Management of early ectopic pregnancy.
OBJECTIVE
Management of early ectopic pregnancy was investigated in a multicenter, prospective study.


METHODS
Serum beta-hCG levels were monitored after therapy and correlated to the type of management, gestational age, and initial serum beta-hCG levels in 119 patients with ectopic pregnancies detected at 5-7 postmenstrual weeks.


RESULTS
Salpingectomy was performed in 16 patients. No post-operative complications were reported. After conservative laparoscopic surgery of 51 ectopic pregnancies, 9 (18%) had delayed decrease or an increase of serum beta-hCG levels. Re-operations were performed in 4 (7%) patients. Similar findings were noted in 2/6 patients after conservative operations performed by laparotomy. Intrachorionic injection treatment was successful in 17/18 ectopic pregnancies, and expectant management in 7/8 patients with initial serum beta-hCG levels below 250 mIU/ml.


CONCLUSIONS
Persistence of trophoblastic activity is a potential complication of conservative surgical treatment of ectopic pregnancy. A detailed diagnosis as early as 6-7 post-menstrual weeks may be the key for future non-surgical management of ectopic pregnancy.
Popp
L W
LW
Clinic Dr. Guth, Juergensallee, Hamburg, Germany.
Colditz
A
A
Gaetje
R
R
D000019:Abortifacient Agents / Q000008:administration & dosage; D000032:Abortion, Therapeutic / Q000379:methods; D014408:Biomarkers, Tumor / Q000097:blood; D006063:Chorionic Gonadotropin / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human; D002824:Chorionic Villi; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D006801:Humans; D008727:Methotrexate; D009951:Ornipressin; D010446:Peptide Fragments / Q000097:blood; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011274:Pregnancy, Tubal / Q000453:epidemiology / Q000601:surgery / Q000628:therapy*; D011446:Prospective Studies; D012086:Reoperation
D000019:Abortifacient Agents; D014408:Biomarkers, Tumor; D006063:Chorionic Gonadotropin; D018997:Chorionic Gonadotropin, beta Subunit, Human; D010446:Peptide Fragments; D009951:Ornipressin; D008727:Methotrexate