RCOG World Congress 2025

The Role of Medical Management of Ectopic Pregnancy in District Hospital

Introduction

●The rate of ectopic pregnancy is 11 per 1,000 pregnancies, with a maternal mortality of 0.2 per 1,000 estimated ectopic pregnancies.

●About two-thirds of these deaths are associated with substandard care.

●Management of ectopic pregnancies

●Medical management- same efficacy as expectant management

●Some tertiary centres- not routinely offer medical management.

•Expectant management is more cost-effective than medical management although the follow up will be similar.

•Medical management can be an option for a woman whose HCG is between 1500 and 5000 without symptoms and can follow up as per protocol.

Objective/ Aim

●To assess efficacy and role of medical management of ectopic pregnancy.

Design

•Retrospective review of the cases of ectopic between June 2022 and December 2022.

Method

●From hospital data-base (Evolve, ICE) and from EPC data.

●Microsoft Excel was used for data collection and data analysis.

Conclusion

●70% success rate of expectant and 80% with medical management

●Mean duration of biochemical resolution in Medical Management was 26 days

●No women required second dose of methotrexate.

●Medical Management can be one of the options for women who do not fit for expectant management & decline surgical management.

●Role of medical management in ectopic pregnancy cannot be denied.

●The medical management still has a role especially in District Hospital.

The Role of Medical Management of Ectopic Pregnancy in District Hospital