Skip to main content
NCBI home page
Canadian Medical Association Journal logoLink to Canadian Medical Association Journal
. 1983 Dec 15;129(12):1265–1269.

Update on ectopic pregnancy.

W Wolfman, G Holtz
PMCID: PMC1875711  PMID: 6228291

Abstract

Ectopic pregnancy is the leading cause of maternal death in the first trimester. Its incidence is increasing, probably owing to the increasing incidence of pelvic inflammatory disease. Although up to 15% of patients have been reported to present in shock, a large number seek care earlier because of pelvic pain and irregular menses. With strong clinical suspicion and the use of culdocentesis, assays of the beta subunit of human chorionic gonadotropin in the blood and ultrasonography, the diagnosis can be made before rupture occurs. Although the woman's subsequent fertility has traditionally been poor, some improvement has been achieved with the use of conservative surgical techniques. Early diagnosis facilitates this approach.

Full text

PDF
1265

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ackerman R., Deutsch S., Krumholz B. Levels of human chorionic gonadotropin in unruptured and ruptured ectopic pregnancy. Obstet Gynecol. 1982 Jul;60(1):13–14. [PubMed] [Google Scholar]
  2. Beral V. An epidemiological study of recent trends in ectopic pregnancy. Br J Obstet Gynaecol. 1975 Oct;82(10):775–782. doi: 10.1111/j.1471-0528.1975.tb00572.x. [DOI] [PubMed] [Google Scholar]
  3. Braunstein G. D., Karow W. G., Gentry W. C., Rasor J., Wade M. E. First-trimester chorionic gonadotropin measurements as an aid in the diagnosis of early pregnancy disorders. Am J Obstet Gynecol. 1978 May 1;131(1):25–32. doi: 10.1016/0002-9378(78)90469-6. [DOI] [PubMed] [Google Scholar]
  4. Braunstein G. D., Rasor J., Danzer H., Adler D., Wade M. E. Serum human chorionic gonadotropin levels throughout normal pregnancy. Am J Obstet Gynecol. 1976 Nov 15;126(6):678–681. doi: 10.1016/0002-9378(76)90518-4. [DOI] [PubMed] [Google Scholar]
  5. Breen J. L. A 21 year survey of 654 ectopic pregnancies. Am J Obstet Gynecol. 1970 Apr 1;106(7):1004–1019. doi: 10.1016/s0002-9378(16)34087-x. [DOI] [PubMed] [Google Scholar]
  6. Bronson R. A. Tubal pregnancy and infertility. Fertil Steril. 1977 Mar;28(3):221–228. doi: 10.1016/s0015-0282(16)42429-5. [DOI] [PubMed] [Google Scholar]
  7. Brown T. W., Filly R. A., Laing F. C., Barton J. Analysis of ultrasonographic criteria in the evaluation for ectopic pregnancy. AJR Am J Roentgenol. 1978 Dec;131(6):967–971. doi: 10.2214/ajr.131.6.967. [DOI] [PubMed] [Google Scholar]
  8. Bruhat M. A., Manhes H., Mage G., Pouly J. L. Treatment of ectopic pregnancy by means of laparoscopy. Fertil Steril. 1980 Apr;33(4):411–414. doi: 10.1016/s0015-0282(16)44659-5. [DOI] [PubMed] [Google Scholar]
  9. Budowick M., Johnson T. R., Jr, Genadry R., Parmley T. H., Woodruff J. D. The histopathology of the developing tubal ectopic pregnancy. Fertil Steril. 1980 Aug;34(2):169–171. doi: 10.1016/s0015-0282(16)44902-2. [DOI] [PubMed] [Google Scholar]
  10. Bukovsky I., Langer R., Herman A., Caspi E. Conservative surgery for tubal pregnancy. Obstet Gynecol. 1979 Jun;53(6):709–711. [PubMed] [Google Scholar]
  11. DOUGLAS C. P. TUBAL ECTOPIC PREGNANCY. Br Med J. 1963 Oct 5;2(5361):838–841. doi: 10.1136/bmj.2.5361.838. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. DeCherney A. H., Romero R., Naftolin F. Surgical management of unruptured ectopic pregnancy. Fertil Steril. 1981 Jan;35(1):21–24. doi: 10.1016/s0015-0282(16)45252-0. [DOI] [PubMed] [Google Scholar]
  13. DeCherney A., Kase N. The conservative surgical management of unruptured ectopic pregnancy. Obstet Gynecol. 1979 Oct;54(4):451–455. [PubMed] [Google Scholar]
  14. DeStefano F., Peterson H. B., Layde P. M., Rubin G. L. Risk of ectopic pregnancy following tubal sterilization. Obstet Gynecol. 1982 Sep;60(3):326–330. [PubMed] [Google Scholar]
  15. Grimes D. A., Geary F. H., Jr, Hatcher R. A. Rh immunoglobulin utilization after ectopic pregnancy. Am J Obstet Gynecol. 1981 Jun 1;140(3):246–249. doi: 10.1016/0002-9378(81)90268-4. [DOI] [PubMed] [Google Scholar]
  16. Hallatt J. G. Ectopic pregnancy associated with the intrauterine device: a study of seventy cases. Am J Obstet Gynecol. 1976 Jul 15;125(6):754–758. doi: 10.1016/0002-9378(76)90843-7. [DOI] [PubMed] [Google Scholar]
  17. Holtz G. Human chorionic gonadotropin regression following conservative surgical management of tubal pregnancy. Am J Obstet Gynecol. 1983 Oct 1;147(3):347–348. doi: 10.1016/0002-9378(83)91131-6. [DOI] [PubMed] [Google Scholar]
  18. Hussa R. O. Clinical utility of human chorionic gonadotropin and alpha-subunit measurements. Obstet Gynecol. 1982 Jul;60(1):1–12. [PubMed] [Google Scholar]
  19. Kadar N., Caldwell B. V., Romero R. A method of screening for ectopic pregnancy and its indications. Obstet Gynecol. 1981 Aug;58(2):162–166. [PubMed] [Google Scholar]
  20. Kadar N., DeVore G., Romero R. Discriminatory hCG zone: its use in the sonographic evaluation for ectopic pregnancy. Obstet Gynecol. 1981 Aug;58(2):156–161. [PubMed] [Google Scholar]
  21. Kumar S., Oxorn H. Ectopic pregnancy following tubal sterilization. Can Med Assoc J. 1978 Jul 22;119(2):156–157. [PMC free article] [PubMed] [Google Scholar]
  22. Lucas C., Hassim A. M. Place of culdocentesis in the diagnosis of ectopic pregnancy. Br Med J. 1970 Jan 24;1(5690):200–202. doi: 10.1136/bmj.1.5690.200. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. McCausland A. High rate of ectopic pregnancy following laparoscopic tubal coagulation failures. Incidence and etiology. Am J Obstet Gynecol. 1980 Jan 1;136(1):97–101. doi: 10.1016/0002-9378(80)90573-6. [DOI] [PubMed] [Google Scholar]
  24. Morris J. M., Van Wagenen G. Interception: the use of postovulatory estrogens to prevent implantation. Am J Obstet Gynecol. 1973 Jan 1;115(1):101–106. doi: 10.1016/0002-9378(73)90095-1. [DOI] [PubMed] [Google Scholar]
  25. Rasor J. L., Braunstein G. D. A rapid modification of the beta-hCG radioimmunoassay. Use as an aid in the diagnosis of ectopic pregnancy. Obstet Gynecol. 1977 Nov;50(5):553–558. [PubMed] [Google Scholar]
  26. Rubin G. L., Peterson H. B., Dorfman S. F., Layde P. M., Maze J. M., Ory H. W., Cates W., Jr Ectopic pregnancy in the United States 1970 through 1978. JAMA. 1983 Apr 1;249(13):1725–1729. [PubMed] [Google Scholar]
  27. STROMME W. B., McKELVEY J. L., ADKINS C. D. Conservative surgery for ectopic pregnancy. Obstet Gynecol. 1962 Mar;19:294–301. [PubMed] [Google Scholar]
  28. Schneider J., Berger C. J., Cattell C. Maternal mortality due to ectopic pregnancy. A review of 102 deaths. Obstet Gynecol. 1977 May;49(5):557–561. [PubMed] [Google Scholar]
  29. Schwartz R. O., Di Pietro D. L. beta-hCG as a diagnostic aid for suspected ectopic pregnancy. Obstet Gynecol. 1980 Aug;56(2):197–203. [PubMed] [Google Scholar]
  30. Sherman D., Langer R., Sadovsky G., Bukovsky I., Caspi E. Improved fertility following ectopic pregnancy. Fertil Steril. 1982 Apr;37(4):497–502. doi: 10.1016/s0015-0282(16)46155-8. [DOI] [PubMed] [Google Scholar]
  31. Siegler A. M., Wang C. F., Westoff C. Management of unruptured tubal pregnancy. Obstet Gynecol Surv. 1981 Nov;36(11):599–607. doi: 10.1097/00006254-198111000-00001. [DOI] [PubMed] [Google Scholar]
  32. Smith M., Vessey M. P., Bounds W., Warren J. Progestogen-only oral contraception and ectopic gestation. Br Med J. 1974 Oct 12;4(5936):104–105. doi: 10.1136/bmj.4.5936.104-c. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Snowden R. The Progestasert and ectopic pregnancy. Br Med J. 1977 Dec 17;2(6102):1600–1601. doi: 10.1136/bmj.2.6102.1600-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. St John R. K., Blount J., Jones O. Pelvic inflammatory disease in the United States. Incidence and trends in private practice. Sex Transm Dis. 1981 Apr-Jun;8(2):56–61. doi: 10.1097/00007435-198104000-00003. [DOI] [PubMed] [Google Scholar]
  35. Stangel J. J., Gomel V. Techniques in conservative surgery for tubal gestation. Clin Obstet Gynecol. 1980 Dec;23(4):1221–1228. doi: 10.1097/00003081-198012000-00027. [DOI] [PubMed] [Google Scholar]
  36. Timonen S., Nieminen U. Tubal pregnancy, choice of operative method of treatment. Acta Obstet Gynecol Scand. 1967;46(3):327–339. doi: 10.3109/00016346709158636. [DOI] [PubMed] [Google Scholar]
  37. Weiner C. P. The pseudogestational sac in ectopic pregnancy. Am J Obstet Gynecol. 1981 Apr 15;139(8):959–961. doi: 10.1016/0002-9378(81)90968-6. [DOI] [PubMed] [Google Scholar]

Articles from Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

RESOURCES