Ectopic pregnancy - expectant management

EXPECTANT MANAGEMENT
Criteria

  1. Asymptomatic and haemodynamically stable

  2. HCG low and falling (<1000iu/l)

  3. < 50 - 100ml blood in pouch of Douglas

  4. gestation sac < 2 - 5cm with no FH on scan



  - Low and rapidly falling HCG levels indicate high likelihood of successful expectant management

  - Perform twice weekly serum HCG levels and weekly transvaginal scans to ensure levels falling rapidly and size of ectopic mass decreasing. 
Thereafter, weekly HCG and scans until HCG <20iu/l

  - Provide clear written information on the importance of compliance with follow-up and should have easy access to the hospital

  - Rupture may still occur under these circumstances