterilization

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