Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-76fb5796d-zzh7m Total loading time: 0 Render date: 2024-04-25T17:42:13.597Z Has data issue: false hasContentIssue false

18 - Tubal Ectopic Pregnancy and Pregnancy of Unknown Location

Published online by Cambridge University Press:  16 February 2017

By
Emma Kirk
Edited by
Roy G. Farquharson  and
Mary D. Stephenson
Roy G. Farquharson
Affiliation:
Liverpool Women's Hospital
Mary D. Stephenson
Affiliation:
University of Illinois College of Medicine
Get access
Type
Chapter
Information
Early Pregnancy , pp. 179 - 186
Publisher: Cambridge University Press
Print publication year: 2017

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Lewis, G (ed) (2007). The Confidential Enquiry into Maternal and Child Health (CEMACH). Saving Mothers’ Lives: reviewing maternal deaths to make motherhood safer – 2003–2005. The Seventh Report into Maternal Deaths in the United Kingdom. London: CEMACH.Google Scholar
Ankum, WM, Mol, BW, Van der Veen, F, Bossuyt, PM (1996). Risk factors for ectopic pregnancy: a meta-analysis. Fertil Steril. 65(6): 1093–99.CrossRefGoogle ScholarPubMed
Bouyer, J, Coste, J, Fernandez, H, Pouly, JL, Job-Spira, N (2002). Sites of ectopic pregnancy: a 10-year population-based study of 1800 cases. Hum Reprod 17: 3224–30.CrossRefGoogle Scholar
Li, TC, Tristram, A, Hill, AS, Cooke, ID (1991). A review of 254 ectopic pregnancies in a teaching hospital in the Trent Region, 1977–1990. Hum Reprod. 6(7): 1002–07.CrossRefGoogle Scholar
Atri, M, Leduc, C, Gillett, P, et al (1996). Role of endovaginal sonography in the diagnosis and management of ectopic pregnancy. Radiographics. 16(4): 755–74.CrossRefGoogle ScholarPubMed
Romero, R, Kadar, N, Jeanty, P, et al. (1985). Diagnosis of ectopic pregnancy: value of the discriminatory human chorionic gonadotropin zone. Obstet Gynecol. 66: 357–60.Google ScholarPubMed
Aleem, FA, DeFazio, M, Gintautas, J (1990). Endovaginal sonography for the early diagnosis of intrauterine and ectopic pregnancies. Hum Reprod. 5(6): 755–58.CrossRefGoogle ScholarPubMed
Braffman, BH, Coleman, BG, Ramchandani, P, et al. (1994). Emergency department screening for ectopic pregnancy: a prospective US study. Radiology 190: 797–802.CrossRefGoogle ScholarPubMed
Shalev, E, Yarom, I, Bustan, M, Weiner, E, Ben-Shlomo, I (1998). Transvaginal sonography as the ultimate diagnostic tool for the management of ectopic pregnancy: experience with 840 cases. Fertil Steril 69: 62–65.CrossRefGoogle ScholarPubMed
Atri, M, Valenti, DA, Bret, PM, Gillett, P (2003). Effect of transvaginal sonography on the use of invasive procedures for evaluating patients with a clinical diagnosis of ectopic pregnancy. J Clin Ultrasound 31: 1–8.CrossRefGoogle ScholarPubMed
Condous, G, Okaro, E, Khalid, A, Lu, C, Van Huffel, S, Bourne, T (2005). The accuracy of transvaginal ultrasonography for the diagnosis of ectopic pregnancy prior to surgery. Hum Reprod 20: 1404–09.CrossRefGoogle ScholarPubMed
Kirk, E, Papageorghiou, AT, Condous, G, Tan, L, Bora, S, Bourne, T (2007). The diagnostic effectiveness of an initial transvaginal scan in detecting ectopic pregnancy. Hum Reprod. 22(11): 2824–28.CrossRefGoogle ScholarPubMed
Kirk, E, Daemen, A, Papageorghiou, AT, et al. (2008). Why are some ectopic pregnancies characterized as pregnancies of unknown location at the initial transvaginal ultrasound examination? Acta Obstet Gynecol Scand. 87(11): 1150–54.CrossRefGoogle ScholarPubMed
Stromme, WB (1953). Salpingotomy for tubal pregnancy; report of a successful case. Obstet Gynecol 1: 472–75.Google ScholarPubMed
Bruhat, MA, Manhes, H, Mage, G, Pouly, JL (1980). Treatment of ectopic pregnancy by means of laparoscopy. Fertil Steril 33: 411–14.CrossRefGoogle ScholarPubMed
Garry, R (1996). The laparoscopic treatment of ectopic pregnancy: The long road to acceptance. Gynaecol Endosc 5: 65–68.Google Scholar
Lundorff, P, Thorburn, J, Hahlin, M, Kallfelt, B, Lindblom, B (1991). Laparoscopic surgery in ectopic pregnancy. A randomized trial versus laparotomy. Acta Obstet Gynecol Scand. 70: 343–48.CrossRefGoogle ScholarPubMed
Lundorff, P, Thorburn, J, Lindblom, B (1992). Fertility outcome after conservative surgical treatment of ectopic pregnancy evaluated in a randomized trial. Fertil Steril 57: 998–1002.CrossRefGoogle ScholarPubMed
Mol, F, van Mello, NM, Strandell, A, et al (2014). Salpingotomy versus salpingectomy in women with tubal pregnancy (ESEP study): an open-label, multicentre, randomised controlled trial. Lancet. 383(9927): 1483–89.CrossRefGoogle ScholarPubMed
Becker, S, Solomayer, E, Hornung, R, et al. (2011). Optimal treatment for patients with ectopic pregnancies and a history of fertility-reducing factors. Arch Gynecol Obstet. 283(1): 41–45.CrossRefGoogle Scholar
Yao, M, Tulandi, T (1997). Current status of surgical and non-surgical management of ectopic pregnancy. Fertil Steril 67: 421–33.CrossRefGoogle Scholar
Sowter, M, Frappell, J (2002). The role of laparoscopy in the management of ectopic pregnancy. Rev Gynaecol Practice 2: 73–82.CrossRefGoogle Scholar
Hajenius, PJ, Mol, BW, Ankum, WM, van der Veen, F, Bossuyt, PM, Lammes, FB (1995). Clearance curves of serum human chorionic gonadotrophin for the diagnosis of persistent trophoblast. Hum Reprod. 10: 683–87.CrossRefGoogle ScholarPubMed
Lund, CO1, Nilas, L, Bangsgaard, N, Ottesen, B (2002). Persistent ectopic pregnancy after linear salpingotomy: a non-predictable complication to conservative surgery for tubal gestation. Acta Obstet Gynecol Scand. 81(11): 1053–59.CrossRefGoogle ScholarPubMed
NICE (2012). Ectopic pregnancy and miscarriage: diagnosis and initial management in early pregnancy of ectopic pregnancy and miscarriage. Clinical Guideline 154. London: National Institute for Health and Care Excellence.Google Scholar
Stovall, TG, Ling, FW (1993). Single-dose methotrexate: an expanded clinical trial. Am J Obstet Gynecol. 168(6 Pt 1): 1759–62; discussion 1762–5.CrossRefGoogle ScholarPubMed
Erdem, M, Erdem, A, Arslan, M, Oc, A, Biberoglu, K, Gursoy, R (2004). Single-dose methotrexate for the treatment of unruptured ectopic pregnancy. Arch Gynecol Obstet 270: 201–04.CrossRefGoogle ScholarPubMed
Kirk, E, Condous, G, Bourne, T (2006). The non-surgical management of ectopic pregnancy. Ultrasound Obstet Gynecol. 27(1): 91–100.CrossRefGoogle ScholarPubMed
Lipscomb, GH, Gomez, IG, Givens, VM, Meyer, NL, Bran, DF (2009). Yolk sac on transvaginal ultrasound as a prognostic indicator in the treatment of ectopic pregnancy with single-dose methotrexate. Am J Obstet Gynecol. 200(3): 338.e1–4.CrossRefGoogle ScholarPubMed
Menon, S, Colins, J, Barnhart, KT (2007). Establishing a human chorionic gonadotrophin cutoff to guide methotrexate treatment of ectopic pregnancy: a systematic review. Fertil Steril. 87: 481–84.CrossRefGoogle ScholarPubMed
da Costa Soares, R, , Elito J, Camano, L (2008). Increment in beta-hCG in the 48-h period prior to treatment: a new variable predictive of therapeutic success in the treatment of ectopic pregnancy with methotrexate. Arch Gynecol Obstet. 278(4): 319–24.Google Scholar
Kirk, E, Van Calster, B, Condous, G, et al. (2011). Ectopic pregnancy: using the hCG ratio to select women for expectant or medical management. Acta Obstet Gynecol Scand. 90(3): 264–72.CrossRefGoogle ScholarPubMed
Skubisz, MM, Horne, AW, Johns, TG, et al. (2013). Combination gefitinib and methotrexate compared with methotrexate alone to treat ectopic pregnancy. Obstet Gynecol. 122(4): 745–51.CrossRefGoogle ScholarPubMed
Horne, AW, Skubisz, MM, Doust, A, et al. (2013). Phase II single arm open label multicentre clinical trial to evaluate the efficacy and side effects of a combination of gefitinib and methotrexate to treat tubal ectopic pregnancies (GEM II): study protocol. BMJ Open. 3(7). pii: e002902.CrossRefGoogle ScholarPubMed
Elson, J, Tailor, A, Banerjee, S, Salim, R, Hillaby, K, Jurkovic, D (2004). Expectant management of tubal ectopic pregnancy: prediction of successful outcome using decision tree analysis. Ultrasound Obstet Gynecol. 23(6): 552–56.CrossRefGoogle ScholarPubMed
Craig, LB, Khan, S (2012). Expectant management of ectopic pregnancy. Clin Obstet Gynecol. 55(2): 461–70.CrossRefGoogle ScholarPubMed
Cohen, MA, Sauer, MV (1999). Expectant management of ectopic pregnancy. Clin Obstet Gynecol. 42(1): 48–54.CrossRefGoogle ScholarPubMed
Trio, D, Strobelt, N, Picciolo, C, Lapinski, RH, Ghidini, A (1995). Prognostic factors for successful expectant management of ectopic pregnancy. Fertil Steril. 63: 469–72.CrossRefGoogle ScholarPubMed
Atri, M, Valenti, DA, Bret, PM, Gillett, P (2003). Effect of transvaginal sonography on the use of invasive procedures for evaluating patients with a clinical diagnosis of ectopic pregnancy. J Clin Ultrasound 31: 1–8.CrossRefGoogle ScholarPubMed
van Mello, NM, Mol, F, Verhoeve, HR, van Wely, M et al (2013). Methotrexate or expectant management in women with an ectopic pregnancy or pregnancy of unknown location and low serum hCG concentrations? A randomized comparison. Hum Reprod. 28(1): 60–67.CrossRefGoogle ScholarPubMed
Mol, BW, Lijmer, JG, Ankum, WM, van der Veen, F, Bossuyt, PM (1998). The accuracy of single serum progesterone measurement in the diagnosis of ectopic pregnancy: a meta-analysis. Hum Reprod. 13(11): 3220–27.CrossRefGoogle ScholarPubMed
Hahlin, M, Thorburn, J, Bryman, I (1995). The expectant management of early pregnancies of uncertain site. Hum Reprod 10: 1223–27.CrossRefGoogle ScholarPubMed
Banerjee, S, Aslam, N, Zosmer, N, Woelfer, B, Jurkovic, D (1999). The expectant management of women with pregnancies of unknown location. Ultrasound Obstet Gynecol 14: 231–36.CrossRefGoogle ScholarPubMed
Banerjee, S, Aslam, N, Woelfer, B, Lawrence, A, Elson, J, Jurkovic, D (2001). Expectant management of early pregnancies of unknown location: a prospective evaluation of methods to predict spontaneous resolution of pregnancy. BJOG 108: 158–63.Google ScholarPubMed
Condous, G, Van Calster, B, Kirk, E, et al. (2007a). Prediction of ectopic pregnancy in women with a pregnancy of unknown location. Ultrasound Obstet Gynecol. 29: 680–87.CrossRefGoogle ScholarPubMed
Condous, G, Van Calster, B, Kirk, E, et al. (2007b). Clinical information does not improve the performance of mathematical models in predicting the outcome of pregnancies of unknown location. Fertil Steril. 88: 572–80.CrossRefGoogle Scholar
Kirk, E, Condous, G, Van Calster, B, Van Huffel, S, Timmerman, D, Bourne, T (2007). Rationalizing the follow-up of pregnancies of unknown location. Hum Reprod 22: 1744–50.CrossRefGoogle ScholarPubMed
Condous, G, Timmerman, D, Goldstein, S, Valentin, L, Jurkovic, D, Bourne, T (2006). Pregnancies of unknown location: consensus statement. Ultrasound Obstet Gynecol. 28: 121–22.CrossRefGoogle ScholarPubMed
Cordina, M, Schramm-Gajraj, K, Ross, JA, Lautman, K, Jurkovic, D (2011). Introduction of a single visit protocol in the management of selected patients with pregnancy of unknown location: a prospective study. BJOG. 118(6): 693–97.Google Scholar
van Mello, NM, Mol, F, Opmeer, BC, et al. (2012). Diagnostic value of serum hCG on the outcome of pregnancy of unknown location: a systematic review and meta-analysis. Hum Reprod Update. 18(6): 603–17.CrossRefGoogle ScholarPubMed
Seeber, BE, Sammel, MD, Guo, W, Zhou, L, Hummel, A, Barnhart, KT (2006). Application of redefined human chorionic gonadotropin curves for the diagnosis of women at risk for ectopic pregnancy. Fertil Steril 86: 454–59.CrossRefGoogle ScholarPubMed
Barnhart, K, Sammel, MD, Chung, K, Zhou, L, Hummel, AC, Guo, W (2004). Decline of serum human chorionic gonadotrophin and spontaneous complete abortion: defining the normal curve. Obstet Gynecol 104: 975–81.CrossRefGoogle ScholarPubMed
Condous, G, Kirk, E, Van Calster, B, Van Huffel, S, Timmerman, D, Bourne, T (2006). Failing pregnancies of unknown location: a prospective evaluation of the human chorionic gonadotrophin ratio. BJOG 113: 521–27.CrossRefGoogle ScholarPubMed
Silva, C, Sammel, MD, Zhou, L, Gracia, C, Hummel, AC, Barnhart, K (2006). Human chorionic gonadotropin profile for women with ectopic pregnancy. Obstet Gynecol. 107(3): 605–10.CrossRefGoogle ScholarPubMed
Verhaegen, J, Gallos, ID, van Mello, NM, et al. (2012). Accuracy of single progesterone test to predict early pregnancy outcome in women with pain or bleeding: meta-analysis of cohort studies. BMJ. 27;345: e6077.Google Scholar
Mol, BW, Lijmer, JG, Ankum, W, et al. (1998). The accuracy of single serum progesterone measurement in the diagnosis of ectopic pregnancy: a meta-analysis. Hum Reprod 13: 3220–27.Google Scholar
Gevaert, O, De Smet, F, Kirk, E, et al. (2006). Predicting the outcome of pregnancies of unknown location: Bayesian networks with expert prior information compared to logistic regression. Hum Reprod 21: 1824–31.CrossRefGoogle ScholarPubMed
Van Calster, B, Abdallah, Y, Guha, S, et al. (2013). Rationalizing the management of pregnancies of unknown location: temporal and external validation of a risk prediction model on 1962 pregnancies. Hum Reprod. 28(3): 609–16.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×