An 8 Week Old On A Fallopian Tube Alive

The increased incidence of ectopic pregnancy seen over recent decades has occurred simultaneously with an increased incidence of pelvic inflammatory disease. This suggests a causal relationship (Figure 11.1). Improvements in the treatment of pelvic inflammatory diseases may now preserve tubal function in women who previously would have suffered from tubal factor infertility. However, more recently in Norway a fall in the incidence of ectopic pregnancy has been reported.1 It has been suggested that the falling rates of pelvic inflam matory disease may be responsible for these changes.

Ectopic pregnancy can be defined as the implantation of a fertilized ovum anywhere other than in the endometrial cavity. Ninety-five per cent of ectopic pregnancies occur within the fallopian tube (Table 11.1). Non-tubal ectopic pregnancies, including caesarean section scar pregnancy are discussed elsewhere in this book.2,3

It can be argued that the use of transvaginal ultrasonography (Figure 11.2) and the treatment of ectopic pregnancy using minimal access surgery has contributed to the decreased

Ultrasound Images Hetero Ectopic Cornual

0 1970 1976 1980 1984 1986 1990 1991 1992 1993 1994 1997 1999 2001

Year

Figure 11.1 Ectopic pregnancy trends (from Sintef Health)

0 1970 1976 1980 1984 1986 1990 1991 1992 1993 1994 1997 1999 2001

Year

Table 11.1. Localization of ectopic pregnancy

Fallopian tube

• Ampullary segment

B0%

• Isthmic segment

10%

• Fimbrial end

5%

• Cornual and interstitial

2%

Abdominal

1.4%

Ovarian

0.2%

Cervical

0.2%

Ectopic Pregnancy Weeks
Figure 11.2 Transvaginal ultrasound of a live ectopic pregnancy at 8 weeks 5 days. (See also colour plate)

mortality rate associated with this condition. The result is that the management of unruptured tubal pregnancy has changed from being focused on immediate, life-saving intervention to making more effort to preserve fertility. The treatment options that are available for a given ectopic pregnancy relate to the location, with the majority of tubal ectopic pregnancies surgical management is safe and effective. This chapter will focus on the surgical approach to the management of this condition.

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Responses

  • fiori
    When ectopic pregnancies are ended is the fetus alive?
    8 months ago
  • RALPH BECK
    Is an ectopc pregnancy fetus alive?
    5 months ago

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