Ectopic Pregnancy

A potentially life-threatening condition in which the EMBRYO, MAMMALIAN implants outside the cavity of the UTERUS. Most ectopic pregnancies (>96%) occur in the FALLOPIAN TUBES, known as TUBAL PREGNANCY. They can be in other locations, such as UTERINE CERVIX; OVARY; and abdominal cavity (PREGNANCY, ABDOMINAL).

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Networked: 2730 relevant articles (128 outcomes, 264 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Pelvic Inflammatory Disease (Pelvic Inflammatory Diseases)
2.	Hemorrhage
3.	Tubal Pregnancy
4.	Cicatrix (Scar)
5.	Ectopic Pregnancy

Experts

1.	Horne, Andrew W: 21 articles (12/2015 - 03/2009)
2.	Barnhart, Kurt T: 19 articles (12/2015 - 09/2002)
3.	Fernandez, H: 11 articles (03/2015 - 06/2000)
4.	Bouyer, J: 11 articles (02/2012 - 05/2000)
5.	Critchley, Hilary O D: 10 articles (10/2013 - 03/2009)
6.	Tong, Stephen: 9 articles (02/2015 - 11/2011)
7.	Fernandez, Hervé: 9 articles (01/2015 - 02/2003)
8.	Sammel, Mary D: 9 articles (07/2014 - 03/2006)
9.	Takacs, Peter: 9 articles (10/2012 - 09/2004)
10.	van der Veen, F: 8 articles (09/2015 - 04/2000)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Ectopic Pregnancy:

1.	Methotrexate (Mexate)FDA LinkGeneric 06/01/2009 - "Medical management with methotrexate is highly effective for properly selected patients with ectopic pregnancy. " 11/01/1999 - "To evaluate the efficacy of a predictive score for the systemic treatment of unruptured ectopic pregnancy with a single dose of methotrexate in order to select the best cases for the medical treatment. " 04/01/2004 - "Systemic methotrexate treatment is safety and effective in the treatment of unruptured ectopic pregnancy, for woman with future desire of fertility and if it has unruptured, conservative treatment using methotrexate is an excellent choice." 12/01/2012 - "A case of cervical ectopic pregnancy: successful therapy with methotrexate." 03/01/2010 - "Molar cornual ectopic pregnancy can be successfully treated with laparoscopic cornuostomy and systemic methotrexate therapy."
2.	Chorionic Gonadotropin (Human Chorionic Gonadotropin)FDA LinkGeneric 10/01/2008 - "The introduction of highly sensitive methods, such as transvaginal sonography and measurement of serum b-human chorionic gonadotropin, has dramatically improved ectopic pregnancy diagnosis in recent years. " 04/01/1982 - "Receiver operating characteristic (ROC) curve analysis of the relative efficacy of single and serial chorionic gonadotropin determinations in the early diagnosis of ectopic pregnancy." 04/01/1994 - "Serum human chorionic gonadotropin dynamics during spontaneous resolution of ectopic pregnancy." 06/01/1992 - "Today ectopic pregnancies can be recognized before the appearance of dramatic symptoms, mainly because of improved diagnostic methods, eg, endovaginal sonography and serial human chorionic gonadotropin determinations. " 03/01/1988 - "Improved methods for detecting ectopic pregnancy, including pelvic ultrasound and radioimmunoassay of the beta subunit of human chorionic gonadotropin, have increased the physician's ability to make an early and specific diagnosis. "
3.	ProgesteroneFDA LinkGeneric 05/01/2008 - "The study showed that a protocol combining single serum progesterone measurement and beta hCG is helpful in managing women with suspected ectopic pregnancies, when the ultrasound examination is inconclusive. " 11/01/2012 - "Serum human chorionic gonadotrophin levels, progesterone levels and mathematical models are helpful in the prediction of final outcome of pregnancy: intra uterine pregnancy, ectopic pregnancy, spontaneous resolution or persistent pregnancy of unknown location. " 05/01/1992 - "Improved sensitivity and specificity of a single measurement of serum progesterone over serial quantitative beta-human chorionic gonadotrophin in screening for ectopic pregnancy." 12/01/2012 - "Women included in this study were followed by ultrasound for the viability of the pregnancy till the end of first trimester and the outcome of their pregnancy were recorded, while women with exogenous progesterone support or multiple pregnancies or suspected ectopic pregnancy or Hydatiform mole were excluded from this study. " 11/01/2002 - "The objective of this study was to evaluate a progesterone cutpoint of 5.0 ng/mL ability to identify abnormal pregnancy (abnormal intrauterine pregnancy and ectopic pregnancy) as well as ectopic pregnancy alone in 2 subclasses of indeterminate ultrasounds. "
4.	CopperIBA 12/01/1996 - " The copper device has a significant deleterious effect on sperm and their motility and confers protection against ectopic pregnancy. " 07/01/2008 - "In addition to a favorable safety and tolerability profile, the LNG-IUS offers an advantage over copper IUDs, demonstrating improved efficacy in preventing intrauterine and ectopic pregnancies. " 12/01/1996 - "The copper-containing IUD is effective for up to 10 years, and is protective against ectopic pregnancy. " 04/01/2015 - "However, the LNG IUS was associated with a significantly lower risk of pregnancy, including ectopic pregnancy, than the copper IUDs. " 04/01/2015 - "Tenty-one pregnancies (7 LNG IUS, 14 copper IUD) were ectopic, yielding an adjusted hazard ratio for ectopic pregnancy of 0.26 (95% CI: 0.10-0.66). "
5.	Levonorgestrel (Plan B)FDA LinkGeneric 08/01/1991 - " Beneficial effects associated with Norplant use include protection against unwanted pregnancy and ectopic pregnancy. " 12/01/2015 - "The proportion of ectopic pregnancy ranged from 0 to 100% with an incidence of 0-2.9 per 1000 woman-years in studies of marketed levonorgestrel implants. " 01/01/1998 - " Preliminary findings of the Post-Marketing Surveillance study of Norplant, a 5-year prospective study conducted in 32 family planning clinics in 8 developing countries in 1987-97, indicate an intrauterine pregnancy rate of 0.23/100 woman-years, an ectopic pregnancy rate of 0.03/100 woman-years, and a 67.3% continuation rate at 5 years. " 04/01/1986 - "The two ectopic pregnancies are the only ones reported for Norplant users in The Population Council studies. " 10/01/2012 - "Although pregnancy is rare in women who use intrauterine system Mirena, women who do become pregnant while using Mirena have a high risk of ectopic pregnancy. "
6.	Mifepristone (RU 486)FDA Link 04/01/1999 - "Mifepristone is safe and effective to treat ectopic pregnancy." 09/01/1991 - " RU-486 has been used to manage ectopic pregnancy in preliminary studies. " 03/01/2013 - "Mifepristone does not increase the rate of ectopic pregnancies. " 05/15/2006 - "Use of mifepristone for treatment of ectopic pregnancy." 10/01/2001 - "A total of 89 cases was excluded from full analysis of outcome because either they aborted after mifepristone alone (n = 2), had an ectopic pregnancy (n = 1), or because the outcome was uncertain as they failed to attend their follow-up appointment (n = 86). "
7.	Glucose (Dextrose)FDA LinkGeneric 02/01/2006 - "Local injection of 50% glucose after aspiration of the tubal gestational sac fluid under transvaginal ultrasonographic guidance proved effective in resolving the ectopic pregnancy without adversely affecting the concurrent intrauterine pregnancy. " 09/01/1995 - "Local injection of hyperosmolar glucose guided by transvaginal ultrasound by one skilled investigator is an effective treatment for ectopic pregnancy. " 02/01/1995 - "To evaluate the safety and efficacy of hyperosmolar glucose injection in select unruptured tubal gestations with hCG levels less than 2500 mIU/mL. In this prospective series, 16 patients with an hCG titer less than 2500 mIU/mL and an unruptured ectopic pregnancy were treated by tubal injection with hyperosmolar (50%) glucose. " 09/01/1995 - "To study local treatment of ectopic pregnancy by injection of hyperosmolar (50%) glucose, guided either by transvaginal ultrasound or by laparoscopy. " 09/01/1995 - "Treatment of ectopic pregnancy by local injection of hypertonic glucose: a randomized trial comparing administration guided by transvaginal ultrasound or laparoscopy."
8.	HormonesIBA 02/01/2013 - "In this study, there were 4,034 FET cycles performed in our center between January 2005 and December 2010, and the rates of ectopic pregnancy were compared between natural and hormone replacement cycles. " 02/01/2013 - "We conclude that the incidence of ectopic pregnancy is significantly lower in natural FET cycles than in hormone replacement FET cycles. " 02/01/2013 - "The rate of ectopic pregnancy was lower in natural FET cycles (1.46%) than in hormone replacement FET cycles (3.31%) with a statistical significance (P < 0.05). " 02/01/2013 - "We analyzed the incidence of ectopic pregnancy in frozen-thawed embryo transfer (FET) as a function of natural and hormone replacement cycles and ectopic pregnancy-related factors. " 02/01/2013 - "Clinical utility of serum reproductive hormones for the early diagnosis of ectopic pregnancy in the first trimester."
9.	Biological Markers (Surrogate Marker)IBA 02/15/2000 - "Greater awareness of risk factors and improved technology (biochemical markers and ultrasonography) allow ectopic pregnancy to be identified before the development of life-threatening events. " 01/01/2012 - "The diagnosis of ectopic pregnancy is often difficult and resource intensive owing to a lack of accurate biomarkers, and there is a need for improved medical management of ectopic pregnancy using new or adjuvant treatments. " 12/01/2013 - "Moreover, the present study did not show any relation between initial β-hCG and CPK serum levels, so our findings indicate that they are not possibly considered as two independent biomarkers in ectopic pregnancy." 08/01/2000 - "Previous studies have suggested that serum markers of smooth muscle destruction have utility in predicting ectopic pregnancy. " 03/15/2013 - "Several serum and plasma biomarkers for ectopic pregnancy have been investigated independently and in combination. "
10.	gefitinib (Iressa)FDA Link 07/01/2014 - "Hence, our case series supports a future clinical trial to determine the efficacy of combination gefitinib and methotrexate to treat non-tubal ectopic pregnancies." 10/01/2013 - "To determine the safety, tolerability, and efficacy of combination gefitinib and methotrexate to treat ectopic pregnancy. " 02/01/2015 - "In early human trials, encouraging preliminary efficacy data have shown that combination gefitinib and methotrexate can rapidly resolve tubal ectopic pregnancies, and large extra-tubal ectopic pregnancies. " 01/01/2013 - "Phase II single arm open label multicentre clinical trial to evaluate the efficacy and side effects of a combination of gefitinib and methotrexate to treat tubal ectopic pregnancies (GEM II): study protocol." 02/01/2015 - "If a large clinical randomized controlled trial confirms these findings, combination gefitinib and methotrexate could become a new medical treatment option for ectopic pregnancy. "

Therapies and Procedures

1.	Laparotomy 11/01/2003 - "Surgery by minilaparotomy technique in ectopic pregnancy cases appears to be a safe and feasible method and is superior to conventional laparotomy as there are minimum perioperative and postoperative complications and patients can be discharged early from the hospital without the need of expensive equipment." 12/01/1992 - "The present data demonstrates that operative laparoscopy is not only safe and effective, but also more economical than open laparotomy in the treatment of ectopic pregnancies. " 10/01/2014 - "The diagnosis of ectopic pregnancy was confirmed by direct observation by laparotomy or laparoscopy (which was taken as gold standard). " 01/01/1988 - " Pelvic ultrasound helped establish the diagnosis of an ovarian pregnancy (OP), but diagnosis was confirmed using a laparotomy. " 01/01/2014 - "The aim of this study was to compare the success of surgical procedures performed by laparoscopy and laparotomy in the treatment of tubal ectopic pregnancy. "
2.	Salpingostomy 09/01/1987 - "We conclude that linear salpingostomy for isthmic ectopic pregnancies is as effective as segmental tubal resection with primary microsurgical reanastomosis in achieving tubal patency." 12/01/2010 - "Our follow-up shows that laparoscopic salpingostomy, performed in 84.9% of the patients, is a safe and effective treatment for ectopic pregnancy." 02/01/2014 - "The objective of this study was to review our experience with ectopic pregnancy management and to evaluate major predictive factors for failure of conservative linear salpingostomy. " 05/01/2013 - "This study is aimed to evaluate the impact of laparoscopic salpingostomy on ovarian stromal blood flow indices in patients with ectopic pregnancy, and to compare the ovarian stromal blood flow indices with matched paired healthy women. " 06/01/2002 - "This is a descriptive study which reviewed the regression pattern of serum beta hCG in Thai women with ectopic pregnancy after laparoscopic salpingostomy. "
3.	Salpingectomy 01/01/2014 - "The safety and efficacy of transvaginal endoscopic salpingectomy for tubal ectopic pregnancy are equivalent to those of the laparoscopic procedure. " 06/01/1986 - "One case of ectopic pregnancy was cured by salpingectomy after diagnostic laparoscopy. " 06/01/2015 - "A total of 81 patients with an ampullary ectopic pregnancy undergoing salpingectomy were enrolled in the study. " 12/01/2013 - "The aim of the study was to compare women's fertility after surgical radical or conservative treatment of tubal ectopic pregnancy Out of the 58 patients operated because of tubal EP pregnancy 22 underwent laparoscopic salpingotomy (group 1) and 36 laparoscopic salpingectomy (group 2). " 05/01/2013 - "Data of all women treated for ectopic pregnancy as a result of IVF treatment were evaluated; the study included women who had an unruptured ectopic pregnancy after IVF treatment that was treated with either MTX or laparoscopic salpingectomy and underwent a subsequent IVF cycle. "
4.	Tubal Sterilization (Tubal Ligation) 01/01/2001 - "The purpose of this report is to compare the echogenicity of the tubal ring of an ectopic pregnancy and the corpus luteum with that of the ovary for improved detection of early ectopic pregnancy. " 04/01/1983 - " Intrauterine pregnancies and ectopic pregnancies are 2 concerns regarding the efficacy of tubal sterilization. " 03/01/2014 - "Long-term risk of ectopic pregnancy varies by method of tubal sterilization: a whole-population study." 01/01/2004 - "This study compared the utility of various sonographic features in differentiating between the tubal ring of ectopic pregnancy and the corpus luteum. " 03/13/1997 - " In a study reported in this issue of "The New England Journal of Medicine," the 10-year cumulative rate of ectopic pregnancy after tubal sterilization was 7.3/1000 procedures. "
5.	Contraception (Birth Control) 04/01/1977 - "The reported efficacy of various contraceptive methods has such a wide range that we have not attempted to calculate the likelihood that a woman may experience an ectopic pregnancy within a particular time period while using a specific method. " 09/01/2003 - "The purpose of this work was to study the fertility after ectopic pregnancy (EP) according to the type of contraception at the time of EP (none, IUD, other) and treatment (medical, conservative surgical, radical). " 11/01/2002 - "To alert clinicians to the risk of ectopic pregnancy when certain contraceptive methods fail by summarizing data from trials reviewed by the U.S. " 10/01/1990 - "Studies of the association of ectopic pregnancy with contraception have generated a conflicting array of results because of methodological differences between studies. " 10/01/1990 - "Studies of the association of ectopic pregnancy with contraception have generated a conflicting array of results because of methodologic differences between studies. "