In this chapter an overview is given of the best available evidence on the conservative treatment for tubal ectopic pregnancy, i.e., expectant management and medical treatment with systemic methotrexate. From the two randomized controlled trials on expectant management, no conclusions can be drawn yet. It may be that women with low serum hCG levels need not be treated at all, but more research needs to be done in this subgroup of women to reach firm conclusions. Systemic methotrexate in a fixed multiple-dose i/m regimen can be recommended for hemodynamically stable women with an unruptured tubal ectopic pregnancy and no signs of active bleeding presenting with serum hCG concentrations < 3,000 IU/l. In women with serum hCG concentrations < 1,500 IU/l, a single-dose methotrexate regimen can be considered.
|Number of pages||10|
|Journal||Best Practice & Research: Clinical Obstetrics & Gynaecology|
|Publication status||Published - 1 Aug 2009|
- conservative management
- ectopic pregnancy
- expectant management
- tubal pregnancy