AETIOLOGY AND

PATHOGENESIS
OF ECTOPIC
PREGNANCY

M.AFSAR SAFRINA
S.SINDUJA
(ROLL NO: 29 & 30)
 FACTORSPREVENTING OR DELAYING
THE MIGRATION OF FERTILIZED
OVUM TO UTERINE CAVITY

 FACTORSFACILITATING PRIOR
IMPLANTATION OF FERTILIZED
OVUM IN TUBAL MUCOSA.
PELVIC INFLAMMATORY
DISEASE
 12 fold increase in risk of EP - single PID

 INFECTIONS: Infection of Fallopian tube,

cervix, ovaries by Chlamydia or Gonorrhoea.
 Other lower abdominal infections can result
in pelvic adhesion
 NON INFECTIOUS: Endometriosis or
presence of foreign body.
HISTORY OF PREVIOUS
SURGERY:
 FALLOPIAN TUBE SURGERY:Failed tubal
ligation(tuberectomy) or reversed with tubal
anastomoses. In this case One third of
pregnancy is ectopic

 PELVIC SURGERY: Intrapelvic Adhesion

formation ( myomectomy)

 LOWER ABDOMEN SURGERY

 PRIOR HISTORY OF ECTOPIC PREGNANCY :
12 fold risk for 1st EP. 28 fold risk for 2nd EP

 HISTORY OF INTRA UTERINE DEVICE USE:

1.IUD causes infection
of uterine cavity and Fallopian tube ( just after
insertion). 2.Migration of
fertilised ovum to contralateral tube.
 HISTORY OF DESTRUCTION OF UTERINE
CAVITY: 1.Uterine
synechiae(scar tissue) from previous surgery like
endometrial ablation for dysfunctional bleeding.
2.Presence of multiple submucosal fibrinoid
tumors.

 HISTORY OF IN UTERO EXPOSURE OF

DIETHYLSTILBESTROL(DES): Congenital
Fallopian tube defect.
PATHOGENESIS OF
ECTOPIC PREGNANCY
PATHOGENESIS of
tubal pregnancy
Fertilised ovum is arrested
in any portion of the tube
Burrows itself into the wall
of the tube
No decidual formation or
reaction in the storms of
tubal mucosa
Encapsulated within the muscular
tissue of tubal wall
As the ovum grows, the muscular
tissue tends to hypertrophy
But there is only hyperplasia and no
hypertrophy
Thinning of the Fallopian tube
Early rupture of the tube
Ovarian pregnancy
Fertilisation and trapping
of the ovum within the
follicle just at the time of
rupture
Abdominal pregnancy
When the fertilised
ovum fails to enter or
drop out of the fimbriated
end of the tube
In each abnormal location, the
fertilized ovum develops as usual,
forming placental tissue,amniotic
sac ,and fetus