Management

There are two options of treatment:

Operative

■ Laparoscopy or laparotomy with salpingostomy or segmental resection if the tube is to be retained and salpingectomy if the tube requires removal

Medical

■ Intramuscular methotrexate (prevents DNA synthesis via its antifolate actions)

■ Patient is monitored as an outpatient.

Always do a P-hCG level on a premenopausal woman with abdominal pain.

If ruptured, always stabilize with IV fluids, blood replacement, and pressors if necessary. Operative repair is used.

FETAL DEATH

The frequency of chromosomal abnormalities in stillbirths is 10 times higher than that in live births.

Up to 35% of fetal deaths are associated with the presence of congenital malformation.

Fetal death is defined as death prior to complete expulsion or extraction from the mother, regardless of the duration of pregnancy.

Fetal death can result in a spontaneous abortion and a missed abortion.

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