Conservative approach in the management of ectopic pregnancy

Introduction. Ectopic pregnancy is defined as the implantation of a fertilized ovum outside uterine cavity and it one leading causes maternal morbidity mortality. Localization risk factors. The most common localization ectopic within fallopian tube, while other localizations include abdominal organs, ovaries, scars after previous cesarean sections, cervix. Risk factors for tube injuries, infertility including multiple embryo transfers, use contraceptives, smoking, older age, prior history pregnancy, intentional abortions. Diagnostic procedures. Measurement serum beta-human chorionic gonadotropin levels along with certain ultrasonography signs, i.e. extrauterine gestational sac, present yolk sac and/or embryo, or without cardiac activity, have highest degree reliability in making diagnosis, whereas uncertain such ?blob? ?bagel? also high positive predictive value. Therapeutic modalities. can be treated by surgical, medical expectant management. Expectant management are reserved hemodynamically stable patients who adequately informed where monitoring control possible. Conservative treatment. Before initiation treatment methotrexate, necessary to rule out vital intrauterine consider contraindications methotrexate therapy, based on detailed laboratory tests. Clinic Obstetrics Gynecology Clinical Center Vojvodina uses two-dose protocol which administered intramuscularly has proven highly successful few side effects. Surgical Candidates emergency laparoscopy laparotomy women unstable should not receive methotrexate. Conclusion. In properly selected patients, success rate therapy around 93%.