The Diagnosis and Treatment of Ectopic Pregnancy

Overview

Journal Dtsch Arztebl Int

Specialties General Medicine
Public Health

Date 2015 Nov 12

PMID 26554319

Citations 40

Authors

Florin-Andrei Taran

Karl-Oliver Kagan

Markus Hubner

Markus Hoopmann

Diethelm Wallwiener

Sara Brucker

Affiliations

Soon will be listed here.

Abstract

Background: Extrauterine pregnancy is a complication of the first trimester of pregnancy that arises in 1.3-2.4% of all pregnancies.

Methods: This review is based on articles and guidelines retrieved by a selective PubMed search.

Results: The presentation of extrauterine pregnancy is highly variable, ranging from an asymptomatic state, to pelvic pain that is worse on one side, to tubal rupture with hemorrhagic shock. 75% of tubal pre gnancies can be detected by transvaginal ultrasonography. In patients with a vital extrauterine pregnancy, the human chorionic gonadotropin concentration generally doubles within 48 hours. Laparoscopy is the gold standard of treatment. Two randomized, controlled trials comparing organ-preserving treatment with ablative surgery revealed no significant difference in pregnancy rates after the intervention, but precise details of the surgical procedures were not provided, and long-term fertility data are lacking. Metho - trexate therapy should be used only for strict indications.

Conclusion: Further randomized, controlled trials with longer follow-up will be needed to answer currently open questions about the potential for individualized surgical treatment and the proper role of pharmacotherapy.

Citing Articles

Laryngospasm During Anesthesia in Emergency Surgery for Ruptured Ectopic Pregnancy: A Case Report.

Mashak B, Shbeeb H, Yavari S, Mirzaee M, Saeedinia R, Ghaemi M Clin Case Rep. 2025; 13(3):e70297.

PMID: 40070435 PMC: 11893721. DOI: 10.1002/ccr3.70297.

Evidence for a case-based module in the low-resource setting to teach ectopic pregnancy management.

Hsu I, Lenders J, Johnson-Griggs M, Gist H, Vaishampayan N, Ryder Y Surg Pract Sci. 2025; 14():100209.

PMID: 39845854 PMC: 11750024. DOI: 10.1016/j.sipas.2023.100209.

Ectopic pregnancy.

Chong K, de Waard L, Oza M, van Wely M, Jurkovic D, Memtsa M Nat Rev Dis Primers. 2024; 10(1):94.

PMID: 39668167 DOI: 10.1038/s41572-024-00579-x.

[Guideline project termination of pregnancy in the first trimester].

Scharl A, Wallwiener S Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2024; 68(1):62-68.

PMID: 39630245 DOI: 10.1007/s00103-024-03988-1.

Rectal ectopic pregnancy: A case report.

Saif M, Alahmar S, Saif A, Al Halabi N, Adwan D, Altanoukhi I Int J Surg Case Rep. 2024; 119:109798.

PMID: 38788636 PMC: 11140778. DOI: 10.1016/j.ijscr.2024.109798.

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