Ectopic Pregnancy

In a normal pregnancy, a fertilized egg travels from the location of fertilization (the fallopian tube) to the uterus. Sometimes however, the egg grows in the wrong place, which is known as an ectopic pregnancy. Ectopic pregnancy was first documented as early as 1693 during a routine autopsy performed on a female prisoner condemned to death and executed (Speroff, pg. 947). In order to understand ectopic pregnancy one must understand the normal physiology of conception, how and why things can go wrong to cause ectopic pregnancy, how it is diagnosed, and how it is treated. Each month, with the menstrual cycle every woman goes through hormonal changes. The pituitary gland (located in the brain) releases hormones such as follicle stimulating hormone (FSH) and luteinizing hormone (LH). The FSH stimulates a follicle in the ovaries, which then grows and secretes estrogen. The estrogen levels continue increasing and lead to the thickening of the uterine lining (mucosa). The mucosa thickens and fills with blood vessels in preparation for implantation of an embryo. After the mucosa develops, a surge of LH causes ovulation, which is the release of an egg from the ovary into the fallopian tube. During sexual reproduction, the sperm of the male enters the vagina, passes through the cervix and uterus, and goes to the fallopian tube where it merges with the egg that was released in ovulation. Once the sperm has merges with the egg, the head of the sperm detaches from the tail. The tail will gradually disappear and the head is left with the egg. The head merges genetic information with the egg creating an embryo, which then begins to grow. Note that even in normal fertilization the egg is fertilized and begins growing in the fallopian tube (Pregnancy, 3/10/05). Once fertilized, the egg moves from the fallopian tube to the uterus. During this movement, which generally takes about 72 hours, secretions from the uterine lining nourish the egg. Once the egg reaches the uterus it

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