[Conservative management of ectopic pregnancy]

Minerva Ginecol. 1997 Mar;49(3):67-72.
[Article in Italian]


Background: The aim of this retrospective study was to analyze the safety and efficacy of the conservative approach in the management of ectopic pregnancy.

Methods: Thirty-five women with a tubal ectopic pregnancy, from 1990 to 1995, were subdivided into 2 treatment groups. Inclusion criteria were the following: tubal diameter < 3 cm, free fluid < 100 ml, no embryo heart activity, haemodynamic stability. Desire of future fertility and informed consent were requested. Eighteen women were treated with a single intramuscular injection of methotrexate, whereas in 17 cases expectant management was adopted.

Results: In the first group 2 cases required surgical treatment (resolution rate = 89%). In the second group no surgery was needed and spontaneous resolution was achieved in all cases (100%). In both groups the average resolution time was about 17 days. Serum hCG-beta levels were monitored daily until resolution. The initial hCG-beta value and its following trend seem to be the most important prognostic factors.

Conclusions: More studies are indeed needed to establish the effect of conservative management on fertility after ectopic pregnancy.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Chorionic Gonadotropin, beta Subunit, Human / blood
  • Female
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Injections, Intramuscular
  • Methotrexate / administration & dosage
  • Pregnancy
  • Pregnancy, Tubal / diagnostic imaging
  • Pregnancy, Tubal / surgery
  • Pregnancy, Tubal / therapy*
  • Retrospective Studies
  • Ultrasonography


  • Chorionic Gonadotropin, beta Subunit, Human
  • Immunosuppressive Agents
  • Methotrexate