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Ectopic pregnancy occurs when a fertilized egg implants outside the uterus, commonly in a fallopian tube. Medical management of ectopic pregnancy can be approached primarily through the use of medications and monitoring, particularly in early cases where the ectopic mass is small and the patient is stable. Here are the key components of medical management: Diagnosis can be Confirmed through clinical evaluation, ultrasound, and serum beta-human chorionic gonadotropin (?-hCG) levels. - A rising ?-hCG level can indicate a viable ectopic pregnancy. Patient Selection - Suitable candidates for medical management typically include: - Hemodynamically stable patients. - Early gestational age (usually less than 6 weeks). - ?-hCG levels typically below 5,000 mIU/mL. - un ruptured ectopic pregnancy. - No significant comorbidities. 3. Medication - Methotrexate folic acid antagonist used to manage ectopic pregnancy. It works by inhibiting rapidly dividing cells within the ectopic tissue. Patients may receive: - A single dose or multiple doses depending on ?-hCG levels and the response to treatment. 4. Monitoring - After administration of methotrexate, follow-up ?-hCG levels are essential to assess the effectiveness of the treatment. - Serial ?-hCG testing is typically done on days 1, 4, and then weekly until levels drop to less than 5 mIU/mL. 5. Follow-up Care - Regular follow-up to observe for symptoms of rupture or significant pain indicating complications. Medical management of ectopic pregnancy is a delicate balance of monitoring, medication, and supportive care, aiming to preserve future fertility while ensuring the safety of the patient.