Ectopic pregnancy and miscarriage: diagnosis and initial management: summary of updated NICE guidance

### What you need to know Miscarriage and ectopic pregnancy have an adverse effect on the quality of life of many women, with early pregnancy loss accounting for over 50 000 hospital admissions in the UK annually.1 Ectopic pregnancy (where the pregnancy implants outside the endometrial cavity, most commonly within the fallopian tube) occurs in approximately 11 per 1000 pregnancies.2 Unfortunately, women still die during early pregnancy, with four maternal deaths reported in the UK between 2013 and 2015.3 However, the case fatality rate has decreased over recent years,2 suggesting that earlier diagnosis and treatment has made an impact. Accurate diagnosis and effective management of early pregnancy loss is therefore vital to avoid women dying unnecessarily, and to reduce the incidence of associated physical and psychological morbidity. This article summarises the updated recommendations from the National Institute for Health and Care Excellence (NICE) on the diagnosis and management of tubal ectopic pregnancy and miscarriage in early pregnancy (up to 13 completed weeks of pregnancy).4 In addition to these updated recommendations, the guideline also contains recommendations on providing …