Non-surgical management of ectopic pregnancy: appropriate risk management must be in place

Leroy Edozien, MRCP. FRCOG is a Consultant Obstetrician and Gynaecologist at St Mary’s Hospital, Manchester and Honorary Senior Lecturer, Maternal and Fetal Health Research Centre at the University of Manchester.

He considers how advances in technology have facilitated early diagnosis of ectopic pregnancy, which in turn has increased the scope for non-surgical treatment.

In his article “Non-surgical management of ectopic pregnancy: appropriate risk management must be in place” (published Arch Gynecol Obstet  14th December 2010, 10.1007/s00404-010-1788-3), he discusses the risks of medical management which include: rupture of ectopic pregnancy during treatment with methotrexate or during expectant management; inadvertent administration of methotrexate to viable early intrauterine pregnancy; methotrexate embryopathy; allergic reaction to methotrexate; development of methotrexate pneumonitis; and fatal administration.

He argues the need for appropriate risk management procedures to be applied in units where non-surgical (i.e. expectant or medical) management of ectopic pregnancy is offered.