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Ectopic Pregnancy Causes:

Highest mortality in young age (may not understand well, hide it) Maternal mortality : haemorrhage, anaesthesia, infection Sexually transmitted disease ( STDS , gonnerea. Antibodiesdisease causing tubal scarring) IUDS Tubal surgery- obstruction for normal function Ovum transmigration from one overy/fallopian tube to to another Ampullary, isthemic, interstial = all tubal pregnancy Extrauterine pregnancy Heterotopic pregnancy (interstitial+ extrauterine) , use of hormonal therapy during the in-vitro procedure Severe abdominal pain with dizziness, lighheadedness, syncope Irregular vaginal bleeding, cervical tenderness, unstable vital signs not all patients have these symptioms

Risk Factors:
3 levels: slight, moderate, high Slight: early age of sexual intercourse, smoking, pelvic surjury, Moderate: more than one sexual partners, infertility, history of genital infections High: intrauterine devices, In utero exposure (?), tubal surgery/sterilization, previous ectopic pregnancy

Occur more often in non white females Poor access to health care Sexually transmitted diseases Highest mortality in young age - altered tubal anatomy, decrease/absent fimbrial tissue. Shorter tube length, diameter Reproductive technologies gamete intra fallopian thransfer (GIFT), in vitro firtilization Failed tubal ligation- utbes recannulate (15-50%)

Induced abortion - low grade infection lead to tubal scarring

Reduced tubal motility smoking- effect tubal musculature Contraception methods using progesterone- reduce motility to ciliated cells in the fallopian tube.