ACOG Practice Bulletin No. 193: Tubal Ectopic Pregnancy.

  title={ACOG Practice Bulletin No. 193: Tubal Ectopic Pregnancy.},
  journal={Obstetrics \& Gynecology},
  • Published 2018
  • Medicine
  • Obstetrics & Gynecology
Ectopic pregnancy is defined as a pregnancy that occurs outside of the uterine cavity. The most common site of ectopic pregnancy is the fallopian tube. Most cases of tubal ectopic pregnancy that are detected early can be treated successfully either with minimally invasive surgery or with medical management using methotrexate. However, tubal ectopic pregnancy in an unstable patient is a medical emergency that requires prompt surgical intervention. The purpose of this document is to review… 

Updates in Diagnosis and Management of Ectopic Pregnancy

Methotrexate, a folic acid antagonist, has been extensively studied in medicine and causes trophoblastic cells to divide rapidly and reducing tetrahydrofolate levels (a cofactor for deoxyribon nucleic acid and ribonucleic acid formation).

Interstitial Pregnancy: Case Report of Atypical Ectopic Pregnancy

A 36-year-old woman with complaints of transvaginal bleeding and abdominal pain associated with amenorrhea for seven weeks and positive beta-human chorionic gonadotropin (HCG) is reported, confirming the diagnosis of interstitial ectopic pregnancy.

Ectopic Pregnancy.

Not Like the Textbook: An Atypical Case of Ectopic Pregnancy

This case provides an illustration of ectopic pregnancy that presented without classically associated symptoms, and also highlights how anchoring bias and pre-emptive closure, among other cognitive biases, contributed to a missed diagnosis.

Ruptured Ectopic Pregnancy with an Intrauterine Device: Case Report and Sonographic Considerations

While pregnancy with an IUD in place is rare, when it is encountered the emergency provider should maintain a high degree of suspicion for extrauterine pregnancy and perform prompt evaluation for hemorrhagic shock using diagnostic POCUS.

Ectopic pregnancy: a resident’s guide to imaging findings and diagnostic pitfalls

This review aims to describe and illustrate sonographic findings of each type of EP, as well as present mimickers and various imaging pitfalls, and clarify how to avoid potential misdiagnoses that could adversely affect patient outcomes.

Conservative Management of Interstitial Pregnancy With Beta-hCG of Over 39,000 mIU/mL: A Case Report

This report identifies the successful medical management of a patient with interstitial ectopic pregnancy with β-hCG of more than 39,000 utilizing methotrexate.

Ectopic Pregnancy: Diagnosis and Management.

Ectopic pregnancy should be considered in any patient presenting early in pregnancy with vaginal bleeding or lower abdominal pain in whom intrauterine pregnancy has not yet been established and treatment includes medical management with intramuscular methotrexate, surgical management via salpingostomy or salpingectomy, and, in rare cases, expectant management.

Conservative approach in the management of ectopic pregnancy

The Clinic of Obstetrics and Gynecology of the Clinical Center of Vojvodina uses a two-dose protocol by which methotrexate is administered intramuscularly and which has proven to be highly successful with few side effects.

Technical Notes Surgical treatment of a ruptured interstitial pregnancy.




Ectopic pregnancy diagnosis and the pseudo-sac.

Methotrexate embryopathy in a surviving intrauterine fetus after presumed diagnosis of ectopic pregnancy: case report.

  • M. Addar
  • Medicine
    Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
  • 2004

Interventions for tubal ectopic pregnancy.

The effectiveness and safety of surgery, medical treatment and expectant management of tubal ectopic pregnancy is evaluated in view of primary treatment success, tubal preservation and future fertility.

Controversies and problems in the current management of tubal pregnancy.

With adequate patient selection, expectant management of the tubal pregnancy is a reasonable approach with good results and the real future challenge remains prevention of the disease, especially among high risk patients, such as those undergoing infertility treatment.

Ectopic pregnancy: evolution after treatment with transvaginal methotrexate.

The increase in tubal size and vascularity, in spite of the falling beta-hCG level, represents a healing process and should cause no concern about the follow-up of these patients.

Treatment of ectopic pregnancy: is a human chorionic gonadotropin level of 2,000 mIU/mL a reasonable threshold?

It is reasonable to closely follow up rather than treat many of these early, stable cases of ectopic pregnancy, and an hCG level of 2,000 mIU/mL without US findings of IUP, while suggestive of an abnormal pregnancy, is not diagnostic.

Sites of ectopic pregnancy: a 10 year population-based study of 1800 cases.

It is shown that current IUD use 'protects' against interstitial pregnancies, which are the most difficult to manage, and shows that subsequent fertility tends to be higher in women with distal EP.