Ectopic Implantation Research

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Tubal pregnancy historic.jpg

Introduction

Tubal Pregnancy

Ectopic pregnancy is 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])

Our research group has established a uterine tube Biobank in order to investigate factors and markers associated with ectopic pregnancies. This page introduces the project and provides some introductory information for students who may wish to carry out an Honours, Independent Research Project or higher degree in the research laboratory.


Links: Implantation | Week 2 | Placenta - Abnormalities | Trophoblast | Trophoblast Protein Expression

Some Recent Findings

Abnormal implantation sites
  • Comparison of double- and single-dose methotrexate protocols for treatment of ectopic pregnancy (EP)[2]

About Ectopic Pregnancy

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[3], 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%).[4]


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


Methotrexate

(MTX, amethopterin) Drug with several different uses including the treatment of ectopic pregnancy[5] and for the induction of medical abortions. Acts as a antimetabolite and antifolate (folic acid antagonist) drug that inhibits DNA synthesis in actively dividing cells, including trophoblasts, and therefore has other medical uses include cancer and autoimmune disease treatment. Treatment success in ectopic pregnancy relates to serum β human chorionic gonadotropin (β-hCG) concentration.


Links: Medline Plus

References

  1. <pubmed>7823895</pubmed>
  2. <pubmed>22035883</pubmed>
  3. Confidential Enquiry into Maternal Deaths (CEMD) Why Mothers Die 2000–2002 PDFPDF2
  4. <pubmed>12456628</pubmed>
  5. <pubmed>8317518</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


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Cite this page: Hill, M.A. (2020, April 1) Embryology Ectopic Implantation Research. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Ectopic_Implantation_Research

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© Dr Mark Hill 2020, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G