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A 10‐year retrospective cohort study of non‐tubal ectopic pregnancy management outcomes in an Australian tertiary centre

A 10‐year retrospective cohort study of non‐tubal ectopic pregnancy management outcomes in an... IntroductionEctopic pregnancies (EPs) are pregnancies that implant outside the main cavity of the uterus, and these occur in approximately 1% of all pregnancies.1 The majority of EPs are tubal (approximately 90–95%), while the remainder are non‐tubal EP (NTEPs) which are located at more uncommon sites, for example the cervix, the interstitial part of the fallopian tube, the ovary, within the caesarean scar and the abdominal cavity. The unique sites of NTEP implantation can contribute to significant diagnostic and management challenges, resulting in diagnostic delays, increased haemorrhagic complications, increased surgery complexity and ultimately increased risks of maternal morbidity and mortality compared to its tubal counterpart.2The mode of treatment is largely influenced by the ectopic site, patient's haemodynamic stability and desire for fertility preservation.1,3 In addition to patient factors, the type of NTEP management provided may also be influenced by the experience of the treating specialist. Surgery has traditionally provided a key advantage for the timely removal of the ectopic tissue and achievement of haemostasis in haemodynamically unstable patients. The availability of high‐quality early pregnancy transvaginal ultrasonography has allowed us to identify a subset of stable NTEP patients who might be appropriate candidates for conservative medical management and avoid the morbidity http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Australasian Journal of Ultrasound in Medicine Wiley

A 10‐year retrospective cohort study of non‐tubal ectopic pregnancy management outcomes in an Australian tertiary centre

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References (29)

Publisher
Wiley
Copyright
Copyright © 2022 Australasian Society for Ultrasound in Medicine
ISSN
1836-6864
eISSN
2205-0140
DOI
10.1002/ajum.12312
Publisher site
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Abstract

IntroductionEctopic pregnancies (EPs) are pregnancies that implant outside the main cavity of the uterus, and these occur in approximately 1% of all pregnancies.1 The majority of EPs are tubal (approximately 90–95%), while the remainder are non‐tubal EP (NTEPs) which are located at more uncommon sites, for example the cervix, the interstitial part of the fallopian tube, the ovary, within the caesarean scar and the abdominal cavity. The unique sites of NTEP implantation can contribute to significant diagnostic and management challenges, resulting in diagnostic delays, increased haemorrhagic complications, increased surgery complexity and ultimately increased risks of maternal morbidity and mortality compared to its tubal counterpart.2The mode of treatment is largely influenced by the ectopic site, patient's haemodynamic stability and desire for fertility preservation.1,3 In addition to patient factors, the type of NTEP management provided may also be influenced by the experience of the treating specialist. Surgery has traditionally provided a key advantage for the timely removal of the ectopic tissue and achievement of haemostasis in haemodynamically unstable patients. The availability of high‐quality early pregnancy transvaginal ultrasonography has allowed us to identify a subset of stable NTEP patients who might be appropriate candidates for conservative medical management and avoid the morbidity

Journal

Australasian Journal of Ultrasound in Medicine – Wiley

Published: Nov 1, 2022

Keywords: ectopic; methotrexate; non‐tubal; ultrasound guided injection

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