The term used when a fetus is implanted outside the uterus, most commonly in the FALLOPIAN TUBE. Occasionally it may occur in an OVARY and rarely in the CERVIX or the abdominal cavity. Around one in 200 pregnant women have an ectopic gestation, often due to previous PELVIC INFLAMMATORY DISEASE (PID) including CHLAMYDIA. The first symptoms usually appear during the first two months of pregnancy, perhaps before the woman realises she is pregnant. Severe lower abdominal pain and vaginal bleeding are common presenting symptoms.

As pregnancy proceeds, surrounding tissues may be damaged and, if serious bleeding happens, the woman may present as an ‘abdominal emergency’. A life-threatening condition, this needs urgent surgery. Most women recover satisfactorily and can have further pregnancies despite the removal of one Fallopian tube as a result of the ectopic gestation. Ultrasound can be used to diagnose the condition and laparoscopy can be used to remove the products of conception. (See PREGNANCY AND LABOUR.)