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Chapter 19. ECTOPIC (EXTRAUTERINE) PREGNANCY

ICD-10 Codes

О00 Ectopic (extrauterine) pregnancy.

О00.0 Abdominal (intraperitoneal) pregnancy.

О00.1 Tubal (fallopian) pregnancy.

О00.2 Ovarian pregnancy.

О00.8 Other forms of extrauterine pregnancy.

О00.9 Extrauterine pregnancy not otherwise specified.

19.1. GENERAL INFORMATION

Pregnancy in which a fertilized egg implants and develops outside the uterus is referred to as ectopic or extrauterine.

Epidemiology

Despite the advances of medical science and clinical practice, ectopic pregnancy still remains a serious issue encountered not only by obstetrician gynecologists but also by surgeons. This condition is noted in 1-6% of gynecologic patients admitted to gynecology department in hospitals. The number of patients with ectopic gestation does not decline which is due to a high rate of abortions, female genital inflammations, use of IUDs, ovarian dysfunction, wide use of assisted reproduction technologies.

Ectopic pregnancy steadily rates fourth or fifth in the structure of maternal mortality causes in civilized countries (5-7%).

Classification

Ectopic pregnancy is classified on the basis of fertilized egg localization. The most common site of abnormal implantation is fallopian tubes (98-99%); in less common cases gestation develops on the ovary (0.1-0.7%), peritoneum (0.3-0.4%), between uterine ligaments (0.1%), in the rudimentary horn of uterus (0.1-0.9%), in the cervix (0.1-0.4%) in the uterine scar after cesarean section (fig. 19.1).

Etiology

Causes resulting in ectopic pregnancy are varied: adnexal inflammation, STIs, disorder of fallopian tube contractility, sexual infantilism, endocrine disorders, enhanced trophoblast activity, and other.

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