A 27-year-old woman who had an episode of documented pelvic inflammatory disease two years ago conceives spontaneously. Compared with a woman who has never had PID, her risk of ectopic pregnancy is increased approximately:

• A Twofold
• B It is unchanged if she conceived spontaneously
• C Twentyfold
• D Six to tenfold ✓

Explanation

Tubal damage from PID, namely loss of cilia, peritubal adhesions and impaired tubal transport, raises the risk of ectopic pregnancy roughly six to tenfold after a single episode, and higher after repeated episodes. Twofold underestimates the effect, while twentyfold overstates it even for recurrent disease. Spontaneous conception does not normalise the risk, because damaged tubes still transport the embryo abnormally.

Reference: Williams Gynecology, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.