Ectopic pregnancy: a review

Arch Gynecol Obstet. 2013 Oct;288(4):747-57. doi: 10.1007/s00404-013-2929-2. Epub 2013 Jun 21.

Abstract

Purpose: Ectopic pregnancy (EP) presents a major health problem for women of child-bearing age. EP refers to the pregnancy occurring outside the uterine cavity that constitutes 1.2-1.4 % of all reported pregnancies. All identified risk factors are maternal: pelvic inflammatory disease, Chlamydia trachomatis infection, smoking, tubal surgery, induced conception cycle, and endometriosis. These developments have provided the atmosphere for trials using methotrexate as a non-surgical treatment for EP. The diagnosis measure of EP is serum human chorionic gonadotropin, urinary hCGRP/i-hCG, progesterone measurement, transvaginal ultrasound scan, computed tomography, vascular endothelial growth factor, CK, disintegrin and metalloprotease-12 and hysterosalpingography. The treatment option of EP involves surgical treatment by laparotomy or laparoscopy, medical treatment is usually systemic or through local route, or by expectant treatment.

Results: It was concluded that review data reflect a decrease in surgical treatment and not an actual decline in EP occurrence so that further new avenues are needed to explore early detection of the EP.

Publication types

  • Review

MeSH terms

  • Abortifacient Agents, Nonsteroidal / therapeutic use
  • Female
  • Humans
  • Laparoscopy
  • Methotrexate / therapeutic use
  • Pregnancy
  • Pregnancy, Ectopic* / diagnosis
  • Pregnancy, Ectopic* / etiology
  • Pregnancy, Ectopic* / therapy
  • Risk Factors
  • Salpingectomy
  • Salpingostomy
  • Watchful Waiting

Substances

  • Abortifacient Agents, Nonsteroidal
  • Methotrexate