Ectopic pregnancy: Choosing a treatment
- Togas Tulandi, MD, MHCM
Togas Tulandi, MD, MHCM
- Professor of Obstetrics and Gynecology
- Milton Leong Chair in Reproductive Medicine
- McGill University, Canada
An ectopic pregnancy is a pregnancy outside of the uterine cavity. Almost all ectopic pregnancies implant in the fallopian tube (98 percent) , but other possible sites include cervical, interstitial (also referred to as cornual, a pregnancy located in the proximal segment of the fallopian tube that is embedded within the muscular wall of the uterus), hysterotomy scar (eg, in patient with a previous cesarean delivery), intramural, ovarian, or abdominal. In addition, in rare cases, a multiple gestation may be heterotopic (include both a uterine and extrauterine pregnancy).
Ectopic pregnancy is a potentially life-threatening condition. While surgical approaches are the gold-standard treatment, advances in early diagnosis in the 1980s facilitated the introduction of medical therapy with methotrexate . With the routine use of early ultrasound, diagnosis of ectopic pregnancy can be established early and medical treatment can be administered in many cases. The overall success rate of medical treatment in properly selected women is nearly 90 percent [3-5]. In select cases of early ectopic pregnancy or pregnancy of unknown location, expectant management is an option.
Guidance regarding how to choose a treatment for ectopic pregnancy will be reviewed here. Related topics regarding ectopic pregnancy are discussed in detail separately, including:
●Epidemiology, risk factors, and pathology (see "Ectopic pregnancy: Incidence, risk factors, and pathology")
●Clinical manifestations and diagnosis (see "Ectopic pregnancy: Clinical manifestations and diagnosis")To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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