Which of the following is a risk factor for ectopic pregnancy?

• A. Prior ectopic pregnancy
• B. Tubal ligation
• C. Pelvic inflammatory disease
• D. All of the above

Answer: (D)

Risk factors for ectopic pregnancy come from conditions that damage the fallopian tubes or disrupt normal embryo transport. A prior ectopic pregnancy indicates existing tubal damage, which stays a risk for recurrence. Tubal ligation can still allow conception, but when it occurs the implantation is more likely to be tubal because the normal uterine pathway is altered, making ectopic implantation more probable. Pelvic inflammatory disease causes scarring and adhesions in the tubes, hindering the fertilized egg’s passage to the uterus and increasing the chance of implantation outside the uterus. Since each of these factors independently raises the risk, all of the above are risk factors for ectopic pregnancy.