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Nonsurgical diagnosis and management of ectopic pregnancy
Author(s) -
Sau Ashis,
HamiltonFairley Diana
Publication year - 2003
Publication title -
the obstetrician and gynaecologist
Language(s) - English
Resource type - Journals
eISSN - 1744-4667
pISSN - 1467-2561
DOI - 10.1576/toag.5.1.29
Subject(s) - ectopic pregnancy , methotrexate , medicine , expectant management , obstetrics , pregnancy , human chorionic gonadotropin , gynecology , laparoscopy , fertility , gestation , surgery , hormone , population , genetics , environmental health , biology
Laparoscopy is not mandatory for the diagnosis of ectopic pregnancy, which can be diagnosed by the use of transvaginal scan together with colour Doppler and estimation of quantitative β‐human chorionic gonadotrophin (β‐hCG). The role of expectant management in ectopic pregnancy is limited. Spontaneous resolution occurs only in selected groups of women typically with an unruptured ectopic pregnancy and an initial β‐hCG of <1o00 miu/ml, which is declining. Measurement of serum progesterone levels may be helpful in identifying this group. Systemic methotrexate administration is a promising treatment in patients with early and unruptured ectopic pregnancy. It preserves fertility with no morbidity of surgery.