A tubal pregnancy, or ectopic pregnancy, is a pregnancy in which the fertilized ovum implants on any tissue other than the endometrial lining of the uterus. The figures showing the location of a tubal pregnancy indicate that 95% of them occur in the fallopian tube, 1.5% are in the abdomen. It is extremely rare for a tubal pregnancy to develop in the ovaries or cervix but these do happen.
The death rate from a tubal pregnancy in the developed world is about one in every two thousand. This equates to approximately 45 women dying from a tubal pregnancy. This figure has dropped significantly over the past 30 years as diagnosis and treatment for a tubal pregnancy has improved greatly. The most important factor in reducing the number of deaths from a tubal pregnancy is that many more women are aware of the symptoms of the condition and seek help earlier.
There are a number of risk factors that can increase a woman’s chances of having a tubal pregnancy. The most common of these is the pelvic inflammatory disease. Pelvic inflammatory disease is most often caused by the invasion of either gonorrhea or chlamydia from the cervix up to the uterus and fallopian tubes. The infection in these tissues causes an intense inflammatory response where bacteria, white blood cells, and other fluids fill the fallopian tubes to combat the infection.
During the healing process, the delicate inner lining of the fallopian tubes is permanently scarred and the ends may become partially or completely blocked. If this is not treated then the chances of a woman having a tubal pregnancy can be increased by up to ten times. It is not just the odds that a woman will have a tubal pregnancy that is affected but the chances of her having a healthy pregnancy are also greatly reduced. It is important that a woman discusses any previous bouts of this disease if she is contemplating becoming pregnant.
Some contraceptives can actually increase the woman’s chance of having a tubal pregnancy too. This is especially the case with progesterone-bearing IUDs. It is important that a woman has stopped using any progestin contraceptives well in advance of deciding to try to become pregnant. Obviously, the failure rate of these contraceptives is extremely low but if a woman does fall pregnant whilst using them then her risk of suffering a tubal pregnancy is greatly increased.
Any surgery that a woman has had on her fallopian tubes will also increase her risk level of having a tubal pregnancy. This is because the scar tissue formed may lead to a blockage in the fallopian tubes and a tubal pregnancy is almost inevitable.