[Conservative management of ectopic pregnancy].
BACKGROUND
The aim of this retrospective study was to analyze the safety and efficacy of the conservative approach in the management of ectopic pregnancy.


METHODS
Thirty-five women with a tubal ectopic pregnancy, from 1990 to 1995, were subdivided into 2 treatment groups. Inclusion criteria were the following: tubal diameter < 3 cm, free fluid < 100 ml, no embryo heart activity, haemodynamic stability. Desire of future fertility and informed consent were requested. Eighteen women were treated with a single intramuscular injection of methotrexate, whereas in 17 cases expectant management was adopted.


RESULTS
In the first group 2 cases required surgical treatment (resolution rate = 89%). In the second group no surgery was needed and spontaneous resolution was achieved in all cases (100%). In both groups the average resolution time was about 17 days. Serum hCG-beta levels were monitored daily until resolution. The initial hCG-beta value and its following trend seem to be the most important prognostic factors.


CONCLUSIONS
More studies are indeed needed to establish the effect of conservative management on fertility after ectopic pregnancy.
Lui
A
A
Divisione di Ostetricia e Ginecologia, Istituto per l'Infanzia, IRCCS, Trieste.
D'Ottavio
G
G
Rustico
M A
MA
Conoscenti
G
G
Fischer Tamaro
F
F
Meir
Y J
YJ
Maieron
A
A
Mandruzzato
G P
GP
D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007273:Injections, Intramuscular; D008727:Methotrexate / Q000008:administration & dosage; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D014463:Ultrasonography
D018997:Chorionic Gonadotropin, beta Subunit, Human; D007166:Immunosuppressive Agents; D008727:Methotrexate