Ectopic pregnancy (EP) occurs in around 1–2% of all pregnancies, and is associated with significant morbidity and mortality. Identifying those most at risk of harm relies on effective information sharing between primary and secondary care, and between secondary care services including early pregnancy assessments units. There is a need to improve the recognition of symptoms of ectopic pregnancy and to ensure that women are given appropriate advice while awaiting further assessment. The mainstay of diagnosis of EP is by transvaginal ultrasound supported by serial serum human chorionic gonadotrophin (hCG) measurements. Surgery is the main treatment in women who become acutely unwell, and in those where medical management is not likely to work or is no longer working. Otherwise, tubal EP may be managed with medical management (methotrexate) and in selected cases, expectant management. There is a lack of good quality evidence on the management of non-tubal EP and these are best managed on an individual basis.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Obstetrics, Gynaecology and Reproductive Medicine
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Diagnosis and management of ectopic pregnancy.BJOG. 2016; 123: e15-e55
- Interventions for tubal ectopic pregnancy.Cochrane Database Syst Rev (Online). 2007; : CD000324https://doi.org/10.1002/14651858.CD000324.pub2
- Saving lives, improving mothers' care - lessons learned to inform maternity care from the UK and Ireland confidential enquiries into maternal deaths and morbidity 2016-18.in: Knight M. Bunch K. Tuffnell D. Shakespeare J. Kotnis R. Kenyon S. Kurinczuk J.J. National Perinatal Epidemiology Unit, University of Oxford, Oxford2020
- Saving lives, improving mothers' care - surveillance of maternal deaths in the UK 2012-14 and lessons learned to inform maternity care from the UK and Ireland confidential enquiries into maternal deaths and morbidity 2009-14.in: Knight M. Nair M. Tuffnell D. Kenyon S. Shakespeare J. Brocklehurst P. Kurinczuk J.J. National Perinatal Epidemiology Unit, University of Oxford, Oxford2016
- Interventions for non-tubal ectopic pregnancy.Cochrane Database Syst Rev. 2020; : CD011174https://doi.org/10.1002/14651858.CD011174.pub2
- Ectopic pregnancy and miscarriage: diagnosis and initial management CG126.National Institute for Health and Care Excellence, 2019 (April 2021)
Published online: February 01, 2023
© 2023 Elsevier Ltd. All rights reserved.