| Abstract [eng] |
Ectopic pregnancy occurs when the embryo implants outside the uterine cavity. Although mortality rates associated with ectopic pregnancy have declined in recent years, it remains the leading cause of maternal death during the first trimester of pregnancy. It affects approximately 2% of pregnant women, with tubal localization accounting for 98% of ectopic pregnancies. Various factors increase the risk of tubal pregnancy, including a history of pelvic infections, ectopic pregnancies, tubal surgeries, and assisted reproductive technology procedures. These factors can disrupt the normal tubal transport of the fertilized egg, leading to implantation outside the uterus. Currently, treatment choices for women with ectopic pregnancy include surgical, medical, and expectant management 3 approaches. As diagnostics improve, ectopic pregnancies are being detected earlier, often in stable patients, enabling health professionals to opt for conservative methods more frequently. Critical considerations in conservative management include patient selection, risk stratification, and monitoring protocols. Optimal candidates typically are asymptomatic and present with low beta-human chorionic gonadotropin levels, small ectopic masses, and absence of hemodynamic instability or fetal cardiac activity. The success of expectant management depends on initial beta-human chorionic gonadotropin and its early tendencies. Close monitoring of beta-human chorionic gonadotropin levels until they normalize is essential during conservative management. Compared to other tubal pregnancy treatment methods, expectant management offers benefits such as reduced post-operative complications and medication side effects, shorter hospital stays, and better reproductive outcomes. However, the risk of treatment failure, ectopic rupture and prolonged follow-up monitoring persists. |
