278 Obstetrics and Gynecology Board Review •••
❍ What can increase the likelihood of early diagnosis of ectopic pregnancy?
Identification of risk factors, high index of suspicion, and transvaginal ultrasound.
❍ What is the most common risk factor for ectopic pregnancy?
About half of ectopic pregnancies can be linked to a history of pelvic inflammatory disease (PID).
❍ Do chromosomal abnormalities increase the risk of ectopic pregnancy?
Pregnancy associated with chromosomal abnormality does not increase the risk of having an ectopic pregnancy.
❍ What is the rate of ectopic pregnancy in women with a history of PID, as compared with the general
population?
A fivefold increase in ectopic pregnancy from 16.8/1000 is seen in women with a history of PID.
❍ List the high risk factors for ectopic pregnancy.
Previous ectopic pregnancy.
Previous tubal surgery.
Tubal ligation.
Tubal pathology.
History of PID.
In utero DES exposure.
Current intrauterine device (IUD) use.
❍ List the moderate risk factors for ectopic pregnancy.
Infertility.
Previous cervicitis (gonorrhea and Chlamydia).
Multiple sexual partners.
Smoking.
❍ List the low risk factors for ectopic pregnancy.
Previous pelvic/abdominal surgery.
Vaginal douching.
Early age of intercourse (<18 years).
Advanced maternal age.
❍ What percentage of pregnancies after tubal ligation are ectopic pregnancies?
The incidence depends on the type of tubal ligation; up to 50% of pregnancies after laparoscopic fulguration are
ectopic pregnancies.
❍ Is there an association between ectopic pregnancy and endometriosis?
Ectopic pregnancy is not increased in women with a history of endometriosis.