CLINICAL AND MORPHOLOGICAL FEATURES OF TUBAL PREGNANCY
Keywords:
ectopic pregnancy; β-hCG; ultrasound; tubectomy; laparoscopy; treatment strategyAbstract
Ectopic pregnancy remains one of the most frequent causes of urgent conditions in gynecology. Its major clinical manifestations often include delayed menstruation, irregular bleeding (the classical sign), and abdominal pain of varying severity that may radiate to the thigh or rectum, depending on the localization and stage of the pregnancy. Internal bleeding in the abdominal cavity is a frequent accompanying symptom. Successful treatment depends on early recognition and the provision of prompt, qualified medical care. The most informative diagnostic methods are the detection of the β-subunit of human chorionic gonadotropin (hCG) in blood serum—with diagnostic accuracy around 85%—and ultrasound examination, whose accuracy ranges from 78 to 100%. Surgical management is the main treatment approach, with laparoscopy being preferred due to its minimal invasiveness. In cases of massive bleeding or dense adhesions, laparotomy is performed. The primary operative procedure in tubal pregnancy is tubectomy, while tube-preserving
References
Zeng H., Chang Y., Liu N. et al. “Ectopic pregnancy is associated with increased risk of displaced implantation window: a retrospective study.” BMC Pregnancy & Childbirth. 2024;24:839. doi:10.1186/s12884-024-07072-z. BioMed Central+1
Li J., Dai T., Liu Y. et al. “Establishing a predictive model for ectopic pregnancy risk following assisted reproductive technology.” BMC Pregnancy & Childbirth. 2025;25:365. doi:10.1186/s12884-025-07455-w. BioMed Central
Tremmel E., Starrach T., Buschmann C. et al. “Management of non-tubal ectopic pregnancies: analysis of a large tertiary center case series.” Archives of Gynecology and Obstetrics. 2024;309:1227–1236. doi:10.1007/s00404-023-07290-4. SpringerLink
Ji JS., Liu L., Huang H. et al. “The body mass index and the risk of ectopic pregnancy: a 5-year retrospective case-control study.” BMC Pregnancy & Childbirth. 2024;24:143. doi:10.1186/s12884-024-06319-z. BioMed Central
Zheng M., Peng Y., Cai P. et al. “Surgical treatment of fallopian tubal pregnancy and interstitial pregnancy has no differential effect on intrauterine pregnancy after in vitro fertilization-embryo transfer.” BMC Pregnancy & Childbirth. 2024;24:762. doi:10.1186/s12884-024-06943-9. BioMed Central
Pujol Gualdo N. et al. “Genome-wide association study meta-analysis supports association between MUC1 and ectopic pregnancy.” Human Reproduction. 2023;38(12):2516–2525. doi:10.1093/humrep/dead217. OUP Academic
Aljassim F., Georgopoulou N. “Exploring the presence of markers of decidualization in the fallopian tubes: a systematic review.” Biology of Reproduction. 2023;109(2):125–136. doi:10.1093/biolre/ioad062. OUP Academic
Leziak M., Żak K., Frankowska K. et al. “Future Perspectives of Ectopic Pregnancy Treatment — Review of Possible Pharmacological Methods.” International Journal of Environmental Research and Public Health. 2022;19(21):14230. doi:10.3390/ijerph192114230. MDPI
Baxi S., Koyani M., Sabugar MH., Pandya D. “Muscular and Vascular Fallopian Tube Morphology in Ectopic Tubal Pregnancy.” Annals of Pathology & Laboratory Medicine. 2024;11(4):A42–50. doi:10.21276/apalm.3292. pacificejournals.com+2pacificejournals.com+2
Chen W., Qi JH. “Heterotopic pregnancy after a single embryo transfer with successful perinatal outcome: case report and literature review.” Contraception and Reproductive Medicine. 2024;9:3. doi:10.1186/s40834-024-00266-y. BioMed Central
Ahmad B., Khan N., Younus Z. “Minimally invasive management of ectopic pregnancy.” International Journal of Clinical Obstetrics & Gynaecology. 2024;8(2):47–49. doi:10.33545/gynae.2024.v8.i2a.1435. gynaecologyjournal.com
Sanjana C., Panda S. “Clinical study of ectopic pregnancy in a tertiary care centre in Andhra Pradesh.” International Journal of Clinical Obstetrics & Gynaecology. 2023;7(2):28–33. doi:10.33545/gynae.2023.v7.i2a.1283. gynaecologyjournal.com
Dwivedi N., Gupta A., Vij A. “Clinical profile and outcome of ectopic pregnancy in tertiary care hospital.” International Journal of Clinical Obstetrics & Gynaecology. 2023;7(4):18–21. doi:10.33545/gynae.2023.v7.i4a.1363. gynaecologyjournal.com
Suliman AA., Ibrahim HS., Hammad KM., et al. “Ectopic Pregnancy Risk Factors Presentation and Management Outcomes.” Clinical Journal of Obstetrics & Gynaecology. 2023;6:143–149. doi:10.29328/journal.cjog.1001143. obstetricgynecoljournal.com
Mishra VV., Rane P., Aggarwal RS., Shah KN. “A retrospective study on ectopic pregnancy aspiration by transvaginal ultrasound at Institute of Kidney Diseases And Research Centre.” International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2023;12(6):1710–1715. doi:10.18203/2320-1770.ijrcog20231541. ijrcog.org
Bonasoni MP., Zuntini R., Shah K., et al. “A Partial Hydatidiform Mole in an Ovarian Ectopic Pregnancy: An Exceptional Occurrence.” Diagnostics. 2025;15(16):2024. doi:10.3390/diagnostics15162024. MDPI
Global Burden of Pelvic Inflammatory Disease and Ectopic Pregnancy from 1990 to 2019. BMC Public Health. 2023;23:1894. doi:10.1186/s12889-023-16663-y. BioMed Central
Novel ultrasound classification of tubal ectopic pregnancy: exploring underlying connections among sonographic and serum markers. Insights into Imaging. 2025. doi:10.1186/s13244-025-02079-2. insightsimaging.springeropen.com
Mao Y., Peng Y., Zheng M. et al. “Is expectant management feasible for select patients diagnosed with a heterotopic tubal pregnancy following in vitro fertilization/intracytoplasmic sperm injection?” BMC Pregnancy & Childbirth. 2024;24:813. doi:10.1186/s12884-024-07029-2. BioMed Central
Distinguishing tubal rupture from tubal abortion in ectopic pregnancies after methotrexate treatment: a retrospective cohort study. Archives of Gynecology & Obstetrics. 2025;312:833–839. doi:10.1007/s00404-025-08069-5.
