Ectopic pregnancy risk factors: Difference between revisions

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Revision as of 02:15, 18 February 2021

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Moises Romo M.D.

Overview

Ectopic pregnancy usually occurs in women with fallopian tube dysfunction. There are a number of risk factors for ectopic pregnancies, among them pelvic inflammatory disease, infertility, DES exposure, tubal surgery, smoking, previous ectopic pregnancy, multiple sexual partners, current IUD use, tubal ligation, and previous abortion. The most potent risk factor in the development of ectopic pregnancy is tubal surgery.

Risk Factors

Common risk factors in the development of ectopic pregnancies may be occupational, environmental, genetic, and viral. The folowing table summarizes these risks and its odds ratio:


Risk Factors Odds Ratios for Ectopic Pregnancy
Risk Factor	Odds Ratio
Tubal surgery	21
Tubal ligation	9.3
Previous ectopic pregnancy	8.3
In-utero DES exposure	5.6
IUD	4.2 – 45
Documented tubal pathology	3.8 – 21
Infertility	2.5 – 21
Previous STD	2.5 – 3.7
Multiple sexual partners	2.1
Prior pelvic / abd surgery	0.9 – 3.8
Cigarette smoking	2.3 – 2.5
Vaginal douching	1.1 – 3.1
1st intercourse < 18 years old	1.6

Common Risk Factors

Tubal surgery.
Tubal ligation. Although tubal ligation is highly effective in preventing pregnancies, if a pregnancy does occur, it is more likely to be ectopic.
Previous ectopic pregnancy. Same as having a previous ectopic pregnancy increases the risk for further ectopic pregnancies, having a intrauterine pregnancy decreases this risk.
In-utero DES exposure. The usage causes a loss of fimbriae and stenosis of fallopian tubes, which may increase up to 3 times the risk of ectopic pregnancy as compared to unexposed women.
IUD
Documented tubal pathology

Less common Risk Factors

Infertility. Treatment of infertility, such as in vitro fertilization is associated with a 2 – 3 % increased risk compared with the general population.
Previous STD
Multiple sexual partners
Prior pelvic / abd surgery
Cigarette smoking
Vaginal douching
1st intercourse < 18 years old
Advanced age.
Vaginal douching. It is thought by some to increase ectopic pregnancies.

References

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@@ Line 5: / Line 5: @@
 ==Overview==
-There are a number of risk factors for ectopic pregnancies.  They include: [[pelvic inflammatory disease]], [[infertility]], those who have been exposed to [[DES]], tubal surgery, [[smoking]], previous ectopic pregnancy, multiple sexual partners, current [[IUD]] use, [[tubal ligation]], and previous abortion.<ref>{{cite web |url=http://www.bestbets.org/bets/bet.php?id=921 |title=BestBets: Risk Factors for Ectopic Pregnancy |format= |work= |accessdate=}}</ref>
+'''[[Ectopic pregnancy]]''' usually occurs in women with fallopian tube dysfunction. There are a number of risk factors for ectopic pregnancies, among them [[pelvic inflammatory disease]], [[infertility]], [[DES]] exposure, tubal surgery, [[smoking]], previous ectopic pregnancy, multiple sexual partners, current [[IUD]] use, [[tubal ligation]], and previous abortion. The most potent [[risk factor]] in the development of [[ectopic pregnancy]] is [[Fallopian tube|tubal]] surgery.
 ==Risk Factors==
+Common risk factors in the development of ectopic pregnancies may be occupational, environmental, genetic, and viral. The folowing table summarizes these risks and its odds ratio:
-*Although tubal ligation prevents pregnancies, if a pregnancy does occur, it is more likely to be ectopic.
+{| class="wikitable"
-*The risk of EP increases in women who have had prior ectopics, but decreases for each subsequent intrauterine pregnancy.
+|+
-*Diethylstilbestrol (DES) causes a loss of fimbriae, a small opening, and fallopian tubes that are shorter and thinner than normal.
+| colspan="2" |Risk Factors Odds Ratios for Ectopic Pregnancy
-*Infertility primarily increases the risk of EP during treatment – IVF (in vitro fertilization) is associated with a 2 – 3 % increased risk compared with the general population.
-{|
 |- style="background:silver; color:black"
 |'''Risk Factor'''||'''Odds Ratio'''
 |- style="background:silver; color:black"
-|'''Tubal surgery'''||'''21'''
+|Tubal surgery||21
-|- style="background:silver; color:black"
-|'''Tubal ligation'''||'''9.3'''
 |- style="background:silver; color:black"
-|'''Previous ectopic'''||'''8.3'''
+|Tubal ligation||9.3
 |- style="background:silver; color:black"
-|'''In-utero DES exposure'''||'''5.6'''
+|Previous ectopic pregnancy||8.3
 |- style="background:silver; color:black"
-|'''IUD'''||'''4.2 – 45'''
+|In-utero DES exposure||5.6
 |- style="background:silver; color:black"
-|'''Documented tubal pathology'''||'''3.8 – 21'''
+|IUD||4.2 – 45
 |- style="background:silver; color:black"
-|'''Moderate Risk'''||
+|Documented tubal pathology||3.8 – 21
 |- style="background:silver; color:black"
-|'''Infertility'''||'''2.5 – 21'''
+|Infertility||2.5 – 21
 |- style="background:silver; color:black"
-|'''Previous STD'''||'''2.5 – 3.7'''
+|Previous STD||2.5 – 3.7
 |- style="background:silver; color:black"
-|'''Multiple sexual partners'''||'''2.1'''
+|Multiple sexual partners||2.1
-|- style="background:silver; color:black"
-|'''Low Risk'''||
 |- style="background:silver; color:black"
-|'''Prior pelvic / abd surgery'''||'''0.9 – 3.8'''
+|Prior pelvic / abd surgery||0.9 – 3.8
 |- style="background:silver; color:black"
-|'''Cigarette smoking'''||'''2.3 – 2.5'''
+|Cigarette smoking||2.3 – 2.5
 |- style="background:silver; color:black"
-|'''Vaginal douching'''||'''1.1 – 3.1'''
+|Vaginal douching||1.1 – 3.1
 |- style="background:silver; color:black"
-|'''1st intercourse < 18 years old'''||'''1.6'''
+|1st intercourse < 18 years old||1.6
 |}
+=== Common Risk Factors ===
+* Tubal surgery.
+* Tubal ligation. Although tubal ligation is highly effective in preventing pregnancies, if a pregnancy does occur, it is more likely to be ectopic.
+* Previous ectopic pregnancy. Same as having a previous ectopic pregnancy increases the risk for further ectopic pregnancies, having a intrauterine pregnancy decreases this risk.
+* In-utero DES exposure. The usage causes a loss of fimbriae and stenosis of fallopian tubes, which may increase up to 3 times the risk of ectopic pregnancy as compared to unexposed women.
+* IUD
+* Documented tubal pathology
+=== Less common Risk Factors ===
-Patients are at higher risk for ectopic pregnancy with advancing age. Also, it has been noted that [[Tobacco smoking|smoking]] is associated with ectopic risk. Vaginal douching is thought by some to increase ectopic pregnancies; this is speculative. Women exposed to [[diethylstilbestrol]] (DES) in utero (aka "DES Daughters") also have an elevated risk of ectopic pregnancy, up to 3 times the risk of unexposed women.
+* Infertility. Treatment of infertility, such as in vitro fertilization is associated with a 2 – 3 % increased risk compared with the general population.
+* Previous STD
+* Multiple sexual partners
+* Prior pelvic / abd surgery
+* Cigarette smoking
+* Vaginal douching
+* 1st intercourse < 18 years old
+* Advanced age.
+* Vaginal douching. It is thought by some to increase ectopic pregnancies.
 ==References==