Follow-up care and future pregnancy outcome
There is undoubtedly a psychological and emotional impact associated with EP, both with implications for the current pregnancy and for future pregnancies.
The woman and her partner should be offered testing and treatment for Chlamydia infection.
Successful treatment may limit further tubal damage, although this may be less relevant in women undergoing IVF-ET where Chlamydia screening and clearance is part of the workup for IVF. Similarly, women treated for EP who do not wish to conceive immediately may opt to start or switch their contraception, which will reduce the risk of recurrence.For women with EP as their first pregnancy, their risk of repeat EP is around 10% regardless of the mode of treatment (7). An early ultrasound scan in the subsequent pregnancy around 6 weeks’ gestation can help identified an EP prior to the development of symptoms, or provide reassurance about the intrauterine location of the current pregnancy. Sadly, women with a previous EP have a higher rate of miscarriage in subsequent pregnancies. This is thought to be because of overlapping and persistent risk factors for EP, miscarriage, and subfertility. If the pregnancy progresses beyond the first trimester, the reproductive outcomes are similar to women without a history of EP (7).