Ectopic pregnancy is one of the most representative gynecological emergencies. Almost all women who are told that they may have an ectopic pregnancy are frightened because even if she has no obvious symptoms yet, the doctor will solemnly remind her to stay in the hospital for close observation, and failure to diagnose and treat her in time may be life-threatening. …… Medical Knowledge Quick Read The formal medical term for ectopic pregnancy is The formal medical terminology for ectopic pregnancy is “ectopic” pregnancy, which refers to a fertilized egg lodging outside the body cavity of the uterus, either in the fallopian tubes, ovaries or abdominal cavity. Cervical pregnancy is also a specific type of ectopic pregnancy. The incidence of ectopic pregnancy has been on the rise in recent years and is associated with an increase in sexually transmitted infections. Among them, tubal pregnancy is the most common, accounting for approximately 95% of ectopic pregnancies. The first risk factor causing ectopic pregnancy is pelvic inflammatory disease, of which the two aspects to be alerted to are: first, the gradual increase in sexually transmitted infections, especially chlamydial infection may have unknowingly caused tubal mucositis: second, lack of awareness of contraception and repeated abortions increase the chance of pelvic infection and even periovarian inflammation. Adhesions, twisting of the fallopian tubes, narrowing of the lumen and weakened peristalsis of the wall muscles will prevent the fertilized egg from reaching the uterine cavity within the scheduled time and will only be forced to remain in the fallopian tubes. Other risk factors include history of pelvic surgery (especially tubal surgery), history of ectopic pregnancy, smoking (nicotine alters the cilia movement in the lining of the fallopian tubes), age ≥40 years, ovulation induction therapy, pregnancy with an IUD or pregnancy with progestogen-only contraceptives. There is also a condition called fertilized egg wandering, in which the egg ovulated by one ovary crosses the uterine cavity or bypasses the abdominal cavity in favor of fertilization in the opposite fallopian tube, resulting in a delay in entering the uterus. The fertilized egg growing in the fallopian tube has three outcomes: one is natural death (not the majority): the second is abortion into the abdominal cavity or conversion to abdominal pregnancy or death, but the residual fallopian tube trauma may continue to bleed: the third is protrusion of the fallopian tube causing rapid intra-abdominal hemorrhage followed by shock and death with the greatest risk of death. The symptoms of early ectopic pregnancy are very non-specific and the triad of so-called ‘menopause, abdominal pain and irregular bleeding’ is often atypical. Bleeding in ectopic pregnancy comes from the uterine cavity, not from the site of pregnancy, and is an irregular shedding of the endometrium with inadequate hormonal support. It is often the case that a so-called “period” has just occurred within a predetermined period and still turns out to be an ectopic pregnancy. The pain is often vague at the beginning and only suddenly increases around the time of rupture, which may be followed by a rapid decline in the manifestation of shock. Minimally invasive laparoscopic surgery is the preferred method, depending on the fertility requirements and tubal destruction, tubectomy or tubal ostomy (removal of the pregnancy tissue and preservation of the tube) is performed. Early ectopic pregnancies without ectopic symptoms can be treated with drugs if the pregnancy mass is small and the chorionic villi are not very active. The most commonly used drugs are methotrexate and mifepristone, which can be more than 90% effective if the indications are reasonable. In fact, the most common situation is the “sub-critical” condition between the above two, where the lesion in the abdominal cavity is relatively stable, allowing doctors to improve various tests and patients and families to prepare accordingly, but it is a “time bomb” after all, and early surgery is the best The best way out is to operate as soon as possible. A pregnancy with abnormal bleeding and abdominal pain is always suspicious. Just because you have had vaginal bleeding for an expected period of time does not mean that pregnancy will not occur. If the doctor draws non-clotting blood from your body through the top of the vagina or the abdominal wall, it usually means that emergency surgery is needed. In times of crisis, life is the most important thing. If the receiving hospital is not equipped for laparoscopy, open surgery is worthwhile and should never be risked for referral. Medication has a narrower indication and should not be reluctantly done, otherwise the likelihood of conversion to surgery is greater. After either surgery or pharmacological treatment, please follow up regularly as prescribed by your doctor, as there is still a risk of persistent ectopic pregnancy. After an ectopic pregnancy, do not wait too long until the next pregnancy, during which time the use of IUDs or progestogen-only contraceptives is not recommended. In new pregnancies after an ectopic pregnancy, be alert to the possibility of repeat ectopic pregnancy and it is advisable to have an ultrasound examination at 6-7 weeks of menopause to clarify whether the pregnancy is intrauterine.