A hemodynamically stable nulliparous patient with ectopic preganancy has adnexal mass of 2.5 x 3 cms and Beta hCG titre of 1500 miu/ml. What modality of treatment is suitable for her:
1. Conservative management.
2. Medical Management.
3. Laparoscopic Surgery.
4. Laparotomy.
Answer
2. Medical Management.
Reference
Test book of Obstetrics 4th Edition D.C.Dutta Page 202
Mudaliar Ninth Edition Page 233
Quality
Reader
Status
Repeat
QTDF
Dutta
Discussion
The indications of Medical Management are
1. Hemodynam,ically Stable Patient
2. Size of Ectopic < 4 cm
3. Gestation < 6 weeks
4. FH Absent
5. Serum beta HCG less than 1500 mIU/ml
Methotrexate is used in Medical Management
Dose 50 mg /M2
Explanation
1. Conservative management is not a definite management in this case.
2. Medical Management is the most approprite.
3. Laparoscopic Surgery is not needed as size less than 4 cm.
4. Laparotomy is not needed.
Comments
StraIght from Dutta
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