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Obstetrics & Gynecology


Answer 4
  1. History of PID. PID is the leading cause of ectopic pregnancy. Plical agglutination within the endosalpinx of the fallopian tubes can prevent normal passage of the blastocyst through the tubes to the uterus. At least 50% of first ectopic pregnancies are associated with a history of PID. In most other cases, no risk factor can be identified. Prior tubal surgery is associated with an elevated risk for ectopic pregnancy but is not as common as PID. Progesterone-only intrauterine devices decrease the overall risk of ectopic pregnancy when compared with no contraception. However, should conception occur, the risk of ectopic implantation is about 5%. A history of 2 or more prior abortions may be associated with an elevated risk for ectopic pregnancy, although 1 prior abortion has not been shown to increase the risk.1 Structurally abnormal embryos appear to increase risk for ectopic implantation, but genetic abnormalities do not.

    REFERENCE
    1. Herbst AL, Mishell DR, Stenchever MA, Droegemueller W. Ectopic pregnancy. In: Comprehensive gynecology. 2nd ed. St. Louis: Mosby-Year Book; 1992:457-88.

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