Risk Factors for Ectopic Pregnancy

Any sexually active woman of child-bearing age is at risk, with as many as 1 in 80 pregnancies being affected, but the presence of the following are risk factors for developing ectopic pregnancy:

  • Aged between 25 and 34 years old
  • History of pelvic inflammatory disease, such as chlamydia
  • Endometriosis
  • Previous abdominal surgery, such as removal of the appendix
  • IntraUterine Contraceptive Device (IUCD) (coil)
  • Taking the progesterone-only contraceptive pill (mini pill)
  • IVF treatment
  • Previous ectopic pregnancy
  • Smoking

Risk factors for ectopic pregnancy: Chlamydia

Chlamydia is a common cause of pelvic infection (PID, pelvic sepsis, salpingitis), which can be spread by unprotected intercourse. It is a major public health concern because it can damage the fallopian tubes causing infertility and is a risk factor for ectopic pregnancy. Indeed chlamydia pelvic inflammatory disease (PID) is believed to be an important risk factor for ectopic pregnancy. The bacteria lives in the cells of the cervix (neck of the womb), the urethra (urine tube) and the rectum. About half of men are infected and do not have symptoms or very mild symptoms that they may not notice. More than two thirds of women may likewise be asymptomatic.

Infection in women can spread from the cervix to the womb, fallopian tube and into the abdomen. The presenting symptoms are usually lower abdominal pains, abnormal or heavy periods, painful sexual intercourse, change in vaginal discharge or painful urination. It may also predispose women to pelvic sepsis, tubal abscesses, and abdominal adhesions.

Men may have a penile discharge, which may be cloudy or clear. They may also experience pain on passing urine. Testicular involvement may cause pain. Infected body fluids in contact with the eyes may cause conjunctivitis. The eyes may be painful, swollen, reddened and have a discharge. Other areas of the body to be involved are the rectum and throat but that is uncommon.

If you think you or your partner may be exposed to chlamydia infection, you may wish to have it investigated as a matter of urgency. In England there are local sexual health clinics that offer a free service. They may test you for other sexually transmitted diseases. The treatment is antibiotics.

How is Chlamydia tested?

Testing for Chlamydia involves taking swabs from the cervix, urethra, throat or rectum. The swab will collect cells from these areas and sent to a laboratory. The results can take 7 to 10 days. Other ways of testing are available which can give you a result quicker. These are available for purchase commercially. They usually require you to provide a urine sample. It is important that both you and your partner are tested. If not then re-infection may occur.

The laboratory test is about 90% accurate and in a small number of cases the test can be negative when you do have an infection.

If your test comes back as positive then treatment will be needed. It is unlikely Chlamydia will go away is left untreated. Although you are not obliged to tell your partner it is advisable you do so. Interaction with your doctor will be confidential.

The more commonly used drugs are doxycycline, erythromycin and azithromycin. You should not have sexual contact for one week after treatment has started. If you do have sexual contact you must use a condom.

If you are pregnant and has been diagnosed with Chlamydia you should be treated. Although your baby will be protected in the womb infection can occur if the baby comes in contact with the birth passage. Chlamydia infection in babies does not cause abnormalities but can cause conjunctivitis or sticky eyes in the first few days of life. Your doctor will tell you what treatment is fine in pregnancy.

Read more about Chlamydia and ectopic pregnancy.