الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
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UMMARY
ctopic pregnancy (EP), defined as the implantation of a fertilized ovum outside of the endometrial cavity, accounts for approximately 1 – 2 percent of all pregnancies.
In an ectopic pregnancy, β-hCG concentrations are just as likely to fall as to rise, with no single pattern able to characterize the condition. However, 71 percent have serial serum β-hCG values that increase more slowly than would be expected with a viable intrauterine pregnancy and decrease more slowly than would be expected with a spontaneous abortion.
Clinically stable women who present with ectopic pregnancy and low serum β-hCG levels are sometimes managed expectantly in clinical practice.
Expectant management of EP is the management approach, also called ’wait and watch’, when no medical or surgical treatment is given. The aim is to see if the condition will resolve naturally.
This study was conducted to assess the efficacy and safety of expectant management in the treatment of tubal ectopic pregnancy and identification of different factors that can be used to predict its success.
In this study, 728 women were diagnosed as ectopic pregnancy along the period from January 2016 to December
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Summary
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2020. 556 out of 728 women (76.37%) were diagnosed as tubal ectopic pregnancy and were included in this study.
Women received expectant management were 90 out of 556 which represented 16.2 percent and were the main subjects for the study. Eighty eight women (97.8%) achieved successful expectant management, while two women (2.2%) failed to success and needed surgical intervention.
The final study group included 88 out of 728 women with tubal ectopic pregnancies who were successfully managed expectantly. This accounted for 12.1 percent of all ectopic pregnancies diagnosed during the study period.
The baseline characteristics of women achieved successful expectant management included that the mean age (years) of the studied group was 28.94 ± 5.36 and the period of amenorrhea was 6.65 ± 1.25 weeks.
History of previous abortion was found in 27.2 percent of women and 3.4 percent had history of previous ectopic pregnancy.
The ultrasound findings at time of presentation showed that the mean vertical diameter of ectopic mass was 30.0 ± 9.73 mm and the mean horizontal diameter was 26.8 ± 8.45 mm.
Solid masses were found in 81.5 percent of tubal ectopic pregnancy while 16.9 percent showed gestational sac without fetal pole. Gestational sac with fetal pole and no cardiac activity
Summary
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was presented only in 1.5 percent of the cases. 49.2 percent showed mild free fluid in the peritoneal cavity while no free fluid was found in 18.5 percent of cases.
In this study, the median serum β-HCG concentration at the initial visit was 724.20 IU/L with a β-HCGmax 4617.00 IU/L and the median serum β-hCG clearance time was 15.00 (IQR 12.00-18.00) with a maximum duration of follow up 45.0 days.
The mean duration of hospital stay (days) in this study was 5.2 ± 3.6.
As regards the future fertility outcome in the study group, 41.02% of the cases got pregnant after successful expectant management of tubal ectopic pregnancy.
Conclusion
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C
CONCLUSIONONCLUSION
xpectant management of tubal ectopic pregnancy recorded a great success rate in this study (97.8 percent). So expectant management of tubal ectopic pregnancy is considered to be a safe and effective method of treatment for those cases diagnosed as tubal ectopic pregnancy and matched the selection criteria to be managed expectantly.
The initial β-HCG, β-HCG max and β-HCG sub titers significantly correlated with duration of follow up.
Also women treated with expectant management have a good fertility outcome and spontaneous regression of EP does not lead to increased harm or damage to the tube.