Question
All are risk factors for ectopic pregnancy except ‑
| A. | Past history |
| B. |
Tubal ligation failure |
| C. |
IVF |
| D. |
LNG IUCD |
|
Correct Answer » D Explanation |
 |
Ectopic Pregnancy
Definition: Implantation outside uterus (most commonly tubal ampulla).
Risk factors: Previous ectopic (strongest), PID, tubal surgery, IVF, sterilization failure, smoking.
Presentation: Amenorrhea + abdominal pain + vaginal bleeding.
Diagnosis:
Positive β-hCG + empty uterus on TVS.
β-hCG fails to double in 48 hrs.
Management:
-
Stable → Methotrexate
-
Unstable/ruptured → Emergency surgery
Most dangerous complication: Tubal rupture → shock.
A. Past history of ectopic pregnancy
-
Strongest risk factor
-
Damaged fallopian tubes increase recurrence risk
B. Tubal ligation failure
-
If pregnancy occurs after sterilization, it is more likely to be ectopic
-
Due to altered tubal anatomy
C. IVF
-
Increased risk of ectopic and heterotopic pregnancy
-
Embryo may implant in tube instead of uterus
Reason Why D is NOT a Risk Factor
LNG-IUCD:
-
Prevents fertilization and implantation
-
Overall reduces the absolute risk of ectopic pregnancy
Important concept:
-
If pregnancy occurs with IUCD in situ, it has a higher proportion of ectopic pregnancy.
-
However, IUCD itself is not a risk factor because it significantly reduces overall pregnancy rates.
