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Ectopic pregnancy. A recent five-year study and review of the last 50 years' literature
N C Ramirez1, W D Lawrence, K A Ginsburg
1Department of Pathology, Hutzel Hospital-Detroit Medical Center, Wayne State University School of Medicine, Michigan, USA.
Objective:
To compare the past and current clinical and pathologic factors that are responsible for ectopic pregnancy (EP).
Study Design:
We performed a retrospective chart and histopathologic specimen review of 740 cases of EP during a recent, five-year period. Products of conception, as well as 240 cases of concomitant endometrial biopsies, were examined.
Results:
The mean age at presentation, proportion of patients with a history of pelvic inflammatory disease, voluntary interruption of pregnancy (VIP), previous surgery and laterality (right side) of the tubal EP were similar to rates reported in previous studies. Ninety-four percent of the EPs were tubal, and 90% of the tubes exhibited some pathologic changes, including chronic salpingitis (49.5%) and follicular salpingitis (10%), among others. Gestational endometrial patterns were seen in 44% of cases. The corpus luteum of pregnancy was contralateral in 30% of cases in which an ovarian biopsy was performed.
Conclusion:
The factors classically associated with EP remained similar over a period of about 50 years, although the association with VIP still appears to be controversial. Endometrial curettage alone cannot be used to exclude an EP. Ovum transmigration may play a role in the genesis of EP.
