Ectopic pregnancy How the diagnostic and therapeutic management has changed

The diagnosis and treatment of ectopic pregnancy has changed drastically over the last century. A comprehensive overview of the historical developments leading to current clinical practice was attempted.

Norah Melina van Mello, M.D., Femke Mol, M.D., Willem M. Ankum, M.D., Ph.D., Ben Willem Mol, M.D., Ph.D., Fulco van der Veen, M.D., Ph.D., Petra J. Hajenius, M.D., Ph.D.

Volume 98, Issue 5, Pages 1066-1073, November 2012

Nowadays ectopic pregnancy often can be diagnosed before the woman’s condition has deteriorated, which has altered the former clinical picture of a life-threatening disease into a more benign condition. This review describes the historical developments in the diagnostic and therapeutic management of ectopic pregnancy leading up to current clinical practice. The first attempts to diagnose ectopic pregnancy originate from the beginning of the 20th century.

  • Dr. Kumar

    Thanks for the review. As a pathologist I need to clarify a point. To diagnose ectopic or PUL is it enough if urine pregnancy test is positive + ultrasound evidence?
    What is the role of beta HCG in aiding diagnosis of ectopic pregnancy when urine pregnancy test is positive?
    Please clarify.

  • Thank you for your extensive review on this interesting issue. It describes the evolution of diagnostic tools and the therapeutic management. In relation to the expectant management in patients with low or plateauing serum hCG concentration, it remains very controversial. As the difference in the rate of surgical interventions between both approaches ( 2% in the methotrexate group and 13% in the expectant management group) is six times higher in expectant management, we should be cautious to suggest this treatment.

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