Ectopic Pregnancy: Diagnosis and Management

Abstract

The incidence of ectopic pregnancies is increasing, which may be related to better diagnostic tools as well as the increasing use of assisted reproductive technologies. However, the signs and symptoms of ectopic pregnancy can be similar to other complications of early pregnancy such as miscarriage. Diagnosis often requires serial human chorionic gonadotropin levels along with ultrasound and, in some cases, dilation and curettage. Once a diagnosis has been made, treatment options include medical therapy with methotrexate and surgery, which can often be performed via the laparoscope. Fertility rates after therapy are similar for both medically and surgically treated patients.

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“…However, they are not specific because they are also present in all entities of abortions, making early diagnosis difficult [6,7]. These associated symptoms are also not consistent with stage of the disease progression at time of presentation for evaluation.…”

Tubal Damage, Infertility and Tubal Ectopic Pregnancy: Chlamydia trachomatis and Other Microbial Aetiologies

“…These authors further conclude that the significant rise in ectopic pregnancies may in fact be related to an increase in positive tests for chlamydial infection of the genital tracts (Mol et al, 2010). The management of ectopic pregnancy has recently been addressed (Kulp & Barnhart 2008;Mol et al, 2011).…”

“…A recent review also summarises the results of investigations of the Fallopian tube with respect to the roles of of caspase 1, cannabinoid receptor and Dicer 1 knockout mice and how these contribute to tubal dysfunction and contribute to ectopic pregnancies (Shao 2010). A recent review highlighted the many risk factors for ectopic pregnancy and these are summarised in Table 1 Kulp and Barnhart, 2008) www.intechopen.com Ectopic pregnancy accounts for up to 11% of all pregnancies and there is serological evidence that links ectopic pregnancies with C. trachomatis infection in women (Chow et al, 1990; It was noted in one study that 19/21 C. trachomatis seropositive women with ectopic pregnancies had antibodies to the chlamydial 57kDa antigen and it was suggested that perhaps immune responses to this antigen may be involved in the immunopathogenesis of ectopic pregnancy associated with C. trachomatis infections (Brunham et al, 1992). A recent review has reported that one third of ectopic pregnancies could be attributable to chlamydial infection (Bebear and de Barbeyrac, 2009).…”

Fertility after ectopic pregnancy in a district hospital in Cameroon

“…Its incidence is increasing worldwide, which is associated with an increase in the prevalence of risk factors for EP (e.g. pelvic infections) [1]. A frequency of EP of 3.45 per 100 live births has been reported in the South Region of Cameroon [2].…”

“…In rural areas, patients present to the hospital late, usually after tubal rupture. The treatment is often laparotomy, and in most cases, salpingectomy is the only option [1].…”