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Tubal Pregnancy, Management (Green-top Guideline No. 21)

Published: 01/05/2004

Update November 2014: This guideline is currently being revised, with publication anticipated early 2016. The version available on the website and app will remain valid until replaced.

This guideline replaces The Management of Tubal Pregnancies, produced in October 1999.

There were 13 maternal deaths resulting from ectopic pregnancy in the UK during the period 1997–99. The incidence of ectopic pregnancy has remained static in recent years (11.1/1000 pregnancies) and nearly 32,000 ectopic pregnancies are diagnosed in the UK within a 3-year period.

Tubal pregnancy can be managed by laparotomy, operative laparoscopy, medically and occasionally by observation alone. Management must be tailored to the clinical condition and future fertility requirements of the woman.

One concern raised in the Confidential Enquiry into Maternal Deaths was the difficulty encountered in diagnosing ectopic pregnancy. The remit of this guideline is not to discuss the methods available for the diagnosis of ectopic pregnancy but to discuss the methods and techniques that may be used once a diagnosis has been made. However, it is acknowledged that, when discussing the expectant and medical management of tubal pregnancy, in some women the site of pregnancy implantation will be uncertain.

Elsewhere on the site

Consent advice for laparoscopic management of tubal pregnancy
Consent Advice No. 8 provides advice for clinicians on obtaining consent from women undergoing laparoscopic salpingectomy or salpingotomy for ectopic pregnancy