Controversies and problems in the current management of tubal pregnancy

Ron Maymon, Adrian Shulman

Research output: Contribution to journalReview articlepeer-review

Abstract

The two main conservative treatment alternatives for tubal pregnancy, methotrexate administration and laparoscopic salpingostomy are under constant review. Recently, expectant management of tubal pregnancy has become increasingly popular. In this review, we assess the outcome of conservative management modalities for extrauterine pregnancy and compare the results of treatment with methotrexate and operative laparoscopy. Outcomes of extrauterine pregnancy were obtained from a review compiled from the English literature identified by directed Medline search. Methotrexate and laparoscopic salpingostomies yield good final treatment rates of 85-95% respectively and relatively low rates for further surgical complication (5-10% respectively). Tubal patency, as well as future fertility performance, are quite similar after both techniques. Although they appear to suit the demands of the 21st century, each one has its own benefits and contra-indications. With adequate patient selection, expectant management of the tubal pregnancy is a reasonable approach with good results. Although the morbidity rate after tubal pregnancy treatment is decreasing and the main concern is to reduce the decline in fertility potential, the real future challenge remains prevention of the disease, especially among high risk patients, such as those undergoing infertility treatment.

Original languageEnglish
Pages (from-to)541-551
Number of pages11
JournalHuman Reproduction Update
Volume2
Issue number6
DOIs
StatePublished - Nov 1996

Keywords

  • Assisted reproductive techniques
  • Conservative treatment
  • Methotrexate
  • Operative laparoscopy
  • Tubal pregnancy

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