Causes of ectopic pregnancy

Ectopic pregnancy means that under normal circumstances, the fertilized egg will migrate from the fallopian tube to the uterine cavity, then settle down and slowly develop into a fetus. However, due to various reasons, the fertilized egg goes wrong during the migration process and does not reach the uterus, but stays somewhere else, which becomes an ectopic pregnancy, also known as ectopic pregnancy in medical terms.

What causes ectopic pregnancy?

Tubal pregnancy is one of the common acute abdominal diseases in obstetrics and gynecology. When tubal pregnancy aborts or ruptures acutely, it can cause severe bleeding in the abdominal cavity. If it is not diagnosed in time and rescued actively, it can be life-threatening. More than 90% of ectopic pregnancies occur in the fallopian tube. Such fertilized eggs not only cannot develop into normal fetuses, but also cause danger like a time bomb.

The most common site of tubal pregnancy is the ampulla, accounting for about 55-60%; the second is the isthmus, accounting for 20-25%; the third is the fimbria, accounting for 17%; the interstitial pregnancy is the least common, accounting for only 2-4%.

(A) Chronic salpingitis

Chronic salpingitis can cause adhesions in the fallopian tube mucosal folds, leading to stenosis of the tubal lumen, mucosal destruction, loss of epithelial cilia, adhesions around the fallopian tube, and distortion of the tube shape. The above conditions affect the normal operation and passage of the fertilized egg in the fallopian tube and are the main cause of tubal pregnancy.

(ii) Abnormal fallopian tube development or function Abnormal fallopian tube development such as excessively long fallopian tubes, hypoplastic myometrium, absence of mucociliary tissue, double fallopian tubes, and extra fimbria can all be the cause of tubal pregnancy.

The physiological functions of the fallopian tube are complex. The peristalsis of the fallopian tube wall, ciliary activity and secretion of epithelial cells are all regulated by estrogen and progesterone. If the balance between the two hormones is disturbed, it will affect the transportation of the fertilized egg and cause fallopian tube pregnancy.

(III) Tubal sterilization after fallopian tube surgery, whether by ligation, electrocoagulation or cuffing, may lead to tubal pregnancy if a fallopian tube fistula is formed or recanalized. Recanalization or tuboplasty after tubal sterilization may also cause scarring and narrowing of the lumen, resulting in poor patency.

(IV) Pelvic Endometriosis Tubal pregnancy caused by endometriosis is mainly due to mechanical factors. In addition, the ectopic endometrium in the pelvic cavity may have a chemotactic effect on the fertilized egg, prompting it to implant outside the uterine cavity.

When does an ectopic pregnancy rupture?

After an ectopic pregnancy ruptures, the patient will feel severe abdominal pain and massive internal bleeding, and will experience shock symptoms such as pale complexion, rapid pulse, and decreased blood pressure. Generally, an ectopic pregnancy ruptures around the 6th to 8th week after pregnancy. An ectopic pregnancy rupture can penetrate the fallopian tube wall or miscarry from the fallopian tube fimbria into the abdominal cavity, threatening the life of the pregnant woman.

If a woman experiences severe abdominal pain, heavy bleeding, etc. after becoming pregnant, she should consider the possibility of ectopic pregnancy rupture and must receive timely symptomatic treatment to avoid any danger.

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