Embarazo ectópico: tratamiento conservador en presencia de enfermedad tubárica contralateral

Abstract

Introduction: Ectopic pregnancy (EP) is rare; although there are different implantation sites, 97% of them are located in the uterine tubes. It is also the first cause of maternal death in the first trimester. There are several treatment alternatives, the most important of which are pharmacological and surgical, to try to preserve the mother's fertility, especially in those cases where there is a contralateral tubal disease. Literature Review: Different risk factors contribute to EP decrease or increase. However, an early and accurate diagnosis helps prevent complications; the most used are transvaginal ultrasound and measurement of human chorionic gonadotropin (hCG) levels. Expectant management is usually used in cases with a very early diagnosis and in selected cases where there is no need for intervention. It is necessary to complement it with psychological support for all patients due to its emotional impact on them. Conclusions: In this review, the main objective is to emphasize conservative treatment in ectopic pregnancy in the presence of contralateral tubal disease. As for the surgical treatment, salpingostomy or salpingectomy can be performed, depending on the need of the patient, although, at this point, it is possible to opt for laparoscopic surgery, which is less invasive and the recovery is faster, or by laparotomy, which is usually performed in more critical situations. In addition, the treatment should be individualized according to each patient’s clinical situation.