Background: Treatment options for tubal ectopic pregnancy are: (1) surgery, such as salpingectomy or salpingostomy, 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.
Objective: To be aware of the recent modalities in management of tubal pregnancy.
Methods: A systematic literature search of studies describing clinical trials published at the last twenty years was conducted. Literature searches of the PubMed and Cochrane Library databases were conducted. Using the following keywords:pregnancy, ectopic, tubal, interstitial, abdominal, angular, cornual, heterotopic, ovarian, gravidity, obstetric, cervical ripening, labor onset, labor presentation, trial of labor, treatment, therapeutics, therapy, medical, medication & surgical. The initial literature search identified articles were assessed for possible inclusion.
Results: Among the 62,588 women identified with ectopic pregnancy, 49,090 (78.4%) underwent surgery with salpingectomy or salpingostomy, while 13,498 (21.6%) received medical management with methotrexate. As can be seen in next figure, use of methotrexate increased significantly from 14.5% in 2011 to 27.3% by 2020 while surgical management declined from 85.5% to 72.7% over the same time period (P < 0.001).
Conclusion: Ectopic pregnancies account for the majority of first trimester maternal death. Tubal pregnancies account for the majority of ectopic pregnancies.