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概述异位妊娠（ectopic pregnancy）是指受精卵在子宫体腔以外的任何部位着床，俗称宫外孕。
根据受精卵再子宫体腔外种植部位的不同可以分为：输卵管妊娠（tubal pregnancy）、卵巢妊娠（ovarian pregnancy）、腹腔妊娠（abdominal pregnancy）、阔韧带妊娠（broad ligament pregnancy）、宫颈妊娠（cervical pregnancy）。
其中以输卵管妊娠最常见，约占95%以上，以壶腹部妊娠为最多，占50～70％；其次为峡部，占30～40％；伞部、间质部最少见，占1～2％。
病因一、输卵管炎症是异位妊娠的主要原因。
慢性输卵管炎，输卵管内膜因炎症粘连形成狭窄部，输卵管曲折或输卵管周围有炎症粘连，常使孕卵受阻。
输卵管炎不仅引起形态上的变化，且使输卵管内膜纤毛常有缺损，输卵管蠕动能力降低，影响孕卵移行。
二、输卵管发育不良或畸形、功能不良输卵管发育不良者，其壁之肌纤维发育差或缺乏，内膜纤毛缺乏，其外形较正常输卵管细薄，并弯曲呈螺旋状，较正常为长。
发育畸形者有多孔、憩室、双输卵管口或另有一发育不全的输卵管，为副输卵管。
输卵管功能包括蠕动、纤毛活动、上皮细胞的分泌等受雌、孕激素的调节，若调解失败，可影响受精卵俄的正常运行。
此外，精神因素引起输卵管痉挛和蠕动异常，干扰受精卵运送。
三、输卵管的子宫内膜异位症子宫内膜组织可侵入输卵管间质部，使间质部增厚，管腔狭窄或阻塞为输卵管妊娠原因之一。
有人提出，异位于输卵管、卵巢、盆腔的子宫内膜，对受精卵可能有某些趋化作用，诱发受精卵在宫腔以外的位置着床。
四、盆腔内肿瘤子宫肌瘤或卵巢肿瘤压迫输卵管，可使输卵管变细变长，迂回曲折，阻碍孕卵通过。
五、节育措施与异位妊娠宫内节育器是否会引起异位妊娠，是一个人们关注和争议的问题。
1965年李普首先报告了IUD使用者，有较高的异位妊娠。
多数学者认为惰性或活性IUD能有效的防止宫内妊娠，部分防止输卵管妊娠，而不能防止卵巢妊娠。
Ectopic pregnancy 异位妊娠【DEFINITION:】In a normal pregnancy, the fertilized egg enters the uterus 子宫and settles into the uterine lining 子宫内膜where it has plenty of room to divide and grow.however,under some abnormal circumstances, the embryo ['ɛmbrɪo] implants outside the uterine cavity, so that an ectopic pregnancy ,or eccysis,happens.【LOCATION:】Most ectopic pregnancies occur in the Fallopian tube [fə'ləupiən]输卵管. but implantation can also occur in the cervix 子宫颈，ovary 卵巢and abdomen 腹腔.Tips：in most cases, ectopic pregnancies are dangerous for the mother, since internal haemorrhage内出血is a life-threatening complication. so an ectopic pregnancy is a potential medical emergency, and, if not treated properly, can lead to death.【SIGNS AND SYMPTOMS:】（Early symptoms are either absent or subtle）--Pain in the lower abdomen, and inflammation (pain may be confused with a strong stomach pain, it may also feel like a strong cramp 痉挛，绞痛).--Pain while urinating 排尿--Pain and discomfort, usually mild.--Vaginal bleeding 阴道出血[və'dʒaɪnl], usually mild.This is due to the falling progesterone 黄体酮[pro'dʒɛstə'ron] levels.--Internal bleeding (hematoperitoneum 腹腔积血[,peritəu'ni:əm]) is due to hemorrhage from the affected tube.【CAUTION：】Ectopic pregnancy can mimic 酷似，呈现...症状symptoms of other diseases such as appendicitis, other gastrointestinal disorder, problems of the urinary system, as well as pelvic inflammatory disease and other gynaecologic [,ɡainikə'lɔdʒik]妇科的problems.If doctors misdiagnose it ,the rupture of the Fallopian tube with internal haemorrhage may lead to hypovolaemic shock失血性休克，even death.【DIGNOSIS:】①An ectopic pregnancy should be considered in any woman with abdominal pain or vaginal bleeding who has a positive pregnancy test. An ultrasound 超声诊断showing a gestational sac 孕囊[dʒe'steiʃənəl] with fetal 胎儿的['fitl] heart in the fallopian tube is clear evidence of ectopic pregnancy.②A laparoscopy 腹腔镜检查or laparotomy can also be performed to visually confirm an ectopic pregnancy. Often if a tubal abortion or tubal rupture has occurred, it is difficult to find the pregnancy tissue. A laparoscopy in very early ectopic pregnancy rarely shows a normal looking fallopian tube.③Culdocentesis后穹窿穿刺[,kʌldəusen'ti:sis], in which fluid is retrieved from the space separating the vagina阴道[və'dʒaɪnə] and rectum, is a less commonly performed test that may be used to look for internal bleeding. In this test, a needle is inserted into the space at the very top of the vagina, behind the uterus 子宫['jutərəs] and in front of the rectum直肠. Any blood or fluid found may have been derived from a ruptured ectopic pregnancy.【TREATMENT:】--medical :Early treatment of an ectopic pregnancy with methotrexate(MTX ,一种抗癌药物) is a viable 可行的alternative to surgical treatment.If administered early in the pregnancy, MTX terminates the growth of the developing embryo; this may cause an abortion, or the tissue may then be either resorbed by the woman's body or pass with a menstrual period. Contraindications 禁忌症include liver, kidney, or blood disease, as well as an ectopic mass > 3.5 cm.--surgical:If hemorrhage has already occurred, surgical intervention may be necessary.However, whether to pursue surgical intervention is an often difficult decision in a stable patient with minimal evidence of blood clot on ultrasound.。
