Treatment of ectopic pregnancy: the new gynaecological dilemma

Recent diagnostic advances have resulted in earlier and more consistent diagnosis of ectopic pregnancy. This may be responsible, in part, for the increasing incidence of the condition. Also, early diagnosis of ectopic pregnancies has prompted conservative surgical treatment, the use of medical therapy and even expectant management in selected cases. The present article analyses the following main controversial questions concerning the management of ectopic pregnancy: whether to treat or not, and how to apply expectant management; whether therapy should be conservative or radical; whether conservative management should be surgical or medical; whether surgical intervention should be laparotomic or laparoscopic; and whether medical therapy should be systemic or local.