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Chapter 29 Ectopic Pregnancy
Lindsay Curtis, MD
❍ What has happened to the rate of ectopic pregnancies in the United States during the past 10 years?
The incidence of ectopic pregnancy has been relatively stable over the last 10 years. However, from 1972 to 1992
the rate did increase from 4.5 to 20/1000 pregnancies.
❍ What percentage of conceptions are ectopic pregnancies?
About 2 in 100 women in the United States have an ectopic pregnancy (2%).
❍ Are ectopic pregnancies more common in multigravid or nulligravid women?
Multigravid—only 10% to 15% of ectopic pregnancies are found in nulligravid women, while more than half
occur in women who have been pregnant more than three times.
❍ What has happened to ectopic mortality since 1970?
The rate of death has dropped 10-fold from 35 per 10,000 women with ectopic pregnancy in 1970 to 3.8 per
10,000 in 1989. Ectopic pregnancy remains the most common cause of maternal death in the first trimester and
accounts for 4% to 10% of all pregnancy-related deaths.
❍ Are there racial discrepancies in the incidence and mortality rates from ectopic pregnancy in the
United States?
Yes. The incidence of ectopic pregnancy in nonwhite women is approximately 3% and the death-to-case rate is
four times higher. Therefore, a pregnant black woman is about five times more likely to die of ectopic pregnancy
than a white woman.
❍ What percentage of patients presenting to an emergency room with a positive pregnancy test and pelvic pain
and/or vaginal bleeding will have an ectopic pregnancy?
Approximately 7% to 20%.
❍ What is the most common cause of death in women with ectopic pregnancies?
Acute blood loss accounts for over 85% of deaths.