Nonoperative management of ectopic pregnancy. A preliminary report

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Abstract

The incidence of ectopic pregnancy is increasing throughout the Western world; at present it is uncertain how much of this increase is due to the disease and/or its antecedents and how much due to better means of diagnosis. That the treatment of the obvious or ruptured ectopic pregnancy should be surgical is beyond doubt. However, in view of the natural tendency of some ectopic pregnancies to terminate in tubal abortion or complete resorption, it is questionable whether surgery is always necessary in every early case or whether some patients can be monitored by means of rising or falling levels of beta subunits of human chorionic gonadotropin (HCG) until tubal abortion or resorption occurs. This may be the best means of preserving tubal function and fertility. Five patients are described, one of whom had a history highly suggestive of extrauterine pregnancy; although the diagnosis was unproven, she was treated expectantly, with no untoward effects and patency of that tube was demonstrated some months later on laparoscopy. Two patients with ectopic pregnancies confirmed by laparoscopy that resolved spontaneously are then described. The fourth patient had an ectopic pregnancy confirmed by laparoscopy until a rising beta HCG level necessitated operation and cessation of watchful expectancy. Also described is a classical tubal abortion; had this patient presented two days earlier, she would have undergone salpingectomy. Her late presentation to the hospital clearly showed this procedure to be unnecessary.

Original languageEnglish
Pages (from-to)127-132
Number of pages6
JournalThe Journal of reproductive medicine
Volume27
Issue number3
StatePublished - 1982
Externally publishedYes

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