Nonsurgical diagnosis and management of ectopic pregnancy

Abstract

Laparoscopy is not mandatory for the diagnosis of ectopic pregnancy, which can be diagnosed by the use of transvaginal scan together with colour Doppler and estimation of quantitative β‐human chorionic gonadotrophin (β‐hCG). The role of expectant management in ectopic pregnancy is limited. Spontaneous resolution occurs only in selected groups of women typically with an unruptured ectopic pregnancy and an initial β‐hCG of <1o00 miu/ml, which is declining. Measurement of serum progesterone levels may be helpful in identifying this group. Systemic methotrexate administration is a promising treatment in patients with early and unruptured ectopic pregnancy. It preserves fertility with no morbidity of surgery.