Non tubal ectopic pregnancy
Purpose11 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.MethodsLiterature regarding cornual, ovarian, abdominal, interstitial, cervical and Caesarean scar ectopic pregnancy was reviewed using EMBASE and Medline databases.ResultsNon 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.ConclusionsNon 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.
Archives of Gynecology and Obstetrics