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Ectopic pregnancy: a review

Archives of Gynecology and Obstetrics volume 288, pages 747–757 (2013)Cite this article

Abstract

Purpose

Ectopic pregnancy (EP) presents a major health problem for women of child-bearing age. EP refers to the pregnancy occurring outside the uterine cavity that constitutes 1.2–1.4 % of all reported pregnancies. All identified risk factors are maternal: pelvic inflammatory disease, Chlamydia trachomatis infection, smoking, tubal surgery, induced conception cycle, and endometriosis. These developments have provided the atmosphere for trials using methotrexate as a non-surgical treatment for EP. The diagnosis measure of EP is serum human chorionic gonadotropin, urinary hCGRP/i-hCG, progesterone measurement, transvaginal ultrasound scan, computed tomography, vascular endothelial growth factor, CK, disintegrin and metalloprotease-12 and hysterosalpingography. The treatment option of EP involves surgical treatment by laparotomy or laparoscopy, medical treatment is usually systemic or through local route, or by expectant treatment.

Results

It was concluded that review data reflect a decrease in surgical treatment and not an actual decline in EP occurrence so that further new avenues are needed to explore early detection of the EP.

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Fig. 1
Fig. 2

Abbreviations

EP:

Ectopic pregnancy

CEP:

Cervical ectopic pregnancy

OEP:

Ovarian ectopic pregnancy

CSEP:

Cesarean scar ectopic pregnancy

IP:

Interstitial pregnancy

PID:

Pelvic inflammatory disease

PROKR:

Prokineticin receptor

IVF:

In vitro fertilization

ART:

Assisted reproductive technology

β-hCG:

Serum human chorionic gonadotropin

TVS:

Transvaginal ultrasound scan

CT:

Computed tomography

VEGF:

Vascular endothelial growth factor

ADAM-12:

Disintegrin and metalloprotease-12

Hsg:

Hysterosalpingography

MTX:

Methotrexate

PPV:

Positive predictive value

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Authors and Affiliations

  1. Siddhartha Institute of Pharmacy, Dehradun, 248001, Uttarakhand, India

    Poonam Rana, Imran Kazmi, Rajbala Singh, Muhammad Afzal, Ruqaiyah Khan & Firoz Anwar

  2. Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia

    Fahad A. Al-Abbasi

  3. Lab Director, Jeddah Eye Hospital, Ministry of Health, Jeddah, Saudi Arabia

    Ali Aseeri

  4. Alchemist Hospital, Panchkula, Haryana, India

    Rajbir Singh

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  1. Poonam Rana
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  2. Imran Kazmi
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  3. Rajbala Singh
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  4. Muhammad Afzal
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  5. Fahad A. Al-Abbasi
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  6. Ali Aseeri
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Correspondence to Rajbala Singh, Muhammad Afzal or Firoz Anwar.

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Rana, P., Kazmi, I., Singh, R. et al. Ectopic pregnancy: a review. Arch Gynecol Obstet 288, 747–757 (2013). https://doi.org/10.1007/s00404-013-2929-2

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Keywords

  • β-hCG
  • TVS
  • Methotrexate
  • Laparotomy