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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Clinical diagnosis and treatment of ectopic pregnancy
Obstetrical and Gynecological Survey, Volume 68, No. 8, Year 2013
Notification
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Description
BACKGROUND: Implantation of the zygote outside the uterine cavity occurs in 2% of all pregnancies. The product of conception can be removed safely by laparoscopic surgery and be submitted for histological examination. The rate of ectopic pregnancies has increased from 0.5% in 1970 to 2% today. The prevalence of ectopic pregnancy in all women presenting to an emergency department with first-trimester bleeding, lower abdominal pain, or a combination of the 2 is between 6% and 16%. DESIGNATION: Workup of all localizations of ectopic pregnancies at a university department of obstetrics and gynecology. METHODS: Comparison of diagnostic and therapeutic modalities from the surgical laparoscopic approach to nonsurgical, medical options. FINDINGS: Surgical treatment: Tubal pregnancies: (1) to preserve tubal function, salpingotomy, partial salpingectomy followed by laparoscopic anastomosis, or fimbrial milking is performed. (2) Tubectomy or salpingectomy is performed only in severely damaged or ruptured tubes or if the patient does not desire further pregnancies. Nontubal ectopic pregnancies (ovarian pregnancy, ectopic abdominal pregnancy, interstitial or cornual pregnancy/rudimentary horn, intraligamental and cervical pregnancies) all require their own specific treatment. MEDICAL TREATMENT: The predominant drug is methotrexate, but other systemic drugs, such as actinomycin D, prostaglandins, and RU 486, can also be applied. COMPLICATIONS: Tubal rupture is a complication of late diagnosed tubal pregnancy that is more difficult to treat conservatively and often indicates tubectomy or segmental resection. In 5% to 15% of treated ectopic pregnancy cases, remnant conception product parts may require a final methotrexate injection. CONCLUSIONS: This article is a review to aid clinical diagnosis of ectopic pregnancies that now can be diagnosed earlier and treated effectively by laparoscopic surgery. TARGET AUDIENCE: Obstetricians and gynecologists, family physicians LEARNING OBJECTIVES: After completing this CME activity, obstetricians and gynecologists should be better able to diagnose ectopic pregnancy in its early stages to provide safe treatment, choose the appropriate treatment for patients with ectopic pregnancy, and identify the role that human chorionic gonadotropin plays in ectopic pregnancy. Copyright © 2013 Lippincott Williams & Wilkins.
Authors & Co-Authors
Alkatout, Ibrahim
Germany, Kiel
Universitätsklinikum Schleswig-holstein Campus Kiel
Honemeyer, Ulrich
United Arab Emirates, Dubai
Welcare Hospital Ehl
Strauss, Alexander
Germany, Kiel
Universitätsklinikum Schleswig-holstein Campus Kiel
Tinelli, Andrea
Italy, Lecce
Ospedale Vito Fazzi
Malvasi, Antonio
Italy, Bari
Santa Maria Hospital
Jonat, Walter
Germany, Kiel
Universitätsklinikum Schleswig-holstein Campus Kiel
Mettler, Lieselotte L.
Germany, Kiel
Universitätsklinikum Schleswig-holstein Campus Kiel
Schollmeyer, Thoralf
Germany, Kiel
Universitätsklinikum Schleswig-holstein Campus Kiel
Statistics
Citations: 138
Authors: 8
Affiliations: 4
Identifiers
Doi:
10.1097/OGX.0b013e31829cdbeb
ISSN:
00297828
e-ISSN:
15339866
Research Areas
Health System And Policy
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Participants Gender
Female