Document Detail


Controversies and problems in the current management of tubal pregnancy.
MedLine Citation:
PMID:  9111187     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The two main conservative treatment alternatives for tubal pregnancy, methotrexate administration and laparoscopic salpingostomy are under constant review. Recently, expectant management of tubal pregnancy has become increasingly popular. In this review, we assess the outcome of conservative management modalities for extrauterine pregnancy and compare the results of treatment with methotrexate and operative laparoscopy. Outcomes of extrauterine pregnancy were obtained from a review compiled from the English literature identified by directed Medline search. Methotrexate and laparoscopic salpingostomies yield good final treatment rates of 85-95% respectively and relatively low rates for further surgical complication (5-10% respectively). Tubal patency, as well as future fertility performance, are quite similar after both techniques. Although they appear to suit the demands of the 21st century, each one has its own benefits and contraindications. With adequate patient selection, expectant management of the tubal pregnancy is a reasonable approach with good results. Although the morbidity rate after tubal pregnancy treatment is decreasing and the main concern is to reduce the decline in fertility potential, the real future challenge remains prevention of the disease, especially among high risk patients, such as those undergoing infertility treatment.
Authors:
R Maymon; A Shulman
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Human reproduction update     Volume:  2     ISSN:  1355-4786     ISO Abbreviation:  Hum. Reprod. Update     Publication Date:    1996 Nov-Dec
Date Detail:
Created Date:  1997-06-20     Completed Date:  1997-06-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9507614     Medline TA:  Hum Reprod Update     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  541-51     Citation Subset:  IM    
Affiliation:
Department of Obstetrics, Assaf Harofeh Medical Center, Tel Aviv, Israel.
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents*
Female
Fertility
Fertilization in Vitro
Hemodynamics
Humans
Laparoscopy
Methotrexate / therapeutic use*
Morbidity
Pregnancy
Pregnancy, Ectopic / physiopathology,  therapy
Pregnancy, Tubal / epidemiology,  surgery,  therapy*
Reproductive Techniques
Salpingostomy
Chemical
Reg. No./Substance:
0/Abortifacient Agents; 59-05-2/Methotrexate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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