Current knowledge of the aetiology of human tubal ectopic pregnancy

Abstract

BACKGROUND An ectopic pregnancy is a pregnancy which occurs outside of the uterine cavity, and over 98% implant in the Fallopian tube. Tubal ectopic pregnancy remains the most common cause of maternal mortality in the first trimester of pregnancy. The epidemiological risk factors for tubal ectopic pregnancy are well established and include: tubal damage as a result of surgery or infection (particularly Chlamydia trachomatis), smoking and in vitro fertilization. This review appraises the data to date researching the aetiology of tubal ectopic pregnancy. METHODS Scientific literature was searched for studies investigating the underlying aetiology of tubal ectopic pregnancy. RESULTS Existing data addressing the underlying cause of tubal ectopic pregnancy are mostly descriptive. There are currently few good animal models of tubal ectopic pregnancy. There are limited data explaining the link between risk factors and tubal implantation. CONCLUSIONS Current evidence 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. Future studies are needed that address the functional consequences of infection and smoking on Fallopian tube physiology. A greater understanding of the aetiology of tubal ectopic pregnancy is critical for the development of improved preventative measures, the advancement of diagnostic screening methods and the development of novel treatments.

Frequency of Tubal Ectopic Pregnancy and Mode of Management at Al-Thawra General Modern Hospital

“…This is similar to the study done by Romero et al [21]. Thus, the reproductive age is the risky period for having ectopic pregnancy and this correlates with the findings of Udigwee and et al [2], and Etuknwa [22]. In the study done by Manjui et al [23], it was found that incidence of ectopic pregnancy is higher among nilipara women, which conflicts with the result of our study [24].…”

“…It results in significant morbidity for the mother and inevitable loss of pregnancy [1,2,3]. Ectopic pregnancy is major cause of maternal morbidity and mortality, especially in developing countries where the majority of patients tend to present late with a ruptured form and hemodynamic compromise.…”

“…Tubal ectopic pregnancy is a common life-threatening emergency in pregnancy and the leading cause of death in the first trimester [1,2]. It results in significant morbidity for the mother, and inevitable loss of pregnancy [3].…”

Biomimetic study of rolling transport through smooth muscle contraction

“…A prominent example is the transport of oosperm from ovary to uterus through the fallopian tube during pregnancy. While it is clear that the transport of oosperm involves smooth muscle contraction [1,2], the detailed mechanism still remains elusive [1][2][3][4][5][6][7], due in part to the complexity of cellsubstrate interactions via receptor-ligand binding as well as various physical forces inside and outside of the cytoskeleton [8][9][10][11][12]. Cells are known to respond to mechanical forces exerted through surrounding fluid, adhering beads or substrates [9,[12][13][14], and they could detach, slip or roll on a substrate in response to these forces [15][16][17][18][19][20][21][22].…”

Laboratory? or Fertility? in Ectopic Pregnancy Management

“…Ektopik gebelik maternal mortalitenin %10'undan sorumludur (2). Ektopik gebelik için çeşitli risk faktörleri olmasına rağmen, etyoloji halen belirsizliğini korumaktadır (3). Gelişmiş ülkelerde ektopik gebelik insidansı yılları arasında) son yıllarda görece stabil kalmış olmasına rağmen, ektopik gebelik insidansında yaklaşık altı kat artış tesbit edilmiştir (4).…”