CMAJ • October 11, 2005; 173 (8). doi:10.1503/cmaj.050222.
© 2005 CMA Media Inc. or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
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Synthèse

Diagnosis and treatment of ectopic pregnancy

Heather Murray, Hanadi Baakdah, Trevor Bardell and Togas Tulandi

From the Departments of Emergency Medicine (Murray) and Surgery (Bardell), Queen's University, Kingston, Ont., and the Department of Obstetrics and Gynecology, McGill University, Montréal, Que. (Baakdah, Tulandi)

Correspondence to: Dr. Heather Murray, Department of Emergency Medicine, Queen's University, Kingston General Hospital, 76 Stuart St., Kingston ON K7L 2V7; fax 613 548-1374; hm9{at}post.queensu.ca

Abstract

ECTOPIC PREGNANCY IS A LIFE- AND FERTILITY-threatening condition that is commonly seen in Canadian emergency departments. Increases in the availability and use of hormonal markers, coupled with advances in formal and emergency ultrasonography have changed the diagnostic approach to the patient in the emergency department with first-trimester bleeding or pain. Ultrasonography should be the initial investigation for symptomatic women in their first trimester; when the results are indeterminate, the serum ß human chorionic gonadotropin (ß-hCG) concentration should be measured. Serial measurement of ß-hCG and progesterone concentrations may be useful when the diagnosis remains unclear. Advances in surgical and medical therapy for ectopic pregnancy have allowed the proliferation of minimally invasive or noninvasive treatment. Guidelines for laparoscopy and for methotrexate therapy are provided.




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eLetters:

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Ectopic pregnancy: Role of suction curettage
Gurusamy Sivagnanam
CMAJ, 11 Oct 2005 [Full text]
Ectopic Pregnancy: Minimal role of curettage
Togas Tulandi
CMAJ, 31 Oct 2005 [Full text]