What is management of ectopic pregnancy?
1. Expectant - if HCG level less than 1,000 mIU per ml and declining, gestational sac less than 3mm, no heart beat; the patient is compliant with follow-up requirements. 2. Medical, Methotrexate (folic acid antagonist); most effective if HCG level less than 5,000-6,000 mIU per ml. 3. Surgical (laparoscopic salpingostomy or salpingectomy) - if HCG level more than 15,000, there are signs of rupture (hemoperitoneum)
What are side effects of Methotrexate?
Bone marrow suppression, rash, alopecia, elevated liver enzymes, nausea, vomiting, stomatitis
No intrauterine gestational sac. Left adnexal/left fallopian tube gestational sac with fetal pole and cardiac activity (8 weeks and 4 days gestational age by CRL), which appears separable from the left ovary. Moderate amount of the complex pelvic fluid.
There is corpus luteum cyst in the left ovary.