ABSTRACT
Ectopic pregnancy occurs when the developing blastocyst becomes implanted at a site other than the endometrial cavity. It occurs in approximately 1.5%–2% of pregnancies, and accounts for 9% of pregnancy-related mortality and less than 1% of overall mortality in women. The prevalence of ectopic pregnancy among women who present to an emergency department with first-trimester bleeding, pain, or both ranges from 6% to 16%. Significant hemorrhage resulting from ectopic pregnancy is the leading cause of maternal mortality in the first trimester and accounts for 9% of all pregnancy-related deaths in the United States. The overall incidence of ectopic pregnancy has increased during the mid-20th century, plateauing at approximately almost 20 per 1000 pregnancies in the early 1990s, the last time national data were reported by the Centers for Disease Control and Prevention. This rising incidence is strongly associated with an increased incidence of pelvic inflammatory disease and advanced reproductive technologies. This likely represents an underestimation of what is actually occurring due to underreporting of women treated in physician offices.
