ECTOPIC PREGNANCY - NEW ADVANCES IN DIAGNOSIS AND TREATMENT

Citation
Je. Buster et Sa. Carson, ECTOPIC PREGNANCY - NEW ADVANCES IN DIAGNOSIS AND TREATMENT, Current opinion in obstetrics & gynecology, 7(3), 1995, pp. 168-176
Citations number
NO
Categorie Soggetti
Obsetric & Gynecology
ISSN journal
1040872X
Volume
7
Issue
3
Year of publication
1995
Pages
168 - 176
Database
ISI
SICI code
1040-872X(1995)7:3<168:EP-NAI>2.0.ZU;2-R
Abstract
Recent reports affirm that ectopic pregnancy has become a medical rath er than a surgical disease. Early diagnosis is the key to effective no nsurgical treatment. Diagnostic algorithms using serum progesterone, s erial beta-human chorionic gonadotropin measurements, ultrasound, and office curettage now make definitive diagnosis possible without laparo scopy. Laparoscopic salpingostomy, the surgical gold standard, is an e ffective therapy but carries surgical complications and is expensive. Systemic variable dose methotrexate produces outcomes close to laparos copic salpingostomy in similar patients. Single dose systemic methotre xate and intratubal methotrexate appear to be less effective. In many cases, ectopic pregnancies do not meet suitable medical criteria and s till require surgery. The challenge today is identifying patients at r isk and bringing them into the system during the early first trimester when treatment is simple.