Ectopic pregnancy, the new gynecological epidemic disease: review of the modern work-up and the nonsurgical treatment option

Abstract

Over the past few decades, the incidence of ectopic pregnancy has increased almost to the extent of an "epidemic disease." Early diagnosis of tubal pregnancy, with the aid of serum human chorionic gonadotropin, high-resolution ultrasound, and the more liberal use of laparoscopy, has dramatically reduced both maternal mortality and the need for radical surgery. Despite this, women with previous ectopic pregnancies still have reduced fertility potential. We report on some current aspects of the epidemiology, etiology, and work-up of ectopic pregnancy. In a review of 328 patients, gleaned from the literature, who were treated with various nonsurgical options, 283 (86%) were able to avoid surgery. The benefits, safety, and efficacy of the various treatment options are discussed, with appropriate recommendations for their use.