The management of ectopic pregnancies and pregnancies of unknown location

Abstract

Since the introduction of dedicated Early Pregnancy Units and the use of high-resolution transvaginal probes ectopic pregnancies are diagnosed at earlier gestations. As a result, the treatment options in the management of ectopic pregnancies have diversified. In this review, the role of transvaginal sonography in the management of women with ectopic pregnancies is described and the different treatment modalities available in their management are critically evaluated. We assert that ectopic pregnancy should be diagnosed on the basis of positively visualising an adnexal mass using transvaginal sonography, rather than the absence of an intrauterine pregnancy. If a pregnancy cannot be seen, either inside or outside the uterus, this should be described as a pregnancy of unknown location and managed expectantly until the outcome is confirmed.

Enough is enough! Time for a new model of care for women with early pregnancy complications

“…Ultrasound, especially TVS, has enabled rapid diagnosis of early pregnancy conditions such as miscarriage and ectopic pregnancy. These conditions are seen much earlier in their natural history, and consequently, more conservative treatment modalities have been adopted including expectant and medical management 4–9 . Prompt gynaecological input, creation of a sympathetic environment for women and preservation of women's dignity have revolutionised first trimester loss.…”

Unusual ectopic pregnancies: A retrospective analysis of 65 cases

“…Reportedly, MTX can be used by systemic or local injection. It could reach a high effect of 80% . Usage of both mifepristone and MTX was better than single MTX for cervical pregnancy, as the former showed a high success rate and lower toxicity .…”

“…It could reach a high effect of 80%. 13 Usage of both mifepristone and MTX was better than single MTX for cervical pregnancy, as the former showed a high success rate and lower toxicity. 14 This method could enhance the toxicity to trophoblast cells and kill the embryo effectively.…”

Cervical Ectopic Pregnancy With Massive Bleeding: A Case Report

“…Conservative treatment achieves good results before 12 weeks' gestation, as the invasion of trophoblast cells in the wall of the cervical canal is not deep enough [14]. Methotrexate administered systemic or locally, has a high efficiency (80%) [15]. The combined administration of mifepristone and methotrexate gives better results than the use of methotrexate alone [16].…”