Location of ectopic pregnancy

Ultrasound

75-80%
10-15%
5%
2-4%
 
 
0.5%
 
rare
rare

 

 

very rare

Ampullary portion of tube.
Isthmic or interstitial portion of tube.
Fimbrial end of tube.
Interstitial end of fallopian tube.
 
 
Ovarian in origin.
 
Abdominal ectopic (almost always
occurs in patients with previous
aborted or ruptured tubal pregnancy).
Cervical ectopic.

Ectopic pregnancy in a cesarean section scar

(4)

EP close to ovary
EP close to uterus
EP close to ovary
EP close to uterus +
extension of myometrium
to its border/periphery
EP has surrounding
ovarian tissue

 

 

 

 

Gestational sac in the anterior

part of the isthmic portion of the

uterus

1 – Ovarian ectopic

2 -  Fimbrial end of tube

3 – Ampullary ectopic

4 – Ectopic implantation in proximal or mid portion of the tube.

5 – Abdominal ectopic

6 – Interstitial ectopic

7 – Implantation at internal cervical os

8 – Cervical ectopic

 

 

* Decidual reaction at the site of implantation is uncommon.
* Products of conception may grow on the mucosal or serosal surface of the fallopian tube or in a mixed position.
* Distortion and expansion of fallopian tube is caused by bleeding into the wall and lumen rather than from the products of conception.
 

 

 

REFERENCES
  1. Breen JL. A 21 year survey of 654 ectopic pregnancies. Am J Obstet Gynecol 1970;106:1004-1019.
  2. Senterman M, Jiboth R, Tulandi T. Histopathologic study of ampullary and isthmic tubal ectopic pregnancy. Am J Obstet Gynecol 1988;159;939-941.
  3. Atri M, Leduc C, Gillet P et.al. Role of endovaginal sonography in the diagnosis and management of ectopic pregnancy. Radiographics 1996;16:755-774.
  4. Seow K –m, Hwang J –L, Tsai Y –l. Ultrasound diagnosis of a pregnancy in a Cesarean section scar. Ultrasound Obstet Gynecol 2001’18:547-549,