Ectopic pregnancy resulting from gamete intrafallopian transfer and in vitro fertilization. Role of ultrasonography in diagnosis and treatment.
Forty-five cases of ectopic pregnancy occurred after gamete intrafallopian transfer (32 cases) or in vitro fertilization (13 cases). Ultrasonography positively identified ectopic pregnancy in 33 cases (73.4%) and suggested the presence of one in 7 cases (15.6%). There were five false-negative results (11.1%). The incidence of rare types of ectopic pregnancy after assisted fertility procedures, such as ovarian, heterotopic, cervical and ectopic pregnancy, in patients who had undergone a previous salpingectomy was increased. Ultrasound scanning was used to monitor three cases of nonviable ectopic pregnancy; all three required no further treatment. In 14 cases of viable ectopic pregnancy the gestational sac was aspirated and injected with potassium chloride and methotrexate. In seven of those cases no further treatment was needed. Patients who conceive as a result of assisted fertility procedures should be scanned four to six weeks after the procedure or sooner if they are considered at high risk of developing an ectopic pregnancy or if the condition is symptomatic.
Guirgis
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Fertility and In Vitro Fertilization Unit, Humana Hospital Wellington, London, England.
Craft
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IL
D000028:Abortion, Induced; D000328:Adult; D005188:False Negative Reactions; D005260:Female; D005307:Fertilization in Vitro; D015181:Gamete Intrafallopian Transfer / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008131:London / Q000453:epidemiology; D008875:Middle Aged; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy; D012307:Risk Factors; D014463:Ultrasonography