From the Guidelines
Predisposing factors for an ectopic pregnancy include a history of tubal surgery, previous ectopic pregnancy, and salpingitis with resulting tubal occlusion, as these conditions can lead to tubal damage and altered embryo transport. According to the study published in the Annals of Emergency Medicine 1, these factors are strongly associated with an increased risk of ectopic pregnancy. Some key points to consider include:
- History of tubal surgery, including sterilization, carries the highest risk
- Previous ectopic pregnancy results in a significant risk increase due to surgical management or persistence of risk factors associated with the original ectopic pregnancy
- Salpingitis with resulting tubal occlusion doubles the likelihood of ectopic pregnancy with each recurrent episode
- In vitro fertilization and induced ovulation are also important risk factors, although tubal factors remain the most significant contributors to ectopic pregnancy risk 1. It is essential to note that these factors generally increase risk by causing damage to the fallopian tubes, creating adhesions or scarring that impede the normal transport of the fertilized egg to the uterus. Women with multiple risk factors should be monitored closely in early pregnancy for signs of ectopic implantation.
From the Research
Predisposing Factors for Ectopic Pregnancy
Some of the predisposing factors for an ectopic pregnancy include:
- Prior ectopic pregnancy 2, 3, 4, 5
- Pelvic inflammatory disease history 2, 3, 4, 5
- Previous pelvic surgery 3, 4, 5
- Infertility treatment 3, 4
- Advanced maternal age 4
- Smoking 4
- History of spontaneous and induced abortion 4
- Previous use of emergency contraception 4
- Previous use of intrauterine device 4, 5, 6
- Previous tubal ligation 4
- Abdominal and pelvic surgeries 4
- History of endometriosis 6
Patient Characteristics
Patient characteristics such as:
- Age younger than 25 years may be protective from ectopic pregnancy 2
- Multigravida may be at higher risk 3
- Gestational age of 6-8 weeks at the time of presentation may be common in ectopic pregnancy 3
- Presenting features such as amenorrhea, abdominal pain, and tenderness may be common in ectopic pregnancy 3
Risk Factors
Risk factors such as: