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Ectopic pregnancy: Choosing a treatment

Author
Togas Tulandi, MD, MHCM
Section Editor
Courtney A Schreiber, MD, MPH
Deputy Editor
Sandy J Falk, MD, FACOG

INTRODUCTION

An ectopic pregnancy is a pregnancy outside of the uterine cavity. The majority of ectopic pregnancies occur in the fallopian tube (84 percent) [1], 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 [2]. 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: Epidemiology, risk factors, and anatomic sites")

Clinical manifestations and diagnosis (see "Ectopic pregnancy: Clinical manifestations and diagnosis")

            
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Literature review current through: Nov 2017. | This topic last updated: Dec 01, 2017.
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