Premium
Management of early ectopic pregnancy
Author(s) -
Popp L.W.,
Colditz A.,
Gaetje R.
Publication year - 1994
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/0020-7292(94)90173-2
Subject(s) - ectopic pregnancy , medicine , laparotomy , salpingectomy , conservative management , conservative treatment , obstetrics , complication , expectant management , gestational age , pregnancy , gynecology , surgery , gestation , genetics , biology
OBJECTIVE: Management of early ectopic pregnancy was investigated in a multicenter, prospective study. METHODS: Serum β‐hCG levels were monitored after therapy and correlated to the type of management, gestational age, and initial serum β‐hCG levels in 119 patients with ectopic pregnancies detected at 5–7 postmentrual weeks. RESULTS: Salpingectomy was performed in 16 patients. No postoperative complications were reported. After conservative laparoscopic surgery of 51 ectopic pregnancies, 9 (18%) had delayed decrease or an increase of serum β‐hCG levels. Re‐operations were performed in 4 (7%) patients. Similar findings were noted in 216 patients after conservative operations performed by laparotomy. Intrachorionic injection treatment was sucessful in 17/18 ectopic pregnancies, and expectant management in 7/8 patients with initial serum β‐hCG levels below 250 mIU/ml. CONCLUSIONS: Persistence of trophoblastic activity is a potential complication of conservative surgical treatment of ectopic pregnancy. A detailed diagnosis as early as 6–7 postmenstrual weeks may be the key for future nonsurgical management of ectopic pregnancy.