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Chapter 19 - Medical Management of Tubal Pregnancy

Published online by Cambridge University Press:  16 April 2025

By
Scott C. Mackenzie  and
Andrew W. Horne
Edited by
Roy G. Farquharson ,
Mary D. Stephenson  and
Mariëtte Goddijn
Roy G. Farquharson
Affiliation:
Liverpool Women’s Hospital
Mary D. Stephenson
Affiliation:
University of Illinois, Chicago
Mariëtte Goddijn
Affiliation:
Amsterdam University Medical Centers
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Summary

Ectopic pregnancy is a common gynaecological emergency accounting for a significant proportion of early pregnancy mortality. The chemotherapeutic methotrexate, through targeting rapidly diving cells, is a widely used non-invasive treatment option that has allowed many to avoid invasive surgery. Failure of methotrexate treatment necessitates emergency surgical management, at times to manage haemorrhage related to tubal rupture. As such, careful characterisation, and selection of those suitable for methotrexate treatment is essential. This chapter discusses the use of methotrexate for managing tubal ectopic pregnancy, including eligibility, factors associated with treatment success, and necessary patient counselling. Lastly, we explore the recent advances in knowledge and current landscape of novel therapeutics with potential to improve medical treatment of tubal ectopic pregnancy.

Keywords

methotrexatetubal ectopic pregnancymedical managementpredictiontreatment successeligibilitycounsellingnovel therapeutics
Type
Chapter
Information
Early Pregnancy , pp. 189 - 198
Publisher: Cambridge University Press
Print publication year: 2025

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