PREGNANCY-BIRTH Messages for May, 2001: Re: 2 ectopics

Re: 2 ectopics - question re smoking

From: William McIntosh, MD (anonymous@obgyn.net)
Tue, 15 May 2001 11:02:40 -0500 (CDT)

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In reply to: Elizabeth: "2 ectopics - question re smoking"

At Tue, 15 May 2001, Elizabeth wrote: >
>I am 39, and just received shot of Methotrexate for my second eptopic.
>First one was in January, both in left tube. January was my first
>pregnancy, and was an accident. Discovered the eptopic too late for
>Meth - had salpingostomy and tube was saved. At that time I was smoking
>a little over a pack a day, have since cut way back, and at the time of
>this second conception was down to less than half a pack with the intent
>of quitting. After the first one I did some research on the internet
>and never saw anything linking smoking to eptopics. (My doctor also
>knew I was a smoker and never mentioned this.) Last week while doing
>more searching online, I happened upon one article that mentioned a link
>between smoking and eptopic pregnancy, then searched specifically for
>that and found some more. This was enough to help me quit completely,
>needless to say, I was devastated that something I did could have caused
>this. I have never had PID or endometriosis (that I know of, and have
>visited gyn regularly). I did contract gonorrhea about 20 years ago,
>but had it treated before I even showed any symptoms. I realize that
>after two eptopics, the chances for recurrence are already high, but
>what I'd like to know is 1)could the smoking have been the primary cause
>of the eptopics?, and if so is it worthwhile to try again since I have
>quit? 2)Or should I have any tests first, such as HSG or falloposcopy?

Smokers have more ectopics, but the mechanism is somewhat up in the air. Some believe that smoking interferes with tubal transport systems, and if that is the case, then stopping smoking should reduce your risk of another ectopic. However, in your case, there is room for additional injury to your tubes, from the surgery and the methotrexate, so an HSG or falloposcopy is a very good idea.

-- William D. McIntosh, MD, FACOG

This is for educational purposes only, and is not a substitute for consultation and examination by a licensed medical professional.

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