Expectant management Most women with a PUL are followed up with serum hCG measurements and repeat TVS examinations until a final diagnosis is confirmed. Low-risk cases of PUL that appear to be failing pregnancies may be followed up with a urinary pregnancy test after two weeks and get subsequent telephone advice. Low-risk cases of PUL that are likely intrauterine pregnancies may have another TVS in two weeks to access viability. High-risk cases of PUL require further assessment, either with a TVS within 48 h or additional hCG measurement. Medical Early treatment of an<unk>  with methotrexate is a viable alternative to surgical treatment which was developed in the 1980s. If administered early in the pregnancy, methotrexate terminates the growth of the developing embryo; this may cause an abortion, or the developing embryo may then be either resorbed by the woman's body or pass with a menstrual period. Contraindications include liver, kidney, or blood disease, as well as an<unk>  embryonic mass > 3.5 cm. Also, it may lead to the inadvertent termination of an undetected intrauterine pregnancy, or severe abnormality in any surviving pregnancy. Therefore, it is recommended that methotrexate should only be administered when hCG has been serially monitored with a rise less than 35% over 48 hours, which practically excludes a viable intrauterine pregnancy. For nontubal<unk> , evidence from randomised clinical trials in women with CSP is uncertain regarding treatment success, complications and side effects of methotrexate compared with surgery (uterine arterial embolization or uterine arterial chemoembolization). The United States uses a multi dose protocol of methotrexate (MTX) which involves 4 doses of intramuscular along with an intramuscular injection of folinic acid to protect cells from the effects of the drugs and to reduce side effects. In France, the single dose protocol is followed, but a single dose has a greater chance of failure. Surgery Surgical treatment: Laparoscopic view of an<unk>  located in the left Fallopian tube, hematosalpinx is present on the left, the right tube is of normal appearance The left Fallopian tube containing the<unk>  has been removed (salpingectomy). If bleeding has already occurred, surgical intervention may be necessary. However, whether to pursue surgical intervention is an often difficult decision in a stable patient with minimal evidence of blood clot on ultrasound. Surgeons use laparoscopy or laparotomy to gain access to the pelvis and can either incise the affected Fallopian and remove only the pregnancy (salpingostomy) or remove the affected tube with the pregnancy (salpingectomy). The first successful surgery for an<unk>  was performed by Robert Lawson Tait in 1883. It is estimated that an acceptable rate of PULs that eventually undergo surgery is between 0.5 and 11%. People that undergo salpingectomy and salpingostomy have a similar recurrent<unk>  rate of 5% and 8% respectively. Additionally, their intrauterine pregnancy rates are also similar, 56% and 61%. Autotransfusion of a woman's own blood as drained during surgery may be useful in those who have a lot of bleeding into their abdomen. Published reports that a re-implanted embryo survived to birth were debunked as false.
Ectopic pregnancy
Miscarriage
Ovarian torsion
Appendicitis
Tubo-ovarian abscess
Ovarian cyst
Ovarian pregnancy
Dysmenorrhea