Spontaneous resolution of ectopic tubal pregnancy: natural history.
OBJECTIVE
To determine the characteristics and long-term outcome of women succeeding or failing expectant management of ectopic pregnancy (EP).


METHODS
Prospective, defined protocol.


METHODS
University-affiliated gynecology department.


METHODS
We used a protocol that selected women with laparoscopic confirmed ectopic tubal pregnancy and declining plasma hCG values. Over a 5-year period, 60 women representing 20.1% of EPs fulfilled the inclusion criteria. Women were followed with serial hCG testing and transvaginal ultrasound.


METHODS
Success or failure of expectant management.


RESULTS
Expectant management was successful in 28 (47.7%) of the patients. Thirty-two (53.3%) failed expectant management, and a treatment procedure was required. There was no difference in the resultant ipsilateral tubal patency or 1-year fertility rates of those women succeeding or failing expectant management. Analysis showed that in the face of declining values and with a starting hCG > 2,000 mIU/mL (conversion to SI unit, 1.00), 93.3% failed expectant management, whereas < 2,000 mIU/mL, 60.0% succeeded.


CONCLUSIONS
We conclude that expectant management should be offered as a treatment option only in those women fulfilling the criteria for a good prognosis.
Shalev
E
E
Department of Obstetrics and Gynecology, Central Emek Hospital, Afula, Israel.
Peleg
D
D
Tsabari
A
A
Romano
S
S
Bustan
M
M
D000290:Adnexa Uteri / Q000000981:diagnostic imaging; D006063:Chorionic Gonadotropin / Q000097:blood; D005186:Fallopian Tube Patency Tests; D005260:Female; D005298:Fertility; D006801:Humans; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D011446:Prospective Studies; D014463:Ultrasonography
D006063:Chorionic Gonadotropin