This expert group recommends prompt withdrawal of the culprit drug, meticulous supportive care, and judicious and early (preferably within 72 h) initiation of moderate to high doses of oral or parenteral corticosteroids (prednisolone 1-2 mg/kg/day or equivalent), tapered rapidly within 7-10 days. Cyclosporine (3-5 mg/kg/day) for 10-14 days may also be used either alone, or in combination with corticosteroids. Owing to the systemic nature of the disease, a multidisciplinary approach in the management of these patients is helpful.

Key content Early abdominal ectopic pregnancy (EAP), though rare, has a high mortality rate. There are no pathognomic symptoms of abdominal pregnancy. Symptoms are akin as for other types of ectopic pregnancy, thus a high index of suspicion is necessary for diagnosis. The tool of choice for diagnosis is ultrasound but it only gives 50% accuracy when used along with clinical evaluation. On occasion, magnetic resonance imaging may help to diagnose EAP. Medical management is commonly used where potential life‐threatening bleeding is anticipated. A number of women who are treated medically may need subsequent treatment with multiple therapies. Surgical management requires a great deal of surgical expertise and in most cases a multidisciplinary approach in anticipation of possible life‐threatening bleeding during the operation. Learning objectives To outline the classification of EAP. To understand the common risk factors associated with EAP. To understand how to diagnose EAP. To be aware of the different medical and surgical management of EAP and the ethical issues associated with diagnosis and treatment. Ethical issues Distinguishing an abdominal pregnancy from the more common variants of ectopic pregnancy remains difficult and a definitive diagnosis is usually made at surgery. There is no established guidance available for the diagnosis and management of EAP. Many EAP are never diagnosed because of a successful response to medical management for a pregnancy of unknown location. As it is not uncommon to diagnose EAP for the first time during surgery, the difficulties in diagnosis prior to surgery means that patients require life‐saving surgery beyond the scope of the preoperative signed consent form.

The study showed that 70% of TCA is a safe and effective treatment option in all types of atrophic acne scars, especially in severe boxcar scars.

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