caa a22 4500 445308389 CHVBK 20180317142620.0 cr unu---uuuuu 170323e20110501xx s 000 0 eng 10.1007/s00404-010-1788-3 doi (NATIONALLICENCE)springer-10.1007/s00404-010-1788-3 Edozien Leroy St Mary's Hospital, M13 9WL, Manchester, UK aut Non-surgical management of ectopic pregnancy: appropriate risk management must be in place [Elektronische Daten] [Leroy Edozien] Introduction: Advances in technology have facilitated early diagnosis of ectopic pregnancy, which in turn has increased the scope for non-surgical treatment. Unfortunately risks associated with such management, including maternal death, are coming to the fore. This paper highlights the risks and how they could be avoided. Findings: The risks include rupture of ectopic pregnancy during treatment with methotrexate or during expectant management, inadvertent administration of methotrexate to viable early intrauterine pregnancy, methotrexate embryopathy, allergic reaction to methotrexate, development of methotrexate pneumonitis and fatal administration of methotrexate to a woman with a concurrent medical problem. Conclusion: There is an urgent need for appropriate risk management procedures to be applied in units where non-surgical (i.e. expectant or medical) management of ectopic pregnancy is offered. Risk management should address organisational issues such as safe handling of the chemotherapeutic agent, prescription and supply, consent (informed choice), documentation and adequacy of follow-up arrangements. Women undergoing non-surgical management should have ready access (for example by telephone) to professional advice and to surgical intervention in the event of an emergency. Springer-Verlag, 2010 Risk management nationallicence Ectopic pregnancy nationallicence Methotrexate nationallicence Archives of Gynecology and Obstetrics Springer-Verlag 283/5(2011-05-01), 925-927 0932-0067 283:5<925 2011 283 404 https://doi.org/10.1007/s00404-010-1788-3 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00404-010-1788-3 text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Edozien Leroy St Mary's Hospital, M13 9WL, Manchester, UK aut NATIONALLICENCE 773 0- Archives of Gynecology and Obstetrics Springer-Verlag 283/5(2011-05-01), 925-927 0932-0067 283:5<925 2011 283 404 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer