An Update on the Medical Treatment of Ectopic Pregnancy

Ectopic pregnancy is a life-threatening condition that every practicing obstetrician-gynecologist encounters in his or her practice; therefore, it is imperative to be familiar with the latest methods of treatment. With the advent of assays to quantitate human chorionic gonadotropin (hCG) levels and transvaginal ultrasound monitoring, the detection of an abnormal gestation can be achieved much earlier. Although treatment is still primarily surgical, management with methotrexate is a viable and potentially cost-effective alternative. Medical treatment of ectopic pregnancy with methotrexate has been shown to be effective and safe in carefully selected patients. It is no longer considered experimental therapy. Not all patients diagnosed with an ectopic pregnancy are candidates for medical management, and therapy is not 100% effective. All practicing clinicians must be aware of the indications, contraindications, and side effects of medical therapy. This article reviews the medical treatment of ectopic pregnancy.