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Non-tubal ectopic pregnancy

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Abstract

Purpose

11 per 1000 pregnancies are ectopic (NICE Guidelines, 2012) with 95 % of ectopic pregnancies being tubal in origin, and 80 % of these occurring within the ampulla (The Ectopic Pregnancy Trust). 5% therefore are non-tubal. In this review we aim to collate literature relevant to non-tubal ectopic pregnancy.

Methods

Literature regarding cornual, ovarian, abdominal, interstitial, cervical and Caesarean scar ectopic pregnancy was reviewed using EMBASE and Medline databases.

Results

Non-tubal ectopic pregnancies are often overlooked, diagnosed late and are associated with higher maternal morbidity and mortality. Ultrasound remains the mainstay of diagnosis in corroboration with clinical features. Management may include medical treatment with methotrexate, surgery or expectancy. There is also an increasing interest in the use of minimally invasive radiological approaches.

Conclusions

Non-tubal ectopic pregnancy is a rare but potentially life-threatening and often misdiagnosed condition. This is particularly pertinent for Caesarean scar ectopic pregnancies, the prevalence of which is increasing due to the rising proportion of women having Caesarean sections (Litwicka and Greco, 2011). Practitioners should be aware of non-tubal pregnancies to aid more efficient diagnosis, optimise management and increase patient safety.

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Acknowledgments

Figure 1 utilised with permission from The Ectopic Pregnancy Trust who have image copyright.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Barnsley Hospital NHS Foundation Trust, Gawber Road, Barnsley, South Yorkshire, S75 2EP, UK

    Victoria Louise Parker & M. Srinivas

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  1. Victoria Louise Parker
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  2. M. Srinivas
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Correspondence to Victoria Louise Parker.

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The authors declare that they have no conflict of interest.

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Parker, V.L., Srinivas, M. Non-tubal ectopic pregnancy. Arch Gynecol Obstet 294, 19–27 (2016). https://doi.org/10.1007/s00404-016-4069-y

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