Current Approach to Surgical Treatment of Ectopic Pregnancy

Abstract

Purpose of Review The purpose of this review is to update readers on recent surgical treatment modalities of ectopic pregnancies (EP) and their advantages vs disadvantages. Recent Findings EP was generally managed with surgical treatment, and of the available applications, methotrexate (MTX) may be preferred for selected patients. Wait-and-see can be another treatment method, depending on preference or need. Surgical treatment indications are haemodynamic instability, suspected or risk of rupture, contraindications for MTX, or failure of medical treatment. Summary Salpingostomy or salpingectomy is generally the first surgical choice in tubal EPs. The selection of salpingostomy or salpingectomy is based on several factors and the decision should be made by the surgeon and patient together. For women who have completed fertility, bilateral salpingectomy can be applied for permanent sterilisation. The sterilisation method of salpingectomy has the additional potential benefit of reducing the risk of tubal neoplasia and ovarian cancer. The advantage of salpingostomy is the potential to preserve the tube to meet the patient's wishes for potential future fertility. The selection of surgical approach (laparoscopy vs laparotomy) should be made by the surgeon in consultation with the anaesthetist and taking the clinical condition of the patient into account.