Ectopic pregnancy |
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| Affiliation: | 1. Fundación Institut de Recerca de la Vall d’Hebron (VHIR), Barcelona, España;2. Servicio de Neonatología, Hospital Universitario Vall d’Hebron, Barcelona, España;3. Servicio de Obstetricia y Ginecología, Hospital Universitario Vall d’Hebron, Barcelona, España;4. Servicio de Pediatría y Endocrinología Pediátrica, Hospital Universitario Vall d’Hebron, Barcelona, España;5. Red de Salud Materno Infantil y del Desarrollo (RED SAMID), Barcelona, España;6. Universidad Autónoma de Barcelona, Barcelona, España;7. CIBERER, Barcelona, España;1. Department of Anatomy and Embryology, Faculty of Medicine, Cairo University, Egypt;2. Department of Obstetrics & Gynecology, Faculty of Medicine, Cairo University, Egypt;1. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, Washington;2. Department of Clinical Investigation, Madigan Army Medical Center, Tacoma, Washington;3. Department of Pathology, Madigan Army Medical Center, Tacoma, Washington;1. AP-HP, Hôpital Bicêtre, GHU Sud, Department of Gynecology Obstetric, 94276 Le Kremlin-Bicêtre, France;2. Inserm, Centre of research in Epidemiology and Population Health (CESP), U1018, 94276 Le Kremlin-Bicêtre, France;3. Faculty of Medicine, Univ Paris Sud, 94276 Le-Kremlin Bicêtre, France |
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| Abstract: | Ectopic pregnancy (EP) occurs in 1–2% of pregnancies, and is associated with significant morbidity and mortality. Women with abdominal pain or vaginal bleeding in early pregnancy, or risk factors for EP, are generally assessed by Early Pregnancy Assessment Units. Diagnosis is predominantly by trans-vaginal ultrasound supported by quantified serum human chorionic gonadotrophin (hCG). The resolution limit of trans-vaginal ultrasound means not all EPs can be identified, leaving women with a ‘Pregnancy of Unknown Location’. Management for EP has moved away from surgery with growing experience in medical management, and evidence-based recognition of expectant management for selected women. Surgery will always have a role in the management of women with EP who are acutely unwell, when medical management is not likely to work, or has failed. On-going areas of research include improvements in women's risk stratification at their first attendance with symptoms, shortening time until diagnosis of EP, and combination medical treatments. |
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| Keywords: | ectopic pregnancy human chorionic gonadotrophin methotrexate salpingectomy salpingotomy |
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