Medical Management of Ectopic Pregnancy

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Abstract
Recent reports affirm that ectopic pregnancy is evolving into a medical disease. This evolution is driven first by increasingly reliable nonsurgical diagnosis. Algorithms using combinations of hormone measurements and gynecologic ultrasound facilitate timely diagnosis and eliminate need for surgical visualization. Second, the evolution is driven by lower costs. In the United States, national costs for diagnosis and management of ectopic pregnancy in 1990 was estimated at 1.1 billion dollars. Third, and finally, medical therapy virtually eliminates surgical complications from treatment. Systemic methotrexate is emerging as the standard medical regimen in the United States and Europe. It is the principal medical therapy discussed in this chapter.