Ectopic pregnancy Classification and external resources
Ectopic by Reinier de Graaf
ICD-10	O00.
ICD-9	633
DiseasesDB	4089
MedlinePlus	000895
eMedicine	med/3212  emerg/478 radio/231

An ectopic pregnancy is a complication of pregnancy in which the fertilized ovum is implanted in any tissue other than the uterine wall. Most ectopic pregnancies occur in the Fallopian tube (so-called tubal pregnancies), but implantation can also occur in the cervix, ovaries, and abdomen. The fetus produces enzymes that allow it to implant in varied types of tissues, and thus an embryo implanted elsewhere than the uterus can cause great tissue damage in its efforts to reach a sufficient supply of blood. Ectopic by R. de Graaf This image is in the public domain because its copyright has expired in the United States and those countries with a copyright term of life of the author plus 100 years. ... Regnier de Graaf (b. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // O00-O99 - Pregnancy, childbirth and the puerperium (O00-O08) Pregnancy with abortive outcome (O00) Ectopic pregnancy (O01) Hydatidiform mole (O02) Other abnormal products of conception (O03) Spontaneous abortion (O04) Medical abortion (O05) Other abortion (O06) Unspecified abortion (O07) Failed attempted abortion (O08) Complications following abortion and ectopic and molar pregnancy... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Complications of pregnancy are the symptoms and problems that are associated with pregnancy. ... This article is about fertilisation in animals and plants. ... A human ovum Sperm cells attempting to fertilize an ovum An ovum (plural ova) is a haploid female reproductive cell or gamete. ... This article is about female reproductive anatomy. ... The Fallopian tubes, also known as oviducts, uterine tubes, and salpinges (singular salpinx) are two very fine tubes leading from the ovaries of female mammals into the uterus. ... The cervix (from Latin neck) is the lower, narrow portion of the uterus where it joins with the top end of the vagina. ... // For ovary as part of plants see ovary (plants) An ovary is an egg-producing reproductive organ found in female organisms. ... The abdomen in a human and an ant. ...

Overview

Oviduct with an ectopic pregnancy (tubal pregnancy) showing a 1 month embryo

Another example of a tubal pregnancy (6 week old embryo)

In a normal pregnancy, the fertilized egg enters the uterus and settles into the uterine lining where it has plenty of room to divide and grow. About 1% of pregnancies are in an ectopic location with implantation not occurring inside of the womb, and of these 98% occur in the Fallopian tubes.^[1] Image File history File links Download high-resolution version (1874x2000, 1514 KB) This image was selected as a Featured Picture on the English language Wikipedia on 29 November 2006. ... Image File history File links Download high-resolution version (1874x2000, 1514 KB) This image was selected as a Featured Picture on the English language Wikipedia on 29 November 2006. ... Image File history File links No higher resolution available. ... Image File history File links No higher resolution available. ... This article is about human pregnancy in biological females. ... This article is about female reproductive anatomy. ... The endometrium is the uterine membrane in mammals which is thickened in preparation for fertilization, and into which a fertilized egg is implanted upon its arrival into the uterus. ...

In a typical ectopic pregnancy, the embryo does not reach the uterus, but instead adheres to the lining of the Fallopian tube. The implanted embryo burrows actively into the tubal lining. Most commonly this invades vessels and will cause bleeding. This bleeding expels the implantation out of the tubal end as a tubal abortion. Some women thinking they are having a miscarriage are actually having a tubal abortion. There is no inflammation of the tube in ectopic pregnancy. The pain is caused by prostaglandins released at the implantation site, and by free blood in the peritoneal cavity, which is a local irritant. Sometimes the bleeding might be heavy enough to threaten the health or life of the woman. Usually this degree of bleeding is due to delay in diagnosis, but sometimes, especially if the implantation is in the proximal tube (just before it enters the uterus), it may invade into the nearby Sampson artery, causing heavy bleeding earlier than usual. For other uses, see Embryo (disambiguation). ... Miscarriage or spontaneous abortion is the natural or spontaneous end of a pregnancy at a stage where the embryo or the fetus is incapable of surviving, generally defined in humans at a gestation of prior to 20 weeks. ... E1 - Alprostadil I2 - Prostacyclin A prostaglandin is any member of a group of lipid compounds that are derived enzymatically from fatty acids and have important functions in the animal body. ... This article is considered orphaned, since there are very few or no other articles that link to this one. ...

If left untreated, about half of ectopic pregnancies will resolve without treatment. These are the tubal abortions. The advent of methotrexate treatment for ectopic pregnancy has reduced the need for surgery; however, surgical intervention is still required in cases where the Fallopian tube has ruptured or is in danger of doing so. This intervention may be laparoscopic or through a larger incision, known as a laparotomy. Amethopterin redirects here. ... Laparoscopic surgery, also called keyhole surgery (when natural body openings are not used), bandaid surgery, or minimally invasive surgery (MIS), is a surgical technique. ... A laparotomy is a surgical maneuver involving an incision through the abdominal wall to gain access into the abdominal cavity. ...

Causes

The causes of ectopic pregnancy are unknown. After fertilization of the oocyte in the peritoneal cavity, the egg takes about nine days to migrate down the tube to the uterine cavity at which time it implants. Wherever the embryo finds itself at that time, it will begin to implant. An oocyte or ovocyte is a female gametocyte or germ cell involved in reproduction. ...

There are some speculative specific causes or associations. Smoking, advanced maternal age and prior tubal damage of any origin are well known risk factors for ectopic pregnancy^{[citation needed]}.

Cilial damage and tube occlusion

Hair-like cilia located on the internal surface of the Fallopian tubes carry the fertilized egg to the uterus. Damage to the cilia or blockage of the Fallopian tubes is likely to lead to an ectopic pregnancy. Women with pelvic inflammatory disease (PID) have a high occurrence of ectopic pregnancy. This results from the build-up of scar tissue in the Fallopian tubes, causing damage to cilia. If however both tubes were occluded by PID, pregnancy would not occur and this would be protective against ectopic pregnancy. Tubal surgery for damaged tubes might remove this protection and increase the risk of ectopic pregnancy. Tubal ligation can predispose to ectopic pregnancy. Seventy percent of pregnancies after tubal cautery are ectopic, while 70% of pregnancies after tubal clips are intrauterine. Reversal of tubal sterilization (Tubal reversal) carries a risk for ectopic pregnancy. This is higher if more destructive methods of tubal ligation (tubal cautery, partial removal of the tubes) have been used than less destructive methods (tubal clipping). A history of ectopic pregnancy increases the risk of future occurrences to about 10%. This risk is not reduced by removing the affected tube, even if the other tube appears normal. The best method for diagnosing this is to do an early ultrasound. cross-section of two cilia, showing 9+2 structure A cilium (plural cilia) is a fine projection from a eukaryotic cell that constantly beats in one direction. ... Pelvic inflammatory disease (or disorder) (PID) is a generic term for inflammation of the female uterus, fallopian tubes, and/or ovaries as it progresses to scar formation with adhesions to nearby tissues and organs. ... This article does not cite any references or sources. ... Tubal ligation (informally known as getting ones tubes tied) is a permanent form of female sterilization, in which the fallopian tubes are severed and sealed or pinched shut, in order to prevent fertilization. ... Tubal reversal - short for tubal sterilization reversal or tubal ligation reversal - is a surgical procedure that restores fertility to women after a tubal ligation. ...

Hysterectomy

Ectopic pregnancy occasionally occurs in women who have had a hysterectomy. Rather than implanting in the absent uterus, the embryo implants in the abdomen, and must be delivered via caesarean section.[1] ^[2] This article or section is in need of attention from an expert on the subject. ... For other uses, see Embryo (disambiguation). ... A caesarean section (AE cesarean section), or c-section, is a form of childbirth in which a surgical incision is made through a mothers abdomen (laparotomy) and uterus (hysterotomy) to deliver one or more babies. ...

Other

Patients are at higher risk for ectopic pregnancy with advancing age. Also, it has been noted that smoking is associated with ectopic risk. Vaginal douching is thought by some to increase ectopic pregnancies; this is speculative. Women exposed to diethylstilbestrol (DES) in utero (aka "DES Daughters") also have an elevated risk of ectopic pregnancy, up to 3 times the risk of unexposed women. The cigarette is the most common method of smoking tobacco. ... Diethylstilbestrol (DES) is a drug, a synthetic nonsteroidal estrogen that was first synthesized in 1938. ...

Symptoms

Early symptoms are either absent or subtle. Clinical presentation of ectopic pregnancy occurs at a mean of 7.2 weeks after the last normal menstrual period, with a range of 5 to 8 weeks. Later presentations are more common in communities deprived of modern diagnostic ability.

The early signs are:

• Pain in the lower abdomen, and inflammation (Pain may be confused with a strong stomach pain, it may also feel as a strong cramp)
• Pain while urinating
• Pain and discomfort, usually mild. A corpus luteum on the ovary in a normal pregnancy may give very similar symptoms.
• Vaginal bleeding, usually mild. An ectopic pregnancy is usually a failing pregnancy and falling levels of progesterone from the corpus luteum on the ovary cause withdrawal bleeding. This can be indistinguishable from an early miscarriage or the 'implantation bleed' of a normal early pregnancy.
• Pain while having a bowel movement

Patients with a late ectopic pregnancy typically experience pain and bleeding. This bleeding will be both vaginal and internal and has two discrete pathophysiologic mechanisms. The corpus luteum (Latin for yellow body) is a small, temporary endocrine structure in animals. ...

• External bleeding is due to the falling progesterone levels.
• Internal bleeding is due to hemorrhage from the affected tube.

The differential diagnosis at this point is between miscarriage, ectopic pregnancy, and early normal pregnancy. The presence of a positive pregnancy test virtually rules out pelvic infection as it is rare indeed to find pregnancy with an active Pelvic Inflammatory Disease (PID). The most common misdiagnosis assigned to early ectopic pregnancy is PID.

More severe internal bleeding may cause:

• Lower back, abdominal, or pelvic pain.
• Shoulder pain. This is caused by free blood tracking up the abdominal cavity, and is an ominous sign.
• There may be cramping or even tenderness on one side of the pelvis.
• The pain is of recent onset, meaning it must be differentiated from cyclical pelvic pain, and is often getting worse.

• Ectopic pregnancy can mimic symptoms of other diseases such as appendicitis, other gastrointestinal disorder, problems of the urinary system, as well as pelvic inflammatory disease and other gynaecologic problems.

Look up Back in Wiktionary, the free dictionary. ... The abdomen in a human and an ant. ... The pelvis (pl. ... Pain redirects here. ... This article is about muscular pain. ... The pelvis (pl. ... Appendicitis (or epityphlitis) is a condition characterized by inflammation of the appendix. ... Pelvic inflammatory disease (or disorder) (PID) is a generic term for inflammation of the female uterus, fallopian tubes, and/or ovaries as it progresses to scar formation with adhesions to nearby tissues and organs. ...

Diagnosis

An ectopic pregnancy has to be suspected in any woman with lower abdominal pain or unusual bleeding who is or might be sexually active and whose pregnancy test is positive. An abnormal rise in blood βhCG levels may also indicate an ectopic pregnancy. The threshold of discrimination of intrauterine pregnancy today is around 1500 IU/ml of β-human chorionic gonadotropin (βhCG). A high resolution, vaginal ultrasound scan showing no intrauterine pregnancy is presumptive evidence that an ectopic pregnancy is present if the threshold of discrimination for βhCG has been reached. An empty uterus with levels lower than 1500 IU/ml may be evidence of an ectopic pregnancy, but may also be consistent with an intrauterine pregnancy which is simply too small to be seen on ultrasound. If the diagnosis is uncertain, it may be necessary to wait a few days and repeat the blood work and ultrasound. If the βhCG falls on repeat examination, this strongly suggests an abortion or rupture. A modern pregnancy test A pregnancy test is a test to determine whether or not a woman is pregnant. ... Human female internal reproductive anatomy The vagina (from the Latin for sheath or scabbard ) is the tubular tract leading from the uterus to the exterior of the body in female mammals, or to the cloaca in female birds and some reptiles. ... For other uses, see Ultrasound (disambiguation). ... For other uses, see Ultrasound (disambiguation). ...

An ultrasound showing a gestational sac with fetal heart in the fallopian tube is clear evidence of ectopic pregnancy. For other uses, see Ultrasound (disambiguation). ... The gestational sac is the only available intrauterine structure that can be used to determine if an intrauterine pregnancy (IUP) exists, until the embryo is identified. ... The Fallopian tubes, also known as oviducts, uterine tubes, and salpinges (singular salpinx) are two very fine tubes leading from the ovaries of female mammals into the uterus. ...

Free fluid which is non-echogenic is a normal finding in the late menstrual cycle and early normal pregnancy. This is a transudate and is not presumptive evidence of bleeding. Echogenic free fluid suggests the presence of blood clot and is suggestive of free blood in the peritoneum.

A laparoscopy or laparotomy can also be performed to visually confirm an ectopic pregnancy. Often if a tubal abortion has occurred, or a tubal rupture has occurred, it is difficult to find the pregnancy tissue. A laparoscopy in very early ectopic pregnancy rarely shows a normal looking fallopian tube. Laparoscopic surgery, also called keyhole surgery (when natural body openings are not used), bandaid surgery, or minimally invasive surgery (MIS), is a surgical technique. ... A laparotomy is a surgical maneuver involving an incision through the abdominal wall to gain access into the abdominal cavity. ... The Fallopian tubes, also known as oviducts, uterine tubes, and salpinges (singular salpinx) are two very fine tubes leading from the ovaries of female mammals into the uterus. ...

A less commonly performed test, a culdocentesis, may be used to look for internal bleeding. In this test, a needle is inserted into the space at the very top of the vagina, behind the uterus and in front of the rectum. Any blood or fluid found there likely comes from a ruptured ectopic pregnancy.

Cullen's sign can indicate a ruptured ectopic pregnancy. Cullens sign is blue-black bruising of the area around the umbilicus. ...

Nontubal ectopic pregnancy

2% of ectopic pregnancies occur in the ovary, cervix, or are intraabdominal. Transvaginal ultrasound examination is usually able to detect a cervical pregnancy. An ovarian pregnancy is differentiated from a tubal pregnancy by the Spiegelberg criteria.^[3] For other uses, see Ultrasound (disambiguation). ...

While a fetus of ectopic pregnancy is typically not viable, very rarely, a live baby has been salvaged from an abdominal pregnancy. In such a situation the placenta sits on the intraabdominal organs or the peritoneum and has found sufficient blood supply. This is generally bowel or mesentery, but other sites, such as the renal (kidney), liver or hepatic (liver) artery or even aorta have been described. Support to near viability has occasionally been described, but even in third world countries, the diagnosis is most commonly made at 16 to 20 weeks gestation. Such a fetus would have to be delivered by laparotomy. Maternal morbidity and mortality from extrauterine pregnancy is high as attempts to remove the placenta from the organs to which it is attached usually lead to uncontrollable bleeding from the attachment site. If the organ to which the placenta is attached is removable, such as a section of bowel, then the placenta should be removed together with that organ. This is such a rare occurrence that true data are unavailable and reliance must be made on anecdotal reports. ^[4][5] However, the vast majority of abdominal pregnancies require intervention well before fetal viability because of the risk of hemorrhage. The placenta (Latin for cake, referencing its appearance in humans) is an ephemeral organ present in placental vertebrates, such as eutherial mammals and sharks during gestation (pregnancy). ... A laparotomy is a surgical maneuver involving an incision through the abdominal wall to gain access into the abdominal cavity. ... Look up viability in Wiktionary, the free dictionary. ...

On May 29, 2008 an Australian woman, Meera Thangarajah (age 34), who had an ectopic pregnancy in the ovary, gave birth to a healthy full term 6 pound 3 ounce (2.8 kg) baby girl, Durga, via Caesarean section, according to a manager at Darwin Private Hospital and to the obstetrician. She had no problems or complications during the 38 week pregnancy.^[6][7]

Treatment

Nonsurgical treatment

Early treatment of an ectopic pregnancy with the antimetabolite methotrexate has proven to be a viable alternative to surgical treatment^[8] since 1993^{[citation needed]} (though the literature dates back to at least 1989).^[9] If administered early in the pregnancy, methotrexate can disrupt the growth of the developing embryo causing the cessation of pregnancy. Amethopterin redirects here. ... Year 1993 (MCMXCIII) was a common year starting on Friday (link will display full 1993 Gregorian calendar). ... An abortion is the removal or expulsion of an embryo or fetus from the uterus, resulting in or caused by its death. ...

Surgical treatment

If hemorrhaging has already occurred, surgical intervention may be necessary if there is evidence of ongoing blood loss. However, as already stated, about half of ectopics result in tubal abortion and are self limiting. The option to go to surgery is thus often a difficult decision to make in an obviously stable patient with minimal evidence of blood clot on ultrasound.

Surgeons use laparoscopy or laparotomy to gain access to the pelvis and can either incise the affected Fallopian and remove only the pregnancy (salpingostomy) or remove the affected tube with the pregnancy (salpingectomy). The first successful surgery for an ectopic pregnancy was performed by Robert Lawson Tait in 1883.^[10] Laparoscopic surgery, also called keyhole surgery (when natural body openings are not used), bandaid surgery, or minimally invasive surgery (MIS), is a surgical technique. ... Salpingectomy refers to the surgical removal of a Fallopian tube. ... Lawson Tait, born Robert Lawson Tait May 1, 1845 in Edinburgh, Scotland, became a pioneer in pelvic and abdominal surgery and developped new techniques and procedures. ... Year 1883 (MDCCCLXXXIII) was a common year starting on Monday (link will display the full calendar) of the Gregorian calendar (or a common year starting on Saturday of the 12-day slower Julian calendar). ...

Chances of future pregnancy

The chance of future pregnancy depends on the status of the adnexa left behind. The chance of recurrent ectopic pregnancy is about 10% and depends on whether the affected tube was repaired (salpingostomy) or removed (salpingectomy). Successful pregnancy rates vary widely between different centries, and appear to be operator dependent. Pregnancy rates with successful methotrexate treatment compare favorably with the highest reported pregnancy rates. Often, patients may have to resort to in vitro fertilisation to achieve a successful pregnancy. The use of in vitro fertilisation does not preclude further ectopic pregnancies, but the likelihood is reduced. For the Inter-Varsity Fellowship, see Universities and Colleges Christian Fellowship. ... For the Inter-Varsity Fellowship, see Universities and Colleges Christian Fellowship. ...

Complications

The most common complication is rupture with internal bleeding that leads to shock. Death from rupture is rare in women who have access to modern medical facilities. Infertility occurs in 10 - 15% of women who have had an ectopic pregnancy.

References

1. ^ Serdar Ural (May 2004). Ectopic pregnancy. KidsHealth. Retrieved on 2006-11-26.
2. ^ SA Carson, JE Buster, Ectopic Pregnancy. New Engl J Med 329:1174-1181
3. ^ Spiegelberg's criteria at Who Named It
4. ^ "'Special' baby grew outside womb", BBC news, 2005-08-30. Retrieved on 2006-07-14. 
5. ^ ""Bowel baby born safely", BBC news, 2005-03-09. Retrieved on 2006-11-10. 
6. ^ "Baby Born After Rare Ovarian Pregnancy", Associated Press, 2008-05-30. Retrieved on 2008-05-30. 
7. ^ Cavanagh, Rebekah. "Miracle baby may be a world first", 2008-05-30. Retrieved on 2008-05-30. 
8. ^ Mahboob U, Mazhar SB (2006). "Management of ectopic pregnancy: a two-year study". Journal of Ayub Medical College, Abbottabad : JAMC 18 (4): 34–7. PMID 17591007. 
9. ^ Clark L, Raymond S, Stanger J, Jackel G (1989). "Treatment of ectopic pregnancy with intraamniotic methotrexate--a case report". The Australian & New Zealand journal of obstetrics & gynaecology 29 (1): 84–5. PMID 2562613. 
10. ^ eMedicine - Surgical Management of Ectopic Pregnancy : Article Excerpt by R Daniel Braun. Retrieved on 2007-09-17.

Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 330th day of the year (331st in leap years) in the Gregorian calendar. ... Who Named It is a Norwegian database of several thousand eponymous medical signs and the doctors associated with their identification. ... Year 2005 (MMV) was a common year starting on Saturday (link displays full calendar) of the Gregorian calendar. ... is the 242nd day of the year (243rd in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 195th day of the year (196th in leap years) in the Gregorian calendar. ... Year 2005 (MMV) was a common year starting on Saturday (link displays full calendar) of the Gregorian calendar. ... is the 68th day of the year (69th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 314th day of the year (315th in leap years) in the Gregorian calendar. ... The Associated Press, or AP, is an American news agency, the worlds largest such organization. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance with the Gregorian calendar. ... is the 150th day of the year (151st in leap years) in the Gregorian calendar. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance with the Gregorian calendar. ... is the 150th day of the year (151st in leap years) in the Gregorian calendar. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance with the Gregorian calendar. ... is the 150th day of the year (151st in leap years) in the Gregorian calendar. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance with the Gregorian calendar. ... is the 150th day of the year (151st in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 260th day of the year (261st in leap years) in the Gregorian calendar. ... This article is about human pregnancy in biological females. ... Parturition redirects here. ... Postnatal (Latin for after birth) is the period beginning immediately after the birth of a child and extending for about six weeks. ... An abortion is the removal or expulsion of an embryo or fetus from the uterus, resulting in or caused by its death. ... Miscarriage or spontaneous abortion is the natural or spontaneous end of a pregnancy at a stage where the embryo or the fetus is incapable of surviving, generally defined in humans at a gestation of prior to 20 weeks. ... Edema (BE: oedema, formerly known as dropsy) is swelling of any organ or tissue due to accumulation of excess fluid. ... Proteinuria (from protein and urine) means the presence of an excess of serum proteins in the urine. ... In medicine, hypertension refers to the problem of abnormally high blood pressure. ... Pregnancy-induced hypertension (PIH) (or gestational hypertension) is defined as the development of new arterial hypertension in a pregnant woman after 20 weeks gestation. ... Pre-eclampsia (US: preeclampsia) is a medical condition where hypertension arises in pregnancy (pregnancy-induced hypertension) in association with significant amounts of protein in the urine. ... Gestational diabetes is a form of diabetes found in pregnant women. ... Hyperemesis gravidarum (from the Latin for extreme vomiting of the pregnant woman) is a severe form of morning sickness. ... Gestational Pemphigoid or Pemphigoid Gestationis (PG) is a rare autoimmune blistering skin disease that occurs during pregnancy, typically in the second or third trimester, and/or immediately following pregnancy. ... For other uses, see Fetus (disambiguation). ... amniotic sac The amniotic sac is a tough but thin transparent pair of membranes, which hold a developing embryo (and later fetus) until shortly before birth. ... Parturition redirects here. ... Polyhydramnios (polyhydramnion, hydramnios) is the medical condition of too much amniotic fluid in the amniotic sac. ... The amniotic sac is a tough but thin transparent pair of membranes which holds a developing embryo (and later fetus) until shortly before birth. ... Chorioamnionitis is a inflammatory condition of pregnancy affecting the uterus. ... Amniotic band syndrome (ABS, also called amniotic band constriction, congenital constriction bands or rings, congential amputation, ADAM syndrome) is a congenital disorder caused by entrapment of fetal parts (usually a limb or digits) in fibrous amniotic bands while in utero. ... For the album Braxton Hicks by Jebediah see Braxton Hicks (album). ... Antepartum haemorrhage (spelled Antepartum hemorrhage in the United States) is when bleeding from the vagina occurs in pregnant women before birth; it is generally considered to be any vaginal bleeding after the 28th week. ... Placental abruption (Also known as abruptio placentae) is a complication of pregnancy, wherein the placental lining has separated from the uterus of the mother. ... Parturition redirects here. ... Parturition redirects here. ... In most systems of human pregnancy, the condition, premature birth (also known as a preterm birth), occurs when the baby is born within sooner than 36 weeks of completed gestation. ... A postmature birth occurs when a pregnancy lasts longer than 42 weeks. ... Dystocia (antonym eutocia) is an abnormal or difficult childbirth or labour. ... Dystocia (antonym eutocia) is an abnormal or difficult childbirth. ... In medicine (obstetrics), fetal distress is the presence of signs in a pregnant woman—before or during childbirth—that the fetus is not well or is becoming excessively fatigued. ... Vasa praevia (vasa previa AE) is an obstetric complication defined as fetal vessels crossing or running in close proximity to the inner cervical os. ... Uterine rupture is a potentially catastrophic event during childbirth by which the integrity of the myometrial wall is breached. ... Obstetrical hemorrhage refers to heavy bleeding during pregnancy,labor, or the puerperium. ... Placenta accreta is a severe obstetric complication involving an abnormal attachment of the placenta to the myometrium (the middle layer of the uterine wall). ... Cord prolapse, depicted by W.Smellie, 1792 Cord prolapse is an obstetric emergency during pregnancy or labour that endangers the life of the baby. ... Amniotic fluid embolism (AFE) is a rare and incompletely understood obstetric emergency in which amniotic fluid, fetal cells, hair or other debris enters the mothers blood stream via the placental bed of the uterus and triggers an allergic reaction. ... Parturition redirects here. ... Puerperal fever (from the latin puer, child), also called childbed fever or puerperal sepsis, is a serious form of septicaemia contracted by a woman during or shortly after childbirth or abortion. ... Peripartum cardiomyopathy (PPCM) is a form of dilated cardiomyopathy that is defined as a deterioration in cardiac function presenting between the last month of gestation and up to five months post-partum. ... Galactorrhea or galactorrhoea is the spontaneous flow of milk from the breast, unassociated with childbirth or nursing. ... Postpartum depression (also postnatal depression) is a form of clinical depression which can affect women, and less frequently men, after childbirth. ... For other uses, see Fetus (disambiguation). ... Fetal intervention involves in-utero medical treatment for a fetus—usually one suffering from some form of birth defect. ... Open fetal surgery is an invasive form of fetal intervention in the treatment of birth defects where the uterus is opened up for direct surgery on the fetus. ... It has been suggested that this article or section be merged with Maternal health. ...

External links

• The Ectopic Pregnancy Trust - Information and support for those who have suffered the condition by a medically overseen and moderated, UK based charity, recognised by the National Health Service (UK) Department of Health (UK) and The Royal College of Obstetricians and Gynaecologists