In extrauterine pregnancy (EUG) – colloquially called “ectopic pregnancy* ” – (synonyms: extrauterine gravidity; ectopic gravidity; thesaurus synonyms: Abdominal gravidity; abortus ampullaris; abdominal gravidity; abdominal pregnancy; cervical extrauterine gravidity; cervical extrauterine pregnancy; cervical gravidity; cervical pregnancy extrauterine gravidity; ovarian pregnancy; tubal rupture due to pregnancy; ectopic gravidity; ectopic pregnancy; ectopic graviditas abdominalis; ectopic ruptured gravidity; ectopic ruptured pregnancy; ectopic pregnancy; extrauterine gravidity; extrauterine pregnancy in the uterine horn; extrauterine pregnancy; extrauterine pregnancy in the uterine horn; graviditas ampullaris; graviditas extrauterina; graviditas isthmica; graviditas ovarica; gravidity in the mesometrium; gravidity in the uterine horn; gravidity in the cervix uteri; Hematocele in extrauterine pregnancy; interstitial gravidity; interstitial pregnancy; intraligamentous gravidity; intraligamentous pregnancy; intramural gravidity; intramural pregnancy; intraperitoneal gravidity; intraperitoneal pregnancy; ovarian gravidity; ovarian pregnancy; peritoneal gravidity; peritoneal pregnancy; Rupture of uterine tube due to pregnancy; ruptured extrauterine pregnancy; ruptured extrauterine pregnancy; pregnancy outside the uterus; pregnancy outside the uterus; pregnancy in the mesometrium; pregnancy in the uterine horn; pregnancy in the cervix uteri; tubal abortion; tubal pregnancy; tubal mole; tubal rupture due to gravidity; tubal pregnancy; ICD-10 O00. -) is a gravidity (pregnancy) in which the nidation (implantation) of the blastocyte (embryo in the early stage of development; arises from the morula/mulberry stage on about the 4th day after fertilization) takes place outside the uterus (womb). * Because implantation (nidation; implantation) often occurs in the tubal (fallopian tube) area, the term ectopic pregnancy (tubaria; tubal pregnancy) is known in the general population. An incorrectly implanted egg is basically an acute and life-threatening disease! One can distinguish the following forms of extrauterine pregnancy according to ICD-10:
- Abdominal pregnancy (O00.0) – abdominal pregnancy (implantation of the fertilized egg in the abdominal cavity: Douglas space, omentum (abdominal mesh), intestine, liver, spleen); < 1%.
- Tubal pregnancy (O00.1) – ectopic pregnancy (implantation of the fertilized egg in the fallopian tube); most common form of EUG (approximately 98%)
- Ampullary EUG – distal area (76%).
- Isthmic EUG – proximal region (12 %)
- Interstitial/cornual/intramural EUG – transition between tube (fallopian tube) and uterus (womb) (2%).
- Ovarian gravidity (O00.2) – implantation of the fertilized egg in the ovary (0.2 to 2%).
- Other extrauterine pregnancy (O00.8).
- Extrauterine pregnancy, unspecified (O00.9).
Special form: heterotopic pregnancy refers to geminigravidity (twin pregnancy) in which there is simultaneous (synchronous) intrauterine and extrauterine gravidity (pregnancy). Note: Due to the increasing rates of sectio (cesarean section), there is a higher incidence of secondary sectio complications in subsequent pregnancies, namely so-called scar pregnancies. This is a special type of ectopic pregnancy (pregnancy in which the fertilized egg has nested outside the uterine cavity (cavum uteri)) in which implantation of the blastocyst (implantation of the vesicle stage) occurs directly in the scar area. The prevalence (disease incidence) is 0.15%. Cicatricial pregnancy necessitates termination of pregnancy. Frequency peak: The disease occurs predominantly with increasing age. In a 20-year-old, the risk of extrauterine gravidity is 0.4% and increases to 1.3-2% between the ages of 30 and 40. The prevalence (disease incidence) is 1-2% of all pregnancies, with an increasing trend (in Germany). Course and prognosis: In the early phase of tubal or abdominal pregnancy, the embryo initially develops normally, but later develops inadequately.Usually, a natural abortion (miscarriage) occurs in the first 12 weeks. Often tubal or abdominal pregnancy remains undetected. Note: In every sexually active woman of reproductive age, regardless of whether contraceptives are used, extrauterine pregnancy must be ruled out without a doubt in the case of lower abdominal pain and acyclic bleeding! It can become life-threatening if there is a rupture (lat. ruptura, rupture, rupture) of the tube (fallopian tube) and thus severe internal bleeding into the abdominal cavity (hemorrhage). Approximately 4-9% of pregnancy-related deaths are due to extrauterine pregnancies. The earlier extrauterine pregnancy is detected, the better the prognosis. Thus, with early intervention, fallopian tube-preserving surgery can be performed, which is particularly important for women with an existing desire to have children. The lethality of EUG due to acute rupture with severe internal hemorrhage is 3.8 per 10,000 pregnancies. Up to 6% of pregnancy-related mortality (number of deaths in a given period, based on the number of the population in question) is still based on the diagnosis of extrauterine pregnancy.
