TY - JOUR
T1 - Conservative management of tubal ectopic pregnancy
AU - van Mello, N M
AU - Mol, F
AU - Mol, B W
AU - Hajenius, P J
PY - 2009/8
Y1 - 2009/8
N2 - In this chapter an overview is given of the best available evidence on the conservative treatment for tubal ectopic pregnancy, i.e., expectant management and medical treatment with systemic methotrexate. From the two randomized controlled trials on expectant management, no conclusions can be drawn yet. It may be that women with low serum hCG levels need not be treated at all, but more research needs to be done in this subgroup of women to reach firm conclusions. Systemic methotrexate in a fixed multiple-dose i/m regimen can be recommended for hemodynamically stable women with an unruptured tubal ectopic pregnancy and no signs of active bleeding presenting with serum hCG concentrations<3,000 IU/l. In women with serum hCG concentrations<1,500 IU/l, a single-dose methotrexate regimen can be considered.
AB - In this chapter an overview is given of the best available evidence on the conservative treatment for tubal ectopic pregnancy, i.e., expectant management and medical treatment with systemic methotrexate. From the two randomized controlled trials on expectant management, no conclusions can be drawn yet. It may be that women with low serum hCG levels need not be treated at all, but more research needs to be done in this subgroup of women to reach firm conclusions. Systemic methotrexate in a fixed multiple-dose i/m regimen can be recommended for hemodynamically stable women with an unruptured tubal ectopic pregnancy and no signs of active bleeding presenting with serum hCG concentrations<3,000 IU/l. In women with serum hCG concentrations<1,500 IU/l, a single-dose methotrexate regimen can be considered.
KW - Abortifacient Agents, Nonsteroidal/administration & dosage
KW - Chorionic Gonadotropin/blood
KW - Female
KW - Humans
KW - Infertility, Female/psychology
KW - Laparoscopy/adverse effects
KW - Methotrexate/administration & dosage
KW - Pregnancy
KW - Pregnancy, Tubal/blood
KW - Randomized Controlled Trials as Topic
KW - Ultrasonography, Prenatal
U2 - 10.1016/j.bpobgyn.2008.12.007
DO - 10.1016/j.bpobgyn.2008.12.007
M3 - Article
C2 - 19299204
VL - 23
SP - 509
EP - 518
JO - Baillière's Best Practice and Research. Clinical Obstetrics and Gynaecology
JF - Baillière's Best Practice and Research. Clinical Obstetrics and Gynaecology
SN - 1521-6934
IS - 4
ER -