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  • Print publication year: 2010
  • Online publication date: October 2010

Chapter 3 - Ectopic pregnancy

Summary

The majority of ectopic pregnancies occur within the Fallopian tube, with most implanted in the ampullary region. A number of risk factors have been identified for ectopic pregnancy. Transvaginal ultrasound (TVU) has now become the diagnostic technique of choice for ectopic pregnancy. Historically, laparotomy with salpingectomy was the standard treatment for ectopic pregnancy. Laparoscopic surgery has been shown to be superior to laparotomy, making it the surgical approach of choice. A number of drugs have been used for the treatment of ectopic pregnancy including potassium chloride, prostaglandins, hyperosmolar glucose, mifepristone and actinomycin D. However, the most commonly used drug in clinical practice for the treatment of ectopic pregnancy is methotrexate. The reported success rates for expectant management range between 48-100%. Subsequent hysterosalpingography has shown patency for the affected tube in up to 93% of cases of ectopic pregnancy managed expectantly.

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