Expert Commentary

Indonesia Kehamilan Ektopik (Ectopic Pregnancy in Indonesia)

Valeria Syulfani, MD

The definition of an ectopic pregnancy is a failure of the developing embryo to implant in the uterine wall with implantation elsewhere. The usual site of implantation is the fallopian tube. This results in a tubal pregnancy which cannot be allowed to go to term. In very rare cases, secondary abdominal implantation following a ruptured ectopic pregnancy can occur. In a handful of cases this has been successful but generally the prognosis is poor. The consequences of an untreated tubal pregnancy can be severe for the woman and range from fallopian rupture and hemorrhaging to intense pain, hemoperitoneum, neurological symptoms, infection and death. Ectopic pregnancy remains a leading cause of death from pregnancy worldwide, especially during the first trimester. Although ectopic pregnancies may result from a variety of causes, Chlamydia infection should be considered early on after diagnosis. Although laparoscopic surgery is often the best approach to resolving an extrauterine pregnancy, methotrexate given intramuscularly has been used to treat early or unruptured ectopic pregnancies with a success rate manifested in low maternal mortality and morbidity.

References

1. Dhar, H et al (2011) Methotrexate treatment of ectopic pregnancy: experience at Nizwa Hospital, Oman Med J. 2011 Mar; 26(2):94-8.

2. Debennetot M. et al (2011) Risk factors for recurrence of ectopic pregnancy. J Gynecol Obstet Biol Reprod (Paris). 2011 Oct 19

3. Ngu, S.F. and Cheung, VY (2011) Non-tubal ectopic pregnancy. Int J Gynaecol Obstet. 2011 Dec;115(3):295-7.