Conservative management of nontubal ectopic pregnancies

Objective: To report successful conservative management of nontubal ectopic pregnancies. Design: Retrospective case series. Setting: University tertiary-care hospital. Patient(s): Sixty-four women with diagnosis of nontubal ectopic pregnancies (cervical, cornual, and cesarean section scar) were treated with minimally invasive procedures. Intervention(s): Systemic methotrexate alone or combined with ultrasound-guided fetal intracardiac injection of potassium chloride. Main Outcome Measure(s): Success of the treatment, preservation of the uterus, rate of serious complications, and the need for additional interventions. Result(s): Conservative treatment was successful in 63 patients with nontubal ectopic pregnancies. One patient had rupture of cornual pregnancy and underwent cornual resection. None of the patients in this case series required hysterectomy. This series included four patients with heterotopic pregnancies, three of whom continued intrauterine pregnancy to term gestation after conservative treatment. Seven patients experienced minimal morbidity that was treated with additional nonsurgical interventions. Conclusion(s): Conservative management and fertility preservation is feasible in most nontubal ectopic pregnancies.