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Amy J. Voedisch Carrie E. Frederick Antonia F. Nicosia Thomas G. Stovall
Spontaneous pregnancy loss is common, occurring in up to 20% of recognized conceptions.
Following an ectopic pregnancy, approximately 15% of women will have a subsequent ectopic pregnancy.
Single-dose methotrexate appears to be the treatment of choice if medical therapy is indicated and selected.
Surgical management and medical therapy appear to be equivalent in a randomized comparison.
An abnormal gestation can be either intrauterine or extrauterine. Extrauterine or ectopic pregnancy occurs when the fertilized ovum becomes implanted in tissue other than the endometrium. Although 70% of ectopic gestations are located in the ampullary segment of the fallopian tube, such pregnancies may also occur in other sites (Fig. 20.1) (1). Abnormal intrauterine pregnancy often results in pregnancy loss early in gestation. Such losses can be related to a number of factors such as age, previous pregnancy loss, and maternal smoking (Table 20.1). With both abnormal intrauterine and extrauterine gestation, early recognition is key to diagnosis and management.