Abnormal Development - Ectopic Implantation: Difference between revisions
mNo edit summary |
mNo edit summary |
||
Line 156: | Line 156: | ||
==Ectopic Molar Pregnancy== | ==Ectopic Molar Pregnancy== | ||
[[File:Ectopic molar pregnancy 01.jpg]] | [[File:Ectopic molar pregnancy 01.jpg|400px]] | ||
Left-sided unruptured ampullary ectopic pregnancy at laparoscopy.<ref><pubmed>22655097</pubmed></ref> | Left-sided unruptured ampullary ectopic pregnancy at laparoscopy.<ref><pubmed>22655097</pubmed></ref> | ||
:'''Links:''' [[Abnormal_Development_-_Hydatidiform_Mole|Hydatidiform Mole]] | |||
==International Classification of Diseases== | ==International Classification of Diseases== | ||
The International Classification of Diseases (ICD) World Health Organization's classification used worldwide as the standard diagnostic tool for epidemiology, health management and clinical purposes. | The International Classification of Diseases (ICD) World Health Organization's classification used worldwide as the standard diagnostic tool for epidemiology, health management and clinical purposes. |
Revision as of 13:02, 19 March 2014
Embryology - 14 Jun 2024 Expand to Translate |
---|
Google Translate - select your language from the list shown below (this will open a new external page) |
العربية | català | 中文 | 中國傳統的 | français | Deutsche | עִברִית | हिंदी | bahasa Indonesia | italiano | 日本語 | 한국어 | မြန်မာ | Pilipino | Polskie | português | ਪੰਜਾਬੀ ਦੇ | Română | русский | Español | Swahili | Svensk | ไทย | Türkçe | اردو | ייִדיש | Tiếng Việt These external translations are automated and may not be accurate. (More? About Translations) |
Introduction
Human development during week 2 is about implantation and the endocrine signaling to block the normal menstrual cycle. The blastocyst implantation process should normally and does occur within the body of the uterus. There are a number of additional abnormal sites of implantation that are outside the uterine body, these are described as ectopic implantation or ectopic pregnancy (Greek, ektopos = "out of place").
The most common form of human ectopic pregnancy is when implantation occurs within the uterine tube, described as a tubal pregnancy. Note that the endocrine signals blocking the menstrual cycle and indicating a pregnancy will still be released following this ectopic implantation. Ectopic pregnancies are therefore often identified by early ultrasound scans.
Ectopic pregnancy is also a high-risk maternal medical condition with an approximate incidence of 1.5 to 2 % in reported pregnancies. There is some indication that the incidence may be increasing (United States has increased from 4.5 per 1,000 pregnancies in 1970 to an estimated 19.7 per 1,000 pregnancies in 1992[1])
The risk factors for tubal ectopic pregnancy include: tubal damage by infection (particularly Chlamydia trachomatis) or surgery, smoking and in vitro fertilization therapy. Prolonged tubal damage is often described as pelvic inflammatory disease and "scarring" can affect the cilia-mediated transport of the blastocyst during the first week of development.
This is also the most common cause of pregnancy-related deaths in the first trimester. A recent United Kingdom enquiry into maternal deaths[2], identified ectopic pregnancy as the fourth most common cause of maternal death (73% of early pregnancy deaths).
Ectopic sites are named according to the anatomical location: Tubal (Ampullary, Isthmic, Cornual), Cervical and Ovarian. A study of 1800 surgically treated ectopics between 1992 and 2001 identified implantation sites by frequency: interstitial (2.4%), isthmic (12.0%), ampullary (70.0%), fimbrial (11.1%), ovarian (3.2%) or abdominal (1.3%).[3]
- International Classification of Diseases: Chapter XV Pregnancy Childbirth - O00 Ectopic pregnancy | O01 Hydatidiform mole
- Links: Implantation | Week 2 | Placenta - Abnormalities | Ultrasound - Ectopic Pregnancy | Ultrasound | Historic 1920 Paper
Some Recent Findings
|
More recent papers |
---|
This table allows an automated computer search of the external PubMed database using the listed "Search term" text link.
More? References | Discussion Page | Journal Searches | 2019 References | 2020 References Search term: Ectopic Pregnancy <pubmed limit=5>Ectopic Pregnancy</pubmed> |
Ultrasound Ectopic Implantation
Ultrasound images of ectopic tubal pregnancy from movie.
- Links: Quicktime | Quicktime version | Flash version | Ectopic Implantation | Ultrasound
Computed Tomography Ectopic Implantation
Computed Tomography imaging findings of a 37-year-old woman with interstitial pregnancy.[7] Showing initial CT detection and a subsequent scan following rupture causing a hematoma around uterus and a massive hemoperitoneum.
Initial CT - gestational sac |
Follow-up CT - massive hemoperitoneum |
CT - hematoma around uterus |
- Links: Computed Tomography
Magnetic Resonance Imaging Abdominal Ectopic Implantation
2W SPAIR sagittal MRI of lower abdomen demonstrating the placental invasion.[8]
|
See also Heterotopic Pregnancy
Statistics
Ectopic Pregnancies- United-States 1970-1992[9]
Ectopic Pregnancy Histology
CDC Image by Dr. Edwin P. Ewing, Jr., 1972
Ed Uthman Image (pathologist in Houston, Texas) section of ectopic (tubal) pregnancy about Carnegie stage 7 in Week 3.
Image version links: ExtraLarge 1712x1206px | Large 1024x721px | Medium 500x352px
Ed Uthman Image (pathologist in Houston, Texas) image of of ectopic (tubal) pregnancy about Carnegie stage 15 in Week 5.
Image version links: ExtraLarge 1874 x 2000px | Large 959 x 1024px | Medium 468 x 500px
Tubal Ectopic Pregnancy
Chlamydia infections (Chlamydia trachomatis) are the most common bacterial sexually transmitted infection, often undiagnosed and asymptomatic. The infections can ascend the female genital tract, colonizing the endometrial mucosa, then the uterine tubes. This type of infection is described as pelvic inflammatory disease (PID). |
Interstitial Pregnancy
(cornual pregnancy) A less common type 2 to 4% of ectopic pregnancies. The gestation develops in the uterine portion of the fallopian tube lateral to the round ligament. |
Ovarian Ectopic Pregnancy
Clinical operative photograph at the beginning of the procedure of the laparoscopic treatment of the ovarian pregnancy.
|
Ovarian Ectopic Pregnancy[11] |
Cervical Ectopic Pregnancy
This form of ectopic pregnancy is a rare high-risk condition and represents less than 1% of all ectopic pregnancies. The reported incidence varies between 1:1,000 to 1:18,000.
Rudimentary Horn Pregnancy
A rare types of ectopic pregnancy (about 1 in 76,000 pregnancies) in most cases the horn is non-communicating. Therefore fertilisation probably occurs by transperitoneal migration. This form untreated can also lead to uterine rupture.
Caesarean Scar Pregnancy
A rare types of ectopic pregnancy (about 1 in 2000 pregnancies), but probably increasing as caesarean rates rise. The gestation is completely surrounded by both myometrium and fibrous tissue of the caesarean section scar and separated from the endometrial cavity and endocervical canal.
Heterotopic Pregnancy
(Greek, heteros = other) Clinical term for a very rare pregnancy of two or more embryos, consisting of both a uterine cavity embryo implantation and an ectopic implantation. The ectopic implantation usually identified by prenatal scanning as occurring within the uterine tube (tubal pregnancy) though has also been identified as abdominal pregnancies.[13][14]
Ectopic Molar Pregnancy
Left-sided unruptured ampullary ectopic pregnancy at laparoscopy.[15]
- Links: Hydatidiform Mole
International Classification of Diseases
The International Classification of Diseases (ICD) World Health Organization's classification used worldwide as the standard diagnostic tool for epidemiology, health management and clinical purposes.
The two main codes cover O00 Ectopic pregnancy and O01 Hydatidiform mole.
Note that there is an additional code covering complications of the clinical treatment O08 Complications following abortion and ectopic and molar pregnancy This code is provided primarily for morbidity coding. For use of this category reference should be made to the morbidity coding rules and guidelines in Volume 2.
- Links: O00 Ectopic pregnancy | O01 Hydatidiform mole | Chapter XV Pregnancy Childbirth | International Classification of Diseases
References
- ↑ <pubmed>7823895</pubmed>
- ↑ Confidential Enquiry into Maternal Deaths (CEMD) Why Mothers Die 2000–2002 PDFPDF2
- ↑ <pubmed>12456628</pubmed>
- ↑ <pubmed>22035883</pubmed>
- ↑ <pubmed>21748311</pubmed>
- ↑ <pubmed>20023297</pubmed>
- ↑ <pubmed>20046504</pubmed>| PMC2799642 | Korean J Radiol.
- ↑ <pubmed>19918376</pubmed>| Cases J.
- ↑ <pubmed>7823895</pubmed>
- ↑ <pubmed>20725587</pubmed>| German Medical Science
- ↑ <pubmed>23198195</pubmed>| Case Rep Obstet Gynecol.
- ↑ <pubmed>22110520</pubmed>| PMC3205779
- ↑ 13.0 13.1 <pubmed>23259128</pubmed>| Case Rep Radiol.
- ↑ <pubmed>23234516</pubmed>| N Engl J Med.
- ↑ <pubmed>22655097</pubmed>
Reviews
<pubmed>20071358</pubmed> <pubmed>20023297</pubmed> <pubmed>16595714</pubmed>
Articles
<pubmed>7194809</pubmed> <pubmed>19978839</pubmed>
Search Pubmed
June 2010
- "ectopic pregnancy" All (14958) Review (1350) Free Full Text (1196)
- "tubal pregnancy" All (8010) Review (683) Free Full Text (630)
Search Pubmed: ectopic pregnancy | ectopic implantation | tubal pregnancy | tubal implantation
Glossary Links
- Glossary: A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | Numbers | Symbols | Term Link
Cite this page: Hill, M.A. (2024, June 14) Embryology Abnormal Development - Ectopic Implantation. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Abnormal_Development_-_Ectopic_Implantation
- © Dr Mark Hill 2024, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G