A hemodynamically stable nulliparous patient with ectopic pregnancy has adnexal mass of 2.5 x 3 cms and beta hCG titer of 1500 mIU/ml. There is no foetal cardiac activity. Which of the following modality of treatment is suitable for her?
The patient in the question is suffering from unruptured tubal pregnancy. Medical management is suitable for her as she meets the criteria for medical management. The best candidate for medical therapy is the woman who is asymptomatic, motivated, and compliant and with the following conditions: Initial serum Beta-hCG level: This is the single best prognostic indicator of successful treatment with single-dose methotrexate. Repoed failure rates of 1.5 percent if the initial serum hCG concentration was Ectopic pregnancy size: Lipscomb and colleagues (1998) repoed a 93-percent success rate with single-dose methotrexate when the ectopic mass was 3.5 cm. Fetal cardiac activity: Most studies repo increased failure rates if there is cardiac activity, Lipscomb and colleagues (1998) repoed an 87-percent success rates in such cases. A single dose of methotrexate 50mg/m2 is given I.M Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 10. Ectopic Pregnancy. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e. ; Textbook of Obstetrics By D.C. Dutta 6th, Edition, Page 189
Laparotomy
Laparoscopic surgery
Medical management
Conservative management