Ectopic Pregnancy: An Overview
Objectives: Purpose of this narrative review is to compare, the latest findings about ectopic pregnancy (EP) reporting pathogenetic hypothesis, common and uncommon symptoms, diagnostic work-up, treatment alternatives. EP is a pathological condition characterized by an abnormal blastocyst implant at...
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| Format: | Article |
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IMR Press
2022-11-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
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| Online Access: | https://www.imrpress.com/journal/CEOG/49/12/10.31083/j.ceog4912262 |
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| author | Daniele Di Gennaro Gianluca Raffaello Damiani Giuseppe Muzzupapa Massimo Stomati Rossana Cicinelli Maria Gaetani Luca Maria Schonauer Edoardo Di Naro Giuseppe Trojano Ettore Cicinelli |
| author_facet | Daniele Di Gennaro Gianluca Raffaello Damiani Giuseppe Muzzupapa Massimo Stomati Rossana Cicinelli Maria Gaetani Luca Maria Schonauer Edoardo Di Naro Giuseppe Trojano Ettore Cicinelli |
| author_sort | Daniele Di Gennaro |
| collection | DOAJ |
| description | Objectives: Purpose of this narrative review is to compare, the latest findings about ectopic pregnancy (EP) reporting pathogenetic hypothesis, common and uncommon symptoms, diagnostic work-up, treatment alternatives. EP is a pathological condition characterized by an abnormal blastocyst implant at any site apart from uterine cavity. Dealing with pathogenesis we can recognize many factors: hormonal imbalance, post infective or mechanical induced defects of the tube, assisted reproduction techniques. This condition has aroused interest for its capacity to evolve instantly in a life-threatening condition, needing an early diagnosis and an urgent surgical solution. Mechanism: A comprehensive literature research of recent articles has been performed. Researches for relevant data were conducted utilizing multiple databases, including PubMed, SCOPUS and Ovid. Searches included combinations of the key terms: tubal pregnancy, cervical pregnancy, cesarean scar pregnancy, ‘twin and ectopic pregnancy’, ‘twin and tubal pregnancy’, ‘twin heterotopic pregnancy’, ‘laparoscopy and twin pregnancy’, ‘laparoscopy and tubal pregnancy’, ‘surgery and pregnancy’, ‘surgery and ectopic’, ‘surgery and twin tubal pregnancy’, “methotrexate and twin pregnancy ‘cornual pregnancy’ ”. Findings in brief: EP is frequently located in the salpinges but may also occur in many other sites like uterine horns, cervix, ovaries, cesarean scar or in splanchnic organs. Typical signs and symptoms of EP usually consist of pelvic pain, vaginal bleeding or sudden amenorrhea. Beta-human chorionic gonadotropin (b-hCG) dosages are fundamental tools for diagnosis of the early pregnancy whether is normal or not, always considering tubal pregnancy a possible event. Imaging diagnostic tools are described in our review, Ultrasound, Magnetic resonance imaging (MRI), Computed Tomography (CT) are the main options. When the serum b-hCG is positive but at ultrasound examination of pregnancy cannot be found, physician must define this condition as a pregnancy of unknown location (PUL). In this literature-based review we found three therapeutic solutions: expectant, medical or surgical management. Expectant strategy consists of strictly monitoring b-hCG values with no pharmacological or surgical intervention. Methotrexate administration following therapeutic schemes is a cost-effective solution and keeps patient away from surgical risks. Surgery maintains a key role in treatment choice considering that is the only one available in emergency scenario. Conclusions: EP is a diagnostic challenge for the physician, therapy choice is a careful and difficult decision that must be always individualized to ensure patient life uppermost and also future fertility desire. |
| format | Article |
| id | doaj-art-43fcbd81a49541f6aebf383ad123e9fc |
| institution | OA Journals |
| issn | 0390-6663 |
| language | English |
| publishDate | 2022-11-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj-art-43fcbd81a49541f6aebf383ad123e9fc2025-08-20T02:05:50ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632022-11-01491226210.31083/j.ceog4912262S0390-6663(22)01912-1Ectopic Pregnancy: An OverviewDaniele Di Gennaro0Gianluca Raffaello Damiani1Giuseppe Muzzupapa2Massimo Stomati3Rossana Cicinelli4Maria Gaetani5Luca Maria Schonauer6Edoardo Di Naro7Giuseppe Trojano8Ettore Cicinelli9Department of Biomedical Sciences and Human Oncology, Gynaecologic and Obstetrics Clinic, University of Bari ALDO MORO, 70121 Bari, ItalyDepartment of Biomedical Sciences and Human Oncology, Gynaecologic and Obstetrics Clinic, University of Bari ALDO MORO, 70121 Bari, ItalyDepartment of Biomedical Sciences and Human Oncology, Gynaecologic and Obstetrics Clinic, University of Bari ALDO MORO, 70121 Bari, ItalyDivision of Gynaecologic and Obstetrics Clinic, Dario Camberlingo, 72021 Francavilla Fontana, ItalyDepartment of Biomedical Sciences and Human Oncology, Gynaecologic and Obstetrics Clinic, University of Bari ALDO MORO, 70121 Bari, ItalyDepartment of Biomedical Sciences and Human Oncology, Gynaecologic and Obstetrics Clinic, University of Bari ALDO MORO, 70121 Bari, ItalyDepartment of Biomedical Sciences and Human Oncology, Gynaecologic and Obstetrics Clinic, University of Bari ALDO MORO, 70121 Bari, ItalyDepartment of Biomedical Sciences and Human Oncology, Gynaecologic and Obstetrics Clinic, University of Bari ALDO MORO, 70121 Bari, ItalyDivision of Gynaecologic and Obstetrics Clinic, Hospital of Matera, Madonna delle Grazie, 75100 Matera, ItalyDepartment of Biomedical Sciences and Human Oncology, Gynaecologic and Obstetrics Clinic, University of Bari ALDO MORO, 70121 Bari, ItalyObjectives: Purpose of this narrative review is to compare, the latest findings about ectopic pregnancy (EP) reporting pathogenetic hypothesis, common and uncommon symptoms, diagnostic work-up, treatment alternatives. EP is a pathological condition characterized by an abnormal blastocyst implant at any site apart from uterine cavity. Dealing with pathogenesis we can recognize many factors: hormonal imbalance, post infective or mechanical induced defects of the tube, assisted reproduction techniques. This condition has aroused interest for its capacity to evolve instantly in a life-threatening condition, needing an early diagnosis and an urgent surgical solution. Mechanism: A comprehensive literature research of recent articles has been performed. Researches for relevant data were conducted utilizing multiple databases, including PubMed, SCOPUS and Ovid. Searches included combinations of the key terms: tubal pregnancy, cervical pregnancy, cesarean scar pregnancy, ‘twin and ectopic pregnancy’, ‘twin and tubal pregnancy’, ‘twin heterotopic pregnancy’, ‘laparoscopy and twin pregnancy’, ‘laparoscopy and tubal pregnancy’, ‘surgery and pregnancy’, ‘surgery and ectopic’, ‘surgery and twin tubal pregnancy’, “methotrexate and twin pregnancy ‘cornual pregnancy’ ”. Findings in brief: EP is frequently located in the salpinges but may also occur in many other sites like uterine horns, cervix, ovaries, cesarean scar or in splanchnic organs. Typical signs and symptoms of EP usually consist of pelvic pain, vaginal bleeding or sudden amenorrhea. Beta-human chorionic gonadotropin (b-hCG) dosages are fundamental tools for diagnosis of the early pregnancy whether is normal or not, always considering tubal pregnancy a possible event. Imaging diagnostic tools are described in our review, Ultrasound, Magnetic resonance imaging (MRI), Computed Tomography (CT) are the main options. When the serum b-hCG is positive but at ultrasound examination of pregnancy cannot be found, physician must define this condition as a pregnancy of unknown location (PUL). In this literature-based review we found three therapeutic solutions: expectant, medical or surgical management. Expectant strategy consists of strictly monitoring b-hCG values with no pharmacological or surgical intervention. Methotrexate administration following therapeutic schemes is a cost-effective solution and keeps patient away from surgical risks. Surgery maintains a key role in treatment choice considering that is the only one available in emergency scenario. Conclusions: EP is a diagnostic challenge for the physician, therapy choice is a careful and difficult decision that must be always individualized to ensure patient life uppermost and also future fertility desire.https://www.imrpress.com/journal/CEOG/49/12/10.31083/j.ceog4912262ectopic pregnancytubal pregnancyabdominal pregnancyultrasoundmethotrexatelaparoscopy |
| spellingShingle | Daniele Di Gennaro Gianluca Raffaello Damiani Giuseppe Muzzupapa Massimo Stomati Rossana Cicinelli Maria Gaetani Luca Maria Schonauer Edoardo Di Naro Giuseppe Trojano Ettore Cicinelli Ectopic Pregnancy: An Overview Clinical and Experimental Obstetrics & Gynecology ectopic pregnancy tubal pregnancy abdominal pregnancy ultrasound methotrexate laparoscopy |
| title | Ectopic Pregnancy: An Overview |
| title_full | Ectopic Pregnancy: An Overview |
| title_fullStr | Ectopic Pregnancy: An Overview |
| title_full_unstemmed | Ectopic Pregnancy: An Overview |
| title_short | Ectopic Pregnancy: An Overview |
| title_sort | ectopic pregnancy an overview |
| topic | ectopic pregnancy tubal pregnancy abdominal pregnancy ultrasound methotrexate laparoscopy |
| url | https://www.imrpress.com/journal/CEOG/49/12/10.31083/j.ceog4912262 |
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