Ectopic pregnancy: an update

Abstract

This review addresses recent publications that investigate etiology, epidemiology and different modalities in diagnosis and therapy for ectopic pregnancy. A significant proportion of recent work has focused in the development of new diagnostic tools to aid in the early detection of ectopic pregnancy. Diagnostic modalities have included systemic and local markers, vascular endothelial growth factor, vascular cell adhesion molecule-1, urokinase plasminogen activator receptor, cervical fetal fibronectin, and hormonal level determinations. In addition, magnetic resonance imaging, ultrasonography, color flow mapping and endometrial thickness have been evaluated. New studies have investigated controversial issues related to the cost of the medical versus surgical treatment and the use of different medications and techniques for the management of ectopic pregnancy. Most important of all, several lines of investigation have addressed the use of human chorionic gonadotropin, algorithms, and scoring systems as prognostic indicators of successful therapy and to determine the risk of complications. The management of cervical, interstitial and heterotopic pregnancy is evaluated in this review and a summary of recent proposed diagnostic tools and concepts in management is also presented.

Concurrent ovarian and ipsilateral tubal ectopic pregnancies after a double embryo transfer: a case report

“…Though of little clinical use today, there are specific diagnostic criteria for an ovarian ectopic described by Spiegelberg in 1878: (1) an intact ipsilateral tube, clearly separate from the ovary; (2) a gestational sac occupying the position of the ovary; (3) a gestational sac connected to the uterus by the ovarian ligament; and (4) ovarian tissue in the wall of the gestational sac [5]. The risk of ovarian pregnancy after assisted reproductive techniques is approximately 0.3 % and is likely to increase with widespread use of these procedures [6][7][8]. However, given the extremely low incidence of an ovarian ectopic pregnancy, even after ovulation induction and assisted reproduction, it still remains a very rare diagnosis.…”

Ectopic Pregnancy Rates after Frozen versus Fresh Embryo Transfer: A Meta-Analysis

“…The incidence of ectopic pregnancy (EP) has been reported to be increased after in vitro fertilization and embryo transfer (IVF-ET) with a range from 2 to 5% [1][2][3] . It is well known that women with tubal disease are at increased risk of developing EP after IVF compared with women without the disease [2,4,5] .…”

Clinical Outcomes of Tubal Heterotopic Pregnancy: Assisted vs. Spontaneous Conceptions

“…In a woman with a natural conception cycle, its frequency is very rare and varies from 1/10,000 to 1/50,000. The heterotopic pregnancy resulting from assisted reproductive technologies (ART) was first reported in 1985 [2] , and the incidence of heterotopic pregnancy has been increased with the widespread use of ART [3] . Today in ART-treated patients, its frequency is as high as 1: 100 to 1: 500 [4,5] .…”