title: A 5-year experience of the changing management of ectopic pregnancy.
abstract: This retrospective audit reviewed all ectopic pregnancies over a 5-year period in a district general hospital setting. Of 215 ectopic pregnancies identified, notes were available for 208 (97%). 202 cases were determined to have been diagnosed and managed as ectopic pregnancies. Six cases were excluded as they were pregnancies of unknown location managed as such. The proportion of patients managed non-surgically has increased following the introduction of our consultant-led early pregnancy assessment unit from 25% prior to 31% currently. The success rates have improved in both those managed expectantly (50%-73%) and those with methotrexate (75%-90%). There has been a corresponding drop in those managed surgically from 75% to 69%, and a reduction in negative laparoscopies from 13% to 6%. Provided recommended criteria and follow-up are adhered to, non-surgical management has been shown to have comparative safety to traditional surgical management with acceptable efficacy and patient acceptability.
authors.affiliation: a Wessex Deanery Rotation, Department of Obstetrics and Gynaecology , Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust , Southampton , UK .
authors.forename: Janet
authors.initials: J
authors.lastname: Berry
authors.affiliation: b Wessex Deanery Rotation, Department of Obstetrics and Gynaecology , Princess Anne Hospital, University Hospital Southampton NHS Foundation Trust , Southampton , UK .
authors.forename: Mark
authors.initials: M
authors.lastname: Davey
authors.affiliation: c Department of Obstetrics and Gynaecology , Worthing Hospital, Western Sussex Hospitals NHS Foundation Trust , Worthing , UK , and.
authors.forename: Mei-See
authors.initials: MS
authors.lastname: Hon
authors.affiliation: d Department of Obstetrics and Gynaecology , Hampshire Hospitals Foundation Trust , Winchester , UK.
authors.forename: Renée
authors.initials: R
authors.lastname: Behrens
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal; D000028:Abortion, Induced / Q000379:methods / Q000639:trends*; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000639:trends*; D008485:Medical Audit; D008727:Methotrexate; D008875:Middle Aged; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000628:therapy*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate
keywords: Ectopic pregnancy; early pregnancy assessment unit; expectant; management; methotrexate