Ectopic PregnancyEctopic Pregnancy异位妊娠异位妊娠Jun Ma 马军马军

Dept. of Obstetrics & GynecologyThe First Hospital of Xi’an Jiaotong Univ

Ectopic:

(Ektopos) out of place

Definition

Ectopic pregnancy: fertilized

embryo implanted outside the

uterine cavity

intrauterine implantation

Animation of intrauterine implantation

Animation of ectopic implantation

>95%

Classification of ectopic pregnancy

Overview Leading cause of maternal deaths in

the first trimester Constituting 1-2% of all conceptions Subsequent infertility Incidence increasing Mortality decreasing with better

detection

Tubal pregnancy

输卵管妊娠

Incidence of tubal pregnancy by location

Incidence of tubal pregnancy by location

Interstitial

2-3%

isthmic

12%Ampullary

78%

Fimbrial

5%

Which women are at Which women are at higher risk for tubal higher risk for tubal pregnancy?pregnancy?

High-risk FactorsHigh-risk Factors Prior history of PID (pelvic inflammatory

disease)

High-risk FactorsHigh-risk Factors

Prior history of PID (pelvic

inflammatory disease)

Tubal Surgery

Previous Ectopic Pregnancy

IUD (intrauterine device)???

Other tubal abnormalities

Pathology & outcomesPathology & outcomes

1.1. Tubal abortionTubal abortion

OutcomesOutcomes

2.2. Rupture of tubal pregnancyRupture of tubal pregnancy

3.3. Secondary abdominal pregnancySecondary abdominal pregnancy

4.4. Tubal mole & pelvic hematomaTubal mole & pelvic hematoma

Other pathological changesOther pathological changes

HCGHCG

Corpus luteumCorpus luteum

EndometriumEndometrium

Vaginal bleeding Vaginal bleeding

UterusUterus

Intact embryo

maintain

maintain

decidua

-

slightly enlarged

drop

regress

decidua shedding

+/ irregular

slightly enlarged or normal size

Rupture or abortion

QuestionQuestion

How to explain the situation

when a woman with ectopic

pregnancy claimed that she

had expelled an “intra-unterine

embryo-like tissue”?

Endometrium

Vaginal bleeding

Vaginal pass of tissue

Pregnancy test

Histology (Intrauterine

villi))

Tubal abortion

decidua shedding

+/ irregular

+

+

_

decidua

+/ irregular

+

+

+

Intrauterine abortion

SummarySummary

What is ectopic pregancy? Which patients are at higher risk for

tubal pregnancy?

What are the fates of tubal pregnancy?

Thank you.