In this chapter an overview is given of the best available evidence on the conservative treatment for tubal ectopic pregnancy, i.e., expectant management and medical treatment with systemic methotrexate. From the two randomized controlled trials on expectant management, no conclusions can be drawn yet. It may be that women with low serum hCG levels need not be treated at all, but more research needs to be done in this subgroup of women to reach firm conclusions. Systemic methotrexate in a fixed multiple-dose i/m regimen can be recommended for hemodynamically stable women with an unruptured tubal ectopic pregnancy and no signs of active bleeding presenting with serum hCG concentrations<3,000 IU/l. In women with serum hCG concentrations<1,500 IU/l, a single-dose methotrexate regimen can be considered.
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机译:本章概述了输卵管异位妊娠保守治疗的最佳证据,即全身氨甲蝶呤的预期治疗和药物治疗。从两项关于预期管理的随机对照试验中,尚不能得出任何结论。血清hCG水平低的女性可能根本不需要接受治疗,但是需要对该女性亚组进行更多的研究才能得出肯定的结论。对于没有破裂输卵管异位妊娠且血液中hCG浓度<3,000 IU / l没有活动性出血迹象的血液动力学稳定的女性,建议采用固定剂量的i / m方案全身性氨甲蝶呤。在血清hCG浓度<1,500 IU / l的女性中,可以考虑单剂量甲氨蝶呤治疗方案。
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