title: [Diagnosis and treatment of extrauterine pregnancy in The Netherlands].
abstract: OBJECTIVE
  To inventory current policy in the diagnosis and treatment of ectopic pregnancy (EP) in the Netherlands.
  
  
  METHODS
  Questionnaire.
  
  
  METHODS
  Academic Medical Centre, Amsterdam, the Netherlands.
  
  
  METHODS
  A questionnaire was sent to all I30 departments of gynaecology in the Netherlands.
  
  
  RESULTS
  The response rate was 94% (n = 122). Transvaginal ultrasonography was very widely used, whereas results of serum hCG measurements were only available within 24 h in 75% of the departments. Eighty-three per cent of the respondents screen for EP in high-risk patients. Laparoscopic surgery was used in 62% of the departments, open surgery in 9%, whereas in 28% the surgical technique depended upon the skills of the operating gynaecologist. If desire for pregnancy was present, 53% of the departments operated always conservatively, 2% always radically, whereas in 43% conservative surgery was performed only in case of a healthy ipsilateral tube. Methotrexate was used in 38% of the departments for persistent trophoblast, in 16% as primary treatment of interstitial pregnancies and in 13% as primary treatment for tubal pregnancy.
  
  
  CONCLUSIONS
  Diagnostic strategies for EP in the Netherlands are homogeneous and in conformity with the state of the art in the literature. For treatment, laparoscopic techniques are widely used. In almost all departments, conservative surgery is the treatment of choice. Use of methotrexate is so far limited to treatment of persistent trophoblast after a failure of conservative surgery.
authors.affiliation: Afd. Klinische Epidemiologie en Biostatistiek, Academisch Medisch Centrum, Amsterdam.
authors.forename: B W
authors.initials: BW
authors.lastname: Mol
authors.forename: P J
authors.initials: PJ
authors.lastname: Hajenius
authors.forename: S
authors.initials: S
authors.lastname: Engelsbel
authors.forename: W M
authors.initials: WM
authors.lastname: Ankum
authors.forename: F
authors.initials: F
authors.lastname: van der Veen
authors.forename: P M
authors.initials: PM
authors.lastname: Bossuyt
mesh_terms: D006063:Chorionic Gonadotropin / Q000097:blood; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D007813:Laparotomy / Q000379:methods; D008727:Methotrexate / Q000627:therapeutic use; D009426:Netherlands; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy / Q000601:surgery; D011271:Pregnancy, Ectopic / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D014328:Trophoblastic Neoplasms / Q000188:drug therapy / Q000601:surgery; D014463:Ultrasonography / Q000379:methods; D014594:Uterine Neoplasms / Q000188:drug therapy / Q000601:surgery
chemical_list: D006063:Chorionic Gonadotropin; D008727:Methotrexate
vernacular_title: Diagnostiek en behandeling van extra-uteriene graviditeit in Nederland.