[Skip to Content]

Claim CME

Pregnancy

Ectopic Pregnancy and Lifesaving Care

To identify the key insights or developments described in this article

1 Credit CME

JAMA

Published Online: June 1, 2023

JAMA Insights

Article Information and Disclosures

Kassie J. Bollig, MD¹;

Hilary Friedlander, MD²;

Danny J. Schust, MD^2,3

Author Affiliations

¹Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Pennsylvania, Philadelphia
²Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Duke University School of Medicine, Morrisville, North Carolina
³Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Duke University School of Medicine, Durham, North Carolina

Read article on JAMA Network

Read Article Claim CME

Ectopic pregnancy, defined as a pregnancy that implants outside of the endometrial cavity, accounts for approximately 2% of all reported pregnancies according to the Centers for Disease Control and Prevention.¹ In the first trimester, ectopic pregnancies are the most common cause of pregnancy-related death, accounting for 2.7% of these deaths.¹^,2 Ectopic pregnancies cannot be relocated to the endometrial cavity and thus lack potential to safely progress to birth. Given these facts, treatment of an ectopic pregnancy is incontrovertibly necessary and lifesaving care; denying or restricting such care would be both unethical and illegal.³^,4

Claim CME

Sign in to take quiz and track your certificates

Buy This Activity

Article Information

Corresponding Author: Danny J. Schust, MD, Duke University School of Medicine, 200 Trent Dr, Baker House 203, Durham, NC 27710 (danny.schust@duke.edu).

Published Online: June 1, 2023. doi:10.1001/jama.2023.7292

Conflict of Interest Disclosures: None reported.

Disclaimer: The views expressed in the article represent those of the authors and are not an official position of the institutions represented.

Additional Contributions: The authors thank Linda Graziadei, PhD, for her assistance in the editing of this article. Dr Graziadei was not compensated in association with her assistance on this article.

References

American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Gynecology. ACOG practice bulletin No. 193: tubal ectopic pregnancy. Obstet Gynecol. 2018;131(3):e91-e103. doi:10.1097/AOG.0000000000002560 PubMed Google Scholar Crossref

Creanga AA , Shapiro-Mendoza CK , Bish CL , Zane S , Berg CJ , Callaghan WM . Trends in ectopic pregnancy mortality in the United States: 1980-2007. Obstet Gynecol. 2011;117(4):837-843. doi:10.1097/AOG.0b013e3182113c10 PubMed Google Scholar Crossref

Centers for Medicare & Medicaid Services. Reinforcement of EMTALA obligations specific to patients who are pregnant or are experiencing pregnancy loss. Accessed February 16, 2023. https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/reinforcement-emtala-obligations-specific-patients-who-are-pregnant-or-are-experiencing-pregnancy-0

American College of Obstetricians and Gynecologists. Facts are important: understanding ectopic pregnancy. Accessed February 16, 2023. https://www.acog.org/advocacy/facts-are-important/understanding-ectopic-pregnancy

Bouyer J , Coste J , Shojaei T , et al. Risk factors for ectopic pregnancy: a comprehensive analysis based on a large case-control, population-based study in France. Am J Epidemiol. 2003;157(3):185-194. doi:10.1093/aje/kwf190 PubMed Google Scholar Crossref

Barrenetxea G , Barinaga-Rementeria L , Lopez de Larruzea A , Agirregoikoa JA , Mandiola M , Carbonero K . Heterotopic pregnancy: two cases and a comparative review. Fertil Steril. 2007;87(2):417.e9-417.e15. doi:10.1016/j.fertnstert.2006.05.085 PubMed Google Scholar Crossref

Bollig KJ , Senapati S , Sammel MD , et al. Validation of a multiple marker test for early pregnancy outcome prediction. J Assist Reprod Genet. Published online July 16, 2022. doi:10.1007/s10815-023-02719-w PubMed Google Scholar Crossref

Miller R , Gyamfi-Bannerman C ; Society for Maternal-Fetal Medicine (SMFM); Publications Committee Society for Maternal-Fetal Medicine Consult Series #63: cesarean scar ectopic pregnancy. Am J Obstet Gynecol. Published online July 16, 2022. doi:10.1016/j.ajog.2022.06.024 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.