Commonest cause of ectopic pregnancy: March 2007
Ans. A: Previous Tubal Disease Hair-like cilia located on the internal surface of the Fallopian tubes carry the feilized egg to the uterus. Damage to the cilia or blockage of the Fallopian tubes is likely to lead to an ectopic pregnancy. Pelvic inflammatory disease (PID) increases the occurrence of ectopic pregnancy by 6-10 fold. This results from the build-up of scar tissue in the Fallopian tubes, causing damage to cilia. If however both tubes were occluded by PID, pregnancy would not occur and this would be protective against ectopic pregnancy. IUD increases the likelihood of tubal pregnancy by 7 times, should the pregnancy occurs with IUD in situ. Progestin only pill/postcoital estrogen preparations increases the risk due to impaired tubal motility. Tubal ligation can predispose to ectopic pregnancy. Reversal of tubal sterilization (Tubal reversal) carries a risk for ectopic pregnancy. A history of ectopic pregnancy increases the risk of future occurrences to about 10%. Ectopic pregnancy occasionally occurs in women who have had a hysterectomy. 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.
Previous tubal disease
Oral contraceptives
IUCD
Endometriosis