Ectopic pregnancy and miscarriage: diagnosis and initial management Ectopic pregnancy and miscarriage: Ectopic pregnancy and miscarriage: diagnosis and initial management diagnosis and initial management NICE guideline Published: 17 April 2019 nice.org.uk/guidance/ng126 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guideline represent the view (...) in this guideline should be interpreted in a way that would be inconsistent with complying with those duties. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Ectopic pregnancy and miscarriage: diagnosis and initial management (NG126) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms

Ectopic pregnancy Ectopic pregnancy - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Ectopic pregnancy Last reviewed: February 2019 Last updated: October 2018 Summary Typically presents 6-8 weeks after last normal menstrual period, but can present earlier or later. Risk increases with prior ectopic pregnancy, tubal surgery, history of sexually transmitted infections, smoking, in vitro fertilisation, or if pregnant (...) of referred pain from intraperitoneal blood. Definition A fertilised ovum implanting and maturing outside of the uterine endometrial cavity, with the most common site being the fallopian tube (97%), followed by the ovary (3.2%) and the abdomen (1.3%). Bouyer J, Coste J, Fernandez H, et al. Sites of ectopic pregnancy: a 10 year population-based study of 1800 cases. Hum Reprod. 2002 Dec;17(12):3224-30. http://humrep.oxfordjournals.org/content/17/12/3224.full http://www.ncbi.nlm.nih.gov/pubmed/12456628?tool

Tubal Ectopic Pregnancy Tubal Ectopic Pregnancy - ACOG Menu ▼ Tubal Ectopic Pregnancy Page Navigation ▼ INTERIM UPDATE Number 193, March 2018 (Replaces Practice Bulletin Number 191, February 2018) Committee on Practice Bulletins—Gynecology . This Practice Bulletin was developed by the Committee on Practice Bulletins—Gynecology in collaboration with Kurt T. Barnhart, MD, MSCE; and Jason M. Franasiak, MD, TS (ABB). This information is designed as an educational resource to aid clinicians (...) on the assessment of hCG levels after uterine aspiration in women with a pregnancy of unknown location. Tubal Ectopic Pregnancy Ectopic pregnancy is defined as a pregnancy that occurs outside of the uterine cavity. The most common site of ectopic pregnancy is the fallopian tube. Most cases of tubal ectopic pregnancy that are detected early can be treated successfully either with minimally invasive surgery or with medical management using methotrexate. However, tubal ectopic pregnancy in an unstable patient

Injectable methotrexate and ectopic pregnancy. An alternative to surgery, but patients must be made aware of the risks Prescrire IN ENGLISH - Spotlight ''Injectable methotrexate and ectopic pregnancy. An alternative to surgery, but patients must be made aware of the risks'', 1 February 2018 {1} {1} {1} | | > > > Injectable methotrexate and ectopic pregnancy. An alternative to surgery, but patients must be made aware of the risks Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 (...) most recent :  |   |   |   |   |   |   |   |   |  Spotlight Injectable methotrexate and ectopic pregnancy. An alternative to surgery, but patients must be made aware of the risks FEATURED REVIEW For some women with an ectopic pregnancy, intramuscular injection of methotrexate can be an alternative to surgery. But methotrexate carries the risks of a cytotoxic drug, and is teratogenic: women treated with methotrexate should wait

Ectopic pregnancy Ectopic pregnancy - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Ectopic pregnancy Last reviewed: February 2019 Last updated: October 2018 Summary Typically presents 6-8 weeks after last normal menstrual period, but can present earlier or later. Risk increases with prior ectopic pregnancy, tubal surgery, history of sexually transmitted infections, smoking, in vitro fertilisation, or if pregnant (...) of referred pain from intraperitoneal blood. Definition A fertilised ovum implanting and maturing outside of the uterine endometrial cavity, with the most common site being the fallopian tube (97%), followed by the ovary (3.2%) and the abdomen (1.3%). Bouyer J, Coste J, Fernandez H, et al. Sites of ectopic pregnancy: a 10 year population-based study of 1800 cases. Hum Reprod. 2002 Dec;17(12):3224-30. http://humrep.oxfordjournals.org/content/17/12/3224.full http://www.ncbi.nlm.nih.gov/pubmed/12456628?tool

Ectopic pregnancy Ectopic pregnancy - NICE CKS Share Ectopic pregnancy: Summary An ectopic pregnancy is a pregnancy that implants outside the uterine cavity. Most ectopic pregnancies (93–98%) implant in the fallopian tube. The others are non-tubal and may implant in the ovary, abdomen, cervix, caesarean section scar, interstitial part of the fallopian tube, or the cornua of a unicornuate or bicornuate uterus. There are about 11,000 ectopic pregnancies in the UK each year, with an ectopic (...) pregnancy occurring in about 11 in 1000 pregnancies. Risk factors include tubal damage, maternal age over 35 years, and smoking. However, in about a third of cases, there are no identifiable risk factors. Complications include: Tubal rupture (which may lead to maternal death, if treatment is delayed). Recurrent ectopic pregnancy. Grief, anxiety, or depression. The clinical features of an ectopic pregnancy may be atypical and can resemble those of other more common conditions, such as urinary tract

Clinical audit of ectopic pregnancy The aim of this study was to determine the risk factors of ectopic pregnancy in cases presented to the Woman's Health Hospital (WHH) in Assuit University, and to perform clinical audit on strategies for management of ectopic pregnancy in the WHH.This descriptive hospital based study was conducted at the Woman's Health Hospital (WHH) of Assuit University (Egypt). There were 210 patients who were admitted to the WHH with the diagnosis of ectopic pregnancy (...) in the period between February 1, 2015 through the end of October 2015. Data were analyzed by SPSS version 21, using descriptive statistics, Mann-Whitney U test, and Chi square.Ectopic pregnancy affects woman in the reproductive age. There are many risk factors that increase the chance of its occurrence; however, it may also occur in the absence of any risk factors (14.0%). Internal VD (72.5%) is the most frequent risk factor; other risk factors include history of abortion, previous CS, ovulation induction

Ectopic pregnancy

Flowchart: Ectopic pregnancy Queensland Health State of Queensland (Queensland Health) 2018 http://creativecommons.org/licenses/by-nc-nd/3.0/au/deed.en Queensland Clinical Guidelines, Guidelines@health.qld.gov.au Queensland Clinical Guidelines www.health.qld.gov.au/qcg Ectopic pregnancy Queensland Clinical Guidelines: Early pregnancy loss. Flowchart version: F17.29-3-V5-R22 ß-hCG: human chorionic gonadtrophin, ELFT: electrolyte & liver function test, EPAS: Early Pregnancy Assessment Service (...) , FBC: full blood count, GP: General Practitioner, GTD: gestational trophoblast disease, IMI: intramuscular injection, IU/L: international units per litre, IUP: intrauterine pregnancy, IVI: intravenous injection, MFM: maternal fetal medicine, POC: products of conception, PUL: pregnancy of unknown location, PV: per vaginam, QTC: Queensland Trophoblast Centre, RhD-Ig: RhD immunoglobulin, TVS: transvaginal scan, USS: ultrasound scan, >: greater than, 5000 IU/L • Ectopic > 3 cm on TVS • Fetal heart

Aberrant expression of interleukin-6 and its receptor in Fallopian tubes bearing an ectopic pregnancy with and without tubal cytomegalovirus infection Cytomegalovirus (CMV) has recently been suggested as a potential risk factor for the development of ectopic pregnancy (EP) following upper genital tract infection in women. However, little is known about its associated underlying pathogenic mechanisms. This was a prospective case-control study that measured the prevalence of CMV infection

Diagnosis and Management of Ectopic Pregnancy Diagnosis and Management of Ectopic Pregnancy - 2016 - BJOG: An International Journal of Obstetrics & Gynaecology - Wiley Online Library

Bleeding and pain in early pregnancy (Ectopic pregnancy, Miscarriage, PUL)

The Diagnosis of Ectopic Pregnancy Systematic Review Snapshot TAKE-HOME MESSAGE Transvaginal sonography should be used in conjunction with quantitative serum b-hCG testing to rule out ectopic pregnancy in hemodynamically stable patients. No single level of b-hCG can be used in isolation to rule out ectopic pregnancy. The Diagnosis of Ectopic Pregnancy EBEM Commentator Lisa T. Barker, MD University of Illinois College of Medicine at Peoria/OSF St. Francis Medical Center Peoria, IL Shelly Zhou (...) , MD Medical University of South Carolina Charleston, SC Results Table. Findings supporting the diagnosis of ectopic pregnancy. Finding LR (D) 95% CI LR (–) 95% CI Abdominal pain with cough or light palpation 4.2–4.5 * 0.78–0.81 * Bimanual examination Cervical motion tenderness 4.9 1.7–14 0.62 0.47–0.83 Palpated adnexal mass 2.4 1.6–3.7 0.94 0.87–1.0 Transvaginal sonography (þ) adnexal mass, absent IUP 111 (12–1,208) 0.12 (0.03–0.55) IUP, Intrauterine pregnancy. *Finding only included in 2 studies

Inexscreen as a screening test for ectopic pregnancy and miscarriage Inexscreen as a screening test for ectopic pregnancy and miscarriage Inexscreen as a screening test for ectopic pregnancy and miscarriage Malaysian Health Technology Assessment (MaHTAS) Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Malaysian Health Technology (...) Assessment (MaHTAS). Inexscreen as a screening test for ectopic pregnancy and miscarriage. Putrajaya: Malaysian Health Technology Assessment (MaHTAS). 2014 Authors' objectives To assess the safety, effectiveness (diagnostic accuracy) and cost-effectiveness of Inexscreen as a screening tool for ectopic pregnancy and miscarriage. Authors' conclusions There was limited retrievable fair level of evidence on the safety and effectiveness (diagnostic accuracy) of Inexscreen as a screening test for ectopic

Randomised controlled trial: Salpingectomy for tubal ectopic pregnancy is appropriate in the presence of healthy-looking contralateral tube Salpingectomy for tubal ectopic pregnancy is appropriate in the presence of healthy-looking contralateral tube | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log (...) in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Salpingectomy for tubal ectopic pregnancy is appropriate in the presence of healthy-looking contralateral tube Article Text Therapeutics

Does this woman have an ectopic pregnancy? The rational clinical examination systematic review Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

Does this woman have an ectopic pregnancy?: the rational clinical examination systematic review. The rapid identification and accurate diagnosis of women who may have an ectopic pregnancy is critically important for reducing the maternal morbidity and mortality associated with this condition.To systematically review the accuracy and precision of the patient history, clinical examination, readily available laboratory values, and sonography in the diagnosis of ectopic pregnancy in women (...) with abdominal pain or vaginal bleeding during early pregnancy.We conducted MEDLINE and EMBASE searches for English-language articles from 1965 to December 2012 reporting on the diagnosis of ectopic pregnancy.The analysis included prospective studies of 100 or more pregnant women with abdominal pain or vaginal bleeding that evaluated patient history, physical examination, laboratory values, and sonography compared with a reference standard of either (1) direct surgical visualization of ectopic pregnancy

Medical treatment of ectopic pregnancy: a committee opinion Medical treatment of ectopic pregnancy: a committee opinion The Practice Committee of the American Society for Reproductive Medicine American Society for Reproductive Medicine, Birmingham, Alabama Methotrexate,afolicacidantagonist,isaneffectivetreatmentforearlyunrupturedectopicpregnancy.Severaltreatmentregimensare available. Methotrexate is more effective when used to treat ectopic pregnancies with lower human chorionic gonadotropin (...) to this document at www.asrm.org/elearn Discuss: You candiscuss thisarticlewith its authorsandwith otherASRM membersat http:// fertstertforum.com/goldsteinj-methotrexate-ectopic-pregnancy/ Use your smartphone to scan this QR code and connect to the discussion forum for this article now.* * Download a free QR code scanner by searching for “QR scanner” in your smartphone’s app store or app marketplace. E ctopic pregnancy is a signi?cant cause of morbidity and mortality inthe?rsttrimesterofpregnancy (1).Currently

Ectopic pregnancy and miscarriage: diagnosis and initial management Ectopic pregnancy and miscarriage: Ectopic pregnancy and miscarriage: diagnosis and initial management diagnosis and initial management Clinical guideline Published: 12 December 2012 nice.org.uk/guidance/cg154 © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guideline represent (...) . Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Ectopic pregnancy and miscarriage: diagnosis and initial management (CG154) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk

Emergency physician ultrasonography for evaluating patients at risk for ectopic pregnancy: a meta-analysis Ectopic pregnancy is a common concern in emergency departments (EDs) and remains the leading cause of first-trimester mortality. Pelvic ultrasonography by emergency physicians has been investigated as a diagnostic test for ectopic pregnancy. We present a meta-analysis of the use of emergency physician ultrasonography in the evaluation of patients at risk of ectopic pregnancy.A structured (...) search was performed of both MEDLINE and EMBASE. Inclusion criteria were that (1) the study reported original research on ED patients at risk for ectopic pregnancy; (2) an emergency physician performed and interpreted the initial pelvic ultrasonography; and (3) follow-up was conducted on all patients. Sensitivity was defined as the proportion of patients with ectopic pregnancy for which ED ultrasonography demonstrated no intrauterine pregnancy. A random-effects model was used to obtain summary test