Ectopic Pregnancy and Spontaneous Abortion

Ectopic pregnancy, the implantation of an embryo outside the endometrial cavity, is the leading cause of morbidity and mortality in the first trimester. The embryo may be implanted in the fallopian tubes, ovaries, abdomen, or cervix, with the fallopian tubes being the site of implantation in 95% of cases. If left untreated, ectopic pregnancy can result in rupture of the fallopian tube, which can lead to hemorrhagic shock and death. The signs and symptoms of ectopic pregnancy and diagnosis and treatment are detailed in the chapter. Spontaneous abortion, defined as a natural termination of a pregnancy before 20 weeks’ gestation, occurs in almost 30% of known pregnancies and an estimated 50% of all conceptions. Causes include genetic, environmental, endocrine, and immunologic factors; anatomic abnormalities; antiphospholipid syndrome; and polycystic ovary syndrome.  This review contains 6 figures, 7 tables, and 42 references. Keywords: Ectopic pregnancy, miscarriage, spontaneous abortion, early pregnancy loss, vaginal spotting