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  • Title: Expectant management of ectopic pregnancy.
    Author: Ylöstalo P, Cacciatore B, Sjöberg J, Kääriäinen M, Tenhunen A, Stenman UH.
    Journal: Obstet Gynecol; 1992 Sep; 80(3 Pt 1):345-8. PubMed ID: 1386659.
    Abstract:
    OBJECTIVE: To evaluate expectant management in selected cases of ectopic pregnancy. METHODS: Transvaginal sonography and estimation of serum hCG concentrations were used in the evaluation and follow-up of ectopic pregnancy. Entry criteria for expectant management were: decreasing level of serum hCG, diameter of the ectopic pregnancy less than 4 cm, and no signs of rupture or acute bleeding by vaginal sonography. RESULTS: Expectant management was studied in 83 patients, representing 26% of all ectopic pregnancies during a 2-year period. In 57 patients (69%), spontaneous resolution occurred, corresponding to 18% of all ectopic pregnancies. Laparoscopy was performed in 26 because of clinical symptoms or a rise in hCG level after expectant management for 1-18 days. One patient had a tubal rupture requiring tubal resection by laparoscopy. No serious complications occurred. With increasing experience, the rate of expectant management and spontaneous resolution increased during study period. CONCLUSION: Expectant management with repeated vaginal sonography and estimations of serum hCG concentrations is a useful form of treatment for ectopic pregnancy in selected cases.
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