Ectopic pregnancy
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Ectopic pregnancy
Reproductive system
Male and female reproductive system disorders
Precocious puberty
Delayed puberty
Klinefelter syndrome
Turner syndrome
Androgen insensitivity syndrome
5-alpha-reductase deficiency
Kallmann syndrome
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Neonatal conjunctivitis
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Congenital rubella syndrome
Neonatal sepsis
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Miscarriage
Gestational trophoblastic disease
Ectopic pregnancy
Fetal hydantoin syndrome
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Reproductive system pathology review
Disorders of sex chromosomes: Pathology review
Prostate disorders and cancer: Pathology review
Testicular tumors: Pathology review
Uterine disorders: Pathology review
Ovarian cysts and tumors: Pathology review
Cervical cancer: Pathology review
Vaginal and vulvar disorders: Pathology review
Benign breast conditions: Pathology review
Breast cancer: Pathology review
Complications during pregnancy: Pathology review
Congenital TORCH infections: Pathology review
Disorders of sexual development and sex hormones: Pathology review
Amenorrhea: Pathology Review
Testicular and scrotal conditions: Pathology review
Sexually transmitted infections: Warts and ulcers: Pathology review
Sexually transmitted infections: Vaginitis and cervicitis: Pathology review
HIV and AIDS: Pathology review
Penile conditions: Pathology review
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Ectopic pregnancy
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Rishi Desai, MD, MPHIn ectopic pregnancy, ectopic means “out of place,” so an ectopic pregnancy means that a pregnancy occurs somewhere other than in the uterine cavity.
In order for an ectopic pregnancy to take place, a couple of things need to happen differently from the normal process of a pregnancy.
First, following ovulation, the egg must be fertilized and come to rest somewhere other than the endometrium of the uterine cavity.
Next, when it arrives at this destination, it must implant on a surface with a rich enough blood supply to support a developing embryo.
Ectopic pregnancies have been known to occur on various surfaces, including the ovaries, intestines, and most commonly, in the ampulla of the Fallopian tube.
After implantation, the embryo begins developing and growing just like it would in a normal pregnancy.
Over time, a few different things can happen. Sometimes the tissue can no longer provide a sufficient blood supply for the embryo, leading to its death.
On the other hand, if the tissue can supply the embryo with sufficient blood, then hormones from the corpus luteum and placenta can lead to a missed menstrual period and other body changes like nausea and fullness of breasts, which are typically seen in early pregnancy.
If the ectopic pregnancy occurs in the ampulla of the fallopian tube, it eventually runs out of space.
Slowly the ectopic pregnancy stretches the nerve fibers within the wall of the fallopian tube, causing lower abdominal pain.
Eventually, the expansion causes damage to the wall of the ampulla, potentially rupturing the fallopian tube.
A ruptured ectopic can also lead to massive hemorrhaging into the abdominal cavity, and the blood can irritate the peritoneum which can cause referred pain to the shoulder.
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
- "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
- "Does This Woman Have an Ectopic Pregnancy?" JAMA (2013)
- "Diagnosing ectopic pregnancy and current concepts in the management of pregnancy of unknown location" Human Reproduction Update (2013)
- "Ectopic pregnancy" The Lancet (2005)
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