Interventions for tubal ectopic pregnancy

Cochrane Review by Hajenius PJ, Mol F, Mol BWJ, Bossuyt PMM, Ankum WM, Veen F

This record should be cited as: Hajenius PJ, Mol F, Mol BWJ, Bossuyt PMM, Ankum WM, Veen F. Interventions for tubal ectopic pregnancy. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD000324. DOI: 10.1002/14651858.CD000324.pub2.

ABSTRACT

Title

Interventions for tubal ectopic pregnancy

Background

Treatment options for tubal ectopic pregnancy are; (1) surgery, e.g. salpingectomy or salpingo(s)tomy, either performed laparoscopically or by open surgery; (2) medical treatment, with a variety of drugs, that can be administered systemically and/or locally by various routes and (3) expectant management.

Objectives

To evaluate the effectiveness and safety of surgery, medical treatment and expectant management of tubal ectopic pregnancy in view of primary treatment success, tubal preservation and future fertility.

Search strategy

We searched the Cochrane Menstrual Disorders and Subfertility Group's Specialised Register, Cochrane Controlled Trials Register (up to February 2006), Current Controlled Trials Register (up to October 2006), and MEDLINE (up to October 2006).

Selection criteria

Randomized controlled trials (RCTs) comparing treatments in women with tubal ectopic pregnancy.

Data collection and analysis

Two review authors independently extracted data and assessed quality. Differences were resolved by discussion with all review authors.

Main results

Thirty five studies have been analyzed on the treatment of tubal ectopic pregnancy, describing 25 different comparisons.

Authors' conclusions

In the surgical treatment of tubal ectopic pregnancy laparoscopic surgery is a cost effective treatment. An alternative nonsurgical treatment option in selected patients is medical treatment with systemic methotrexate. Expectant management can not be adequately evaluated yet.

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