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id="toc-Signs_and_symptoms-sublist" class="vector-toc-list"> <li id="toc-Complications" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Complications"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.1</span> <span>Complications</span> </div> </a> <ul id="toc-Complications-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Causes" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Causes"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Causes</span> </div> </a> <button aria-controls="toc-Causes-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Causes subsection</span> </button> <ul id="toc-Causes-sublist" class="vector-toc-list"> <li id="toc-Tube_damage" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Tube_damage"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Tube damage</span> </div> </a> <ul id="toc-Tube_damage-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Endometriosis" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Endometriosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2</span> <span>Endometriosis</span> </div> </a> <ul id="toc-Endometriosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.3</span> <span>Other</span> </div> </a> <ul id="toc-Other-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Diagnosis</span> </div> </a> <button aria-controls="toc-Diagnosis-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Diagnosis subsection</span> </button> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> <li id="toc-Transvaginal_ultrasonography" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Transvaginal_ultrasonography"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.1</span> <span>Transvaginal ultrasonography</span> </div> </a> <ul id="toc-Transvaginal_ultrasonography-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Ultrasonography_and_β-hCG" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Ultrasonography_and_β-hCG"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2</span> <span>Ultrasonography and β-hCG</span> </div> </a> <ul id="toc-Ultrasonography_and_β-hCG-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_methods" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other_methods"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.3</span> <span>Other methods</span> </div> </a> <ul id="toc-Other_methods-sublist" class="vector-toc-list"> <li id="toc-Direct_examination" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Direct_examination"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.3.1</span> <span>Direct examination</span> </div> </a> <ul id="toc-Direct_examination-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Culdocentesis" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Culdocentesis"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.3.2</span> <span>Culdocentesis</span> </div> </a> <ul id="toc-Culdocentesis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Progesterone_levels" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Progesterone_levels"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.3.3</span> <span>Progesterone levels</span> </div> </a> <ul id="toc-Progesterone_levels-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Mathematical_models" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Mathematical_models"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.3.4</span> <span>Mathematical models</span> </div> </a> <ul id="toc-Mathematical_models-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Dilation_and_curettage" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Dilation_and_curettage"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.3.5</span> <span>Dilation and curettage</span> </div> </a> <ul id="toc-Dilation_and_curettage-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Classification" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Classification"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.4</span> <span>Classification</span> </div> </a> <ul id="toc-Classification-sublist" class="vector-toc-list"> <li id="toc-Tubal_pregnancy" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Tubal_pregnancy"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.4.1</span> <span>Tubal pregnancy</span> </div> </a> <ul id="toc-Tubal_pregnancy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Nontubal_ectopic_pregnancy" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Nontubal_ectopic_pregnancy"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.4.2</span> <span>Nontubal ectopic pregnancy</span> </div> </a> <ul id="toc-Nontubal_ectopic_pregnancy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Heterotopic_pregnancy" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Heterotopic_pregnancy"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.4.3</span> <span>Heterotopic pregnancy</span> </div> </a> <ul id="toc-Heterotopic_pregnancy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Rudimentary_horn_pregnancy" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Rudimentary_horn_pregnancy"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.4.4</span> <span>Rudimentary horn pregnancy</span> </div> </a> <ul id="toc-Rudimentary_horn_pregnancy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Persistent_ectopic_pregnancy" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Persistent_ectopic_pregnancy"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.4.5</span> <span>Persistent ectopic pregnancy</span> </div> </a> <ul id="toc-Persistent_ectopic_pregnancy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Pregnancy_of_unknown_location" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Pregnancy_of_unknown_location"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.4.6</span> <span>Pregnancy of unknown location</span> </div> </a> <ul id="toc-Pregnancy_of_unknown_location-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Differential_diagnosis" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Differential_diagnosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.5</span> <span>Differential diagnosis</span> </div> </a> <ul id="toc-Differential_diagnosis-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Treatment" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Treatment"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Treatment</span> </div> </a> <button aria-controls="toc-Treatment-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Treatment subsection</span> </button> <ul id="toc-Treatment-sublist" class="vector-toc-list"> <li id="toc-Expectant_management" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Expectant_management"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.1</span> <span>Expectant management</span> </div> </a> <ul id="toc-Expectant_management-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Medical" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Medical"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2</span> <span>Medical</span> </div> </a> <ul id="toc-Medical-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Surgery" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Surgery"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.3</span> <span>Surgery</span> </div> </a> <ul id="toc-Surgery-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prognosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Prognosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Prognosis</span> </div> </a> <button aria-controls="toc-Prognosis-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Prognosis subsection</span> </button> <ul id="toc-Prognosis-sublist" class="vector-toc-list"> <li id="toc-Future_fertility" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Future_fertility"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.1</span> <span>Future fertility</span> </div> </a> <ul id="toc-Future_fertility-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Epidemiology</span> </div> </a> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Society_and_culture" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Society_and_culture"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Society and culture</span> </div> </a> <ul id="toc-Society_and_culture-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Live_birth" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Live_birth"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>Live birth</span> </div> </a> <ul id="toc-Live_birth-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Animals" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Animals"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>Animals</span> </div> </a> <ul id="toc-Animals-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">11</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">12</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Ectopic pregnancy</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 58 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-58" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">58 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%AD%D9%85%D9%84_%D8%AE%D8%A7%D8%B1%D8%AC_%D8%A7%D9%84%D8%B1%D8%AD%D9%85" title="حمل خارج الرحم – Arabic" lang="ar" hreflang="ar" data-title="حمل خارج الرحم" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-be mw-list-item"><a href="https://be.wikipedia.org/wiki/%D0%9F%D0%B0%D0%B7%D0%B0%D0%BC%D0%B0%D1%82%D0%B0%D1%87%D0%BD%D0%B0%D1%8F_%D1%86%D1%8F%D0%B6%D0%B0%D1%80%D0%BD%D0%B0%D1%81%D1%86%D1%8C" title="Пазаматачная цяжарнасць – Belarusian" lang="be" hreflang="be" data-title="Пазаматачная цяжарнасць" data-language-autonym="Беларуская" data-language-local-name="Belarusian" class="interlanguage-link-target"><span>Беларуская</span></a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%98%D0%B7%D0%B2%D1%8A%D0%BD%D0%BC%D0%B0%D1%82%D0%BE%D1%87%D0%BD%D0%B0_%D0%B1%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82" title="Извънматочна бременност – Bulgarian" lang="bg" hreflang="bg" data-title="Извънматочна бременност" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target"><span>Български</span></a></li><li class="interlanguage-link interwiki-bs mw-list-item"><a href="https://bs.wikipedia.org/wiki/Vanmateri%C4%8Dna_trudno%C4%87a" title="Vanmaterična trudnoća – Bosnian" lang="bs" hreflang="bs" data-title="Vanmaterična trudnoća" data-language-autonym="Bosanski" data-language-local-name="Bosnian" class="interlanguage-link-target"><span>Bosanski</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Embar%C3%A0s_ect%C3%B2pic" title="Embaràs ectòpic – Catalan" lang="ca" hreflang="ca" data-title="Embaràs ectòpic" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Mimod%C4%9Blo%C5%BEn%C3%AD_t%C4%9Bhotenstv%C3%AD" title="Mimoděložní těhotenství – Czech" lang="cs" hreflang="cs" data-title="Mimoděložní těhotenství" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Extrauteringravidit%C3%A4t" title="Extrauteringravidität – German" lang="de" hreflang="de" data-title="Extrauteringravidität" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%88%CE%BA%CF%84%CE%BF%CF%80%CE%B7_%CE%BA%CF%8D%CE%B7%CF%83%CE%B7" title="Έκτοπη κύηση – Greek" lang="el" hreflang="el" data-title="Έκτοπη κύηση" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target"><span>Ελληνικά</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Embarazo_ect%C3%B3pico" title="Embarazo ectópico – Spanish" lang="es" hreflang="es" data-title="Embarazo ectópico" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Ektopia_gravedeco" title="Ektopia gravedeco – Esperanto" lang="eo" hreflang="eo" data-title="Ektopia gravedeco" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target"><span>Esperanto</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Lekuz_kanpoko_habiratze" title="Lekuz kanpoko habiratze – Basque" lang="eu" hreflang="eu" data-title="Lekuz kanpoko habiratze" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%A8%D8%A7%D8%B1%D8%AF%D8%A7%D8%B1%DB%8C_%D8%AE%D8%A7%D8%B1%D8%AC_%D8%B1%D8%AD%D9%85%DB%8C" title="بارداری خارج رحمی – Persian" lang="fa" hreflang="fa" data-title="بارداری خارج رحمی" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Grossesse_extra-ut%C3%A9rine" title="Grossesse extra-utérine – French" lang="fr" hreflang="fr" data-title="Grossesse extra-utérine" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/Toircheas_eacht%C3%B3pach" title="Toircheas eachtópach – Irish" lang="ga" hreflang="ga" data-title="Toircheas eachtópach" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target"><span>Gaeilge</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EC%9E%90%EA%B6%81%EC%99%B8%EC%9E%84%EC%8B%A0" title="자궁외임신 – Korean" lang="ko" hreflang="ko" data-title="자궁외임신" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D4%B1%D6%80%D5%BF%D5%A1%D6%80%D5%A3%D5%A1%D5%B6%D5%A4%D5%A1%D5%B5%D5%AB%D5%B6_%D5%B0%D5%B2%D5%AB%D5%B8%D6%82%D5%A9%D5%B5%D5%B8%D6%82%D5%B6" title="Արտարգանդային հղիություն – Armenian" lang="hy" hreflang="hy" data-title="Արտարգանդային հղիություն" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%8F%E0%A4%95%E0%A5%8D%E0%A4%9F%E0%A5%8B%E0%A4%AA%E0%A4%BF%E0%A4%95_%E0%A4%97%E0%A4%B0%E0%A5%8D%E0%A4%AD%E0%A4%BE%E0%A4%B5%E0%A4%B8%E0%A5%8D%E0%A4%A5%E0%A4%BE" title="एक्टोपिक गर्भावस्था – Hindi" lang="hi" hreflang="hi" data-title="एक्टोपिक गर्भावस्था" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target"><span>हिन्दी</span></a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Ektopi%C4%8Dna_trudno%C4%87a" title="Ektopična trudnoća – Croatian" lang="hr" hreflang="hr" data-title="Ektopična trudnoća" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target"><span>Hrvatski</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Kehamilan_ektopik" title="Kehamilan ektopik – Indonesian" lang="id" hreflang="id" data-title="Kehamilan ektopik" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-ia mw-list-item"><a href="https://ia.wikipedia.org/wiki/Pregnantia_ectopic" title="Pregnantia ectopic – Interlingua" lang="ia" hreflang="ia" data-title="Pregnantia ectopic" data-language-autonym="Interlingua" data-language-local-name="Interlingua" class="interlanguage-link-target"><span>Interlingua</span></a></li><li class="interlanguage-link interwiki-is mw-list-item"><a href="https://is.wikipedia.org/wiki/Utanlegsf%C3%B3stur" title="Utanlegsfóstur – Icelandic" lang="is" hreflang="is" data-title="Utanlegsfóstur" data-language-autonym="Íslenska" data-language-local-name="Icelandic" class="interlanguage-link-target"><span>Íslenska</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Gravidanza_ectopica" title="Gravidanza ectopica – Italian" lang="it" hreflang="it" data-title="Gravidanza ectopica" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%94%D7%99%D7%A8%D7%99%D7%95%D7%9F_%D7%97%D7%95%D7%A5-%D7%A8%D7%97%D7%9E%D7%99" title="היריון חוץ-רחמי – Hebrew" lang="he" hreflang="he" data-title="היריון חוץ-רחמי" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-ky mw-list-item"><a href="https://ky.wikipedia.org/wiki/%D0%96%D0%B0%D1%82%D1%8B%D0%BD%D0%B4%D0%B0%D0%BD_%D1%82%D1%8B%D1%88%D0%BA%D0%B0%D1%80%D1%8B_%D0%B1%D0%BE%D0%B9%D0%B3%D0%BE_%D0%B1%D2%AF%D1%82%D2%AF%D2%AF" title="Жатындан тышкары бойго бүтүү – Kyrgyz" lang="ky" hreflang="ky" data-title="Жатындан тышкары бойго бүтүү" data-language-autonym="Кыргызча" data-language-local-name="Kyrgyz" class="interlanguage-link-target"><span>Кыргызча</span></a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/Negimdinis_n%C4%97%C5%A1tumas" title="Negimdinis nėštumas – Lithuanian" lang="lt" hreflang="lt" data-title="Negimdinis nėštumas" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target"><span>Lietuvių</span></a></li><li class="interlanguage-link interwiki-mad mw-list-item"><a href="https://mad.wikipedia.org/wiki/Ngan%E1%B8%8Dung_%C3%A8ktopik" title="Nganḍung èktopik – Madurese" lang="mad" hreflang="mad" data-title="Nganḍung èktopik" data-language-autonym="Madhurâ" data-language-local-name="Madurese" class="interlanguage-link-target"><span>Madhurâ</span></a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%97%E0%B5%BC%E0%B4%AD%E0%B4%BE%E0%B4%B6%E0%B4%AF%E0%B5%87%E0%B4%A4%E0%B4%B0_%E0%B4%97%E0%B5%BC%E0%B4%AD%E0%B4%82" title="ഗർഭാശയേതര ഗർഭം – Malayalam" lang="ml" hreflang="ml" data-title="ഗർഭാശയേതര ഗർഭം" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target"><span>മലയാളം</span></a></li><li class="interlanguage-link interwiki-ms mw-list-item"><a href="https://ms.wikipedia.org/wiki/Kandungan_luar_rahim" title="Kandungan luar rahim – Malay" lang="ms" hreflang="ms" data-title="Kandungan luar rahim" data-language-autonym="Bahasa Melayu" data-language-local-name="Malay" class="interlanguage-link-target"><span>Bahasa Melayu</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Buitenbaarmoederlijke_zwangerschap" title="Buitenbaarmoederlijke zwangerschap – Dutch" lang="nl" hreflang="nl" data-title="Buitenbaarmoederlijke zwangerschap" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E5%AD%90%E5%AE%AE%E5%A4%96%E5%A6%8A%E5%A8%A0" title="子宮外妊娠 – Japanese" lang="ja" hreflang="ja" data-title="子宮外妊娠" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Ektopisk_svangerskap" title="Ektopisk svangerskap – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Ektopisk svangerskap" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%85%E0%AC%A5%E0%AC%BE%E0%AC%A8_%E0%AC%97%E0%AC%B0%E0%AD%8D%E0%AC%AD" title="ଅଥାନ ଗର୍ଭ – Odia" lang="or" hreflang="or" data-title="ଅଥାନ ଗର୍ଭ" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target"><span>ଓଡ଼ିଆ</span></a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Bachadondan_tashqari_homiladorlik" title="Bachadondan tashqari homiladorlik – Uzbek" lang="uz" hreflang="uz" data-title="Bachadondan tashqari homiladorlik" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target"><span>Oʻzbekcha / ўзбекча</span></a></li><li class="interlanguage-link interwiki-ps mw-list-item"><a href="https://ps.wikipedia.org/wiki/%D9%84%D9%87_%D8%B1%D8%AD%D9%85_%D8%A8%D9%87%D8%B1_%D9%85%D9%8A%D9%86%D8%AF%D9%88%D8%A7%D8%B1%D9%8A" title="له رحم بهر ميندواري – Pashto" lang="ps" hreflang="ps" data-title="له رحم بهر ميندواري" data-language-autonym="پښتو" data-language-local-name="Pashto" class="interlanguage-link-target"><span>پښتو</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Ci%C4%85%C5%BCa_ektopowa" title="Ciąża ektopowa – Polish" lang="pl" hreflang="pl" data-title="Ciąża ektopowa" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Gravidez_ect%C3%B3pica" title="Gravidez ectópica – Portuguese" lang="pt" hreflang="pt" data-title="Gravidez ectópica" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Sarcin%C4%83_ectopic%C4%83" title="Sarcină ectopică – Romanian" lang="ro" hreflang="ro" data-title="Sarcină ectopică" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%92%D0%BD%D0%B5%D0%BC%D0%B0%D1%82%D0%BE%D1%87%D0%BD%D0%B0%D1%8F_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D1%8C" title="Внематочная беременность – Russian" lang="ru" hreflang="ru" data-title="Внематочная беременность" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-si mw-list-item"><a href="https://si.wikipedia.org/wiki/%E0%B6%B6%E0%B7%84%E0%B7%92%E0%B7%82%E0%B7%8A%E0%B6%9A%E0%B7%9A%E0%B6%AD%E0%B6%B1%E0%B6%9A_%E0%B6%9C%E0%B7%90%E0%B6%B6%E0%B7%8A_%E0%B6%9C%E0%B7%90%E0%B6%B1%E0%B7%93%E0%B6%B8%E0%B7%8A" title="බහිෂ්කේතනක ගැබ් ගැනීම් – Sinhala" lang="si" hreflang="si" data-title="බහිෂ්කේතනක ගැබ් ගැනීම්" data-language-autonym="සිංහල" data-language-local-name="Sinhala" class="interlanguage-link-target"><span>සිංහල</span></a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Ectopic_pregnancy" title="Ectopic pregnancy – Simple English" lang="en-simple" hreflang="en-simple" data-title="Ectopic pregnancy" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target"><span>Simple English</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Zunajmaterni%C4%8Dna_nose%C4%8Dnost" title="Zunajmaternična nosečnost – Slovenian" lang="sl" hreflang="sl" data-title="Zunajmaternična nosečnost" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%92%D0%B0%D0%BD%D0%BC%D0%B0%D1%82%D0%B5%D1%80%D0%B8%D1%87%D0%BD%D0%B0_%D1%82%D1%80%D1%83%D0%B4%D0%BD%D0%BE%D1%9B%D0%B0" title="Ванматерична трудноћа – Serbian" lang="sr" hreflang="sr" data-title="Ванматерична трудноћа" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Vanmateri%C4%8Dna_trudno%C4%87a" title="Vanmaterična trudnoća – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Vanmaterična trudnoća" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Kohdunulkoinen_raskaus" title="Kohdunulkoinen raskaus – Finnish" lang="fi" hreflang="fi" data-title="Kohdunulkoinen raskaus" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Utomkvedshavandeskap" title="Utomkvedshavandeskap – Swedish" lang="sv" hreflang="sv" data-title="Utomkvedshavandeskap" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-tl mw-list-item"><a href="https://tl.wikipedia.org/wiki/Pagbubuntis_na_ektopiko" title="Pagbubuntis na ektopiko – Tagalog" lang="tl" hreflang="tl" data-title="Pagbubuntis na ektopiko" data-language-autonym="Tagalog" data-language-local-name="Tagalog" class="interlanguage-link-target"><span>Tagalog</span></a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a href="https://ta.wikipedia.org/wiki/%E0%AE%B5%E0%AF%87%E0%AE%B1%E0%AF%8D%E0%AE%B1%E0%AE%BF%E0%AE%9F%E0%AE%9A%E0%AF%8D%E0%AE%9A%E0%AF%82%E0%AE%B2%E0%AF%8D" title="வேற்றிடச்சூல் – Tamil" lang="ta" hreflang="ta" data-title="வேற்றிடச்சூல்" data-language-autonym="தமிழ்" data-language-local-name="Tamil" class="interlanguage-link-target"><span>தமிழ்</span></a></li><li class="interlanguage-link interwiki-tt mw-list-item"><a href="https://tt.wikipedia.org/wiki/%D0%90%D0%BD%D0%B0%D0%BB%D1%8B%D0%BA%D1%82%D0%B0%D0%BD_%D1%82%D1%8B%D1%88_%D0%B9%D3%A9%D0%BA%D0%BB%D0%B5%D0%BB%D0%B5%D0%BA" title="Аналыктан тыш йөклелек – Tatar" lang="tt" hreflang="tt" data-title="Аналыктан тыш йөклелек" data-language-autonym="Татарча / tatarça" data-language-local-name="Tatar" class="interlanguage-link-target"><span>Татарча / tatarça</span></a></li><li class="interlanguage-link interwiki-te mw-list-item"><a href="https://te.wikipedia.org/wiki/%E0%B0%8E%E0%B0%95%E0%B1%8D%E0%B0%9F%E0%B1%8B%E0%B0%AA%E0%B0%BF%E0%B0%95%E0%B1%8D_%E0%B0%97%E0%B0%B0%E0%B1%8D%E0%B0%AD%E0%B0%82" title="ఎక్టోపిక్ గర్భం – Telugu" lang="te" hreflang="te" data-title="ఎక్టోపిక్ గర్భం" data-language-autonym="తెలుగు" data-language-local-name="Telugu" class="interlanguage-link-target"><span>తెలుగు</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B8%81%E0%B8%B2%E0%B8%A3%E0%B8%95%E0%B8%B1%E0%B9%89%E0%B8%87%E0%B8%84%E0%B8%A3%E0%B8%A3%E0%B8%A0%E0%B9%8C%E0%B8%99%E0%B8%AD%E0%B8%81%E0%B8%A1%E0%B8%94%E0%B8%A5%E0%B8%B9%E0%B8%81" title="การตั้งครรภ์นอกมดลูก – Thai" lang="th" hreflang="th" data-title="การตั้งครรภ์นอกมดลูก" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/D%C4%B1%C5%9F_gebelik" title="Dış gebelik – Turkish" lang="tr" hreflang="tr" data-title="Dış gebelik" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%9F%D0%BE%D0%B7%D0%B0%D0%BC%D0%B0%D1%82%D0%BA%D0%BE%D0%B2%D0%B0_%D0%B2%D0%B0%D0%B3%D1%96%D1%82%D0%BD%D1%96%D1%81%D1%82%D1%8C" title="Позаматкова вагітність – Ukrainian" lang="uk" hreflang="uk" data-title="Позаматкова вагітність" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-ur mw-list-item"><a href="https://ur.wikipedia.org/wiki/%D8%AD%D9%85%D9%84_%D9%85%DB%8C%DA%BA_%D9%BE%DB%8C%DA%86%DB%8C%D8%AF%DA%AF%DB%8C" title="حمل میں پیچیدگی – Urdu" lang="ur" hreflang="ur" data-title="حمل میں پیچیدگی" data-language-autonym="اردو" data-language-local-name="Urdu" 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<div class="mw-indicators"> </div> <div id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Female reproductive system health issue</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Ectopic pregnancy</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">EP, eccyesis, extrauterine pregnancy, EUP, tubal pregnancy <i>(when in fallopian tube)</i></td></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Ectopic_pregnancy_on_laparoscopy.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/2/2a/Ectopic_pregnancy_on_laparoscopy.png/220px-Ectopic_pregnancy_on_laparoscopy.png" decoding="async" width="220" height="162" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/2a/Ectopic_pregnancy_on_laparoscopy.png/330px-Ectopic_pregnancy_on_laparoscopy.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/2a/Ectopic_pregnancy_on_laparoscopy.png/440px-Ectopic_pregnancy_on_laparoscopy.png 2x" data-file-width="1018" data-file-height="751" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data"><a href="/wiki/Laparoscopic" class="mw-redirect" title="Laparoscopic">Laparoscopic</a> view, looking down at the <a href="/wiki/Uterus" title="Uterus">uterus</a> (marked by <span style="color:blue;">blue arrows</span>). In the left <a href="/wiki/Fallopian_tube" title="Fallopian tube">fallopian tube</a>, there is an ectopic pregnancy and <a href="/wiki/Hematosalpinx" title="Hematosalpinx">bleeding</a> (marked by <span style="color:red;">red arrows</span>). The right tube is normal.</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Obstetrics_and_Gynaecology" class="mw-redirect" title="Obstetrics and Gynaecology">Obstetrics and Gynaecology</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data"><a href="/wiki/Abdominal_pain" title="Abdominal pain">Abdominal pain</a>, <a href="/wiki/Vaginal_bleeding" title="Vaginal bleeding">vaginal bleeding</a><sup id="cite_ref-Crochet2013_1-0" class="reference"><a href="#cite_note-Crochet2013-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Risk_factor" title="Risk factor">Risk factors</a></th><td class="infobox-data"><a href="/wiki/Pelvic_inflammatory_disease" title="Pelvic inflammatory disease">Pelvic inflammatory disease</a>, <a href="/wiki/Tobacco_smoking" title="Tobacco smoking">tobacco smoking</a>, prior tubal surgery, history of <a href="/wiki/Infertility" title="Infertility">infertility</a>, use of <a href="/wiki/Assisted_reproductive_technology" title="Assisted reproductive technology">assisted reproductive technology</a><sup id="cite_ref-Cec2014_2-0" class="reference"><a href="#cite_note-Cec2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic method</a></th><td class="infobox-data">Blood tests for <a href="/wiki/Human_chorionic_gonadotropin" title="Human chorionic gonadotropin">human chorionic gonadotropin</a> (hCG), <a href="/wiki/Ultrasound" title="Ultrasound">ultrasound</a><sup id="cite_ref-Crochet2013_1-1" class="reference"><a href="#cite_note-Crochet2013-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Differential_diagnosis" title="Differential diagnosis">Differential diagnosis</a></th><td class="infobox-data"><a href="/wiki/Miscarriage" title="Miscarriage">Miscarriage</a>, <a href="/wiki/Ovarian_torsion" title="Ovarian torsion">ovarian torsion</a>, <a href="/wiki/Acute_appendicitis" class="mw-redirect" title="Acute appendicitis">acute appendicitis</a>,<sup id="cite_ref-Crochet2013_1-2" class="reference"><a href="#cite_note-Crochet2013-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Corpus_luteum_cyst" title="Corpus luteum cyst">corpus luteum cyst</a> rupture<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data"><a href="/wiki/Methotrexate" title="Methotrexate">methotrexate</a>, surgery<sup id="cite_ref-Cec2014_2-1" class="reference"><a href="#cite_note-Cec2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Prognosis" title="Prognosis">Prognosis</a></th><td class="infobox-data">Mortality 0.2% (developed world), 2% (developing world)<sup id="cite_ref-WHO2015Mort_4-0" class="reference"><a href="#cite_note-WHO2015Mort-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">~1.5% of pregnancies (developed world)<sup id="cite_ref-kirk2013_5-0" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></td></tr></tbody></table> <p><b>Ectopic pregnancy</b> is a <a href="/wiki/Complications_of_pregnancy" title="Complications of pregnancy">complication of pregnancy</a> in which the embryo attaches outside the <a href="/wiki/Uterus" title="Uterus">uterus</a>.<sup id="cite_ref-kirk2013_5-1" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Signs and symptoms classically include <a href="/wiki/Abdominal_pain" title="Abdominal pain">abdominal pain</a> and <a href="/wiki/Vaginal_bleeding" title="Vaginal bleeding">vaginal bleeding</a>, but fewer than 50 percent of affected women have both of these symptoms.<sup id="cite_ref-Crochet2013_1-3" class="reference"><a href="#cite_note-Crochet2013-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> The pain may be described as sharp, dull, or crampy.<sup id="cite_ref-Crochet2013_1-4" class="reference"><a href="#cite_note-Crochet2013-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Pain may also spread to the shoulder if bleeding into the abdomen has occurred.<sup id="cite_ref-Crochet2013_1-5" class="reference"><a href="#cite_note-Crochet2013-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Severe bleeding may result in a <a href="/wiki/Tachycardia" title="Tachycardia">fast heart rate</a>, <a href="/wiki/Syncope_(medicine)" title="Syncope (medicine)">fainting</a>, or <a href="/wiki/Shock_(circulatory)" title="Shock (circulatory)">shock</a>.<sup id="cite_ref-kirk2013_5-2" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Crochet2013_1-6" class="reference"><a href="#cite_note-Crochet2013-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> With very rare exceptions, the <a href="/wiki/Fetus" title="Fetus">fetus</a> is unable to survive.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> </p><p>Overall, ectopic pregnancies annually affect less than 2% of pregnancies worldwide.<sup id="cite_ref-kirk2013_5-3" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Risk factors for ectopic pregnancy include <a href="/wiki/Pelvic_inflammatory_disease" title="Pelvic inflammatory disease">pelvic inflammatory disease</a>, often due to <a href="/wiki/Chlamydia_infection" class="mw-redirect" title="Chlamydia infection">chlamydia infection</a>; <a href="/wiki/Tobacco_smoking" title="Tobacco smoking">tobacco smoking</a>; <a href="/wiki/Endometriosis" title="Endometriosis">endometriosis</a>; prior tubal surgery; a history of <a href="/wiki/Infertility" title="Infertility">infertility</a>; and the use of <a href="/wiki/Assisted_reproductive_technology" title="Assisted reproductive technology">assisted reproductive technology</a>.<sup id="cite_ref-Cec2014_2-2" class="reference"><a href="#cite_note-Cec2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Those who have previously had an ectopic pregnancy are at much higher risk of having another one.<sup id="cite_ref-Cec2014_2-3" class="reference"><a href="#cite_note-Cec2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Most ectopic pregnancies (90%) occur in the <a href="/wiki/Fallopian_tube" title="Fallopian tube">fallopian tube</a>, which are known as tubal pregnancies,<sup id="cite_ref-Cec2014_2-4" class="reference"><a href="#cite_note-Cec2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> but <a href="/wiki/Implantation_(embryology)" title="Implantation (embryology)">implantation</a> can also occur on the <a href="/wiki/Cervix" title="Cervix">cervix</a>, <a href="/wiki/Ovary" title="Ovary">ovaries</a>, caesarean scar, or within the <a href="/wiki/Abdomen" title="Abdomen">abdomen</a>.<sup id="cite_ref-Crochet2013_1-7" class="reference"><a href="#cite_note-Crochet2013-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Detection of ectopic pregnancy is typically by blood tests for <a href="/wiki/Human_chorionic_gonadotropin" title="Human chorionic gonadotropin">human chorionic gonadotropin</a> (hCG) and <a href="/wiki/Ultrasound" title="Ultrasound">ultrasound</a>.<sup id="cite_ref-Crochet2013_1-8" class="reference"><a href="#cite_note-Crochet2013-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> This may require testing on more than one occasion.<sup id="cite_ref-Crochet2013_1-9" class="reference"><a href="#cite_note-Crochet2013-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Other causes of similar symptoms include: <a href="/wiki/Miscarriage" title="Miscarriage">miscarriage</a>, <a href="/wiki/Ovarian_torsion" title="Ovarian torsion">ovarian torsion</a>, and <a href="/wiki/Acute_appendicitis" class="mw-redirect" title="Acute appendicitis">acute appendicitis</a>.<sup id="cite_ref-Crochet2013_1-10" class="reference"><a href="#cite_note-Crochet2013-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p><p>Prevention is by decreasing risk factors such as chlamydia infections through screening and treatment.<sup id="cite_ref-Nama2009_7-0" class="reference"><a href="#cite_note-Nama2009-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> While some ectopic pregnancies will miscarry without treatment,<sup id="cite_ref-Cec2014_2-5" class="reference"><a href="#cite_note-Cec2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> the standard treatment for ectopic pregnancy is a procedure to either remove the embryo from the fallopian tube or to remove the fallopian tube all together. The use of the medication <a href="/wiki/Methotrexate" title="Methotrexate">methotrexate</a> works as well as surgery in some cases.<sup id="cite_ref-Cec2014_2-6" class="reference"><a href="#cite_note-Cec2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Specifically it works well when the <a href="/wiki/Beta-HCG" class="mw-redirect" title="Beta-HCG">beta-HCG</a> is low and the size of the ectopic is small.<sup id="cite_ref-Cec2014_2-7" class="reference"><a href="#cite_note-Cec2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Surgery such as a <a href="/wiki/Salpingectomy" title="Salpingectomy">salpingectomy</a> is still typically recommended if the tube has ruptured, there is a fetal heartbeat, or the woman's <a href="/wiki/Vital_sign" class="mw-redirect" title="Vital sign">vital signs</a> are unstable.<sup id="cite_ref-Cec2014_2-8" class="reference"><a href="#cite_note-Cec2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> The surgery may be <a href="/wiki/Laparoscopic" class="mw-redirect" title="Laparoscopic">laparoscopic</a> or through a larger incision, known as a <a href="/wiki/Laparotomy" title="Laparotomy">laparotomy</a>.<sup id="cite_ref-kirk2013_5-4" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Maternal morbidity and mortality are reduced with treatment.<sup id="cite_ref-Cec2014_2-9" class="reference"><a href="#cite_note-Cec2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p>The rate of ectopic <a href="/wiki/Pregnancy" title="Pregnancy">pregnancy</a> is about 11 to 20 per 1,000 live births in developed countries, though it may be as high as 4% among those using <a href="/wiki/Assisted_reproductive_technology" title="Assisted reproductive technology">assisted reproductive technology</a>.<sup id="cite_ref-kirk2013_5-5" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> It is the most common cause of death among women during the first trimester at approximately 6-13% of the total.<sup id="cite_ref-Cec2014_2-10" class="reference"><a href="#cite_note-Cec2014-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> In the <a href="/wiki/Developed_country" title="Developed country">developed world</a> outcomes have improved while in the developing world they often remain poor.<sup id="cite_ref-Nama2009_7-1" class="reference"><a href="#cite_note-Nama2009-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> The risk of death among those in the developed world is between 0.1 and 0.3 percent while in the developing world it is between one and three percent.<sup id="cite_ref-WHO2015Mort_4-1" class="reference"><a href="#cite_note-WHO2015Mort-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> The first known description of an ectopic pregnancy is by <a href="/wiki/Al-Zahrawi" title="Al-Zahrawi">Al-Zahrawi</a> in the 11th century.<sup id="cite_ref-Nama2009_7-2" class="reference"><a href="#cite_note-Nama2009-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> The word "ectopic" means "out of place".<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p> <style data-mw-deduplicate="TemplateStyles:r886046785">.mw-parser-output .toclimit-2 .toclevel-1 ul,.mw-parser-output .toclimit-3 .toclevel-2 ul,.mw-parser-output .toclimit-4 .toclevel-3 ul,.mw-parser-output .toclimit-5 .toclevel-4 ul,.mw-parser-output .toclimit-6 .toclevel-5 ul,.mw-parser-output .toclimit-7 .toclevel-6 ul{display:none}</style><div class="toclimit-3"><meta property="mw:PageProp/toc" /></div> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=1" title="Edit section: Signs and symptoms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Ectopic_Pregnancy.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/4/4c/Ectopic_Pregnancy.png/440px-Ectopic_Pregnancy.png" decoding="async" width="440" height="251" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/4c/Ectopic_Pregnancy.png/660px-Ectopic_Pregnancy.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/4c/Ectopic_Pregnancy.png/880px-Ectopic_Pregnancy.png 2x" data-file-width="1200" data-file-height="685" /></a><figcaption>Ectopic pregnancy</figcaption></figure> <p>Up to 10% of those with ectopic pregnancy have no symptoms, and one-third have no <a href="/wiki/Medical_sign" class="mw-redirect" title="Medical sign">medical signs</a>.<sup id="cite_ref-kirk2013_5-6" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> In many cases the symptoms have low <a href="/wiki/Sensitivity_and_specificity" title="Sensitivity and specificity">specificity</a>, and can be similar to those of other <a href="/wiki/Genitourinary_disorders" class="mw-redirect" title="Genitourinary disorders">genitourinary</a> and <a href="/wiki/Gastrointestinal_disorder" class="mw-redirect" title="Gastrointestinal disorder">gastrointestinal disorders</a>, such as <a href="/wiki/Appendicitis" title="Appendicitis">appendicitis</a>, <a href="/wiki/Salpingitis" title="Salpingitis">salpingitis</a>, rupture of a <a href="/wiki/Corpus_luteum_cyst" title="Corpus luteum cyst">corpus luteum cyst</a>, miscarriage, ovarian torsion or <a href="/wiki/Urinary_tract_infection" title="Urinary tract infection">urinary tract infection</a>.<sup id="cite_ref-kirk2013_5-7" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Clinical presentation of ectopic pregnancy occurs at a mean of 7.2 weeks after the last normal menstrual period, with a range of four to eight weeks. Later presentations are more common in communities deprived of modern diagnostic ability.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2024)">citation needed</span></a></i>]</sup> </p><p>Signs and symptoms of ectopic pregnancy include increased hCG, vaginal bleeding (in varying amounts), sudden lower abdominal pain,<sup id="cite_ref-kirk2013_5-8" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> pelvic pain, a tender cervix, an adnexal mass, or adnexal tenderness.<sup id="cite_ref-Crochet2013_1-11" class="reference"><a href="#cite_note-Crochet2013-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> In the absence of ultrasound or <a href="/wiki/Human_chorionic_gonadotrophin" class="mw-redirect" title="Human chorionic gonadotrophin">hCG</a> assessment, heavy vaginal bleeding may lead to a misdiagnosis of miscarriage.<sup id="cite_ref-kirk2013_5-9" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Nausea" title="Nausea">Nausea</a>, <a href="/wiki/Vomiting" title="Vomiting">vomiting</a> and <a href="/wiki/Diarrhea" title="Diarrhea">diarrhea</a> are more rare symptoms of ectopic pregnancy.<sup id="cite_ref-kirk2013_5-10" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>Rupture of an ectopic pregnancy can lead to symptoms such as <a href="/wiki/Abdominal_distension" title="Abdominal distension">abdominal distension</a>, <a href="/wiki/Tenderness_(medicine)" title="Tenderness (medicine)">tenderness</a>, <a href="/wiki/Peritonism" class="mw-redirect" title="Peritonism">peritonism</a> and <a href="/wiki/Hypovolemic_shock" title="Hypovolemic shock">hypovolemic shock</a>.<sup id="cite_ref-kirk2013_5-11" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Someone with a ruptured ectopic pregnancy may experience pain when lying flat and may prefer to maintain upright posture as intrapelvic blood flow can lead to swelling of the abdominal cavity and cause additional pain.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Complications">Complications</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=2" title="Edit section: Complications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:FluidMorisonsPouchEctop.PNG" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e0/FluidMorisonsPouchEctop.PNG/220px-FluidMorisonsPouchEctop.PNG" decoding="async" width="220" height="183" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e0/FluidMorisonsPouchEctop.PNG/330px-FluidMorisonsPouchEctop.PNG 1.5x, //upload.wikimedia.org/wikipedia/commons/e/e0/FluidMorisonsPouchEctop.PNG 2x" data-file-width="391" data-file-height="325" /></a><figcaption>Blood in <a href="/wiki/Morrison%27s_pouch" class="mw-redirect" title="Morrison's pouch">Morrison's pouch</a> between the liver and kidney due to a ruptured ectopic pregnancy</figcaption></figure> <p>The most common complication is rupture with internal bleeding which may lead to hypovolemic shock. Damage to the fallopian tubes can lead to difficulty becoming pregnant in the future. The woman's other fallopian tube may function sufficiently for pregnancy. After the removal of one damaged fallopian tube, pregnancy remains possible in the future. If both are removed, in-vitro fertilization remains an option for women hoping to become pregnant.<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Causes">Causes</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=3" title="Edit section: Causes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>There are a number of risk factors for ectopic pregnancies. However, in as many as one-third<sup id="cite_ref-pmid16099295_13-0" class="reference"><a href="#cite_note-pmid16099295-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> to one-half<sup id="cite_ref-pmid18232175_14-0" class="reference"><a href="#cite_note-pmid18232175-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> no risk factors can be identified. Risk factors include: <a href="/wiki/Pelvic_inflammatory_disease" title="Pelvic inflammatory disease">pelvic inflammatory disease</a>, infertility, use of an <a href="/wiki/Intrauterine_device" title="Intrauterine device">intrauterine device</a> (IUD), previous exposure to <a href="/wiki/Diethylstilbestrol" title="Diethylstilbestrol">diethylstilbestrol</a> (DES), tubal surgery, intrauterine surgery (e.g. <a href="/wiki/Dilation_and_curettage" title="Dilation and curettage">D&C</a>), <a href="/wiki/Smoking" title="Smoking">smoking</a>, previous ectopic pregnancy, <a href="/wiki/Endometriosis" title="Endometriosis">endometriosis</a>, and <a href="/wiki/Tubal_ligation" title="Tubal ligation">tubal ligation</a>.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> A previous induced <a href="/wiki/Abortion" title="Abortion">abortion</a> does not appear to increase the risk.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> The IUD does not increase the risk of ectopic pregnancy, but with an IUD if pregnancy occurs it is more likely to be ectopic than intrauterine.<sup id="cite_ref-Tubal_ectopic_pregnancy_18-0" class="reference"><a href="#cite_note-Tubal_ectopic_pregnancy-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> The risk of ectopic pregnancy after chlamydia infection is low.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> The exact mechanism through which chlamydia increases the risk of ectopic pregnancy is uncertain, though some research suggests that the infection can affect the structure of fallopian tubes.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> </p> <table class="wikitable"> <caption>Risk factors <sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-ESHRE2015_22-0" class="reference"><a href="#cite_note-ESHRE2015-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> </caption> <tbody><tr> <th colspan="2">Relative risk factors </th></tr> <tr> <td>High </td> <td>Tubal sterilization, IUD, prior ectopic, PID (pelvic inflammatory disease), endometriosis, SIN (salpingitis isthmica nodosa) </td></tr> <tr> <td>Moderate </td> <td>Smoking, having more than 1 partner, infertility, chlamydia </td></tr> <tr> <td>Low </td> <td>Douching, age greater than 35, age less than 18, GIFT (gamete intrafallopian transfer) </td></tr></tbody></table> <div class="mw-heading mw-heading3"><h3 id="Tube_damage">Tube damage</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=4" title="Edit section: Tube damage"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:EUG_2.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/8/82/EUG_2.png/220px-EUG_2.png" decoding="async" width="220" height="209" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/82/EUG_2.png/330px-EUG_2.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/82/EUG_2.png/440px-EUG_2.png 2x" data-file-width="2988" data-file-height="2834" /></a><figcaption>Left fallopian tube with an ectopic pregnancy in a 25-year-old woman after a <a href="/wiki/Salpingectomy" title="Salpingectomy">salpingectomy</a></figcaption></figure> <p>Tubal pregnancy is when the egg is <a href="/wiki/Implantation_(embryology)" title="Implantation (embryology)">implanted</a> in the fallopian tubes. Hair-like <a href="/wiki/Cilium" title="Cilium">cilia</a> located on the internal surface of the fallopian tubes carry the fertilized egg to the uterus. Fallopian cilia are sometimes seen in reduced numbers subsequent to an ectopic pregnancy, leading to a hypothesis that cilia damage in the fallopian tubes is likely to lead to an ectopic pregnancy.<sup id="cite_ref-Lyons_23-0" class="reference"><a href="#cite_note-Lyons-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> Women who smoke have a higher chance of an ectopic pregnancy in the fallopian tubes. Smoking leads to risk factors of damaging and destroying cilia.<sup id="cite_ref-Lyons_23-1" class="reference"><a href="#cite_note-Lyons-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> As cilia degenerate, the amount of time it takes for the fertilized egg to reach the uterus will increase. The fertilized egg, if it does not reach the uterus in time, will hatch from the non-adhesive <a href="/wiki/Zona_pellucida" title="Zona pellucida">zona pellucida</a> and implant itself inside the fallopian tube, thus causing the ectopic pregnancy.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2024)">citation needed</span></a></i>]</sup> </p><p>Women with pelvic inflammatory disease (PID) have a high occurrence of ectopic pregnancy.<sup id="cite_ref-Tay_24-0" class="reference"><a href="#cite_note-Tay-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> This results from the build-up of <a href="/wiki/Scar" title="Scar">scar tissue</a> in the fallopian tubes, causing damage to cilia.<sup id="cite_ref-speroff_25-0" class="reference"><a href="#cite_note-speroff-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> However, if both tubes were completely blocked, so that sperm and egg were physically unable to meet, then fertilization of the egg would naturally be impossible, and neither normal pregnancy nor ectopic pregnancy could occur. Intrauterine adhesions (IUA) present in <a href="/wiki/Asherman%27s_syndrome" title="Asherman's syndrome">Asherman's syndrome</a> can cause ectopic cervical pregnancy or, if adhesions partially block access to the tubes via the <a href="/wiki/Ostium_of_Fallopian_tube" class="mw-redirect" title="Ostium of Fallopian tube">ostia</a>, ectopic tubal pregnancy.<sup id="cite_ref-Schenker_26-0" class="reference"><a href="#cite_note-Schenker-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Klyszejko_27-0" class="reference"><a href="#cite_note-Klyszejko-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Dicker:_28-0" class="reference"><a href="#cite_note-Dicker:-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> Asherman's syndrome usually occurs from intrauterine surgery, most commonly after <a href="/wiki/Dilation_and_curettage" title="Dilation and curettage">D&C</a>.<sup id="cite_ref-Schenker_26-1" class="reference"><a href="#cite_note-Schenker-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> Endometrial/pelvic/genital <a href="/wiki/Tuberculosis" title="Tuberculosis">tuberculosis</a>, another cause of Asherman's syndrome, can also lead to ectopic pregnancy as infection may lead to tubal adhesions in addition to intrauterine adhesions.<sup id="cite_ref-Bukulmez_29-0" class="reference"><a href="#cite_note-Bukulmez-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> </p><p>Tubal ligation can predispose to ectopic pregnancy. Reversal of tubal sterilization (<a href="/wiki/Tubal_reversal" title="Tubal reversal">tubal reversal</a>) carries a risk for ectopic pregnancy. This is higher if more destructive methods of tubal ligation (tubal cautery, partial removal of the tubes) have been used than less destructive methods (tubal clipping). A history of a tubal pregnancy increases the risk of future occurrences to about 10%.<sup id="cite_ref-speroff_25-1" class="reference"><a href="#cite_note-speroff-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> This risk is not reduced by removing the affected tube, even if the other tube appears normal. The best method for diagnosing this is to do an early ultrasound.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2024)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Endometriosis">Endometriosis</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=5" title="Edit section: Endometriosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Endometriosis" title="Endometriosis">Endometriosis</a></div> <p>Endometriosis is a disease in which cells similar to those of the <a href="/wiki/Endometrium" title="Endometrium">endometrium</a>, the tissue covering the inside of the uterus, grow outside the uterus. An embryo attaching to such lesions leads to an ectopic pregnancy. Results of a 30 year study of reproductive and pregnancy outcomes, involving 14,000+ women of child-bearing age, were presented at the 2015 <a href="/wiki/European_Society_of_Human_Reproduction_and_Embryology" title="European Society of Human Reproduction and Embryology">European Society of Human Reproduction and Embryology</a> (ESHRE) annual congress.<sup id="cite_ref-ESHRE2015_22-1" class="reference"><a href="#cite_note-ESHRE2015-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> 39% of the study group had surgically confirmed endometriosis. Compared to their peers, the endometriosis subgroup had a 76% higher risk for miscarriage and a 270% higher risk for ectopic pregnancy. The higher endometriosis risks were attributed to increased pelvic inflammation and structural and functional changes in the uterus' lining.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2024)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Other">Other</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=6" title="Edit section: Other"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Although some investigations have shown that patients may be at higher risk for ectopic pregnancy with advancing age, it is believed that age is a variable which could act as a surrogate for other risk factors. Vaginal douching is thought by some to increase ectopic pregnancies.<sup id="cite_ref-speroff_25-2" class="reference"><a href="#cite_note-speroff-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> Women exposed to <a href="/wiki/Diethylstilbestrol" title="Diethylstilbestrol">DES</a> in utero (also known as "DES daughters") also have an elevated risk of ectopic pregnancy.<sup id="cite_ref-Schrager2004_30-0" class="reference"><a href="#cite_note-Schrager2004-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> However, DES has not been used since 1971 in the United States.<sup id="cite_ref-Schrager2004_30-1" class="reference"><a href="#cite_note-Schrager2004-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> It has also been suggested that pathologic generation of <a href="/wiki/Nitric_oxide" title="Nitric oxide">nitric oxide</a> through increased <a href="/wiki/INOS" class="mw-redirect" title="INOS">iNOS</a> production may decrease <a href="/wiki/Fallopian_tube" title="Fallopian tube">tubal ciliary</a> beats and smooth muscle contractions and thus affect embryo transport, which may consequently result in ectopic pregnancy.<sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> Low socioeconomic status may also be a risk factor for ectopic pregnancy.<sup id="cite_ref-pmid23726169_32-0" class="reference"><a href="#cite_note-pmid23726169-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=7" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>An ectopic pregnancy should be considered as the cause of abdominal pain or vaginal bleeding in everyone who has a positive <a href="/wiki/Pregnancy_test" title="Pregnancy test">pregnancy test</a>.<sup id="cite_ref-Crochet2013_1-12" class="reference"><a href="#cite_note-Crochet2013-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> The primary goal of diagnostic procedures in possible ectopic pregnancy is to <a href="/wiki/Triage" title="Triage">triage</a> according to risk rather than establishing pregnancy location.<sup id="cite_ref-kirk2013_5-12" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Transvaginal_ultrasonography">Transvaginal ultrasonography</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=8" title="Edit section: Transvaginal ultrasonography"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>An <a href="/wiki/Ultrasound" title="Ultrasound">ultrasound</a> showing a <a href="/wiki/Gestational_sac" title="Gestational sac">gestational sac</a> with fetal heart in the fallopian tube has a very high specificity of ectopic pregnancy. It involves a long, thin transducer, covered with the conducting gel and a plastic/latex sheath and inserted into the vagina.<sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Vaginal_ultrasonography" title="Vaginal ultrasonography">Transvaginal ultrasonography</a> has a sensitivity of at least 90% for ectopic pregnancy.<sup id="cite_ref-kirk2013_5-13" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> The diagnostic ultrasonographic finding in ectopic pregnancy is an adnexal mass that moves separately from the ovary. In around 60% of cases, it is an inhomogeneous or a noncystic adnexal mass sometimes known as the "blob sign". It is generally spherical, but a more tubular appearance may be seen in case of <a href="/wiki/Hematosalpinx" title="Hematosalpinx">hematosalpinx</a>. This sign has been estimated to have a sensitivity of 84% and specificity of 99% in diagnosing ectopic pregnancy.<sup id="cite_ref-kirk2013_5-14" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> In the study estimating these values, the blob sign had a <a href="/wiki/Positive_and_negative_predictive_values" title="Positive and negative predictive values">positive predictive value</a> of 96% and a <a href="/wiki/Positive_and_negative_predictive_values" title="Positive and negative predictive values">negative predictive value</a> of 95%.<sup id="cite_ref-kirk2013_5-15" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> The visualization of an empty extrauterine gestational sac is sometimes known as the "bagel sign", and is present in around 20% of cases.<sup id="cite_ref-kirk2013_5-16" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> In another 20% of cases, there is visualization of a gestational sac containing a yolk sac or an embryo.<sup id="cite_ref-kirk2013_5-17" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Ectopic pregnancies where there is visualization of cardiac activity are sometimes termed "viable ectopic".<sup id="cite_ref-kirk2013_5-18" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <ul class="gallery mw-gallery-packed"> <li class="gallerybox" style="width: 161.33333333333px"> <div class="thumb" style="width: 159.33333333333px;"><span typeof="mw:File"><a href="/wiki/File:Schematic_figure_of_vaginal_ultrasonography_in_ectopic_pregnancy.svg" class="mw-file-description" title="Transvaginal ultrasonography of an ectopic pregnancy, showing the field of view in the following image"><img alt="Transvaginal ultrasonography of an ectopic pregnancy, showing the field of view in the following image" src="//upload.wikimedia.org/wikipedia/commons/thumb/0/07/Schematic_figure_of_vaginal_ultrasonography_in_ectopic_pregnancy.svg/239px-Schematic_figure_of_vaginal_ultrasonography_in_ectopic_pregnancy.svg.png" decoding="async" width="160" height="120" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/07/Schematic_figure_of_vaginal_ultrasonography_in_ectopic_pregnancy.svg/358px-Schematic_figure_of_vaginal_ultrasonography_in_ectopic_pregnancy.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/0/07/Schematic_figure_of_vaginal_ultrasonography_in_ectopic_pregnancy.svg/477px-Schematic_figure_of_vaginal_ultrasonography_in_ectopic_pregnancy.svg.png 2x" data-file-width="784" data-file-height="592" /></a></span></div> <div class="gallerytext"><a href="/wiki/Transvaginal_ultrasonography" class="mw-redirect" title="Transvaginal ultrasonography">Transvaginal ultrasonography</a> of an ectopic pregnancy, showing the field of view in the following image</div> </li> <li class="gallerybox" style="width: 280.66666666667px"> <div class="thumb" style="width: 278.66666666667px;"><span typeof="mw:File"><a href="/wiki/File:Blob_sign_of_ectopic_pregnancy.png" class="mw-file-description" title="A "blob sign", which consists of the ectopic pregnancy. The ovary is distinguished from it by having follicles, whereof one is visible in the field. This patient had an intrauterine device (IUD) with progestogen, whose cross-section is visible in the field, leaving an ultrasound shadow distally to it."><img alt="A "blob sign", which consists of the ectopic pregnancy. The ovary is distinguished from it by having follicles, whereof one is visible in the field. This patient had an intrauterine device (IUD) with progestogen, whose cross-section is visible in the field, leaving an ultrasound shadow distally to it." src="//upload.wikimedia.org/wikipedia/commons/thumb/2/21/Blob_sign_of_ectopic_pregnancy.png/418px-Blob_sign_of_ectopic_pregnancy.png" decoding="async" width="279" height="120" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/21/Blob_sign_of_ectopic_pregnancy.png/627px-Blob_sign_of_ectopic_pregnancy.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/21/Blob_sign_of_ectopic_pregnancy.png/835px-Blob_sign_of_ectopic_pregnancy.png 2x" data-file-width="1600" data-file-height="690" /></a></span></div> <div class="gallerytext">A "blob sign", which consists of the ectopic pregnancy. The ovary is distinguished from it by having follicles, whereof one is visible in the field. This patient had an <a href="/wiki/Intrauterine_device_with_progestogen" class="mw-redirect" title="Intrauterine device with progestogen">intrauterine device (IUD) with progestogen</a>, whose cross-section is visible in the field, leaving an ultrasound shadow distally to it.</div> </li> <li class="gallerybox" style="width: 185.33333333333px"> <div class="thumb" style="width: 183.33333333333px;"><span typeof="mw:File"><a href="/wiki/File:Ectopicleftmass.PNG" class="mw-file-description" title="Ultrasound image showing an ectopic pregnancy where a gestational sac and fetus has been formed"><img alt="Ultrasound image showing an ectopic pregnancy where a gestational sac and fetus has been formed" src="//upload.wikimedia.org/wikipedia/commons/thumb/6/6f/Ectopicleftmass.PNG/275px-Ectopicleftmass.PNG" decoding="async" width="184" height="120" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/6f/Ectopicleftmass.PNG/412px-Ectopicleftmass.PNG 1.5x, //upload.wikimedia.org/wikipedia/commons/6/6f/Ectopicleftmass.PNG 2x" data-file-width="468" data-file-height="307" /></a></span></div> <div class="gallerytext">Ultrasound image showing an ectopic pregnancy where a <a href="/wiki/Gestational_sac" title="Gestational sac">gestational sac</a> and fetus has been formed</div> </li> </ul> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:UOTW_61_-_Ultrasound_of_the_Week_1.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/50/UOTW_61_-_Ultrasound_of_the_Week_1.jpg/220px-UOTW_61_-_Ultrasound_of_the_Week_1.jpg" decoding="async" width="220" height="150" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/50/UOTW_61_-_Ultrasound_of_the_Week_1.jpg/330px-UOTW_61_-_Ultrasound_of_the_Week_1.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/50/UOTW_61_-_Ultrasound_of_the_Week_1.jpg/440px-UOTW_61_-_Ultrasound_of_the_Week_1.jpg 2x" data-file-width="792" data-file-height="540" /></a><figcaption>A pregnancy not in the uterus<sup id="cite_ref-34" class="reference"><a href="#cite_note-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup></figcaption></figure> <p>The combination of a positive pregnancy test and the presence of what appears to be a normal intrauterine pregnancy does not exclude an ectopic pregnancy, since there may be either a <a href="/wiki/Heterotopic_pregnancy" title="Heterotopic pregnancy">heterotopic pregnancy</a> or a "<style data-mw-deduplicate="TemplateStyles:r1238216509">.mw-parser-output .vanchor>:target~.vanchor-text{background-color:#b1d2ff}@media screen{html.skin-theme-clientpref-night .mw-parser-output .vanchor>:target~.vanchor-text{background-color:#0f4dc9}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .vanchor>:target~.vanchor-text{background-color:#0f4dc9}}</style><span class="vanchor"><span id="pseudosac"></span><span class="vanchor-text">pseudosac</span></span>", which is a collection of within the endometrial cavity that may be seen in up to 20% of women.<sup id="cite_ref-kirk2013_5-19" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>A small amount of <a href="/wiki/Echogenicity" title="Echogenicity">anechogenic</a>-free fluid in the <a href="/wiki/Recto-uterine_pouch" class="mw-redirect" title="Recto-uterine pouch">recto-uterine pouch</a> is commonly found in both intrauterine and ectopic pregnancies.<sup id="cite_ref-kirk2013_5-20" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> The presence of <a href="/wiki/Echogenic" class="mw-redirect" title="Echogenic">echogenic</a> fluid is estimated at between 28 and 56% of women with an ectopic pregnancy, and strongly indicates the presence of <a href="/wiki/Hemoperitoneum" title="Hemoperitoneum">hemoperitoneum</a>.<sup id="cite_ref-kirk2013_5-21" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> However, it does not necessarily result from tubal rupture but is commonly a result from leakage from the <a href="/wiki/Distal_tubal_opening" class="mw-redirect" title="Distal tubal opening">distal tubal opening</a>.<sup id="cite_ref-kirk2013_5-22" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> As a rule of thumb, the finding of free fluid is significant if it reaches the <a href="/wiki/Fundus_(uterus)" class="mw-redirect" title="Fundus (uterus)">fundus</a> or is present in the <a href="/wiki/Vesico-uterine_pouch" class="mw-redirect" title="Vesico-uterine pouch">vesico-uterine pouch</a>.<sup id="cite_ref-kirk2013_5-23" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> A further marker of serious intra-abdominal bleeding is the presence of fluid in the <a href="/wiki/Hepatorenal_recess_of_subhepatic_space" class="mw-redirect" title="Hepatorenal recess of subhepatic space">hepatorenal recess of the subhepatic space</a>.<sup id="cite_ref-kirk2013_5-24" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>Currently, <a href="/wiki/Doppler_ultrasonography" title="Doppler ultrasonography">Doppler ultrasonography</a> is not considered to significantly contribute to the diagnosis of ectopic pregnancy.<sup id="cite_ref-kirk2013_5-25" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>A common misdiagnosis is of a normal intrauterine pregnancy is where the pregnancy is implanted laterally in an <a href="/wiki/Arcuate_uterus" title="Arcuate uterus">arcuate uterus</a>, potentially being misdiagnosed as an <a href="/wiki/Interstitial_pregnancy" title="Interstitial pregnancy">interstitial pregnancy</a>.<sup id="cite_ref-kirk2013_5-26" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Ultrasonography_and_β-hCG"><span id="Ultrasonography_and_.CE.B2-hCG"></span>Ultrasonography and β-hCG</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=9" title="Edit section: Ultrasonography and β-hCG"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Algorithm_in_pregnancy_of_unknown_location.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/1/14/Algorithm_in_pregnancy_of_unknown_location.svg/340px-Algorithm_in_pregnancy_of_unknown_location.svg.png" decoding="async" width="340" height="197" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/14/Algorithm_in_pregnancy_of_unknown_location.svg/510px-Algorithm_in_pregnancy_of_unknown_location.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/14/Algorithm_in_pregnancy_of_unknown_location.svg/680px-Algorithm_in_pregnancy_of_unknown_location.svg.png 2x" data-file-width="610" data-file-height="354" /></a><figcaption><a href="/wiki/Medical_algorithm" title="Medical algorithm">Algorithm</a> of the management of a pregnancy of unknown location, that is, a positive pregnancy test but no pregnancy is found on <a href="/wiki/Transvaginal_ultrasonography" class="mw-redirect" title="Transvaginal ultrasonography">transvaginal ultrasonography</a>.<sup id="cite_ref-kirk2013_5-27" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> If serum hCG at 0 hours is more than 1000 IU/L and there is no history suggestive of complete miscarriage, the ultrasonography should be repeated as soon as possible.<sup id="cite_ref-kirk2013_5-28" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></figcaption></figure> <p>Where no intrauterine pregnancy (IUP) is seen on ultrasound, measuring <a href="/wiki/Human_chorionic_gonadotropin" title="Human chorionic gonadotropin">β-human chorionic gonadotropin</a> (β-hCG) levels may aid in the diagnosis. The rationale is that a low β-hCG level may indicate that the pregnancy is intrauterine but yet too small to be visible on ultrasonography. While some physicians consider that the threshold where an intrauterine pregnancy should be visible on transvaginal ultrasound is around 1500 mIU/mL of β-hCG, a review in the JAMA Rational Clinical Examination Series showed that there is no single threshold for the β-human chorionic gonadotropin that confirms an ectopic pregnancy. Instead, the best test in a pregnant woman is a high resolution transvaginal ultrasound.<sup id="cite_ref-Crochet2013_1-13" class="reference"><a href="#cite_note-Crochet2013-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> The presence of an adnexal mass in the absence of an intrauterine pregnancy on transvaginal sonography increases the likelihood of an ectopic pregnancy 100-fold (LR+ 111). When there are no adnexal abnormalities on transvaginal sonography, the likelihood of an ectopic pregnancy decreases (LR- 0.12). An empty uterus with levels higher than 1500 mIU/mL may be evidence of an ectopic pregnancy, but may also be consistent with an intrauterine pregnancy which is simply too small to be seen on ultrasound. If the diagnosis is uncertain, it may be necessary to wait a few days and repeat the blood work. This can be done by measuring the β-hCG level approximately 48 hours later and repeating the ultrasound. The serum hCG ratios and <a href="/wiki/Logistic_regression" title="Logistic regression">logistic regression</a> models appear to be better than absolute single serum hCG level.<sup id="cite_ref-35" class="reference"><a href="#cite_note-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> If the β-hCG falls on repeat examination, this strongly suggests a spontaneous abortion or rupture. The fall in serum hCG over 48 hours may be measured as the hCG ratio, which is calculated as:<sup id="cite_ref-kirk2013_5-29" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> <span class="mwe-math-element"><span class="mwe-math-mathml-inline mwe-math-mathml-a11y" style="display: none;"><math xmlns="http://www.w3.org/1998/Math/MathML" alttext="{\displaystyle hCG~ratio={\frac {hCG~at~48h}{hCG~at~0h}}}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi>h</mi> <mi>C</mi> <mi>G</mi> <mtext> </mtext> <mi>r</mi> <mi>a</mi> <mi>t</mi> <mi>i</mi> <mi>o</mi> <mo>=</mo> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mrow> <mi>h</mi> <mi>C</mi> <mi>G</mi> <mtext> </mtext> <mi>a</mi> <mi>t</mi> <mtext> </mtext> <mn>48</mn> <mi>h</mi> </mrow> <mrow> <mi>h</mi> <mi>C</mi> <mi>G</mi> <mtext> </mtext> <mi>a</mi> <mi>t</mi> <mtext> </mtext> <mn>0</mn> <mi>h</mi> </mrow> </mfrac> </mrow> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle hCG~ratio={\frac {hCG~at~48h}{hCG~at~0h}}}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/687dc7f4dc42550876bab3dc142c222139b31d82" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -2.005ex; width:26.322ex; height:5.509ex;" alt="{\displaystyle hCG~ratio={\frac {hCG~at~48h}{hCG~at~0h}}}"></span> </p><p>An hCG ratio of 0.87, that is, a decrease in hCG of 13% over 48 hours, has a sensitivity of 93% and specificity of 97% for predicting a failing <a href="#Pregnancy_of_unknown_location">pregnancy of unknown location</a> (PUL).<sup id="cite_ref-kirk2013_5-30" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> The majority of cases of ectopic pregnancy will have serial serum hCG levels that increase more slowly than would be expected with an IUP (that is, a <i>suboptimal rise</i>), or decrease more slowly than would be expected with a failing PUL. However, up to 20% of cases of ectopic pregnancy have serum hCG doubling times similar to that of an IUP, and around 10% of EP cases have hCG patterns similar to a failing PUL.<sup id="cite_ref-kirk2013_5-31" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Other_methods">Other methods</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=10" title="Edit section: Other methods"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading4"><h4 id="Direct_examination">Direct examination</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=11" title="Edit section: Direct examination"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A <a href="/wiki/Laparoscopy" title="Laparoscopy">laparoscopy</a> or laparotomy can also be performed to visually confirm an ectopic pregnancy. This is generally reserved for women presenting with signs of an <a href="/wiki/Acute_abdomen" title="Acute abdomen">acute abdomen</a> and <a href="/wiki/Hypovolemic_shock" title="Hypovolemic shock">hypovolemic shock</a>.<sup id="cite_ref-kirk2013_5-32" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Often if a tubal abortion or tubal rupture has occurred, it is difficult to find the pregnancy tissue. A laparoscopy in very early ectopic pregnancy rarely shows a normal-looking fallopian tube.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2024)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading4"><h4 id="Culdocentesis">Culdocentesis</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=12" title="Edit section: Culdocentesis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Culdocentesis" title="Culdocentesis">Culdocentesis</a>, in which fluid is retrieved from the space separating the vagina and rectum, is a less commonly performed test that may be used to look for internal bleeding. In this test, a needle is inserted into the space at the very top of the vagina, behind the uterus and in front of the rectum. Any blood or fluid found may have been derived from a ruptured ectopic pregnancy.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (June 2022)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading4"><h4 id="Progesterone_levels">Progesterone levels</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=13" title="Edit section: Progesterone levels"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Progesterone" title="Progesterone">Progesterone</a> levels of less than 20 nmol/L have a high <a href="/wiki/Predictive_value" class="mw-redirect" title="Predictive value">predictive value</a> for failing pregnancies, whilst levels over 25 nmol/L are likely to predict viable pregnancies, and levels over 60 nmol/L are strongly so. This may help in identifying failing PUL that are at low risk and thereby needing less follow-up.<sup id="cite_ref-kirk2013_5-33" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Inhibin_A" class="mw-redirect" title="Inhibin A">Inhibin A</a> may also be useful for predicting spontaneous resolution of PUL, but is not as good as progesterone for this purpose.<sup id="cite_ref-kirk2013_5-34" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Mathematical_models">Mathematical models</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=14" title="Edit section: Mathematical models"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>There are various mathematical models, such as logistic regression models and Bayesian networks, for the prediction of PUL outcome based on multiple parameters.<sup id="cite_ref-kirk2013_5-35" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Mathematical models also aim to identify PULs that are <i>low risk</i>, that is, failing PULs and IUPs.<sup id="cite_ref-kirk2013_5-36" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Dilation_and_curettage">Dilation and curettage</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=15" title="Edit section: Dilation and curettage"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Dilation_and_curettage" title="Dilation and curettage">Dilation and curettage</a> (D&C) is sometimes used to diagnose pregnancy location with the aim of differentiating between an EP and a non-viable IUP in situations where a viable IUP can be ruled out. Specific indications for this procedure include either of the following:<sup id="cite_ref-kirk2013_5-37" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <ul><li>No visible IUP on transvaginal ultrasonography with a serum hCG of more than 2000 mIU/mL.</li> <li>An abnormal rise in hCG level. A rise of 35% over 48 hours is proposed as the minimal rise consistent with a viable intrauterine pregnancy.</li> <li>An abnormal fall in hCG level, such as defined as one of less than 20% in two days.</li></ul> <div class="mw-heading mw-heading3"><h3 id="Classification">Classification</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=16" title="Edit section: Classification"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading4"><h4 id="Tubal_pregnancy">Tubal pregnancy</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=17" title="Edit section: Tubal pregnancy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The vast majority of ectopic pregnancies implant in the fallopian tube. Pregnancies can grow in the fimbrial end (5% of all ectopic pregnancies), the ampullary section (80%), the isthmus (12%), and the cornual and interstitial part of the tube (2%).<sup id="cite_ref-speroff_25-3" class="reference"><a href="#cite_note-speroff-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> Mortality of a tubal pregnancy at the isthmus or within the uterus (interstitial pregnancy) is higher as there is increased vascularity that may result more likely in sudden major internal bleeding. A review published in 2010 supports the hypothesis that tubal ectopic pregnancy is caused by a combination of retention of the embryo within the fallopian tube due to impaired embryo-tubal transport and alterations in the tubal environment allowing early implantation to occur.<sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Nontubal_ectopic_pregnancy">Nontubal ectopic pregnancy</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=18" title="Edit section: Nontubal ectopic pregnancy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Two percent of ectopic pregnancies occur in the ovary, cervix, or are intra-abdominal. Transvaginal ultrasound examination is usually able to detect a <a href="/wiki/Cervical_pregnancy" title="Cervical pregnancy">cervical pregnancy</a>. An <a href="/wiki/Ovarian_pregnancy" title="Ovarian pregnancy">ovarian pregnancy</a> is differentiated from a tubal pregnancy by the <a href="/wiki/Spiegelberg_criteria" title="Spiegelberg criteria">Spiegelberg criteria</a>.<sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> </p><p>While a fetus of ectopic pregnancy is typically not viable, very rarely, a live baby has been delivered from an <a href="/wiki/Abdominal_pregnancy" title="Abdominal pregnancy">abdominal pregnancy</a>. In such a situation the <a href="/wiki/Placenta" title="Placenta">placenta</a> sits on the intra-abdominal organs or the <a href="/wiki/Peritoneum" title="Peritoneum">peritoneum</a> and has found sufficient blood supply. This is generally bowel or mesentery, but other sites, such as the renal (kidney), liver or hepatic (liver) artery or even aorta have been described. Support to near viability has occasionally been described, but even in <a href="/wiki/Third_World" title="Third World">Third World</a> countries, the diagnosis is most commonly made at 16 to 20 weeks' gestation. Such a fetus would have to be delivered by laparotomy. Maternal morbidity and mortality from extrauterine pregnancy are high as attempts to remove the placenta from the organs to which it is attached usually lead to uncontrollable bleeding from the attachment site. If the organ to which the placenta is attached is removable, such as a section of bowel, then the placenta should be removed together with that organ. This is such a rare occurrence that true data is unavailable and reliance must be made on anecdotal reports.<sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid17957101_40-0" class="reference"><a href="#cite_note-pmid17957101-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> However, the vast majority of abdominal pregnancies require intervention well before <a href="/wiki/Fetal_viability" title="Fetal viability">fetal viability</a> because of the risk of bleeding. </p><p>With the increase in Cesarean sections performed worldwide,<sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-42" class="reference"><a href="#cite_note-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> Cesarean section ectopic pregnancies (CSP) are rare, but becoming more common. The incidence of CSP is not well known, however there have been estimates based on different populations of 1:1800–1:2216.<sup id="cite_ref-43" class="reference"><a href="#cite_note-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Cesarean_scar_pregnancy:_issues_in_44-0" class="reference"><a href="#cite_note-Cesarean_scar_pregnancy:_issues_in-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup> CSP are characterized by abnormal implantation into the scar from a previous cesarean section,<sup id="cite_ref-:0_45-0" class="reference"><a href="#cite_note-:0-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup> and allowed to continue can cause serious complications such as uterine rupture and hemorrhage.<sup id="cite_ref-Cesarean_scar_pregnancy:_issues_in_44-1" class="reference"><a href="#cite_note-Cesarean_scar_pregnancy:_issues_in-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup> Patients with CSP generally present without symptoms, however symptoms can include vaginal bleeding that may or may not be associated with pain.<sup id="cite_ref-46" class="reference"><a href="#cite_note-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:1_47-0" class="reference"><a href="#cite_note-:1-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup> The diagnosis of CSP is made by ultrasound and four characteristics are noted: (1) Empty uterine cavity with bright hyperechoic endometrial stripe (2) Empty cervical canal (3) Intrauterine mass in the anterior part of the uterine isthmus, and (4) Absence of the anterior uterine muscle layer, and/or absence or thinning between the bladder and gestational sac, measuring less than 5 mm.<sup id="cite_ref-:0_45-1" class="reference"><a href="#cite_note-:0-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-48" class="reference"><a href="#cite_note-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-49" class="reference"><a href="#cite_note-49"><span class="cite-bracket">[</span>49<span class="cite-bracket">]</span></a></sup> Given the rarity of the diagnosis, treatment options tend to be described in case reports and series, ranging from medical with methotrexate or KCl<sup id="cite_ref-50" class="reference"><a href="#cite_note-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup> to surgical with dilation and curettage,<sup id="cite_ref-51" class="reference"><a href="#cite_note-51"><span class="cite-bracket">[</span>51<span class="cite-bracket">]</span></a></sup> uterine wedge resection,<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (August 2020)">citation needed</span></a></i>]</sup> or hysterectomy.<sup id="cite_ref-:1_47-1" class="reference"><a href="#cite_note-:1-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup> A double-balloon catheter technique has also been described,<sup id="cite_ref-52" class="reference"><a href="#cite_note-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup> allowing for uterine preservation. Recurrence risk for CSP is unknown, and early ultrasound in the next pregnancy is recommended.<sup id="cite_ref-:0_45-2" class="reference"><a href="#cite_note-:0-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Heterotopic_pregnancy">Heterotopic pregnancy</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=19" title="Edit section: Heterotopic pregnancy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Heterotopic_pregnancy" title="Heterotopic pregnancy">Heterotopic pregnancy</a></div> <p>In rare cases of ectopic pregnancy, there may be two fertilized eggs, one outside the uterus and the other inside. This is called a <a href="/wiki/Heterotopic_pregnancy" title="Heterotopic pregnancy">heterotopic pregnancy</a>.<sup id="cite_ref-Crochet2013_1-14" class="reference"><a href="#cite_note-Crochet2013-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Often the intrauterine pregnancy is discovered later than the ectopic, mainly because of the painful emergency nature of ectopic pregnancies. Since ectopic pregnancies are normally discovered and removed very early in the pregnancy, an ultrasound may not find the additional pregnancy inside the uterus. When hCG levels continue to rise after the removal of the ectopic pregnancy, there is the chance that a pregnancy inside the uterus is still viable. This is normally discovered through an ultrasound.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2024)">citation needed</span></a></i>]</sup> </p><p>Although rare, heterotopic pregnancies are becoming more common, likely due to increased use of IVF. The survival rate of the uterine fetus of a heterotopic pregnancy is around 70%.<sup id="cite_ref-53" class="reference"><a href="#cite_note-53"><span class="cite-bracket">[</span>53<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Rudimentary_horn_pregnancy">Rudimentary horn pregnancy</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=20" title="Edit section: Rudimentary horn pregnancy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Rudimentary_horn_pregnancy" title="Rudimentary horn pregnancy">Rudimentary horn pregnancy</a></div> <p>A <a href="/wiki/Pregnancy_in_a_rudimentary_horn" class="mw-redirect" title="Pregnancy in a rudimentary horn">pregnancy in a rudimentary horn</a> refers to a rare and life-threatening condition that occurs when a fertilized egg implants inside the small rudimentary horn of a <a href="/wiki/Unicornuate_uterus" title="Unicornuate uterus">unicornuate uterus</a>, which is a type of congenital uterine abnormality caused by the incomplete development of one of the <a href="/wiki/M%C3%BCllerian_ducts" class="mw-redirect" title="Müllerian ducts">Müllerian ducts</a>. This type of ectopic pregnancy is often results in rupture of the rudimentary horn between 10 and 15 weeks of gestation, leading to a high risk of morbidity and mortality.<sup id="cite_ref-54" class="reference"><a href="#cite_note-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Persistent_ectopic_pregnancy">Persistent ectopic pregnancy</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=21" title="Edit section: Persistent ectopic pregnancy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A persistent ectopic pregnancy refers to the continuation of trophoblastic growth after a surgical intervention to remove an ectopic pregnancy. After a conservative procedure that attempts to preserve the affected fallopian tube such as a <a href="/wiki/Salpingotomy" class="mw-redirect" title="Salpingotomy">salpingotomy</a>, in about 15–20% the major portion of the ectopic growth may have been removed, but some trophoblastic tissue, perhaps deeply embedded, has escaped removal and continues to grow, generating a new rise in hCG levels.<sup id="cite_ref-55" class="reference"><a href="#cite_note-55"><span class="cite-bracket">[</span>55<span class="cite-bracket">]</span></a></sup> After weeks this may lead to new clinical symptoms including bleeding. For this reason hCG levels may have to be monitored after removal of an ectopic pregnancy to assure their decline, also <a href="/wiki/Methotrexate" title="Methotrexate">methotrexate</a> can be given at the time of surgery prophylactically.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (June 2022)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading4"><h4 id="Pregnancy_of_unknown_location">Pregnancy of unknown location</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=22" title="Edit section: Pregnancy of unknown location"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Pregnancy of unknown location (PUL) is the term used for a pregnancy where there is a positive pregnancy test but no pregnancy has been visualized using transvaginal ultrasonography.<sup id="cite_ref-kirk2013_5-38" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Specialized early pregnancy departments have estimated that between 8% and 10% of women attending for an ultrasound assessment in early pregnancy will be classified as having a PUL.<sup id="cite_ref-kirk2013_5-39" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> The true nature of the pregnancy can be an ongoing viable intrauterine pregnancy, a failed pregnancy, an ectopic pregnancy or rarely a <a href="#Persisting_PUL">persisting PUL</a>.<sup id="cite_ref-kirk2013_5-40" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>Because of frequent ambiguity on ultrasonography examinations, the following classification is proposed:<sup id="cite_ref-kirk2013_5-41" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <table class="wikitable"> <tbody><tr> <th>Condition</th> <th>Criteria </th></tr> <tr> <td>Definite ectopic pregnancy</td> <td>Extrauterine <a href="/wiki/Gestational_sac" title="Gestational sac">gestational sac</a> with yolk sac or embryo (with or without cardiac activity). </td></tr> <tr> <td>Pregnancy of unknown location – probable ectopic pregnancy</td> <td>Inhomogeneous adnexal mass or extrauterine sac-like structure. </td></tr> <tr> <td>"True" pregnancy of unknown location</td> <td>No signs of intrauterine nor extrauterine pregnancy on transvaginal ultrasonography. </td></tr> <tr> <td>Pregnancy of unknown location – probable intrauterine pregnancy</td> <td>Intrauterine gestational sac-like structure. </td></tr> <tr> <td>Definite intrauterine pregnancy</td> <td>Intrauterine gestational sac with yolk sac or embryo (with or without cardiac activity). </td></tr></tbody></table> <p>In women with a pregnancy of unknown location, between 6% and 20% have an ectopic pregnancy.<sup id="cite_ref-kirk2013_5-42" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> In cases of pregnancy of unknown location and a history of heavy bleeding, it has been estimated that approximately 6% have an underlying ectopic pregnancy.<sup id="cite_ref-kirk2013_5-43" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Between 30% and 47% of women with pregnancy of unknown location are ultimately diagnosed with an ongoing intrauterine pregnancy, whereof the majority (50–70%) will be found to have failing pregnancies where the location is never confirmed.<sup id="cite_ref-kirk2013_5-44" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Histopathology_of_tubal_pregnancy.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/f5/Histopathology_of_tubal_pregnancy.jpg/220px-Histopathology_of_tubal_pregnancy.jpg" decoding="async" width="220" height="254" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/f5/Histopathology_of_tubal_pregnancy.jpg/330px-Histopathology_of_tubal_pregnancy.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/f5/Histopathology_of_tubal_pregnancy.jpg/440px-Histopathology_of_tubal_pregnancy.jpg 2x" data-file-width="1267" data-file-height="1462" /></a><figcaption><a href="/wiki/Chorionic_villus" class="mw-redirect" title="Chorionic villus">Chorionic villus</a> on <a href="/wiki/Histopathological_examination" class="mw-redirect" title="Histopathological examination">histopathological examination</a> of a tubal pregnancy</figcaption></figure> <p><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238216509"><span class="vanchor"><span id="Persisting_PUL"></span><span class="vanchor-text">Persisting PUL</span></span> is where the hCG level does not spontaneously decline and no intrauterine or ectopic pregnancy is identified on follow-up transvaginal ultrasonography.<sup id="cite_ref-kirk2013_5-45" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> A persisting PUL is likely either a small ectopic pregnancy that has not been visualized, or a retained trophoblast in the endometrial cavity.<sup id="cite_ref-kirk2013_5-46" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Treatment should only be considered when a potentially viable intrauterine pregnancy has been definitively excluded.<sup id="cite_ref-kirk2013_5-47" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> A <i>treated persistent PUL</i> is defined as one managed medically (generally with methotrexate) without confirmation of the location of the pregnancy such as by ultrasound, laparoscopy or uterine evacuation.<sup id="cite_ref-kirk2013_5-48" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> A <i>resolved persistent PUL</i> is defined as serum hCG reaching a non-pregnant value (generally less than 5 IU/L) after expectant management, or after uterine evacuation without evidence of <a href="/wiki/Chorionic_villi" title="Chorionic villi">chorionic villi</a> on <a href="/wiki/Histopathological_examination" class="mw-redirect" title="Histopathological examination">histopathological examination</a>.<sup id="cite_ref-kirk2013_5-49" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> In contrast, a relatively low and unresolving level of serum hCG indicates the possibility of an hCG-secreting tumour.<sup id="cite_ref-kirk2013_5-50" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Differential_diagnosis">Differential diagnosis</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=23" title="Edit section: Differential diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Other conditions that cause similar symptoms include: miscarriage, ovarian torsion, and acute appendicitis, ruptured ovarian cyst, <a href="/wiki/Kidney_stone_disease" title="Kidney stone disease">kidney stone</a>, and pelvic inflammatory disease, among others.<sup id="cite_ref-Crochet2013_1-15" class="reference"><a href="#cite_note-Crochet2013-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=24" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Expectant_management">Expectant management</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=25" title="Edit section: Expectant management"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Most women with a <a href="#Pregnancy_of_unknown_location">PUL</a> are followed up with serum hCG measurements and repeat <a href="/wiki/Vaginal_ultrasonography" title="Vaginal ultrasonography">TVS</a> examinations until a final diagnosis is confirmed.<sup id="cite_ref-kirk2013_5-51" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Low-risk cases of PUL that appear to be failing pregnancies may be followed up with a urinary pregnancy test after two weeks and get subsequent telephone advice.<sup id="cite_ref-kirk2013_5-52" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Low-risk cases of PUL that are likely intrauterine pregnancies may have another TVS in two weeks to access viability.<sup id="cite_ref-kirk2013_5-53" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> High-risk cases of PUL require further assessment, either with a TVS within 48 h or additional hCG measurement.<sup id="cite_ref-kirk2013_5-54" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Medical">Medical</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=26" title="Edit section: Medical"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Early treatment of an ectopic pregnancy with methotrexate is a viable alternative to surgical treatment<sup id="cite_ref-pmid17591007_56-0" class="reference"><a href="#cite_note-pmid17591007-56"><span class="cite-bracket">[</span>56<span class="cite-bracket">]</span></a></sup> which was developed in the 1980s.<sup id="cite_ref-57" class="reference"><a href="#cite_note-57"><span class="cite-bracket">[</span>57<span class="cite-bracket">]</span></a></sup> If administered early in the pregnancy, methotrexate terminates the growth of the developing embryo; the developing embryo may then be either resorbed by the woman's body or pass with a <a href="/wiki/Menstrual_cycle" title="Menstrual cycle">menstrual period</a>. Contraindications include liver, kidney, or blood disease, as well as an ectopic embryonic mass > 3.5 cm.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2024)">citation needed</span></a></i>]</sup> </p><p>Also, it may lead to the inadvertent termination of an undetected intrauterine pregnancy, or severe abnormality in any surviving pregnancy.<sup id="cite_ref-kirk2013_5-55" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Therefore, it is recommended that methotrexate should only be administered when hCG has been serially monitored with a rise less than 35% over 48 hours, which practically excludes a viable intrauterine pregnancy.<sup id="cite_ref-kirk2013_5-56" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>For nontubal ectopic pregnancy, evidence from randomised clinical trials in women with CSP is uncertain regarding treatment success, complications and side effects of methotrexate compared with surgery (<a href="/wiki/Uterine_artery_embolization" title="Uterine artery embolization">uterine arterial embolization</a> or uterine arterial chemoembolization).<sup id="cite_ref-58" class="reference"><a href="#cite_note-58"><span class="cite-bracket">[</span>58<span class="cite-bracket">]</span></a></sup> </p><p>The United States uses a multi dose protocol of methotrexate (MTX) which involves four doses of intramuscular along with an intramuscular injection of folinic acid to protect cells from the effects of the drugs and to reduce side effects. In France, the single dose protocol is followed, but a single dose has a greater chance of failure.<sup id="cite_ref-59" class="reference"><a href="#cite_note-59"><span class="cite-bracket">[</span>59<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Surgery">Surgery</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=27" title="Edit section: Surgery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Ectopic_pregnancy1981.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/6/67/Ectopic_pregnancy1981.jpg/220px-Ectopic_pregnancy1981.jpg" decoding="async" width="220" height="141" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/67/Ectopic_pregnancy1981.jpg/330px-Ectopic_pregnancy1981.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/67/Ectopic_pregnancy1981.jpg/440px-Ectopic_pregnancy1981.jpg 2x" data-file-width="557" data-file-height="358" /></a><figcaption>Surgical treatment: Laparoscopic view of an ectopic pregnancy located in the left fallopian tube, hematosalpinx is present on the left, the right tube is of normal appearance</figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Salpingectomy1981.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/fb/Salpingectomy1981.jpg/220px-Salpingectomy1981.jpg" decoding="async" width="220" height="139" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/fb/Salpingectomy1981.jpg/330px-Salpingectomy1981.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/fb/Salpingectomy1981.jpg/440px-Salpingectomy1981.jpg 2x" data-file-width="618" data-file-height="390" /></a><figcaption>The left fallopian tube containing the ectopic pregnancy has been removed (salpingectomy).</figcaption></figure> <p>If bleeding has already occurred, surgical intervention may be necessary. However, whether to pursue surgical intervention is an often difficult decision in a stable patient with minimal evidence of blood clot on ultrasound.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (December 2009)">citation needed</span></a></i>]</sup> </p><p>Surgeons use laparoscopy or laparotomy to gain access to the pelvis and can either incise the affected fallopian tube and remove only the pregnancy (<a href="/wiki/Salpingectomy" title="Salpingectomy">salpingostomy</a>) or remove the affected tube with the pregnancy (<a href="/wiki/Salpingectomy" title="Salpingectomy">salpingectomy</a>). The first successful surgery for an ectopic pregnancy was performed by <a href="/wiki/Lawson_Tait" title="Lawson Tait">Robert Lawson Tait</a> in 1883.<sup id="cite_ref-60" class="reference"><a href="#cite_note-60"><span class="cite-bracket">[</span>60<span class="cite-bracket">]</span></a></sup> It is estimated that an acceptable rate of PULs that eventually undergo surgery is between 0.5 and 11%.<sup id="cite_ref-kirk2013_5-57" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> People that undergo salpingectomy and salpingostomy have a similar recurrent ectopic pregnancy rate of 5% and 8% respectively. Additionally, their intrauterine pregnancy rates are also similar, 56% and 61%.<sup id="cite_ref-61" class="reference"><a href="#cite_note-61"><span class="cite-bracket">[</span>61<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Autotransfusion" title="Autotransfusion">Autotransfusion</a> of a woman's own blood as drained during surgery may be useful in those who have a lot of bleeding into their abdomen.<sup id="cite_ref-62" class="reference"><a href="#cite_note-62"><span class="cite-bracket">[</span>62<span class="cite-bracket">]</span></a></sup> </p><p>Published reports that a re-implanted embryo survived to birth were debunked as false.<sup id="cite_ref-63" class="reference"><a href="#cite_note-63"><span class="cite-bracket">[</span>63<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Prognosis">Prognosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=28" title="Edit section: Prognosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>When ectopic pregnancies are treated, the prognosis for the mother is very good in Western countries; maternal death is rare, but all babies die or are aborted. For instance, in the UK, between 2003 and 2005 there were 32,100 ectopic pregnancies resulting in 10 maternal deaths (meaning that 1 in 3,210 women with an ectopic pregnancy died).<sup id="cite_ref-64" class="reference"><a href="#cite_note-64"><span class="cite-bracket">[</span>64<span class="cite-bracket">]</span></a></sup> In 2006–2008 the UK Confidential Enquiry into Maternal Deaths found that ectopic pregnancy is the cause of 6 maternal deaths (0.26/100,000 pregnancies).<sup id="cite_ref-Tubal_ectopic_pregnancy_18-1" class="reference"><a href="#cite_note-Tubal_ectopic_pregnancy-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> </p><p>In the developing world, however, especially in Africa, the death rate is very high, and ectopic pregnancies are a major cause of death among women of childbearing age.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2024)">citation needed</span></a></i>]</sup> </p><p>In women having had an ectopic pregnancy, the risk of another one in the next pregnancy is around 10%.<sup id="cite_ref-65" class="reference"><a href="#cite_note-65"><span class="cite-bracket">[</span>65<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Future_fertility">Future fertility</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=29" title="Edit section: Future fertility"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Fertility following ectopic pregnancy depends upon several factors, the most important of which is a prior history of infertility.<sup id="cite_ref-isbn0-8247-0844-X_66-0" class="reference"><a href="#cite_note-isbn0-8247-0844-X-66"><span class="cite-bracket">[</span>66<span class="cite-bracket">]</span></a></sup> The treatment choice does not play a major role; a randomized study in 2013 concluded that the rates of intrauterine pregnancy two years after treatment of ectopic pregnancy are approximately 64% with radical surgery, 67% with medication, and 70% with conservative surgery.<sup id="cite_ref-67" class="reference"><a href="#cite_note-67"><span class="cite-bracket">[</span>67<span class="cite-bracket">]</span></a></sup> In comparison, the cumulative pregnancy rate of women under 40 years of age in the general population over two years is over 90%.<sup id="cite_ref-nice2013_68-0" class="reference"><a href="#cite_note-nice2013-68"><span class="cite-bracket">[</span>68<span class="cite-bracket">]</span></a></sup> </p><p>Methotrexate does not affect future fertility treatments. The number of oocytes that were retrieved before and after treatment with methotrexate does not change.<sup id="cite_ref-69" class="reference"><a href="#cite_note-69"><span class="cite-bracket">[</span>69<span class="cite-bracket">]</span></a></sup> </p><p>In case of ovarian ectopic pregnancy, the risk of subsequent ectopic pregnancy or infertility is low.<sup id="cite_ref-pmid25709640_70-0" class="reference"><a href="#cite_note-pmid25709640-70"><span class="cite-bracket">[</span>70<span class="cite-bracket">]</span></a></sup> </p><p>There is no evidence that massage improves fertility after ectopic pregnancy.<sup id="cite_ref-pmid29593844_71-0" class="reference"><a href="#cite_note-pmid29593844-71"><span class="cite-bracket">[</span>71<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=30" title="Edit section: Epidemiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Tubal_Pregnancy_with_embryo.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/2/21/Tubal_Pregnancy_with_embryo.jpg/220px-Tubal_Pregnancy_with_embryo.jpg" decoding="async" width="220" height="235" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/21/Tubal_Pregnancy_with_embryo.jpg/330px-Tubal_Pregnancy_with_embryo.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/21/Tubal_Pregnancy_with_embryo.jpg/440px-Tubal_Pregnancy_with_embryo.jpg 2x" data-file-width="1874" data-file-height="2000" /></a><figcaption>An opened oviduct with an ectopic pregnancy at about seven weeks' gestational age<sup id="cite_ref-72" class="reference"><a href="#cite_note-72"><span class="cite-bracket">[</span>72<span class="cite-bracket">]</span></a></sup></figcaption></figure> <p>The rate of ectopic pregnancy is about 1% and 2% of that of live births in developed countries, though it is as high as 4% in pregnancies involving assisted reproductive technology.<sup id="cite_ref-kirk2013_5-58" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Between 93% and 97% of ectopic pregnancies are located in a fallopian tube.<sup id="cite_ref-Crochet2013_1-16" class="reference"><a href="#cite_note-Crochet2013-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Of these, in turn, 13% are located in the <a href="/wiki/Isthmus_of_uterine_tube" class="mw-redirect" title="Isthmus of uterine tube">isthmus</a>, 75% are located in the <a href="/wiki/Ampulla_of_uterine_tube" class="mw-redirect" title="Ampulla of uterine tube">ampulla</a>, and 12% in the <a href="/wiki/Fimbriae_of_uterine_tube" class="mw-redirect" title="Fimbriae of uterine tube">fimbriae</a>.<sup id="cite_ref-kirk2013_5-59" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Ectopic pregnancy is responsible for 6% of maternal deaths during the first trimester of pregnancy making it the leading cause of maternal death during this stage of pregnancy.<sup id="cite_ref-Crochet2013_1-17" class="reference"><a href="#cite_note-Crochet2013-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p><p>Between 5% and 42% of women seen for ultrasound assessment with a positive pregnancy test have a pregnancy of unknown location, that is a positive pregnancy test but no pregnancy visualized at transvaginal ultrasonography.<sup id="cite_ref-kirk2013_5-60" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Between 6% and 20% of pregnancy of unknown location are subsequently diagnosed with actual ectopic pregnancy.<sup id="cite_ref-kirk2013_5-61" class="reference"><a href="#cite_note-kirk2013-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Society_and_culture">Society and culture</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=31" title="Edit section: Society and culture"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Salpingectomy" title="Salpingectomy">Salpingectomy</a> as a treatment for ectopic pregnancy is one of the common cases when the <a href="/wiki/Principle_of_double_effect#Medicine" title="Principle of double effect">principle of double effect can be used</a> to justify accelerating the death of the embryo by doctors and patients opposed to outright abortions.<sup id="cite_ref-How_does_the_principle_of_double-effect_relate_to_ectopic_pregnancies?_73-0" class="reference"><a href="#cite_note-How_does_the_principle_of_double-effect_relate_to_ectopic_pregnancies?-73"><span class="cite-bracket">[</span>73<span class="cite-bracket">]</span></a></sup> </p><p>In the <a href="/wiki/Catholic_Church" title="Catholic Church">Catholic Church</a>, there are moral debates on certain treatments. A significant number of Catholic moralists consider use of methotrexate and the salpingostomy procedure to be not "morally permissible" because they destroy the embryo; however, situations are considered differently in which the mother's health is endangered, and the whole fallopian tube with the developing embryo inside is removed.<sup id="cite_ref-74" class="reference"><a href="#cite_note-74"><span class="cite-bracket">[</span>74<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-75" class="reference"><a href="#cite_note-75"><span class="cite-bracket">[</span>75<span class="cite-bracket">]</span></a></sup> </p><p>Organizations exist that provide information and support to help those who experience ectopic pregnancy. Studies show that people can experience post-traumatic stress, depression, and anxiety for which they would need specialist therapies.<sup id="cite_ref-76" class="reference"><a href="#cite_note-76"><span class="cite-bracket">[</span>76<span class="cite-bracket">]</span></a></sup> Partners can also experience post-traumatic stress.<sup id="cite_ref-77" class="reference"><a href="#cite_note-77"><span class="cite-bracket">[</span>77<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Live_birth">Live birth</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=32" title="Edit section: Live birth"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>There have been cases where ectopic pregnancy lasted many months and ended in a live baby delivered by laparotomy. </p><p>In July 1999, Lori Dalton gave birth by <a href="/wiki/Caesarean_section" title="Caesarean section">caesarean section</a> in <a href="/wiki/Ogden,_Utah" title="Ogden, Utah">Ogden, Utah</a>, United States, to a healthy baby girl, Saige, who had developed outside of the uterus. Previous ultrasounds had not discovered the problem. "[Dalton]'s delivery was slated as a routine Caesarean birth at Ogden Regional Medical Center in Utah. When Dr. Naisbitt performed Lori's Caesarean, he was astonished to find Saige within the amniotic membrane outside the womb ... ."<sup id="cite_ref-78" class="reference"><a href="#cite_note-78"><span class="cite-bracket">[</span>78<span class="cite-bracket">]</span></a></sup> "But what makes this case so rare is that not only did mother and baby survive—they're both in perfect health. The father, John Dalton took home video inside the delivery room. Saige came out doing extremely well because even though she had been implanted outside the womb, a rich blood supply from a <a href="/wiki/Uterine_fibroid" title="Uterine fibroid">uterine fibroid</a> along the outer uterus wall had nourished her with a rich source of blood."<sup id="cite_ref-79" class="reference"><a href="#cite_note-79"><span class="cite-bracket">[</span>79<span class="cite-bracket">]</span></a></sup> </p><p>In September 1999 an English woman, Jane Ingram (age 32) gave birth to triplets: Olivia, Mary and Ronan, with an extrauterine fetus (Ronan) below the womb and <a href="/wiki/Twins" class="mw-redirect" title="Twins">twins</a> in the womb. All three survived. The twins in the womb were taken out first.<sup id="cite_ref-80" class="reference"><a href="#cite_note-80"><span class="cite-bracket">[</span>80<span class="cite-bracket">]</span></a></sup> </p><p>On May 29, 2008, an Australian woman, Meera Thangarajah (age 34), who had an ectopic pregnancy in the <a href="/wiki/Ovary" title="Ovary">ovary</a>, gave birth to a healthy full term 6 pound 3 ounce (2.8 kg) baby girl, Durga, via Caesarean section. She had no problems or complications during the 38‑week pregnancy.<sup id="cite_ref-81" class="reference"><a href="#cite_note-81"><span class="cite-bracket">[</span>81<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-82" class="reference"><a href="#cite_note-82"><span class="cite-bracket">[</span>82<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Animals">Animals</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=33" title="Edit section: Animals"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Ectopic gestation exists in <a href="/wiki/Mammal" title="Mammal">mammals</a> other than humans. In <a href="/wiki/Sheep" title="Sheep">sheep</a>, it can go to term, with <a href="/wiki/Mammary_gland" title="Mammary gland">mammary</a> preparation to <a href="/wiki/Parturition" class="mw-redirect" title="Parturition">parturition</a>, and <a href="/wiki/Childbirth" title="Childbirth">expulsion efforts</a>. The fetus can be removed by caesarean section. Pictures of caesarian section of a euthanized <a href="/wiki/Domestic_sheep" class="mw-redirect" title="Domestic sheep">ewe</a>, five days after parturition signs. </p> <ul class="gallery mw-gallery-traditional"> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Poirt%C3%AAye_fo%C3%BB_matrice_pate.JPG" class="mw-file-description" title="Leg of fetal lamb appearing out of the uterus during caesarean section"><img alt="Leg of fetal lamb appearing out of the uterus during caesarean section" src="//upload.wikimedia.org/wikipedia/commons/thumb/c/cd/Poirt%C3%AAye_fo%C3%BB_matrice_pate.JPG/120px-Poirt%C3%AAye_fo%C3%BB_matrice_pate.JPG" decoding="async" width="120" height="68" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/cd/Poirt%C3%AAye_fo%C3%BB_matrice_pate.JPG/180px-Poirt%C3%AAye_fo%C3%BB_matrice_pate.JPG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/cd/Poirt%C3%AAye_fo%C3%BB_matrice_pate.JPG/240px-Poirt%C3%AAye_fo%C3%BB_matrice_pate.JPG 2x" data-file-width="640" data-file-height="360" /></a></span></div> <div class="gallerytext">Leg of fetal lamb appearing out of the uterus during caesarean section</div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Poirt%C3%AAye_fo%C3%BB_matrice_saetch1.JPG" class="mw-file-description" title="External view of fetal sac, necrotic distal part"><img alt="External view of fetal sac, necrotic distal part" src="//upload.wikimedia.org/wikipedia/commons/thumb/6/60/Poirt%C3%AAye_fo%C3%BB_matrice_saetch1.JPG/120px-Poirt%C3%AAye_fo%C3%BB_matrice_saetch1.JPG" decoding="async" width="120" height="68" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/60/Poirt%C3%AAye_fo%C3%BB_matrice_saetch1.JPG/180px-Poirt%C3%AAye_fo%C3%BB_matrice_saetch1.JPG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/60/Poirt%C3%AAye_fo%C3%BB_matrice_saetch1.JPG/240px-Poirt%C3%AAye_fo%C3%BB_matrice_saetch1.JPG 2x" data-file-width="640" data-file-height="360" /></a></span></div> <div class="gallerytext">External view of fetal sac, necrotic distal part</div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Poirt%C3%AAye_fo%C3%BB_matrice_saetch2.JPG" class="mw-file-description" title="Internal view of fetal sac, before resection of distal necrotic part"><img alt="Internal view of fetal sac, before resection of distal necrotic part" src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a0/Poirt%C3%AAye_fo%C3%BB_matrice_saetch2.JPG/120px-Poirt%C3%AAye_fo%C3%BB_matrice_saetch2.JPG" decoding="async" width="120" height="68" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a0/Poirt%C3%AAye_fo%C3%BB_matrice_saetch2.JPG/180px-Poirt%C3%AAye_fo%C3%BB_matrice_saetch2.JPG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a0/Poirt%C3%AAye_fo%C3%BB_matrice_saetch2.JPG/240px-Poirt%C3%AAye_fo%C3%BB_matrice_saetch2.JPG 2x" data-file-width="640" data-file-height="360" /></a></span></div> <div class="gallerytext">Internal view of fetal sac, before resection of distal necrotic part</div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Poirt%C3%AAye_fo%C3%BB_matrice_saetch3.JPG" class="mw-file-description" title="Internal view of fetal sac. The necrotic distal part is to the left."><img alt="Internal view of fetal sac. The necrotic distal part is to the left." src="//upload.wikimedia.org/wikipedia/commons/thumb/c/c4/Poirt%C3%AAye_fo%C3%BB_matrice_saetch3.JPG/120px-Poirt%C3%AAye_fo%C3%BB_matrice_saetch3.JPG" decoding="async" width="120" height="68" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/c4/Poirt%C3%AAye_fo%C3%BB_matrice_saetch3.JPG/180px-Poirt%C3%AAye_fo%C3%BB_matrice_saetch3.JPG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/c4/Poirt%C3%AAye_fo%C3%BB_matrice_saetch3.JPG/240px-Poirt%C3%AAye_fo%C3%BB_matrice_saetch3.JPG 2x" data-file-width="640" data-file-height="360" /></a></span></div> <div class="gallerytext">Internal view of fetal sac. The necrotic distal part is to the left.</div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Poirt%C3%AAye_fo%C3%BB_matrice_saetch%26coine.JPG" class="mw-file-description" title="External side of fetal sac, proximal end, with ovary and uterine horn"><img alt="External side of fetal sac, proximal end, with ovary and uterine horn" src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e4/Poirt%C3%AAye_fo%C3%BB_matrice_saetch%26coine.JPG/120px-Poirt%C3%AAye_fo%C3%BB_matrice_saetch%26coine.JPG" decoding="async" width="120" height="68" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e4/Poirt%C3%AAye_fo%C3%BB_matrice_saetch%26coine.JPG/180px-Poirt%C3%AAye_fo%C3%BB_matrice_saetch%26coine.JPG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/e4/Poirt%C3%AAye_fo%C3%BB_matrice_saetch%26coine.JPG/240px-Poirt%C3%AAye_fo%C3%BB_matrice_saetch%26coine.JPG 2x" data-file-width="640" data-file-height="360" /></a></span></div> <div class="gallerytext">External side of fetal sac, proximal end, with ovary and uterine horn</div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Poirt%C3%AAye_fo%C3%BB_matrice_saetch_%C3%A5dfo%C3%BB_pwels.JPG" class="mw-file-description" title="Resected distal part of fetal sac, with attached placenta"><img alt="Resected distal part of fetal sac, with attached placenta" src="//upload.wikimedia.org/wikipedia/commons/thumb/7/79/Poirt%C3%AAye_fo%C3%BB_matrice_saetch_%C3%A5dfo%C3%BB_pwels.JPG/120px-Poirt%C3%AAye_fo%C3%BB_matrice_saetch_%C3%A5dfo%C3%BB_pwels.JPG" decoding="async" width="120" height="68" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/7/79/Poirt%C3%AAye_fo%C3%BB_matrice_saetch_%C3%A5dfo%C3%BB_pwels.JPG/180px-Poirt%C3%AAye_fo%C3%BB_matrice_saetch_%C3%A5dfo%C3%BB_pwels.JPG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/7/79/Poirt%C3%AAye_fo%C3%BB_matrice_saetch_%C3%A5dfo%C3%BB_pwels.JPG/240px-Poirt%C3%AAye_fo%C3%BB_matrice_saetch_%C3%A5dfo%C3%BB_pwels.JPG 2x" data-file-width="640" data-file-height="360" /></a></span></div> <div class="gallerytext">Resected distal part of fetal sac, with attached placenta</div> </li> </ul> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=34" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Indirect_abortion" title="Indirect abortion">Indirect abortion</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=35" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-Crochet2013-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-Crochet2013_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Crochet2013_1-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Crochet2013_1-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-Crochet2013_1-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-Crochet2013_1-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-Crochet2013_1-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-Crochet2013_1-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-Crochet2013_1-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-Crochet2013_1-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-Crochet2013_1-9"><sup><i><b>j</b></i></sup></a> <a href="#cite_ref-Crochet2013_1-10"><sup><i><b>k</b></i></sup></a> <a href="#cite_ref-Crochet2013_1-11"><sup><i><b>l</b></i></sup></a> <a href="#cite_ref-Crochet2013_1-12"><sup><i><b>m</b></i></sup></a> <a href="#cite_ref-Crochet2013_1-13"><sup><i><b>n</b></i></sup></a> <a href="#cite_ref-Crochet2013_1-14"><sup><i><b>o</b></i></sup></a> <a href="#cite_ref-Crochet2013_1-15"><sup><i><b>p</b></i></sup></a> <a href="#cite_ref-Crochet2013_1-16"><sup><i><b>q</b></i></sup></a> <a href="#cite_ref-Crochet2013_1-17"><sup><i><b>r</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFCrochetBastianChireau2013" class="citation journal cs1">Crochet JR, Bastian LA, Chireau MV (April 2013). "Does this woman have an ectopic pregnancy?: the rational clinical examination systematic review". <i>JAMA</i>. <b>309</b> (16): 1722–9. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1001%2Fjama.2013.3914">10.1001/jama.2013.3914</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23613077">23613077</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:205049738">205049738</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=JAMA&rft.atitle=Does+this+woman+have+an+ectopic+pregnancy%3F%3A+the+rational+clinical+examination+systematic+review&rft.volume=309&rft.issue=16&rft.pages=1722-9&rft.date=2013-04&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A205049738%23id-name%3DS2CID&rft_id=info%3Apmid%2F23613077&rft_id=info%3Adoi%2F10.1001%2Fjama.2013.3914&rft.aulast=Crochet&rft.aufirst=JR&rft.au=Bastian%2C+LA&rft.au=Chireau%2C+MV&rfr_id=info%3Asid%2Fen.wikipedia.org%3AEctopic+pregnancy" class="Z3988"></span></span> </li> <li id="cite_note-Cec2014-2"><span class="mw-cite-backlink">^ <a href="#cite_ref-Cec2014_2-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Cec2014_2-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Cec2014_2-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-Cec2014_2-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-Cec2014_2-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-Cec2014_2-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-Cec2014_2-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-Cec2014_2-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-Cec2014_2-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-Cec2014_2-9"><sup><i><b>j</b></i></sup></a> <a href="#cite_ref-Cec2014_2-10"><sup><i><b>k</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFCecchinoAraujo_JúniorElito_Júnior2014" class="citation journal cs1">Cecchino GN, Araujo Júnior E, Elito Júnior J (September 2014). 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href="#cite_ref-kirk2013_5-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-kirk2013_5-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-kirk2013_5-9"><sup><i><b>j</b></i></sup></a> <a href="#cite_ref-kirk2013_5-10"><sup><i><b>k</b></i></sup></a> <a href="#cite_ref-kirk2013_5-11"><sup><i><b>l</b></i></sup></a> <a href="#cite_ref-kirk2013_5-12"><sup><i><b>m</b></i></sup></a> <a href="#cite_ref-kirk2013_5-13"><sup><i><b>n</b></i></sup></a> <a href="#cite_ref-kirk2013_5-14"><sup><i><b>o</b></i></sup></a> <a href="#cite_ref-kirk2013_5-15"><sup><i><b>p</b></i></sup></a> <a href="#cite_ref-kirk2013_5-16"><sup><i><b>q</b></i></sup></a> <a href="#cite_ref-kirk2013_5-17"><sup><i><b>r</b></i></sup></a> <a href="#cite_ref-kirk2013_5-18"><sup><i><b>s</b></i></sup></a> <a href="#cite_ref-kirk2013_5-19"><sup><i><b>t</b></i></sup></a> <a href="#cite_ref-kirk2013_5-20"><sup><i><b>u</b></i></sup></a> <a href="#cite_ref-kirk2013_5-21"><sup><i><b>v</b></i></sup></a> <a href="#cite_ref-kirk2013_5-22"><sup><i><b>w</b></i></sup></a> <a href="#cite_ref-kirk2013_5-23"><sup><i><b>x</b></i></sup></a> <a href="#cite_ref-kirk2013_5-24"><sup><i><b>y</b></i></sup></a> <a href="#cite_ref-kirk2013_5-25"><sup><i><b>z</b></i></sup></a> <a href="#cite_ref-kirk2013_5-26"><sup><i><b>aa</b></i></sup></a> <a href="#cite_ref-kirk2013_5-27"><sup><i><b>ab</b></i></sup></a> <a href="#cite_ref-kirk2013_5-28"><sup><i><b>ac</b></i></sup></a> <a href="#cite_ref-kirk2013_5-29"><sup><i><b>ad</b></i></sup></a> <a href="#cite_ref-kirk2013_5-30"><sup><i><b>ae</b></i></sup></a> <a href="#cite_ref-kirk2013_5-31"><sup><i><b>af</b></i></sup></a> <a href="#cite_ref-kirk2013_5-32"><sup><i><b>ag</b></i></sup></a> <a href="#cite_ref-kirk2013_5-33"><sup><i><b>ah</b></i></sup></a> <a href="#cite_ref-kirk2013_5-34"><sup><i><b>ai</b></i></sup></a> <a href="#cite_ref-kirk2013_5-35"><sup><i><b>aj</b></i></sup></a> <a href="#cite_ref-kirk2013_5-36"><sup><i><b>ak</b></i></sup></a> <a href="#cite_ref-kirk2013_5-37"><sup><i><b>al</b></i></sup></a> <a href="#cite_ref-kirk2013_5-38"><sup><i><b>am</b></i></sup></a> <a href="#cite_ref-kirk2013_5-39"><sup><i><b>an</b></i></sup></a> <a href="#cite_ref-kirk2013_5-40"><sup><i><b>ao</b></i></sup></a> <a href="#cite_ref-kirk2013_5-41"><sup><i><b>ap</b></i></sup></a> <a href="#cite_ref-kirk2013_5-42"><sup><i><b>aq</b></i></sup></a> <a href="#cite_ref-kirk2013_5-43"><sup><i><b>ar</b></i></sup></a> <a href="#cite_ref-kirk2013_5-44"><sup><i><b>as</b></i></sup></a> <a href="#cite_ref-kirk2013_5-45"><sup><i><b>at</b></i></sup></a> <a href="#cite_ref-kirk2013_5-46"><sup><i><b>au</b></i></sup></a> <a href="#cite_ref-kirk2013_5-47"><sup><i><b>av</b></i></sup></a> <a href="#cite_ref-kirk2013_5-48"><sup><i><b>aw</b></i></sup></a> <a href="#cite_ref-kirk2013_5-49"><sup><i><b>ax</b></i></sup></a> <a href="#cite_ref-kirk2013_5-50"><sup><i><b>ay</b></i></sup></a> <a href="#cite_ref-kirk2013_5-51"><sup><i><b>az</b></i></sup></a> <a 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Retrieved <span class="nowrap">2011-06-22</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Volume+XVI%2C+Number+5&rft.atitle=Registry+Reports&rft.date=1999-10&rft_id=http%3A%2F%2Fwww.ardms.org%2Fdownloads%2FRegistryReports%2FSep99.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3AEctopic+pregnancy" class="Z3988"></span></span> </li> <li id="cite_note-79"><span class="mw-cite-backlink"><b><a href="#cite_ref-79">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation news cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20110930051227/http://web.ksl.com/dump/news/cc/special/science/ectopic.htm">"Miracle baby"</a>. Ogden, Utah: Utah News from KSL-TV. 1999-08-05. 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Archived from <a rel="nofollow" class="external text" href="http://www.news.com.au/story/0,23599,23782145-2,00.html">the original</a> on 2008-05-30<span class="reference-accessdate">. Retrieved <span class="nowrap">2008-05-30</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Miracle+baby+may+be+a+world+first&rft.date=2008-05-30&rft.aulast=Cavanagh&rft.aufirst=Rebekah&rft_id=http%3A%2F%2Fwww.news.com.au%2Fstory%2F0%2C23599%2C23782145-2%2C00.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3AEctopic+pregnancy" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ectopic_pregnancy&action=edit&section=36" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid 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dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-label="Navbox" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q207087" class="extiw" title="d:Q207087">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/O00">O00</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=633">633</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D011271">D011271</a></li><li><b><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a></b>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb4089.htm">4089</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></b>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/000895.htm">000895</a></li><li><b><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a></b>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/med/3212-overview">med/3212</a> <a rel="nofollow" class="external text" href="https://www.emedicine.com/emerg/topic478.htm#">emerg/478</a> <a rel="nofollow" class="external text" href="https://www.emedicine.com/radio/topic231.htm#">radio/231</a></li><li><b><a href="/wiki/Patient_UK" title="Patient UK">Patient UK</a></b>: <a rel="nofollow" class="external text" href="https://patient.info/doctor/ectopic-pregnancy-pro">Ectopic pregnancy</a></li></ul></div></div></td></tr></tbody></table></div> <style data-mw-deduplicate="TemplateStyles:r1235681985">.mw-parser-output .side-box{margin:4px 0;box-sizing:border-box;border:1px solid #aaa;font-size:88%;line-height:1.25em;background-color:var(--background-color-interactive-subtle,#f8f9fa);display:flow-root}.mw-parser-output .side-box-abovebelow,.mw-parser-output .side-box-text{padding:0.25em 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plainlinks sistersitebox"><style data-mw-deduplicate="TemplateStyles:r1126788409">.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}</style> <div class="side-box-flex"> <div class="side-box-image"><span class="noviewer" typeof="mw:File"><span><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/30px-Commons-logo.svg.png" decoding="async" width="30" height="40" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/45px-Commons-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/59px-Commons-logo.svg.png 2x" data-file-width="1024" data-file-height="1376" /></span></span></div> <div class="side-box-text plainlist">Wikimedia Commons has media related to <span style="font-weight: bold; font-style: italic;"><a href="https://commons.wikimedia.org/wiki/Category:Ectopic_pregnancy" class="extiw" title="commons:Category:Ectopic pregnancy">Ectopic pregnancy</a></span>.</div></div> </div> <ul><li><a rel="nofollow" class="external text" href="http://www.claripacs.com/case/CL0019">CT of the abdomen showing abdominal ectopic pregnancy</a></li></ul> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="x18px_Women&#039;s_health" style="padding:3px"><table class="nowraplinks hlist mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2" style="background: #F2D4CE;"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style 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src="//upload.wikimedia.org/wikipedia/commons/thumb/4/49/Women%27s_health_icon.svg/12px-Women%27s_health_icon.svg.png" decoding="async" width="12" height="18" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/49/Women%27s_health_icon.svg/18px-Women%27s_health_icon.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/49/Women%27s_health_icon.svg/24px-Women%27s_health_icon.svg.png 2x" data-file-width="274" data-file-height="412" /></a></span> <a href="/wiki/Women%27s_health" title="Women's health">Women's health</a></div></th></tr><tr><th scope="row" class="navbox-group" style="background: #F2D4CE;;width:1%"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0; line-height:1.2em"><a href="/wiki/Sexual_and_reproductive_health" title="Sexual and reproductive health">Reproductive <br />health</a></div></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="background: #F2D4CE;;width:1%"><a href="/wiki/Female_reproductive_system" title="Female reproductive system">Reproductive <br />tract</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Vulva" title="Vulva">External female genitalia (vulva)</a> <ul><li><a href="/wiki/Clitoris" title="Clitoris">Clitoris</a> <ul><li><a href="/wiki/Clitoral_hood" title="Clitoral hood">Clitoral hood</a></li></ul></li> <li><a href="/wiki/Labia_minora" title="Labia minora">Labia minora</a></li> <li><a href="/wiki/Labia_majora" title="Labia majora">Labia majora</a></li></ul></li> <li><a href="/wiki/Vagina" title="Vagina">Vagina</a></li> <li><a href="/wiki/Cervix" title="Cervix">Cervix</a></li> <li><a href="/wiki/Uterus" title="Uterus">Uterus</a></li> <li><a href="/wiki/Fallopian_tube" title="Fallopian tube">Fallopian tube</a></li> <li><a href="/wiki/Ovary" title="Ovary">Ovary</a></li> <li><a href="/wiki/Reproductive_system_disease" title="Reproductive system disease">Reproductive system disease</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="background: #F2D4CE;;width:1%"><a href="/wiki/Maternal_health" title="Maternal health">Maternal <br />health</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="background: #F2D4CE;;width:1%"><a href="/wiki/Pregnancy" title="Pregnancy">Pregnancy</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Unintended_pregnancy" title="Unintended pregnancy">Unintended pregnancy</a></li> <li><a href="/wiki/Gravidity_and_parity" title="Gravidity and parity">Gravidity and parity</a></li> <li><a href="/wiki/Obstetrics" title="Obstetrics">Obstetrics</a></li> <li><a href="/wiki/Antenatal_care" class="mw-redirect" title="Antenatal care">Antenatal care</a></li> <li><a href="/wiki/Adolescent_pregnancy" class="mw-redirect" title="Adolescent pregnancy">Adolescent pregnancy</a></li> <li><a href="/wiki/Complications_of_pregnancy" title="Complications of pregnancy">Complications of pregnancy</a> <ul><li><a href="/wiki/Hyperemesis_gravidarum" title="Hyperemesis gravidarum">Hyperemesis gravidarum</a></li> <li><a class="mw-selflink selflink">Ectopic pregnancy</a></li> <li><a href="/wiki/Miscarriage" title="Miscarriage">Miscarriage</a></li> <li><a href="/wiki/Obstetrical_bleeding" title="Obstetrical bleeding">Obstetrical bleeding</a></li> <li><a href="/wiki/Gestational_diabetes" title="Gestational diabetes">Gestational diabetes</a></li> <li><a href="/wiki/Hypertensive_disease_of_pregnancy" title="Hypertensive disease of pregnancy">Hypertension</a> <ul><li><a href="/wiki/Preeclampsia" class="mw-redirect" title="Preeclampsia">Preeclampsia</a></li> <li><a href="/wiki/Eclampsia" title="Eclampsia">Eclampsia</a></li></ul></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="background: #F2D4CE;;width:1%"><a href="/wiki/Childbirth" title="Childbirth">Childbirth</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Midwifery" title="Midwifery">Midwifery</a></li> <li><a href="/wiki/Preterm_birth" title="Preterm birth">Preterm birth</a></li> <li><a href="/wiki/Multiple_births" class="mw-redirect" title="Multiple births">Multiple births</a></li> <li><a href="/wiki/Oxytocin" title="Oxytocin">Oxytocin</a></li> <li><a href="/wiki/Obstructed_labor" class="mw-redirect" title="Obstructed labor">Obstructed labor</a></li> <li><a href="/wiki/Cesarian_section" class="mw-redirect" title="Cesarian section">Cesarian section</a></li> <li><a href="/wiki/Retained_placenta" title="Retained placenta">Retained placenta</a></li> <li><a href="/wiki/Obstetrical_fistulae" class="mw-redirect" title="Obstetrical fistulae">Obstetrical fistulae</a> <ul><li><a href="/wiki/Vesicovaginal_fistula" title="Vesicovaginal fistula">Vesicovaginal fistula</a></li> <li><a href="/wiki/Rectovaginal_fistula" title="Rectovaginal fistula">Rectovaginal fistula</a></li></ul></li> <li><a href="/wiki/Episiotomy" title="Episiotomy">Episiotomy</a> <ul><li><a href="/wiki/Husband_stitch" title="Husband stitch">Husband stitch</a></li></ul></li> <li><a href="/wiki/Postpartum_care" title="Postpartum care">Postpartum care</a></li> <li><a href="/wiki/Postpartum_confinement" title="Postpartum confinement">Postpartum confinement</a></li></ul> </div></td></tr><tr><td colspan="2" class="navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Maternal_deaths" class="mw-redirect" title="Maternal deaths">Maternal deaths</a></li> <li><a href="/wiki/Perinatal_mortality" title="Perinatal mortality">Perinatal mortality</a></li> <li><a href="/wiki/Stillbirths" class="mw-redirect" title="Stillbirths">Stillbirths</a></li> <li><a href="/wiki/Abortion" title="Abortion">Abortion</a></li> <li><a href="/wiki/Mother-to-child_transmission" class="mw-redirect" title="Mother-to-child transmission">Mother-to-child transmission</a></li> <li><a href="/wiki/Human_sterilization" class="mw-redirect" title="Human sterilization">Sterilization</a> <ul><li><a href="/wiki/Compulsory_sterilization" title="Compulsory sterilization">Compulsory sterilization</a></li></ul></li> <li><a href="/wiki/Breastfeeding_and_mental_health" title="Breastfeeding and mental health">Breastfeeding and mental health</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="background: #F2D4CE;;width:1%"><a href="/wiki/Reproductive_life_plan" class="mw-redirect" title="Reproductive life plan">Reproductive <br />life plan</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Infertility" title="Infertility">Infertility</a> <ul><li><a href="/wiki/Childlessness" title="Childlessness">Childlessness</a></li> <li><a href="/wiki/Assisted_reproductive_technology" title="Assisted reproductive technology">Assisted reproductive technology</a></li> <li><a href="/wiki/In_vitro_fertilization" class="mw-redirect" title="In vitro fertilization">In vitro fertilization</a></li></ul></li> <li><a href="/wiki/Parenting" title="Parenting">Parenting</a> <ul><li><a href="/wiki/Adoption" title="Adoption">Adoption</a></li> <li><a href="/wiki/Fostering" class="mw-redirect" title="Fostering">Fostering</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="background: #F2D4CE;;width:1%"><a href="/wiki/Contraception" class="mw-redirect" title="Contraception">Contraception</a> and<br /><a href="/wiki/Family_planning" title="Family planning">family planning</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Intrauterine_device" title="Intrauterine device">Intrauterine devices</a></li> <li><a href="/wiki/Oral_contraceptive_pill" title="Oral contraceptive pill">Oral contraceptives</a></li> <li><a href="/wiki/Condom" title="Condom">Condoms</a></li> <li><a href="/wiki/Male_contraceptive" title="Male contraceptive">Male contraceptive</a></li> <li><a href="/wiki/Contraceptive_prevalence" class="mw-redirect" title="Contraceptive prevalence">Contraceptive prevalence</a></li> <li><a href="/wiki/Contraceptive_security" title="Contraceptive security">Contraceptive security</a></li> <li><a href="/wiki/Planned_parenthood" class="mw-redirect" title="Planned parenthood">Planned parenthood</a></li> <li><a href="/wiki/Fertility_awareness" title="Fertility awareness">Fertility awareness</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="background: #F2D4CE;;width:1%"><a href="/wiki/Menstruation" title="Menstruation">Menstruation</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Culture_and_menstruation" title="Culture and menstruation">Culture and menstruation</a></li> <li><a href="/wiki/Feminine_hygiene" title="Feminine hygiene">Feminine hygiene</a></li> <li><a href="/wiki/Menarche" title="Menarche">Menarche</a></li> <li><a href="/wiki/Menstrual_cycle" title="Menstrual cycle">Menstrual cycle</a></li> <li><a href="/wiki/Menstrual_aids" class="mw-redirect" title="Menstrual aids">Menstrual aids</a> <ul><li><a href="/wiki/Cloth_menstrual_pad" title="Cloth menstrual pad">Cloth menstrual pad</a></li> <li><a href="/wiki/Menstrual_cup" title="Menstrual cup">Menstrual cup</a></li> <li><a href="/wiki/Tampon" title="Tampon">Tampon</a></li> <li><a href="/wiki/Sanitary_napkin" class="mw-redirect" title="Sanitary napkin">Sanitary pad</a></li></ul></li> <li><a href="/wiki/Dysmenorrhea" title="Dysmenorrhea">Dysmenorrhea</a></li> <li><a href="/wiki/Menorrhagia" class="mw-redirect" title="Menorrhagia">Menorrhagia</a></li> <li><a href="/wiki/Amenorrhoea" class="mw-redirect" title="Amenorrhoea">Amenorrhoea</a></li> <li><a href="/wiki/Menopause" title="Menopause">Menopause</a> <ul><li><a href="/wiki/Hormone_replacement_therapy" title="Hormone replacement therapy">Hormone replacement therapy</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="background: #F2D4CE;;width:1%">Sexual <br />health</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Sexually_transmittedinfections" scope="row" class="navbox-group" style="background: #F2D4CE;;width:1%"><a href="/wiki/Sexually_transmitted_infections" class="mw-redirect" title="Sexually transmitted infections">Sexually transmitted<br />infections</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Safe_sex" title="Safe sex">Safe sex</a></li> <li><a href="/wiki/HIV" title="HIV">HIV</a></li> <li><a href="/wiki/Human_papilloma_virus" class="mw-redirect" title="Human papilloma virus">Human papilloma virus</a> <ul><li><a href="/wiki/HPV_vaccine" title="HPV vaccine">HPV vaccine</a></li></ul></li> <li><a href="/wiki/Pelvic_inflammatory_disease" title="Pelvic inflammatory disease">Pelvic inflammatory disease</a></li></ul> </div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Female_genital_mutilation" title="Female genital mutilation">Female genital mutilation</a> <ul><li><a href="/wiki/Clitoridectomy" title="Clitoridectomy">Clitoridectomy</a></li> <li><a href="/wiki/Infibulation" title="Infibulation">Infibulation</a></li></ul></li> <li><a href="/wiki/Breast_binding" title="Breast binding">Breast binding</a></li> <li><a href="/wiki/Breast_health" class="mw-redirect" title="Breast health">Breast health</a></li> <li><a href="/wiki/Breast_ironing" title="Breast ironing">Breast ironing</a></li> <li><a href="/wiki/Child_marriage" title="Child marriage">Child marriage</a></li> <li><a href="/wiki/Dyspareunia" title="Dyspareunia">Dyspareunia</a></li> <li><a href="/wiki/Forced_marriage" title="Forced marriage">Forced marriage</a></li> <li><a href="/wiki/Gynaecological_disorders" class="mw-redirect" title="Gynaecological disorders">Gynaecological disorders</a> <ul><li><a href="/wiki/Vaginitis" title="Vaginitis">Vaginitis</a></li></ul></li> <li><a href="/wiki/Leblouh" title="Leblouh">Leblouh</a></li> <li><a href="/wiki/Polygamy" title="Polygamy">Polygamy</a></li> <li><a href="/wiki/Sexual_intercourse" title="Sexual intercourse">Sexual intercourse</a></li> <li><a href="/wiki/Orgasm" title="Orgasm">Orgasm</a></li> <li><a href="/wiki/Puberty" title="Puberty">Puberty</a></li> <li><a href="/wiki/Sex_differences" class="mw-redirect" title="Sex differences">Sex differences</a></li> <li><a href="/wiki/Sex_education" title="Sex education">Sex education</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="background: #F2D4CE;;width:1%">Non-reproductive<br /> health</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Violence_against_women" scope="row" class="navbox-group" style="background: #F2D4CE;;width:1%"><a href="/wiki/Violence_against_women" title="Violence against women">Violence <br />against women</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Abuse_during_childbirth" title="Abuse during childbirth">Abuse during childbirth</a></li> <li><a href="/wiki/Domestic_violence" title="Domestic violence">Domestic violence</a> <ul><li><a href="/wiki/Domestic_violence_and_pregnancy" title="Domestic violence and pregnancy">Pregnancy</a></li></ul></li> <li><a href="/wiki/Intimate_partner_violence" title="Intimate partner violence">Intimate partner violence</a></li> <li><a href="/wiki/Misogyny" title="Misogyny">Misogyny</a></li> <li><a href="/wiki/Sexual_harassment" title="Sexual harassment">Sexual harassment</a></li> <li><a href="/wiki/Sexual_assault" title="Sexual assault">Sexual assault</a> <ul><li><a href="/wiki/Rape" title="Rape">Rape</a></li></ul></li> <li><a href="/wiki/Femicide" title="Femicide">Femicide</a></li> <li><a href="/wiki/Gender_discrimination" class="mw-redirect" title="Gender discrimination">Gender discrimination</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="background: #F2D4CE;;width:1%"><a href="/wiki/Non-communicable_diseases" class="mw-redirect" title="Non-communicable diseases">Non-communicable <br />diseases</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Cancer" scope="row" class="navbox-group" style="background: #F2D4CE;;width:1%"><a href="/wiki/Cancer" title="Cancer">Cancer</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Lung_cancer" title="Lung cancer">Lung cancer</a></li> <li><a href="/wiki/Breast_cancer" title="Breast cancer">Breast cancer</a></li> <li><a href="/wiki/Uterine_cancer" title="Uterine cancer">Uterine cancer</a> <ul><li><a href="/wiki/Endometrial_cancer" title="Endometrial cancer">Endometrial cancer</a></li> <li><a href="/wiki/Cervical_cancer" title="Cervical cancer">Cervical cancer</a> <ul><li><a href="/wiki/Papanicolaou_test" class="mw-redirect" title="Papanicolaou test">Papanicolaou test</a></li></ul></li></ul></li> <li><a href="/wiki/Ovarian_cancer" title="Ovarian cancer">Ovarian cancer</a></li></ul> </div></td></tr></tbody></table><div> <ul><li><a href="/wiki/Cardiovascular_disease" title="Cardiovascular disease">Cardiovascular disease</a></li> <li><a href="/wiki/Dementia" title="Dementia">Dementia</a> <ul><li><a href="/wiki/Alzheimer%27s_disease" title="Alzheimer's disease">Alzheimer's disease</a></li></ul></li> <li><a href="/wiki/Bone_health" title="Bone health">Bone health</a> <ul><li><a href="/wiki/Osteoporosis" title="Osteoporosis">Osteoporosis</a> <ul><li><a href="/wiki/Hip_fracture" title="Hip fracture">Hip fracture</a></li></ul></li></ul></li> <li><a href="/wiki/Anaemia" class="mw-redirect" title="Anaemia">Anaemia</a></li></ul></div></td></tr></tbody></table><div> <ul><li><a href="/wiki/Mental_health" title="Mental health">Mental health</a> <ul><li><a href="/wiki/Anxiety" title="Anxiety">Anxiety</a></li> <li><a href="/wiki/Depression_(mood)" title="Depression (mood)">Depression</a> <ul><li><a href="/wiki/Major_depressive_disorder" title="Major depressive disorder">Major depressive disorder</a></li></ul></li></ul></li> <li><a href="/wiki/Urinary_tract" class="mw-redirect" title="Urinary tract">Urinary tract</a> <ul><li><a href="/wiki/Urethra" title="Urethra">Urethra</a></li> <li><a href="/wiki/Urinary_tract_infection" title="Urinary tract infection">Urinary tract infection</a></li> <li><a href="/wiki/Urinary_incontinence" title="Urinary incontinence">Urinary incontinence</a></li></ul></li></ul></div></td></tr><tr><th scope="row" class="navbox-group" style="background: #F2D4CE;;width:1%">Sociocultural <br />factors</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <li><a href="/wiki/Poverty" title="Poverty">Poverty</a></li> <li><a href="/wiki/Disadvantaged" title="Disadvantaged">Disadvantaged</a></li> <li><a href="/wiki/Gender_equality" title="Gender equality">Gender equality</a></li> <li><a href="/wiki/Healthcare_inequality" class="mw-redirect" title="Healthcare inequality">Healthcare inequality</a></li> <li><a href="/wiki/Gender_disparities_in_health" title="Gender disparities in health">Gender disparities in health</a></li> <li><a href="/wiki/Social_determinants_of_health" title="Social determinants of health">Social determinants of health</a></li> <li><a href="/wiki/Reproductive_justice" title="Reproductive justice">Reproductive justice</a></li> <li><a href="/wiki/Women%27s_empowerment" title="Women's empowerment">Women's empowerment</a></li> </div></td></tr><tr><th scope="row" class="navbox-group" style="background: #F2D4CE;;width:1%">Politics, research<br />and advocacy</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="background: #F2D4CE;;width:1%"><a href="/wiki/United_Nations" title="United Nations">United Nations</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/The_Convention_on_the_Elimination_of_All_Forms_of_Discrimination_against_Women" class="mw-redirect" title="The Convention on the Elimination of All Forms of Discrimination against Women">The Convention on the Elimination of All Forms of Discrimination against Women</a></li> <li><a href="/wiki/Declaration_on_the_elimination_of_violence_against_women" class="mw-redirect" title="Declaration on the elimination of violence against women">Declaration on the elimination of violence against women</a></li> <li><a href="/wiki/International_Day_of_the_Girl_Child" title="International Day of the Girl Child">International Day of the Girl Child</a></li> <li><a href="/wiki/Commission_on_the_Status_of_Women" class="mw-redirect" title="Commission on the Status of Women">Commission on the Status of Women</a></li> <li><a href="/wiki/UN_Women" title="UN Women">UN Women</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="background: #F2D4CE;;width:1%"><a href="/wiki/United_States" title="United States">United States</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Office_of_Research_on_Women%27s_Health" class="mw-redirect" title="Office of Research on Women's Health">Office of Research on Women's Health</a></li> <li><a href="/wiki/Women%27s_Health_Initiative" title="Women's Health Initiative">Women's Health Initiative</a></li></ul> </div></td></tr></tbody></table><div> <ul><li><a href="/wiki/International_Center_for_Research_on_Women" title="International Center for Research on Women">International Center for Research on Women</a></li> <li><a href="/wiki/Nurses%27_Health_Study" title="Nurses' Health Study">Nurses' Health Study</a></li> <li><a href="/wiki/Black_Women%27s_Health_Study" title="Black Women's Health Study">Black Women's Health Study</a></li> <li><a href="/wiki/Cartwright_Inquiry" title="Cartwright Inquiry">Cartwright Inquiry</a></li> <li><a href="/wiki/Society_for_Women%27s_Health_Research" title="Society for Women's Health Research">Society for Women's Health Research</a></li></ul></div></td></tr><tr><th scope="row" class="navbox-group" style="background: #F2D4CE;;width:1%">Women's health<br />by country</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <li><a href="/wiki/Women%27s_health_in_China" title="Women's health in China">China</a></li> <li><a href="/wiki/Women%27s_health_in_Ethiopia" title="Women's health in Ethiopia">Ethiopia</a></li> <li><a href="/wiki/Women%27s_health_in_India" title="Women's health in India">India</a> <ul><li><a href="/wiki/Family_planning_in_India" title="Family planning in India">Family planning</a></li></ul></li> <li><a href="/wiki/Women%27s_reproductive_health_in_Russia" title="Women's reproductive health in Russia">Russia</a></li> <li><a href="/wiki/Birth_control_in_the_United_States" title="Birth control in the United States">Birth control in the United States</a></li> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2" style="background: #F2D4CE;"><div> <ul><li><span class="noviewer" typeof="mw:File"><span title="Category"><img alt="" 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class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Pathology_of_pregnancy,_childbirth,_and_the_puerperium" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Pathology_of_pregnancy,_childbirth,_and_the_puerperium" title="Template:Pathology of pregnancy, childbirth, and the puerperium"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Pathology_of_pregnancy,_childbirth,_and_the_puerperium" title="Template talk:Pathology of pregnancy, childbirth, and the puerperium"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Pathology_of_pregnancy,_childbirth,_and_the_puerperium" title="Special:EditPage/Template:Pathology of pregnancy, childbirth, and the puerperium"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Pathology_of_pregnancy,_childbirth,_and_the_puerperium" style="font-size:114%;margin:0 4em">Pathology of <a href="/wiki/Pregnancy" title="Pregnancy">pregnancy</a>, <a href="/wiki/Childbirth" title="Childbirth">childbirth</a>, and the <a href="/wiki/Postpartum_period" title="Postpartum period">puerperium</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Complications_of_pregnancy" title="Complications of pregnancy">Pregnancy</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pregnancy_with_abortive_outcome" title="Pregnancy with abortive outcome">Pregnancy with<br />abortive outcome</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Abortion" title="Abortion">Abortion</a></li> <li><a class="mw-selflink selflink">Ectopic pregnancy</a> <ul><li><a href="/wiki/Abdominal_pregnancy" title="Abdominal pregnancy">Abdominal</a></li> <li><a href="/wiki/Cervical_pregnancy" title="Cervical pregnancy">Cervical</a></li> <li><a href="/wiki/Heterotopic_pregnancy" title="Heterotopic pregnancy">Heterotopic</a></li> <li><a href="/wiki/Interstitial_pregnancy" title="Interstitial pregnancy">Interstitial</a></li> <li><a href="/wiki/Ovarian_pregnancy" title="Ovarian pregnancy">Ovarian</a></li> <li><a href="/wiki/Rudimentary_horn_pregnancy" title="Rudimentary horn pregnancy">Rudimentary horn</a></li></ul></li> <li><a href="/wiki/Embryo_loss" title="Embryo loss">Embryo loss</a></li> <li><a href="/wiki/Fetal_resorption" title="Fetal resorption">Fetal resorption</a></li> <li><a href="/wiki/Molar_pregnancy" title="Molar pregnancy">Molar pregnancy</a></li> <li><a href="/wiki/Miscarriage" title="Miscarriage">Miscarriage</a></li> <li><a href="/wiki/Stillbirth" title="Stillbirth">Stillbirth</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Edema" title="Edema">Edema</a>, <a href="/wiki/Proteinuria" title="Proteinuria">proteinuria</a>, and<br /><a href="/wiki/Hypertensive_disease_of_pregnancy" title="Hypertensive disease of pregnancy">hypertensive disorders</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gestational_hypertension" class="mw-redirect" title="Gestational hypertension">Gestational hypertension</a></li> <li><a href="/wiki/Pre-eclampsia" title="Pre-eclampsia">Pre-eclampsia</a> <ul><li><a href="/wiki/HELLP_syndrome" title="HELLP syndrome">HELLP syndrome</a></li></ul></li> <li><a href="/wiki/Eclampsia" title="Eclampsia">Eclampsia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other, predominantly<br /> related to pregnancy</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_digestive_system" title="Human digestive system">Digestive system</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Acute_fatty_liver_of_pregnancy" title="Acute fatty liver of pregnancy">Acute fatty liver of pregnancy</a></li> <li><a href="/wiki/Gestational_diabetes" title="Gestational diabetes">Gestational diabetes</a></li> <li><a href="/wiki/Hepatitis_E" title="Hepatitis E">Hepatitis E</a></li> <li><a href="/wiki/Hyperemesis_gravidarum" title="Hyperemesis gravidarum">Hyperemesis gravidarum</a></li> <li><a href="/wiki/Intrahepatic_cholestasis_of_pregnancy" title="Intrahepatic cholestasis of pregnancy">Intrahepatic cholestasis of pregnancy</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Integumentary_system" title="Integumentary system">Integumentary system</a> /<br /> <a href="/wiki/Dermatoses_of_pregnancy" title="Dermatoses of pregnancy">dermatoses of pregnancy</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gestational_pemphigoid" title="Gestational pemphigoid">Gestational pemphigoid</a></li> <li><a href="/wiki/Impetigo_herpetiformis" title="Impetigo herpetiformis">Impetigo herpetiformis</a></li> <li><a href="/wiki/Intrahepatic_cholestasis_of_pregnancy" title="Intrahepatic cholestasis of pregnancy">Intrahepatic cholestasis of pregnancy</a></li> <li><a href="/wiki/Linea_nigra" title="Linea nigra">Linea nigra</a></li> <li><a href="/wiki/Prurigo_gestationis" title="Prurigo gestationis">Prurigo gestationis</a></li> <li><a href="/wiki/Pruritic_folliculitis_of_pregnancy" title="Pruritic folliculitis of pregnancy">Pruritic folliculitis of pregnancy</a></li> <li><a href="/wiki/Pruritic_urticarial_papules_and_plaques_of_pregnancy" title="Pruritic urticarial papules and plaques of pregnancy">Pruritic urticarial papules and plaques of pregnancy (PUPPP)</a></li> <li><a href="/wiki/Stretch_marks" title="Stretch marks">Stretch marks</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Nervous_system" title="Nervous system">Nervous system</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Chorea_gravidarum" title="Chorea gravidarum">Chorea gravidarum</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Blood" title="Blood">Blood</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gestational_thrombocytopenia" title="Gestational thrombocytopenia">Gestational thrombocytopenia</a></li> <li><a href="/wiki/Hypercoagulability_in_pregnancy" title="Hypercoagulability in pregnancy">Pregnancy-induced hypercoagulability</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Maternal care related to the<br /> <a href="/wiki/Fetus" title="Fetus">fetus</a> and <a href="/wiki/Amniotic_cavity" class="mw-redirect" title="Amniotic cavity">amniotic cavity</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Amniotic_fluid" title="Amniotic fluid">amniotic fluid</a></i> <ul><li><a href="/wiki/Oligohydramnios" title="Oligohydramnios">Oligohydramnios</a></li> <li><a href="/wiki/Polyhydramnios" title="Polyhydramnios">Polyhydramnios</a></li></ul></li> <li><a href="/wiki/Braxton_Hicks_contractions" title="Braxton Hicks contractions">Braxton Hicks contractions</a></li> <li><i><a href="/wiki/Chorion" title="Chorion">chorion</a> / <a href="/wiki/Amnion" title="Amnion">amnion</a></i> <ul><li><a href="/wiki/Chorioamnionitis" title="Chorioamnionitis">Chorioamnionitis</a></li> <li><a href="/wiki/Chorionic_hematoma" title="Chorionic hematoma">Chorionic hematoma</a></li> <li><a href="/wiki/Constriction_ring_syndrome" title="Constriction ring syndrome">Constriction ring syndrome</a></li> <li><a href="/wiki/Monoamniotic_twins" title="Monoamniotic twins">Monoamniotic twins</a></li> <li><a href="/wiki/Prelabor_rupture_of_membranes" title="Prelabor rupture of membranes">Prelabor rupture of membranes</a></li></ul></li> <li><a href="/wiki/Obstetrical_bleeding" title="Obstetrical bleeding">Obstetrical bleeding</a> <ul><li><a href="/wiki/Antepartum_bleeding" title="Antepartum bleeding">Antepartum</a></li></ul></li> <li><i><a href="/wiki/Placental_disease" title="Placental disease">placenta</a></i> <ul><li><a href="/wiki/Circumvallate_placenta" title="Circumvallate placenta">Circumvallate placenta</a></li> <li><a href="/wiki/Monochorionic_twins" title="Monochorionic twins">Monochorionic twins</a></li> <li><a href="/wiki/Placenta_accreta_spectrum" title="Placenta accreta spectrum">Placenta accreta</a></li> <li><a href="/wiki/Placenta_praevia" title="Placenta praevia">Placenta praevia</a></li> <li><a href="/wiki/Placental_abruption" title="Placental abruption">Placental abruption</a></li> <li><a href="/wiki/Twin-to-twin_transfusion_syndrome" title="Twin-to-twin transfusion syndrome">Twin-to-twin transfusion syndrome</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Obstetric_labor_complication" title="Obstetric labor complication">Labor</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Amniotic_fluid_embolism" title="Amniotic fluid embolism">Amniotic fluid embolism</a></li> <li><a href="/wiki/Cephalopelvic_disproportion" title="Cephalopelvic disproportion">Cephalopelvic disproportion</a></li> <li><a href="/wiki/Obstructed_labour" title="Obstructed labour">Obstructed labour</a> <ul><li><a href="/wiki/Shoulder_dystocia" title="Shoulder dystocia">Shoulder dystocia</a></li></ul></li> <li><a href="/wiki/Fetal_distress" title="Fetal distress">Fetal distress</a></li> <li><a href="/wiki/Locked_twins" title="Locked twins">Locked twins</a></li> <li><a href="/wiki/Nuchal_cord" title="Nuchal cord">Nuchal cord</a></li> <li><a href="/wiki/Obstetrical_bleeding" title="Obstetrical bleeding">Obstetrical bleeding</a> <ul><li><a href="/wiki/Postpartum_bleeding" title="Postpartum bleeding">Postpartum</a></li></ul></li> <li><a href="/wiki/Pain_management_during_childbirth" title="Pain management during childbirth">Pain management during childbirth</a></li> <li><i><a href="/wiki/Placental_disease" title="Placental disease">placenta</a></i> <ul><li><a href="/wiki/Placenta_accreta_spectrum" title="Placenta accreta spectrum">Placenta accreta</a></li></ul></li> <li><a href="/wiki/Preterm_birth" title="Preterm birth">Preterm birth</a></li> <li><a href="/wiki/Postterm_pregnancy" title="Postterm pregnancy">Postmature birth</a></li> <li><a href="/wiki/Umbilical_cord_prolapse" title="Umbilical cord prolapse">Umbilical cord prolapse</a></li> <li><a href="/wiki/Uterine_inversion" title="Uterine inversion">Uterine inversion</a></li> <li><a href="/wiki/Uterine_rupture" title="Uterine rupture">Uterine rupture</a></li> <li><a href="/wiki/Vasa_praevia" title="Vasa praevia">Vasa praevia</a></li> <li><a href="/wiki/Uterine_atony" title="Uterine atony">Uterine atony</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Puerperal_disorder" class="mw-redirect" title="Puerperal disorder">Puerperal</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Breastfeeding_difficulties" title="Breastfeeding difficulties">Breastfeeding difficulties</a> <ul><li><a href="/wiki/Low_milk_supply" title="Low milk supply">Low milk supply</a></li> <li><a href="/wiki/Cracked_nipple" title="Cracked nipple">Cracked nipples</a></li></ul></li> <li><a href="/wiki/Breast_engorgement" title="Breast engorgement">Breast engorgement</a></li> <li><a href="/wiki/Childbirth-related_post-traumatic_stress_disorder" title="Childbirth-related post-traumatic stress disorder">Childbirth-related post-traumatic stress disorder</a></li> <li><a href="/wiki/Pubic_symphysis_diastasis" title="Pubic symphysis diastasis">Pubic symphysis diastasis</a></li> <li><a href="/wiki/Postpartum_bleeding" title="Postpartum bleeding">Postpartum bleeding</a></li> <li><a href="/wiki/Peripartum_cardiomyopathy" title="Peripartum cardiomyopathy">Peripartum cardiomyopathy</a></li> <li><a href="/wiki/Postpartum_depression" title="Postpartum depression">Postpartum depression</a></li> <li><a href="/wiki/Postpartum_infections" title="Postpartum infections">Postpartum infections</a></li> <li><a href="/wiki/Postpartum_psychosis" title="Postpartum psychosis">Postpartum psychosis</a></li> <li><a href="/wiki/Postpartum_thyroiditis" title="Postpartum thyroiditis">Postpartum thyroiditis</a></li> <li><a href="/wiki/Puerperal_mastitis" class="mw-redirect" title="Puerperal mastitis">Puerperal mastitis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pre-existing_disease_in_pregnancy" title="Pre-existing disease in pregnancy">Concomitant conditions</a> <ul><li><a href="/wiki/Diabetes_and_pregnancy" title="Diabetes and pregnancy">Diabetes mellitus</a></li> <li><a href="/wiki/Lupus_and_pregnancy" title="Lupus and pregnancy">Systemic lupus erythematosus</a></li> <li><a href="/wiki/Thyroid_disease_in_pregnancy" title="Thyroid disease in pregnancy">Thyroid disorders</a></li></ul></li> <li><a href="/wiki/Maternal_death" title="Maternal death">Maternal death</a></li> <li><a href="/wiki/Sexual_activity_during_pregnancy" title="Sexual activity during pregnancy">Sexual activity during pregnancy</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2"><div> <ul><li><b><span class="noviewer" typeof="mw:File"><span title="Category"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/16px-Symbol_category_class.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/23px-Symbol_category_class.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/31px-Symbol_category_class.svg.png 2x" data-file-width="180" data-file-height="185" /></span></span></b> <b><a href="/wiki/Category:Pathology_of_pregnancy,_childbirth_and_the_puerperium" title="Category:Pathology of pregnancy, childbirth and the puerperium">Category</a></b></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Pregnancy_and_childbirth" style="padding:3px"><table class="nowraplinks mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Pregnancy" title="Template:Pregnancy"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Pregnancy" title="Template talk:Pregnancy"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Pregnancy" title="Special:EditPage/Template:Pregnancy"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Pregnancy_and_childbirth" style="font-size:114%;margin:0 4em"><a href="/wiki/Pregnancy" title="Pregnancy">Pregnancy</a> and <a href="/wiki/Childbirth" title="Childbirth">childbirth</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Family_planning" title="Family planning">Planning</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Birth_control" title="Birth control">Birth control</a></li> <li><a href="/wiki/Natural_family_planning" title="Natural family planning">Natural family planning</a></li> <li><a href="/wiki/Male_contraceptive" title="Male contraceptive">Male contraceptive</a></li> <li><a href="/wiki/Pre-conception_counseling" title="Pre-conception counseling">Pre-conception counseling</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_fertilization" title="Human fertilization">Conception</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Assisted_reproductive_technology" title="Assisted reproductive technology">Assisted reproductive technology</a> <ul><li><a href="/wiki/Artificial_insemination" title="Artificial insemination">artificial insemination</a></li> <li><a href="/wiki/Fertility_fraud" title="Fertility fraud">fertility fraud</a></li> <li><a href="/wiki/Fertility_medication" title="Fertility medication">fertility medication</a></li> <li><a href="/wiki/In_vitro_fertilisation" title="In vitro fertilisation">in vitro fertilisation</a></li> <li><a href="/wiki/Partner-assisted_reproduction" title="Partner-assisted reproduction">partner-assisted reproduction</a></li></ul></li> <li><a href="/wiki/Fertility_awareness" title="Fertility awareness">Fertility awareness</a></li> <li><a href="/wiki/Unintended_pregnancy" title="Unintended pregnancy">Unintended pregnancy</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Testing</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/3D_ultrasound" title="3D ultrasound">3D ultrasound</a></li> <li><a href="/wiki/Obstetric_ultrasonography" title="Obstetric ultrasonography">Obstetric ultrasonography</a></li> <li><a href="/wiki/Pregnancy_test" title="Pregnancy test">Pregnancy test</a> <ul><li><a href="/wiki/HCG_pregnancy_strip_test" class="mw-redirect" title="HCG pregnancy strip test">home testing</a></li></ul></li> <li><a href="/wiki/Prenatal_testing" title="Prenatal testing">Prenatal testing</a></li> <li><a href="/wiki/Medical_imaging_in_pregnancy" title="Medical imaging in pregnancy">Medical imaging</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Types</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cervical_pregnancy" title="Cervical pregnancy">Cervical</a></li> <li><a href="/wiki/Cryptic_pregnancy" title="Cryptic pregnancy">Cryptic</a></li> <li><a class="mw-selflink selflink">Ectopic</a></li> <li><a href="/wiki/Abdominal_pregnancy" title="Abdominal pregnancy">Abdominal</a></li> <li><a href="/wiki/Heterotopic_pregnancy" title="Heterotopic pregnancy">Heterotopic</a></li> <li><a href="/wiki/Molar_pregnancy" title="Molar pregnancy">Molar</a></li> <li><a href="/wiki/Ovarian_pregnancy" title="Ovarian pregnancy">Ovarian</a></li> <li><a href="/wiki/Postterm_pregnancy" title="Postterm pregnancy">Postterm</a></li> <li><a href="/wiki/Unintended_pregnancy" title="Unintended pregnancy">Unintended</a></li> <li><a href="/wiki/Interstitial_pregnancy" title="Interstitial pregnancy">Interstitial</a></li> <li><a href="/wiki/Rudimentary_horn_pregnancy" title="Rudimentary horn pregnancy">Rudimentary horn</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Childbirth" title="Childbirth">Childbirth</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Preparation</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bradley_method_of_natural_childbirth" title="Bradley method of natural childbirth">Bradley method</a></li> <li><a href="/wiki/Hypnotherapy_in_childbirth" class="mw-redirect" title="Hypnotherapy in childbirth">Hypnobirthing</a></li> <li><a href="/wiki/Lamaze_technique" title="Lamaze technique">Lamaze</a></li> <li><a href="/wiki/Nesting_instinct" title="Nesting instinct">Nesting instinct</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Roles</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Mother" title="Mother">Mother</a></li> <li><a href="/wiki/Infant" title="Infant">Newborn</a> <ul><li><a href="/wiki/Preterm_birth" title="Preterm birth">Preterm birth</a></li></ul></li> <li><a href="/wiki/Postterm_pregnancy" title="Postterm pregnancy">Postterm pregnancy</a></li> <li><a href="/wiki/Doula" title="Doula">Doula</a></li> <li><a href="/wiki/Birth_attendant" title="Birth attendant">Birth attendant</a></li> <li><a href="/wiki/Men%27s_role_in_childbirth" title="Men's role in childbirth">Men's roles</a></li> <li><a href="/wiki/Midwife" title="Midwife">Midwife</a> <ul><li><a href="/wiki/Auxiliary_nurse_midwife" title="Auxiliary nurse midwife">Auxiliary nurse midwife</a></li></ul></li> <li><a href="/wiki/Obstetrics_and_gynaecology" title="Obstetrics and gynaecology">Obstetrician</a></li> <li><a href="/wiki/Obstetrical_nursing" title="Obstetrical nursing">Perinatal nurse</a></li> <li><a href="/wiki/Traditional_birth_attendant" title="Traditional birth attendant">Traditional birth attendant</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Delivery</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pelvimetry" title="Pelvimetry">Pelvimetry</a> / <a href="/wiki/Bishop_score" title="Bishop score">Bishop score</a> <ul><li><a href="/wiki/Cervical_dilation" title="Cervical dilation">cervical dilation</a></li> <li><a href="/wiki/Cervical_effacement" title="Cervical effacement">cervical effacement</a></li> <li><a href="/wiki/Position_(obstetrics)" title="Position (obstetrics)">position</a></li></ul></li> <li><a href="/wiki/Bloody_show" title="Bloody show">Bloody show</a></li> <li><a href="/wiki/Uterine_contraction" title="Uterine contraction">Uterine contraction</a></li> <li><a href="/wiki/Vaginal_delivery" title="Vaginal delivery">Vaginal delivery</a></li> <li><a href="/wiki/Presentation_(obstetrics)" title="Presentation (obstetrics)">Presentation</a> <ul><li><a href="/wiki/Breech_birth" title="Breech birth">breech</a></li> <li><a href="/wiki/Cephalic_presentation" title="Cephalic presentation">cephalic</a></li> <li><a href="/wiki/Shoulder_presentation" title="Shoulder presentation">shoulder</a></li></ul></li> <li><a href="/wiki/Rupture_of_membranes" title="Rupture of membranes">Rupture of membranes</a></li> <li><a href="/wiki/Caesarean_section" title="Caesarean section">Caesarean</a></li> <li><a href="/wiki/Childbirth_positions" title="Childbirth positions">Childbirth positions</a></li> <li><a href="/wiki/Home_birth" title="Home birth">Home birth</a></li> <li><a href="/wiki/Labor_induction" title="Labor induction">Labor induction</a></li> <li><a href="/wiki/Multiple_birth" title="Multiple birth">Multiple birth</a></li> <li><a href="/wiki/Natural_childbirth" title="Natural childbirth">Natural childbirth</a></li> <li><a href="/wiki/Silent_birth" title="Silent birth">Silent birth</a></li> <li><a href="/wiki/Unassisted_childbirth" title="Unassisted childbirth">Unassisted childbirth</a></li> <li><a href="/wiki/Water_birth" title="Water birth">Water birth</a></li> <li><a href="/wiki/Placental_expulsion" title="Placental expulsion">Placental expulsion</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Prenatal</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Anatomy</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Amniotic_fluid" title="Amniotic fluid">Amniotic fluid</a></li> <li><a href="/wiki/Amniotic_sac" title="Amniotic sac">Amniotic sac</a></li> <li><a href="/wiki/Endometrium" title="Endometrium">Endometrium</a></li> <li><a href="/wiki/Placenta" title="Placenta">Placenta</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Prenatal_development" title="Prenatal development">Development</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Human_embryonic_development" title="Human embryonic development">Embryo</a></li> <li><a href="/wiki/Fetus" title="Fetus">Fetus</a></li> <li><a href="/wiki/Fundal_height" title="Fundal height">Fundal height</a></li> <li><a href="/wiki/Gestational_age" title="Gestational age">Gestational age</a></li> <li><a href="/wiki/Maternal_physiological_changes_in_pregnancy" title="Maternal physiological changes in pregnancy">Maternal physiological changes</a></li> <li><a href="/wiki/Postpartum_physiological_changes" title="Postpartum physiological changes">Postpartum physiological changes</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Prenatal_care" title="Prenatal care">Care</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Brain_health_and_pollution" title="Brain health and pollution">Brain health and pollution</a></li> <li>Nutrition <ul><li><a href="/wiki/Environmental_toxicants_and_fetal_development" title="Environmental toxicants and fetal development">environmental toxicants</a></li> <li><a href="/wiki/Nutrition_and_pregnancy" title="Nutrition and pregnancy">in pregnancy</a></li> <li><a href="/wiki/Prenatal_nutrition" title="Prenatal nutrition">prenatal</a></li></ul></li> <li><a href="/wiki/Antenatal_depression" title="Antenatal depression">Prenatal depression</a></li> <li><a href="/wiki/Immunization_during_pregnancy" title="Immunization during pregnancy">Immunization</a></li> <li>Concomitant conditions <ul><li><a href="/wiki/Anemia_in_pregnancy" title="Anemia in pregnancy">Anemia</a></li> <li><a href="/wiki/Hypertensive_disease_of_pregnancy" title="Hypertensive disease of pregnancy">Hypertension</a></li> <li><a href="/wiki/Hypercoagulability_in_pregnancy" title="Hypercoagulability in pregnancy">Hypercoagulability</a></li> <li><a href="/wiki/Drugs_in_pregnancy" title="Drugs in pregnancy">Substance use</a> <ul><li><a href="/wiki/Smoking_and_pregnancy" title="Smoking and pregnancy">Smoking</a></li> <li><a href="/wiki/Alcohol_and_pregnancy" class="mw-redirect" title="Alcohol and pregnancy">Alcohol</a></li> <li><a href="/wiki/Cannabis_in_pregnancy" title="Cannabis in pregnancy">Cannabis</a></li> <li><a href="/wiki/Opioids_and_pregnancy" title="Opioids and pregnancy">Opioids</a></li></ul></li> <li>Endocrine diseases <ul><li><a href="/wiki/Diabetes_and_pregnancy" title="Diabetes and pregnancy">Diabetes</a></li> <li><a href="/wiki/Thyroid_disease_in_pregnancy" title="Thyroid disease in pregnancy">Thyroid disease</a></li></ul></li> <li>Liver diseases <ul><li><a href="/wiki/Acute_fatty_liver_of_pregnancy" title="Acute fatty liver of pregnancy">Acute fatty liver</a></li> <li><a href="/wiki/Intrahepatic_cholestasis_of_pregnancy" title="Intrahepatic cholestasis of pregnancy">Intrahepatic cholestasis</a></li></ul></li> <li>Infections <ul><li><a href="/wiki/HIV_and_pregnancy" title="HIV and pregnancy">HIV</a></li> <li><a href="/wiki/COVID-19_in_pregnancy" title="COVID-19 in pregnancy">COVID-19</a></li> <li><a href="/wiki/HCV_in_children_and_pregnancy" title="HCV in children and pregnancy">Hepatitis C</a></li> <li><a href="/wiki/Pregnancy-associated_malaria" title="Pregnancy-associated malaria">Malaria</a></li></ul></li> <li>Skin diseases <ul><li><a href="/wiki/Lupus_and_pregnancy" title="Lupus and pregnancy">Lupus</a></li> <li><a href="/wiki/Pruritic_folliculitis_of_pregnancy" title="Pruritic folliculitis of pregnancy">Pruritic folliculitis</a></li> <li><a href="/wiki/Dermatoses_of_pregnancy" title="Dermatoses of pregnancy">Dermatoses</a></li></ul></li> <li>Others <ul><li><a href="/wiki/Drugs_in_pregnancy" title="Drugs in pregnancy">Drugs</a></li> <li><a href="/wiki/Vaginal_flora_in_pregnancy" title="Vaginal flora in pregnancy">Vaginal flora</a></li> <li><a href="/wiki/Obstetrical_bleeding" title="Obstetrical bleeding">Bleeding</a></li> <li><a href="/wiki/Motor_vehicle_emissions_and_pregnancy" class="mw-redirect" title="Motor vehicle emissions and pregnancy">Motor vehicle emissions</a></li> <li><a href="/wiki/Pre-existing_disease_in_pregnancy" title="Pre-existing disease in pregnancy">Pre-existing disease</a></li> <li><a href="/wiki/Pregnancy_and_sleep" title="Pregnancy and sleep">Sleep</a></li></ul></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Procedures</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Amniocentesis" title="Amniocentesis">Amniocentesis</a></li> <li><a href="/wiki/Cardiotocography" title="Cardiotocography">Cardiotocography</a></li> <li><a href="/wiki/Chorionic_villus_sampling" title="Chorionic villus sampling">Chorionic villus sampling</a></li> <li><a href="/wiki/Nonstress_test" title="Nonstress test">Nonstress test</a></li> <li><a href="/wiki/Abortion" title="Abortion">Abortion</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Postpartum_period" title="Postpartum period">Postpartum</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Maternal</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Lochia" title="Lochia">Lochia</a></li> <li><a href="/wiki/Postpartum_care" title="Postpartum care">Postpartum care</a></li> <li><a href="/wiki/Postpartum_depression" title="Postpartum depression">Postpartum depression</a></li> <li><a href="/wiki/Postpartum_confinement" title="Postpartum confinement">Postpartum confinement</a></li> <li><a href="/wiki/Sex_after_pregnancy" title="Sex after pregnancy">Sex after pregnancy</a></li> <li><a href="/wiki/Psychiatric_disorders_of_childbirth" title="Psychiatric disorders of childbirth">Psychiatric disorders of childbirth</a></li> <li><a href="/wiki/Postpartum_physiological_changes" title="Postpartum physiological changes">Postpartum physiological changes</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Roles</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Doula" title="Doula">Doula</a></li> <li><a href="/wiki/Health_visitor" title="Health visitor">Health visitor</a></li> <li><a href="/wiki/Lactation_consultant" title="Lactation consultant">Lactation consultant</a></li> <li><a href="/wiki/Monthly_nurse" title="Monthly nurse">Monthly nurse</a></li> <li><a href="/wiki/Nanny#Maternity_nurse_/_newborn_care_specialists_/_confinement_nanny" title="Nanny">Confinement nanny</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Infant</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Adaptation_to_extrauterine_life" title="Adaptation to extrauterine life">Adaptation to extrauterine life</a></li> <li><a href="/wiki/Apgar_score" title="Apgar score">Apgar score</a></li> <li><a href="/wiki/Child_care" title="Child care">Child care</a></li> <li><a href="/wiki/Birth_defect" title="Birth defect">Congenital disorders</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Obstetric history</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gravidity_and_parity" title="Gravidity and parity">Gravidity and parity</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><style data-mw-deduplicate="TemplateStyles:r1038841319">.mw-parser-output .tooltip-dotted{border-bottom:1px dotted;cursor:help}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1038841319"></div><div role="navigation" class="navbox authority-control" aria-labelledby="Authority_control_databases_frameless&#124;text-top&#124;10px&#124;alt=Edit_this_at_Wikidata&#124;link=https&#58;//www.wikidata.org/wiki/Q207087#identifiers&#124;class=noprint&#124;Edit_this_at_Wikidata" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Authority_control_databases_frameless&#124;text-top&#124;10px&#124;alt=Edit_this_at_Wikidata&#124;link=https&#58;//www.wikidata.org/wiki/Q207087#identifiers&#124;class=noprint&#124;Edit_this_at_Wikidata" style="font-size:114%;margin:0 4em"><a href="/wiki/Help:Authority_control" title="Help:Authority control">Authority control databases</a> <span class="mw-valign-text-top noprint" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q207087#identifiers" title="Edit this at Wikidata"><img alt="Edit this at Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">International</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><span class="uid"><a rel="nofollow" class="external text" href="http://id.worldcat.org/fast/902347/">FAST</a></span></li></ul></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">National</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="Ectopic pregnancy"><a rel="nofollow" class="external text" href="https://id.loc.gov/authorities/sh85106288">United States</a></span></span></li><li><span class="uid"><a rel="nofollow" class="external text" href="https://id.ndl.go.jp/auth/ndlna/00570984">Japan</a></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="mimoděložní těhotenství"><a rel="nofollow" class="external text" href="https://aleph.nkp.cz/F/?func=find-c&local_base=aut&ccl_term=ica=ph921529&CON_LNG=ENG">Czech Republic</a></span></span></li><li><span class="uid"><a rel="nofollow" class="external text" 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