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Medical therapy of ectopic gestation: contemporary paradigms

Published online by Cambridge University Press:  03 June 2009

D Chamoun ,
KHH Wong  and
HD McClamrock
D Chamoun
Affiliation:
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, University of Maryland School of Medicine, Baltimore, Maryland, USA
KHH Wong
Affiliation:
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, University of Maryland School of Medicine, Baltimore, Maryland, USA
HD McClamrock*
Affiliation:
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, University of Maryland School of Medicine, Baltimore, Maryland, USA
*
Associate Professor, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, University of Maryland School of Medicine, 405 W. Redwood Street, Third Floor, Baltimore, MD-21201, USA.
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Extract

There has been an increase in the incidence of ectopic pregnancy to epidemic proportions in many developed countries in the past two decades. In 1989, ectopic pregnancy accounted for 1.6% of all pregnancies in the United States of America. This trend may be explained by an increase in the incidence of established risk factors as well as a dramatic improvement in diagnostic tools and advances in reproductive technology. Technologic advances such as highly sensitive radioimmunoassays for the β-subunit of human chorionic gonadotropin (βhCG), the development of high-resolution ultrasound and a heightened physician awareness have revolutionized the clinical management of ectopic pregnancy, leading to earlier and more consistent diagnoses and consequently reduced maternal mortality rates. 1,3–13 Unfortunately, ectopic pregnancy is still associated with a significant morbidity and mortality and contributes substantially to health-care costs. For example ectopic pregnancy complications accounted for 13% of all pregnancy-related deaths and were the leading cause of maternal mortality in African- American women in 1989. Financially, an estimated 1.1 billion dollars was spent in the United States of America alone for the management of ectopic pregnancy in 1990.

Type
Articles
Information
Reproductive Medicine Review , Volume 5 , Issue 2 , July 1996 , pp. 107 - 127
Copyright
Copyright © Cambridge University Press 1996

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