Interventions for non-tubal ectopic pregnancy

Long, Ying; Zhu, Huili; Hu, Yuanyuan; Shen, Licong; Fu, Jing; Huang, Wei

doi:10.1002/14651858.cd011174.pub2

Cited by 35 publications

(36 citation statements)

References 64 publications

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“…The result observed in our study of the primary success rate for IS injection of MTX alone was 60%. This result is consistent with literature (13,23) where the initial success rates were 61 % and 71% respectively. In our study, the primary success rate for IS+IM injection of MTX was 61.54% which is lower than previous case series which found primary success rates of about 80% (15,18).…”

Section: Discussionsupporting

confidence: 93%

“…Due to the low incidence of NTEPs, literature is sparse and existing guidelines are based on case reports or studies with small sample sizes (7,8,9). The development of methotrexate (MTX) and its efficacy in tubal ectopic pregnancies (TEP) has made it possible to consider its use in NTEPs with a global success rate without recourse to surgery of more than 75% (10)(11)(12)(13). Although the systemic use of MTX is recognised as efficacious the superiority of the in-situ injection path is still the topic of much debate.…”

Section: Introductionmentioning

confidence: 99%

“…Although the systemic use of MTX is recognised as efficacious the superiority of the in-situ injection path is still the topic of much debate. Different protocols of MTX have been proposed for the conservative medical treatment of NTEPs (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of In Situ Methotrexate Injection in the Treatment of Nontubal Ectopic Pregnancies: A Retrospective Multicenter Study

Herondelle

Spiers

Nyangoh-Timoh

et al. 2022

Journal of Minimally Invasive Gynecology

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of In Situ Methotrexate Injection in the Treatment of Nontubal Ectopic Pregnancies: A Retrospective Multicenter Study

Herondelle

Spiers

Nyangoh-Timoh

et al. 2022

Journal of Minimally Invasive Gynecology

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“…When combined with curettage or hysteroscopy, MTX appears more efficient [28]. From a recent intervention review, it emerged that it is uncertain whether there is a difference in treatment success rates, complications, adverse effects or time to normalize β-hCG between suction curettage under hysteroscopy and under ultrasonography (very low-quality evidence) [29].…”

Section: Scar Pregnancymentioning

confidence: 99%

Management of Non-Tubal Ectopic Pregnancies: A Single Center Experience

et al. 2020

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Non-tubal ectopic pregnancies (NT-EPs) are rare but potentially life-threatening conditions. The incidence ranges are between 5–8.3% of all ectopic pregnancies. For this retrospective observational study, 16 patients with NT-EP and treated from January 2014 to May 2020 were recruited. Demographic details, symptoms, Beta human chorionic gonadotrophin (β-hCG) levels, ultrasound findings, management and treatment outcomes were presented. In hemodynamically stable patients, diagnosis was made using ultrasounds and β-hCG levels. Laparoscopy was essential to identify and remove the ectopic pregnancy in clinical unstable patients. A radical laparoscopic approach was chosen in one case of cervical pregnancy diagnosed late in the first trimester. Medical treatment and minimally invasive procedure, alone or combined, resulted in effective strategies in asymptomatic women with an early diagnosis of NT-EP. We report cases of cervical pregnancies successfully treated by hysteroscopy alone or combined with medical treatment, the first case of scar pregnancy treated by mini-reseptoscope and curettage and the fifth case of interstitial pregnancy treated with Methotrexate and Mifepristone. In this manuscript we report a single center experience in the management of NT-EPs with the aim of outlining the importance of the early diagnosis for a minimally invasive treatment in order to reduce maternal morbidity and mortality and preserve future fertility.

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“…There is little data on the optimal treatment strategies for abdominal pregnancies; however, surgical management is still considered as the mainstay of treatment. [ 15 ]…”

Section: Introductionmentioning

confidence: 99%

Rectal ectopic pregnancy

Thắng

Thanh

2021

Medicine

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Rationale: Abdominal ectopic pregnancy is a very rare form of ectopic pregnancy, yet is associated with higher morbidity due to atypical clinical presentation and misdiagnosis. In this report, we present a case of abdominal ectopic pregnancy with placenta invading to the rectal wall. Patient concerns: A 32-year-old woman was admitted to our hospital with an increasing serum ß-hCG level after diagnostic laparoscopy for ectopic pregnancy in the provincial hospital. During the laparoscopy, no gestational sac was found. She was discharged and scheduled for a follow-up visit to assess the level of ß-hCG. One week later, her serum ß-hCG level increased from 7000 IU/l to 12000 IU/l. Transvaginal Doppler ultrasound and abdominal computed tomography (CT) angiography demonstrated a right adnexal mass adherent to the rectal wall. Diagnosis: A rectal ectopic pregnancy is suspected. Interventions: Laparoscopic surgery was successfully performed in our hospital to remove the products of conception. Outcomes: Histologic examination confirmed the diagnosis of a rectal ectopic pregnancy. The patient had an uneventful recovery and was discharged the next few days. Lessons: This case report reveals that an abdominal pregnancy is remarkably difficult to diagnose and manage. The gynecologists need to be aware of the possibility of gestational sac between the uterus and the rectum. To make early diagnosis of abdominal pregnancy, they need to combine clinical findings, imaging techniques (ultrasound, CT, MRI) and serial human chorionic gonadotropin measurements. Laparoscopic management should be considered in early abdominal pregnancy. A multidisciplinary team of gynecologists and gastrointestinal surgeons is required to deal with rectal ectopic pregnancy.

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Interventions for non-tubal ectopic pregnancy

Cited by 35 publications

References 64 publications

Efficacy of In Situ Methotrexate Injection in the Treatment of Nontubal Ectopic Pregnancies: A Retrospective Multicenter Study

Efficacy of In Situ Methotrexate Injection in the Treatment of Nontubal Ectopic Pregnancies: A Retrospective Multicenter Study

Management of Non-Tubal Ectopic Pregnancies: A Single Center Experience

Rectal ectopic pregnancy

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