In this chapter an overview is given of the best available evidence on the conservative treatment for tubal ectopic pregnancy, i.e., expectant management and medical treatment with systemic methotrexate. From the two randomized controlled trials on expectant management, no conclusions can be drawn yet. It may be that women with low serum hCG levels need not be treated at all, but more research needs to be done in this subgroup of women to reach firm conclusions. Systemic methotrexate in a fixed multiple-dose i/m regimen can be recommended for hemodynamically stable women with an unruptured tubal ectopic pregnancy and no signs of active bleeding presenting with serum hCG concentrations <3,000IU/l. In women with serum hCG concentrations <1,500IU/l, a single-dose methotrexate regimen can be considered
Original languageEnglish
Pages (from-to)509-518
Number of pages10
JournalBest practice & research. Clinical obstetrics & gynaecology
Issue number4
Publication statusPublished - Aug 2009


  • Abortifacient Agents, Nonsteroidal/administration & dosage
  • Chorionic Gonadotropin/blood
  • Female
  • Humans
  • Infertility, Female/psychology
  • Laparoscopy/adverse effects
  • Methotrexate/administration & dosage
  • Pregnancy
  • Pregnancy, Tubal/blood
  • Randomized Controlled Trials as Topic
  • Ultrasonography, Prenatal

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