Non-surgical Treatment of Ectopic Pregnancy: a Three-year Review

Abstract

Objectives: To evaluate the success rates of expectant and medical management of ectopic pregnancy in the Department of Obstetrics and Gynaecology in Tseung Kwan O Hospital, Hong Kong, and to look for any differences between the responders and non-responders.
Methods: A retrospective study was conducted from December 2003 to December 2006. 121 women were identified by using a computer database to generate a list of patients with the diagnosis for ectopic pregnancy. Both in-patient and out-patient records were reviewed. The data of women who had received primary expectant management and medical treatment were analysed.
Results: 25 women who were treated with expectant management and 19 who received methotrexate were included in the analysis. The success rates of expectant and medical management were 63% and 73%, respectively. These figures were comparable to previous published results. There were no significant differences in the clinical characteristics such as the presence of abdominal pain, vaginal bleeding, size of adnexal mass, presence of free fluid in the pelvis, and pretreatment levels of serum beta-human chorionic gonadotropin between the responders and non-responders in the expectant and medical management groups.
Conclusion: Both expectant and medical management are reasonable options in selected women with ectopic pregnancy who meet well-defined criteria. The non-surgical management options allow the use of more conservative treatment especially for those women who want to preserve their fertility or those who have high surgical risks.