Intended for healthcare professionals

Endgames onExamination Quiz

Ectopic pregnancy

BMJ 2011; 343 doi: (Published 31 August 2011) Cite this as: BMJ 2011;343:d5485

This week’s question is on predisposing factors for ectopic pregnancy and is taken from the onExamination revision questions for the MRCS Part 1 examination.

Which of the following factors does not predispose to ectopic pregnancy?

  • A Endometriosis

  • B Intrauterine contraceptive device

  • C Ovarian fibroids

  • D Pelvic inflammatory disease

  • E Progesterone only contraceptive pill


Answer C is correct.

Ectopic pregnancy is a relatively rare condition presenting typically with severe lower abdominal pain with or without vaginal bleeding. It typically occurs six weeks after the last period.

Predisposing factors include any condition that may damage the fallopian tubes, including pelvic inflammatory disease, the commonest predisposing factor. Others include:

  • Endometriosis

  • Congenital fallopian tube abnormalities

  • Previous fallopian tube surgery, and

  • Previous ectopic pregnancy

The intrauterine contraceptive device, although itself protective against pregnancy, is often implicated in ectopic pregnancy.

The progesterone only pill is also associated with an increased rate of ectopic pregnancy if the patient does become pregnant while taking this preparation.


Cite this as: BMJ 2011;343:d5485

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