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• W2071738578 abstract "In Brief Women who present with pain and bleeding in the first trimester are at risk for ectopic pregnancy, a life-threatening condition. Conditions that predispose a woman to ectopic pregnancy are damaged fallopian tubes from prior tubal surgery or previous pelvic infection, smoking, and conception using assisted reproduction. Many women without risk factors can develop an ectopic pregnancy. A diagnostic algorithm that includes the use of transvaginal ultrasonography, human chorionic gonadotropin (hCG) concentrations, and, sometimes, uterine curettage can definitively diagnose women at risk in a timely manner. The absence of an intrauterine pregnancy above an established cut point of hCG is consistent with an abnormal pregnancy but does not distinguish a miscarriage from an ectopic pregnancy. When the initial hCG value is low, serial hCG values can be used to determine whether a gestation is potentially viable or spontaneously resolving. The minimal rise in hCG for a viable pregnancy is 53% in 2 days. The minimal decline of a spontaneous abortion is 21–35% in 2 days, depending on the initial level. A rise or fall in serial hCG values that is slower than this is suggestive of an ectopic pregnancy. Women diagnosed with an unruptured ectopic pregnancy are potential candidates for medical management with methotrexate. Intramuscular injection with methotrexate can be used to safely treat an ectopic pregnancy with success rates, tubal patency rates, and future fertility that are similar to those obtained with conservative surgery. Success rates using methotrexate are inversely rated to baseline hCG values and are higher using multidose compared with single-dose regimens. Surgical treatment may be conservative or definitive and should be attempted in most cases via laparoscopy. Women at risk for ectopic pregnancy should be followed carefully until prompt definitive diagnosis enabling conservative treatment, often with methotrexate, before tubal rupture." @default.
• W2071738578 created "2016-06-24" @default.
• W2071738578 creator A5031160235 @default.
• W2071738578 creator A5053242908 @default.
• W2071738578 date "2006-02-01" @default.
• W2071738578 modified "2023-10-16" @default.
• W2071738578 title "Suspected Ectopic Pregnancy" @default.
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• W2071738578 doi "https://doi.org/10.1097/01.aog.0000198632.15229.be" @default.
• W2071738578 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/16449130" @default.
• W2071738578 hasPublicationYear "2006" @default.
• W2071738578 type Work @default.

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