Abstract
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.
Keywords
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Further reading
- 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)
Article info
Publication history
Published online: February 01, 2023
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© 2023 Elsevier Ltd. All rights reserved.
