U.S. flag

An official website of the United States government

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

National Collaborating Centre for Women's and Children's Health (UK). Ectopic Pregnancy and Miscarriage: Diagnosis and Initial Management in Early Pregnancy of Ectopic Pregnancy and Miscarriage. London: RCOG Press; 2012 Dec. (NICE Clinical Guidelines, No. 154.)

  • In April 2019 NICE updated its guideline on ectopic pregnancy and miscarriage. See the evidence reviews for the areas in which new recommendations were developed. The 2012 recommendations have been retained in the new guideline. This 2012 full guideline includes the evidence supporting the 2012 recommendations and has not been updated.

In April 2019 NICE updated its guideline on ectopic pregnancy and miscarriage. See the evidence reviews for the areas in which new recommendations were developed. The 2012 recommendations have been retained in the new guideline. This 2012 full guideline includes the evidence supporting the 2012 recommendations and has not been updated.

Cover of Ectopic Pregnancy and Miscarriage

Ectopic Pregnancy and Miscarriage: Diagnosis and Initial Management in Early Pregnancy of Ectopic Pregnancy and Miscarriage.

Show details

11References

  • Abaid LN, As-Sanie S, Wolfe HM. Relationship between crown-rump length and early detection of cardiac activity. Journal of Reproductive Medicine. 2007;(5):375–378. [PubMed: 17583234]
  • Abdallah Y, Daemen A, Kirk E, Pexsters A, Naji O, Stalder C, Gould D, Ahmed S, Guha S, Syed S, Bottomley C, Timmerman D, Bourne T. Limitations of current definitions of miscarriage using mean gestational sac diameter and crown–rump length measurements: a multicenter observational study. Ultrasound in Obstetrics & Gynecology. 2011;(5):497–502. [PubMed: 21997898]
  • Aboud E, Chaliha C. Nine year survey of 138 ectopic pregnancies. Archives of Gynecology and Obstetrics. 1998;(2):83–87. [PubMed: 9544373]
  • Adolfsson A, Bertero C, Larsson PG. Effect of a structured follow-up visit to a midwife on women with early miscarriage: a randomized study. Acta Obstetricia et Gynecologica Scandinavica. 2006;(3):330–335. [PubMed: 16553182]
  • AEPU. Personal communication. 2012.
  • Akhter P, Padmanabhan A, Babiker W, Sayed A, Molelekwa V, Geary M. Introduction of an early pregnancy assessment unit: audit on the first 6 months of service. Irish Journal of Medical Science. 2007;(1):23–26. [PubMed: 17849519]
  • Al-Suleiman SA, Khwaja SS. Ectopic pregnancy. Journal of Obstetrics and Gynaecology. 1992;(4):254–257.
  • Alexander JM, Rouse DJ, Varner E, Austin JM Jr. Treatment of the small unruptured ectopic pregnancy: a cost analysis of methotrexate versus laparoscopy. Obstetrics and Gynecology. 1996;(1):123–127. [PubMed: 8684744]
  • Ankum WM, Wieringa-de,Waard M, Bindels PJ. Management of spontaneous miscarriage in the first trimester: an example of putting informed shared decision making into practice. BMJ. 2001;(7298):1343–1346. [PMC free article: PMC1120430] [PubMed: 11387184]
  • Ayudhaya OPN, Herabutya Y, Chanrachakul B, Ayuthaya NIN, Prasertsawat P. A comparison of the efficacy of sublingual and oral misoprostol 400 microgram in the management of early pregnancy failure: A randomized controlled trial. Journal of the Medical Association of Thailand. 2006 SUPPL. 4:S5–S10. [PubMed: 17726806]
  • Bagratee JS, Khullar V, Regan L, Moodley J, Kagoro H. A randomized controlled trial comparing medical and expectant management of first trimester miscarriage. Human Reproduction. 2004;(2):266–271. [PubMed: 14747165]
  • Banerjee S, Aslam N, Zosmer N, Woelfer B, Jurkovic D. The expectant management of women with early pregnancy of unknown location. Ultrasound in Obstetrics and Gynecology. 1999;(4):231–236. [PubMed: 10586473]
  • Bangsgaard N, Lund CO, Ottesen B, Nilas L. Improved fertility following conservative surgical treatment of ectopic pregnancy. BJOG: An International Journal of Obstetrics and Gynaecology. 2003;(8):765–770. [PubMed: 12892689]
  • Barnhart KT, Rinaudo P, Hummel A, Pena J, Sammel MD, Chittams J. Acute and chronic presentation of ectopic pregnancy may be two clinical entities. Fertility and Sterility. 2003;(6):1345–1351. [PubMed: 14667867]
  • Barnhart KT, Sammel MD, Appleby D, Rausch M, Molinaro T, Van Calster B, Kirk E, Condous G, Van Huffel S, Timmerman D, Bourne T. Does a prediction model for pregnancy of unknown location developed in the UK validate on a US population? Human Reproduction. 2010;(10):2434–2440. [PMC free article: PMC2939759] [PubMed: 20716562]
  • Barnhart KT, Sammel MD, Gracia CR, Chittams J, Hummel AC, Shaunik A. Risk factors for ectopic pregnancy in women with symptomatic first-trimester pregnancies. Fertility and Sterility. 2006;(1):36–43. [PubMed: 16730724]
  • Basama FM, Crosfill F. The outcome of pregnancies in 182 women with threatened miscarriage. Archives of Gynecology and Obstetrics. 2004;(2):86–90. [PubMed: 12682847]
  • Baumann R, Magos AL, Turnbull A. Prospective comparison of videopelviscopy with laparotomy for ectopic pregnancy. British Journal of Obstetrics and Gynaecology. 1991;(8):765–771. [PubMed: 1911583]
  • Becker S, Solomayer E, Hornung R, Kurek R, Banys M, Aydeniz B, Franz H, Wallwiener D, Fehm T. Optimal treatment for patients with ectopic pregnancies and a history of fertility-reducing factors. Archives of Gynecology and Obstetrics. 2011;(1):41–45. [PubMed: 19902231]
  • Bignardi T, Burnet S, Alhamdan D, Lu C, Pardey J, Benzie R, Condous G. Management of women referred to an acute gynecology unit: impact of an ultrasound-based model of care. Ultrasound in Obstetrics and Gynecology. 2010;(3):344–348. [PubMed: 20069669]
  • Bigrigg MA, Read MD. Management of women referred to early pregnancy assessment unit: care and cost effectiveness. BMJ. 1991;(6776):577–579. [PMC free article: PMC1669428] [PubMed: 1902383]
  • Blanchard K, Taneepanichskul S, Kiriwat O, Sirimai K, Svirirojana N, Mavimbela N, Winikoff B. Two regimens of misoprostol for treatment of incomplete abortion. Obstetrics and Gynecology. 2004;5(1):860–865. [PubMed: 15121557]
  • Blohm F, Friden BE, Milsom I, Platz-Christensen JJ, Nielsen S. A randomised double blind trial comparing misoprostol or placebo in the management of early miscarriage. BJOG: An International Journal of Obstetrics and Gynaecology. 2005;(8):1090–1095. [PubMed: 16045523]
  • Blohm F, Hahlin M, Nielsen S, Milsom I. Fertility after a randomised trial of spontaneous abortion managed by surgical evacuation or expectant treatment. Lancet. 1997;(349):995. [PubMed: 9100628]
  • Blumenthal PD, Remsburg RE. A time and cost analysis of the management of incomplete abortion with manual vacuum aspiration. International Journal of Gynecology and Obstetrics. 1994;(3):261–267. [PubMed: 7926246]
  • Bouyer J, Coste J, Fernandez H, Pouly JL, Job-Spira N. Sites of ectopic pregnancy: A 10 year population-based study of 1800 cases. Human Reproduction. 2002;(12):3224–3230. [PubMed: 12456628]
  • Bouyer J, Job-Spira N, Pouly JL, Coste J, Germain E, Fernandez H. Fertility following radical, conservative-surgical or medical treatment for tubal pregnancy: A population-based study. British Journal of Obstetrics and Gynaecology. 2000;(6):714–721. [PubMed: 10847225]
  • Bree RL, Edwards M, Bohm-Velez M, Beyler S, Roberts J, Mendelson EB. Transvaginal sonography in the evaluation of normal early pregnancy: Correlation with HCG level. American Journal of Roentgenology. 1989;(1):75–79. [PubMed: 2660539]
  • Briggs AH, O'Brien BJ. The death of cost-minimization analysis? Health Economics. 2001;(2):179–184. [PubMed: 11252048]
  • Brown DL, Emerson DS, Felker RE, Cartier MS, Smith WC. Diagnosis of early embryonic demise by endovaginal sonography. Journal of Ultrasound in Medicine. 1990;(11):631–636. [PubMed: 2258994]
  • Brownlea S, Holdgate A, Thou ST, Davis GK. Impact of an early pregnancy problem service on patient care and Emergency Department presentations. Australian and New Zealand Journal of Obstetrics and Gynaecology. 2005;(2):108–111. [PubMed: 15760309]
  • Buckley RG, King KJ, Disney JD, Ambroz PK, Gorman JD, Klausen JH. Derivation of a clinical prediction model for the emergency department diagnosis of ectopic pregnancy. Academic Emergency Medicine. 1998;(10):951–960. [PubMed: 9862584]
  • Cacciatore B, Stenman UH, Ylostalo P. Comparison of abdominal and vaginal sonography in suspected ectopic pregnancy. Obstetrics and Gynecology. 1989;5(1):770–774. [PubMed: 2649821]
  • Cacciatore B, Tiitinen A, Stenman UH, Ylostalo P. Normal early pregnancy: serum hCG levels and vaginal ultrasonography findings. British Journal of Obstetrics and Gynaecology. 1990;(10):899–903. [PubMed: 2223680]
  • Cantwell R, Clutton-Brock T, Cooper G, Dawson A, Drife J, Garrod D, Harper A, Hulbert D, Lucas S, McClure J, Millward-Sadler H, Neilson J, Nelson-Piercy C, Norman J, O'Herlihy C, Oates M, Shakespeare J, de,Swiet M, Williamson C, Beale V, Knight M, Lennox C, Miller A, Parmar D, Rogers J, Springett A. Saving Mothers' Lives: Reviewing maternal deaths to make motherhood safer: 2006-2008. The Eighth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. BJOG: An International Journal of Obstetrics and Gynaecology. 2011;(111):1–203. [PubMed: 21356004]
  • Chatwani A, Yazigi R, min-Hanjani S. Operative laparoscopy in the management of tubal ectopic pregnancy. Journal of Laparoendoscopic Surgery. 1992;(6):319–324. [PubMed: 1489997]
  • Chipchase J, James D. Randomised trial of expectant versus surgical management of spontaneous miscarriage. British Journal of Obstetrics and Gynaecology. 1997;(7):840–841. [PubMed: 9236651]
  • Choi HJ, Im KS, Jung HJ, Lim KT, Mok JE, Kwon YS. Clinical analysis of ovarian pregnancy: a report of 49 cases. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2011;(1):87–89. [PubMed: 21601978]
  • Chung TK, Lee DT, Cheung LP, Haines CJ, Chang AM. Spontaneous abortion: a randomized, controlled trial comparing surgical evacuation with conservative management using misoprostol. Fertility and Sterility. 1999;(6):1054–1059. [PubMed: 10360909]
  • Clancy MJ, Illingworth RN. The diagnosis of ectopic pregnancy in an accident and emergency department. Archives of Emergency Medicine. 1989;(3):205–210. [PMC free article: PMC1285607] [PubMed: 2675882]
  • Colacurci N, De,Franciscis P, Zarcone R, Fortunato N, Passaro M, Mollo A, Russo G. Time length of negativization of hCG serum values after either surgical or medical treatment of ectopic pregnancy. Panminerva Medica. 1998;(3):223–225. [PubMed: 9785922]
  • Colacurci N, Zarcone R, De Franciscis, Mele D, Mollo A, de Placido G. Tubal patency after laparoscopic treatment of ectopic pregnancy. Panminerva Medica. 1998;(1):45–47. [PubMed: 9573753]
  • Condous G, Okaro E, Khalid A, Timmerman D, Lu C, Zhou Y, Van Huffel S, Bourne T. The use of a new logistic regression model for predicting the outcome of pregnancies of unknown location. Human Reproduction. 2004;(8):1910. [PubMed: 15205400]
  • Condous G, Van Calster B, Kirk E, Haider Z, Timmerman D, Van Huffel S, Bourne T. Prediction of ectopic pregnancy in women with a pregnancy of unknown location. Ultrasound in Obstetrics and Gynecology. 2007;(6):680–687. [PubMed: 17486691]
  • Condous G, Van,Calster B, Kirk E, Haider Z, Timmerman D, Van,Huffel S, Bourne T. Clinical information does not improve the performance of mathematical models in predicting the outcome of pregnancies of unknown location. Fertility and Sterility. 2007;(3):572–580. [PubMed: 17499248]
  • Creinin MD, Moyer R, Guido R. Misoprostol for medical evacuation of early pregnancy failure. Obstetrics and Gynecology. 1997;5(1):768–772. [PubMed: 9166318]
  • Creinin MD, Washington AE. Cost of ectopic pregnancy management: Surgery versus methotrexate. Fertility and Sterility. 1993;(6):963–969. [PubMed: 8243700]
  • Dabash R, Ramadan MC, Darwish E, Hassanein N, Blum J, Winikoff B. A randomized controlled trial of 400-mug sublingual misoprostol versus manual vacuum aspiration for the treatment of incomplete abortion in two Egyptian hospitals. International Journal of Gynaecology and Obstetrics. 2010;(2):131–135. [PubMed: 20801444]
  • Dalton VK, Harris L, Weisman CS, Guire K, Castleman L, Lebovic D. Patient preferences, satisfaction, and resource use in office evacuation of early pregnancy failure. Obstetrics and Gynecology. 2006;(1):103–110. [PubMed: 16816063]
  • Dao B, Blum J, Thieba B, Raghavan S, Ouedraego M, Lankoande J, Winikoff B. Is misoprostol a safe, effective and acceptable alternative to manual vacuum aspiration for postabortion care? Results from a randomised trial in Burkina Faso, West Africa. BJOG: An International Journal of Obstetrics and Gynaecology. 2007;(11):1368–1375. [PubMed: 17803715]
  • Dart RG, Mitterando J, Dart LM. Rate of change of serial beta-human chorionic gonadotropin values as a predictor of ectopic pregnancy in patients with indeterminate transvaginal ultrasound findings. Annals of Emergency Medicine. 1999;(6):703–710. [PubMed: 10577398]
  • Daus K, Mundy D, Graves W, Slade BA. Ectopic pregnancy. What to do during the 20-day window. Journal of Reproductive Medicine. 1989;(2):162–166. [PubMed: 2647976]
  • Davies M, Geoghegan J. Developing an early pregnancy assessment unit. Nursing Times. 1994;(44):36–37. [PubMed: 7984480]
  • Davis AR, Hendlish SK, Westhoff C, Frederick MM, Zhang J, Gilles JM, Barnhart K, Creinin MD., National Institute of Child Health and Human Development Management of Early Pregnancy Failure Trial. Bleeding patterns after misoprostol vs surgical treatment of early pregnancy failure: results from a randomized trial. American Journal of Obstetrics and Gynecology. 2007;(1):31–37. [PubMed: 17240222]
  • De Cherney A, Kase N. The conservative surgical management of unruptured ectopic pregnancy. Obstetrics and Gynecology. 1979;(4):451–455. [PubMed: 492625]
  • de Crespigny LC. Early diagnosis of pregnancy failure with transvaginal ultrasound. American Journal of Obstetrics and Gynecology. 1988;(2):408–409. [PubMed: 3044112]
  • De Jonge ET, Makin JD, Manefeldt E, De Wet GH, Pattinson RC. Randomised clinical trial of medical evacuation and surgical curettage for incomplete miscarriage. BMJ. 1995;(7006):662. [PMC free article: PMC2551484] [PubMed: 7549636]
  • De Jonge ET, Pattinson RC, Makin JD, Venter CP. Is ward evacuation for uncomplicated incomplete abortion under systemic analgesia safe and effective? A randomised clinical trial. South African medical journal (Suid-Afrikaanse tydskrif vir geneeskunde). 1994;8(1):481–483. [PubMed: 7825081]
  • Dela Cruz A, Cumming DC. Factors determining fertility after conservative or radical surgical treatment for ectopic pregnancy. Fertility and Sterility. 1997;(5):871–874. [PubMed: 9389818]
  • Demetroulis C, Saridogan E, Kunde D, Naftalin AA. A prospective randomized control trial comparing medical and surgical treatment for early pregnancy failure. Human Reproduction. 2001;(2):365–369. [PubMed: 11157836]
  • Diamond MP, Wiser-Estin M, Jones EE, DeCherney AH. Failure of standard criteria to diagnose nonemergency ectopic pregnancies in a noninfertility patient population. Journal of the American Association of Gynecologic Laparoscopists. 1994;(2):131–134. [PubMed: 9050475]
  • Dias Pereira G, Hajenius PJ, Mol BW, Ankum WM, van der V. Fertility outcome after systemic methotrexate and laparoscopic salpingostomy for tubal pregnancy. Fertility and Sterility. 1998;(3):S411. [PubMed: 10073522]
  • Dimitry ES. A ten year survey of 193 ectopic pregnancies. Journal of Obstetrics and Gynaecology. 1989;(4):309–313. [PubMed: 12316337]
  • Downey LV, Zun LS. Indicators of potential for rupture for ectopics seen in the emergency department. Journal of Emergencies Trauma and Shock. 2011;(3):374–377. [PMC free article: PMC3162708] [PubMed: 21887029]
  • Doyle S, Lloyd A, Walker M. Health state utility scores in advanced non-small cell lung cancer. Lung Cancer. 2008;(3):374–380. [PubMed: 18467000]
  • Drummond MF, Sculpher MJ, Torrance GW, O'Brien BJ, Stoddart GL. Methods for the economic evaluation of health care programmes. 2005.
  • Duan L, Yan D, Zeng W, Yang X, Wei Q. Effect of progesterone treatment due to threatened abortion in early pregnancy for obstetric and perinatal outcomes. Early Human Development. 2010;(1):41–43. [PubMed: 20079582]
  • Easley HA, Olive DL, Holman JF. Contemporary evaluation of suspected ectopic pregnancy. Journal of Reproductive Medicine. 1987;(12):901–906. [PubMed: 3323501]
  • Edey K, Draycott T, Akande V. Early pregnancy assessment units. Clinical Obstetrics and Gynecology. 2007;(1):146–153. [PubMed: 17304031]
  • Edwards S, Tureck R, Fredrick M, Huang X, Zhang J, Barnhart K. Patient acceptability of manual versus electric vacuum aspiration for early pregnancy loss. Journal of Women's Health. 2007;(10):1429–1436. [PubMed: 18062758]
  • Egarter C, Lederhilger J, Kurz C, Karas H, Reisenberger K. Gemeprost for first trimester missed abortion. Archives of Gynecology and Obstetrics. 1995;(1):29–32. [PubMed: 7726651]
  • El Tabbakh MN, El Sayes MS. Tubal Ectopic Pregnancy: Laparoscopy vs. Laparotomy. Kasr El Aini Medical Journal. 2002;5(Supplement):367–382.
  • El-Zibdeh MY, Yousef LT. Dydrogesterone support in threatened miscarriage. Maturitas. 2009:S43–S46. [PubMed: 20007011]
  • Fang A, Chen Q, Zheng W, Li Y, Chen R. Termination of Missed Abortion in A Combined Procedure: A Randomized Controlled Trial. Journal of Reproduction and Contraception. 2009;(1):45–49.
  • Federici D, Conti E, Muggiasca ML, Ferrari S, Arcaini L, Brambilla T, Meroni M, Agarossi A. Laparoscopic conservative surgery in tubal pregnancy. Minimally Invasive Therapy. 1994;(4):201.
  • Fernandez H, Pauthier S, Doumerc S, Lelaidier C, Olivennes F, Ville Y, Frydman R. Ultrasound-guided injection of methotrexate versus laparoscopic salpingotomy in ectopic pregnancy. Fertility and Sterility. 1995;(1):25–29. [PubMed: 7805919]
  • Fernandez H, Yves Vincent SC, Pauthier S, Audibert F, Frydman R. Randomized trial of conservative laparoscopic treatment and methotrexate administration in ectopic pregnancy and subsequent fertility. Human Reproduction. 1998;(11):3239–3243. [PubMed: 9853887]
  • Ferrazzi E, Garbo S, Sulpizio P, Ghisoni L, Levi,Setti, Buscaglia M. Miscarriage diagnosis and gestational age estimation in the early first trimester of pregnancy: transabdominal versus transvaginal sonography. Ultrasound in Obstetrics and Gynecology. 1993;(1):36–41. [PubMed: 12796900]
  • Foulk RA, Steiger RM. Operative management of ectopic pregnancy: a cost analysis. American Journal of Obstetrics and Gynecology. 1996;(1):90–96. [PubMed: 8694081]
  • Fox R, Savage R, Evans T, Moore L. Early pregnancy assessment; a role for the gynaecology nurse-practitioner. Journal of Obstetrics and Gynaecology. 1999;(6):615–616. [PubMed: 15512414]
  • Gavin PS. Rhesus sensitization in abortion. Obstetrics and Gynecology. 1972;(1):37–40. [PubMed: 4621468]
  • Gerhard I, Gwinner B, Eggert-Kruse W, Runnebaum B. Double-blind controlled trial of progesterone substitution in threatened abortion. Biological Research in Pregnancy and Perinatology. 1987;1(1ST Half):26–34. [PubMed: 2437967]
  • Gevaert O, De Smet F, Kirk E, Van Calster B, Bourne T, Van Huffel S, Moreau Y, Timmerman D, De Moor B, Condous G. Predicting the outcome of pregnancies of unknown location: Bayesian networks with expert prior information compared to logistic regression. Human Reproduction. 2006;(7):1824–1831. [PubMed: 16601010]
  • Giambelli E, Candiani M, Natale A, Gruft L, De,Marinis S, Sambruni I, Colombo P, Busacca M. Laparoscopic treatment of ectopic pregnancy: Analysis of 114 consecutive cases. Italian Journal of Gynaecology and Obstetrics. 1996;(1):5–9.
  • Goksedef BP, Kef S, Akca A, Bayik RN, Cetin A. Risk factors for rupture in tubal ectopic pregnancy: definition of the clinical findings. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2011;(1):96–99. [PubMed: 20888681]
  • Goldstein SR. Significance of cardiac activity on endovaginal ultrasound in very early embryos. Obstetrics and Gynecology. 1992;(4):670–672. [PubMed: 1407892]
  • Gonzalez FA, Waxman M. Ectopic pregnancy. A retrospective study of 501 consecutive patients. Diagnostic Gynecology and Obstetrics. 1981;(3):181–186. [PubMed: 7327075]
  • Gray DT, Thorburn J, Lundorff P, Strandell A, Lindblom B. A cost-effectiveness study of a randomised trial of laparoscopy versus laparotomy for ectopic pregnancy. Lancet. 1995;(8958):1139–1143. [PubMed: 7723545]
  • Graziosi G, Bruinse HW, Reuwer PJH, Teteringen O, Mol BJW. Fertility outcome after a randomized trial comparing curettage with misoprostol for treatment of early pregnancy failure. Human Reproduction. 2005;(20):1749–1750. [PubMed: 15901680]
  • Graziosi GC, Bruinse HW, Reuwer PJ, van Kessel PH, Westerweel PE, Mol BW. Misoprostol versus curettage in women with early pregnancy failure: impact on women's health-related quality of life. A randomized controlled trial. Human Reproduction. 2005;(8):2340–2347. [PubMed: 15831508]
  • Graziosi GCM, Mol BWJ, Reuwer PJH, Drogtrop A, Bruinse HW. Misoprostol versus curettage in women with early pregnancy failure after initial expectant management: A randomized trial. Human Reproduction. 2004;(8):1894–1899. [PubMed: 15192065]
  • Graziosi GC, van der Steeg JW, Reuwer PH, Drogtrop AP, Bruinse HW, Mol BW. Economic evaluation of misoprostol in the treatment of early pregnancy failure compared to curettage after an expectant management. Human reproduction. 2005;(4):1067–1071. [PubMed: 15618248]
  • Gruft L, Bertola E, Luchini L, Azzilonna C, Bigatti G, Parazzini F. Determinants of reproductive prognosis after ectopic pregnancy. Human Reproduction. 1994;(7):1333–1336. [PubMed: 7962443]
  • Hahlin M, Sjoblom P, Lindblom B. Combined use of progesterone and human chorionic gonadotropin determinations for differential diagnosis of very early pregnancy. Fertility and Sterility. 1991;(3):492–496. [PubMed: 2001750]
  • Hajenius PJ, Engelsbel S, Mol BW, van der V, Ankum WM, Bossuyt PM, Hemrika DJ, Lammes FB. Randomised trial of systemic methotrexate versus laparoscopic salpingostomy in tubal pregnancy. Lancet. 1997;(9080):774–779. [PubMed: 9297998]
  • Harper J. Midwives and miscarriage: the development of an early pregnancy unit. MIDIRS Midwifery Digest. 2003;(2):183–185.
  • Harwood B, Nansel T., National Institute of Child Health and Human Development Management of Early Pregnancy Failure Trial. Quality of life and acceptability of medical versus surgical management of early pregnancy failure. BJOG: An International Journal of Obstetrics and Gynaecology. 2008;(4):501–508. [PMC free article: PMC2424403] [PubMed: 18271887]
  • Hassan R, Sandu,Aana L, Rich K, Lal S. Is transvaginal ultrasound a reliable test in the diagnosis of early embryonic demise? Outcomes of embryos less than 6mm in crown-rump length without cardiac activity. International Journal of Gynecology and Obstetrics. 2009:S536.
  • Health and Social Care Information Centre. NHS Maternity Statistics, 2010-11. 2012. [February 2012]. Available from http://www​.hesonline​.nhs.uk/Ease/servlet​/ContentServer?siteID​=1937&categoryID=1815.
  • Hensleigh PA, Leslie W, Dixon E, Hall E, Kitay DZ, Jackson JE. Reduced dose of Rho(D) immune globulin following induced first-trimester abortion. American Journal of Obstetrics and Gynecology. 1977;(4):413–416. [PubMed: 410298]
  • Hill K. Improving services provided in an early pregnancy assessment clinic. Nursing Times. 2009;(6):18–19. [PubMed: 19271577]
  • Hinshaw HKS. Medical management of miscarriage. Problems in early pregnancy - advances in diagnosis and management. 1997:284–295.
  • Hua i Hsueh Tsa Chih. [Chinese Medical Journal]. (6):457–462. [PubMed: 7634184]
  • Hughes J, Ryan M, Hinshaw K, Henshaw R, Rispin R, Templeton A. The costs of treating miscarriage: a comparison of medical and surgical management. British Journal of Obstetrics and Gynaecology. 1996;(12):1217–1221. [PubMed: 8968239]
  • Hutton JD, Narayan R. Is ectopic pregnancy too often diagnosed too late? New Zealand Medical Journal. 1986;(794):3–5. [PubMed: 2935754]
  • Jabbar FA, Al-Wakeel M. A study of 45 cases of ectopic pregnancy. International Journal of Gynaecology and Obstetrics. 1980;(3):214–217. [PubMed: 6109659]
  • Jiao LZ, Zhao J, Wan XR, Liu XY, Feng FZ, Ren T, Xiang Y. Diagnosis and treatment of cesarean scar pregnancy. Chinese Medical Sciences Journal. 2008;(1):10–15. [PubMed: 18437903]
  • Jurkovic D, Wilkinson H. Diagnosis and management of ectopic pregnancy. BMJ. 2011;(7811):1353–1357.
  • Katz J, Marcus RG. Incidence of Rh immunization following abortion: possible detection of lymphocyte priming to Rh antigen. American Journal of Obstetrics and Gynecology. 1973;(2):261–267. [PubMed: 4199593]
  • Kazandi M, Turan V. Ectopic pregnancy; risk factors and comparison of intervention success rates in tubal ectopic pregnancy. Clinical and Experimental Obstetrics and Gynecology. 2011;(1):67–70. [PubMed: 21485731]
  • Keith L, Bozorgi N. Small dose anti-Rh therapy after first trimester abortion. International Journal of Gynaecology and Obstetrics. 1977;(3):235–237. [PubMed: 416975]
  • Kivikoski AI, Martin CM, Smeltzer JS. Transabdominal and transvaginal ultrasonography in the diagnosis of ectopic pregnancy: a comparative study. American Journal of Obstetrics and Gynecology. 1990;1(1):123–128. [Erratum appears in Am J Obstet Gynecol 1990 Dec;163(6 Pt 1):2030] [PubMed: 2197862]
  • Kovavisarach E, Jamnansiri C. Intravaginal misoprostol 600 microg and 800 microg for the treatment of early pregnancy failure. International Journal of Gynaecology and Obstetrics. 2005;(3):208–212. [PubMed: 15967450]
  • Kovavisarach E, Sathapanachai U. Intravaginal 400 microg misoprostol for pregnancy termination in cases of blighted ovum: a randomised controlled trial. Australian and New Zealand Journal of Obstetrics and Gynaecology. 2002;(2):161–163. [PubMed: 12069142]
  • Krag Moeller LB, Moeller C, Thomsen SG, Andersen LF, Lundvall L, Lidegaard O, Kjer JJ, Ingemanssen JL, Zobbe V, Floridon C, Petersen J, Ottesen B. Success and spontaneous pregnancy rates following systemic methotrexate versus laparoscopic surgery for tubal pregnancies: a randomized trial. Acta Obstetricia et Gynecologica Scandinavica. 2009;(12):1331–1337. [PubMed: 19961341]
  • Kuroda K, Takeuchi H, Kitade M, Kikuchi I, Shimanuki H, Kumakiri J, Kobayashi Y, Kuroda M, Takeda S. Assessment of tubal disorder as a risk factor for repeat ectopic pregnancy after laparoscopic surgery for tubal pregnancy. Journal of Obstetrics and Gynaecology Research. 2009;(3):520–524. [PubMed: 19527393]
  • Kushwah B, Singh A. Sublingual versus oral misoprostol for uterine evacuation following early pregnancy failure. International Journal of Gynaecology and Obstetrics. 2009;(1):43–45. [PubMed: 19426973]
  • Langebrekke A, Sornes T, Urnes A. Fertility outcome after treatment of tubal pregnancy by laparoscopic laser surgery. Acta Obstetricia et Gynecologica Scandinavica. 1993;(7):547–549. [PubMed: 8213102]
  • Larrain D, Marengo F, Bourdel N, Jaffeux P, ublet-Cuvelier B, Pouly JL, Mage G, Rabischong B. Proximal ectopic pregnancy: a descriptive general population-based study and results of different management options in 86 cases. Fertility and Sterility. 2011;(3):867–871. [PubMed: 21047630]
  • Lecuru F, Robin F, Chasset S, Leonard F, Guitti S, Taurelle R. Direct cost of single dose methotrexate for unruptured ectopic pregnancy. Prospective comparison with laparoscopy. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2000;(1):1–6. [PubMed: 10659909]
  • Lee C, Slade P, Lygo V. The influence of psychological debriefing on emotional adaptation in women following early miscarriage: a preliminary study. British Journal of Medical Psychology. 1996;(Pt 1):47–58. [PubMed: 8829399]
  • Lee DT, Cheung LP, Haines CJ, Chan KP, Chung TK. A comparison of the psychologic impact and client satisfaction of surgical treatment with medical treatment of spontaneous abortion: a randomized controlled trial. American Journal of Obstetrics and Gynecology. 2001;(4):953–958. [PubMed: 11641684]
  • Lelaidier C, Baton-Saint-Mleux C, Fernandez H, Bourget P, Frydman R. Mifepristone (RU 486) induces embryo expulsion in first trimester non-developing pregnancies: a prospective randomized trial. Human Reproduction. 1993;(3):492–495. [PubMed: 8473474]
  • Levi CS, Lyons EA, Lindsay DJ. Early diagnosis of nonviable pregnancy with endovaginal US. Radiology. 1988;(2):383–385. [PubMed: 3282258]
  • Levi CS, Lyons EA, Zheng XH, Lindsay DJ, Holt SC. Endovaginal US: demonstration of cardiac activity in embryos of less than 5.0 mm in crown-rump length. Radiology. 1990;(1):71–74. [PubMed: 2191372]
  • Lewis G. Saving Mothers' Lives: reviewing maternal deaths to make motherhood safer 2003-2005. The Seventh Report on Confidential Enquiries into Maternal Deaths in the United Kingdom. 2007
  • Lister MS, Shaffer LE, Bell JG, Lutter KQ, Moorma KH. Randomized, double-blind, placebo-controlled trial of vaginal misoprostol for management of early pregnancy failures. American Journal of Obstetrics and Gynecology. 2005;(4):1338–1343. [PubMed: 16202723]
  • Lo L, Pun TC, Chan S. Tubal ectopic pregnancy: an evaluation of laparoscopic surgery versus laparotomy in 614 patients. Australian and New Zealand Journal of Obstetrics and Gynaecology. 1999;(2):185–187. [PubMed: 10755775]
  • Lowe PJ. A casemix cost comparison of 2 treatments for ectopic pregnancy (Brief record). Australian and New Zealand Journal of Obstetrics and Gynaecology. 1998;(3):333–335. [PubMed: 9761168]
  • Lundorff P. Laparoscopic surgery in ectopic pregnancy. Acta Obstetricia et Gynecologica Scandinavica – Supplement. 1997:81–84. [PubMed: 9225646]
  • Lundorff P, Thorburn J, Hahlin M, Kallfelt B, Lindblom B. Laparoscopic surgery in ectopic pregnancy. A randomized trial versus laparotomy. Acta Obstetricia et Gynecologica Scandinavica. 1991;(4-5):343–348. [PubMed: 1836087]
  • Lundorff P, Thorburn J, Lindblom B. Fertility outcome after conservative surgical treatment of ectopic pregnancy evaluated in a randomized trial. Fertility and Sterility. 1992;(5):998–1002. [PubMed: 1572493]
  • Makinen J, Nikkanen V, Kivikoski A. Problems and benefits in early diagnosis of ectopic pregnancy. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1984;(6):381–391. [PubMed: 6234191]
  • Mecke H, Semm K, Lehmann-Willenbrock E. Results of operative pelviscopy in 202 cases of ectopic pregnancy. International Journal of Fertility. 1997;(2):93–94. [PubMed: 2565320]
  • Mehra S, Gujral A, Mehra G. Endoscopic vs. conventional surgery for tubal gestation. International Journal of Gynecology and Obstetrics. 1998;(3):297–298. [PubMed: 9688494]
  • Menon S, Sammel MD, Vichnin M, Barnhart KT. Risk factors for ectopic pregnancy: a comparison between adults and adolescent women. Journal of Pediatric and Adolescent Gynecology. 2007;(3):181–185. [PubMed: 17561187]
  • Michelas S, Creatsas G, Fakas G, Kaskarelis D. Ectopic pregnancy: outcome of 152 cases. International Surgery. 1980;(4):355–358. [PubMed: 7228561]
  • Miscarriage Association. Miscarriage and the workplace: a guide for employers. 2011. (available from: http://www​.miscarriageassociation​.org.uk​/wp/wp-content/uploads​/2011/04/Miscarriage-the-Workplace-Feb-20111.pdf)
  • Mol BWJ, Hajenius PJ, Engelsbel S, Ankum WM, Hemrika DJ, van der Veen F, Bossuyt PMM. Treatment of tubal pregnancy in the Netherlands: An economic comparison of systemic methotrexate administration and laparoscopic salpingostomy. American Journal of Obstetrics and Gynecology. 1999;(4):945–951. [PubMed: 10521759]
  • Mol BW, Hajenius PJ, Engelsbel S, Ankum WM, van der Veen F, Hemrika DJ, Bossuyt PM. An economic evaluation of laparoscopy and open surgery in the treatment of tubal pregnancy. Acta Obstetricia et Gynecologica Scandinavica. 1997;(6):596–600. [PubMed: 9246970]
  • Mol BWJ, Hajenius PJ, Engelsbel S, Ankum WM, van der Veen F, Hemrika DJ, Bossuyt PMM. Serum human chorionic gonadotropin measurement in the diagnosis of ectopic pregnancy when transvaginal sonography is inconclusive. Fertility and Sterility. 1998;(5):972–981. [PubMed: 9806587]
  • Mol BWJ, Matthijsse HC, Tinga DJ, Huynh T, Hajenius PJ, Ankum WM, Bossuyt PMM, van der Veen F. Fertility after conservative and radical surgery for tubal pregnancy. Human Reproduction. 1998;(7):1804–1809. [PubMed: 9740428]
  • Montesinos R, Durocher J, Leon W, Arellano M, Pena M, Pinto E, Winikoff B. Oral misoprostol for the management of incomplete abortion in Ecuador. International Journal of Gynaecology and Obstetrics. 2011;(2):135–139. [PubMed: 21872244]
  • Moodliar S, Bagratee JS, Moodley J. Medical vs. surgical evacuation of first-trimester spontaneous abortion. International Journal of Gynaecology and Obstetrics. 2005;(1):21–26. [PubMed: 16051242]
  • Morlock RJ, Lafata JE, Eisenstein D. Cost-effectiveness of single-dose methotrexate compared with laparoscopic treatment of ectopic pregnancy. Obstetrics and Gynecology. 2000;(3):407–412. [PubMed: 10711553]
  • Muffley PE, Stitely ML, Gherman RB. Early intrauterine pregnancy failure: a randomized trial of medical versus surgical treatment. American Journal of Obstetrics and Gynecology. 2002;(2):321–325. [PubMed: 12193919]
  • Murphy AA, Nager CW, Wujek JJ, Kettel LM, Torp VA, Chin HG. Operative laparoscopy versus laparotomy for the management of ectopic pregnancy: a prospective trial. Fertility and Sterility. 1992;(6):1180–1185. [PubMed: 1534771]
  • Murray S, Barron SL. Rhesus isoimmunization after abortion. British Medical Journal. 1971;(5766):90–92. [PMC free article: PMC1800134] [PubMed: 4996968]
  • Murray S, Barron SL, McNay RA. Transplacental haemorrhage after abortion. Lancet. 1970;(7648):631–634. [PubMed: 4190628]
  • National Collaborating Centre for Women's and Children's Health. Caesarean Section. 2011.
  • National Institute for Health and Clinical Excellence. The guidelines manual. 2009. [PubMed: 27905714]
  • Neugebauer R, Kline J, Markowitz JC, Bleiberg KL, Baxi L, Rosing MA, Levin B, Keith J. Pilot randomized controlled trial of interpersonal counseling for subsyndromal depression following miscarriage. Journal of Clinical Psychiatry. 2006;(8):1299–1304. [PubMed: 16965211]
  • Ngai SW, Chan YM, Tang OS, Ho PC. Vaginal misoprostol as medical treatment for first trimester spontaneous miscarriage. Human Reproduction. 2001;(7):1493–1496. [PubMed: 11425836]
  • Ngoc NT, Blum J, Westheimer E, Quan TT, Winikoff B. Medical treatment of missed abortion using misoprostol. International Journal of Gynaecology and Obstetrics. 2004;(2):138–142. [PubMed: 15491558]
  • Ngoc NTN, Blum J, Durocher J, Quan TT, Winikoff B. A randomized controlled study comparing 600 versus 1,200 microg oral misoprostol for medical management of incomplete abortion. Contraception. 2005;(6):438–442. [PubMed: 16307967]
  • Nikcevic AV, Kuczmierczyk AR, Nicolaides KH. The influence of medical and psychological interventions on women's distress after miscarriage. Journal of Psychosomatic Research. 2007;(3):283–290. [PubMed: 17719366]
  • Nikcevic AV, Tunkel SA, Nicolaides KH. Psychological outcomes following missed abortions and provision of follow-up care. Ultrasound in Obstetrics and Gynecology. 1998;(2):123–128. [PubMed: 9549839]
  • Nielsen S, Hahlin M. Expectant management of first-trimester spontaneous abortion. Lancet. 1995;(8942):84–86. [PubMed: 7815886]
  • Nielsen S, Hahlin M, Moller A, Granberg S. Bereavement, grieving and psychological morbidity after first trimester spontaneous abortion: comparing expectant management with surgical evacuation. Human Reproduction. 1996;(8):1767–1770. [PubMed: 8921129]
  • Nielsen S, Hahlin M, Platz-Christensen J. Randomised trial comparing expectant with medical management for first trimester miscarriages. British Journal of Obstetrics and Gynaecology. 1999;(8):804–807. [PubMed: 10453830]
  • Nieuwkerk Pythia T, Hajenius Petra J, Ankum Willem M, Van der Veen Fulco, Wijker Wouter, Bossuyt Patrick MM. Systemic methotrexate therapy versus laparoscopic salpingostomy in patients with tubal pregnancy. Part I. Impact on patients' health-related quality of life. Fertility and Sterility. 1998;(3):511–517. [PubMed: 9757881]
  • Niinimaki M, Jouppila P, Martikainen H, Talvensaari-Mattila A. A randomized study comparing efficacy and patient satisfaction in medical or surgical treatment of miscarriage. Fertility and Sterility. 2006;(2):367–372. [PubMed: 16764872]
  • Niinimaki M, Karinen P, Hartikainen AL, Pouta A. Treating miscarriages: a randomised study of cost-effectiveness in medical or surgical choice. BJOG: An International Journal of Obstetrics and Gynaecology. 2009;(7):984–990. [PubMed: 19385962]
  • Omar MH, Mashita MK, Lim PS, Jamil MA. Dydrogesterone in threatened abortion: pregnancy outcome. Journal of Steroid Biochemistry and Molecular Biology. 2005;(5):421–425. [PubMed: 16293412]
  • Ory SJ, Nnadi E, Herrmann R, O'Brien PS, Melton LJ III. Fertility after ectopic pregnancy. Fertility and Sterility. 1993;(2):231–235. [PubMed: 8339816]
  • Palagiano A, Bulletti C, Pace MC, DE,Ziegler D, Cicinelli E, Izzo A. Effects of vaginal progesterone on pain and uterine contractility in patients with threatened abortion before twelve weeks of pregnancy. Annals of the New York Academy of Sciences. 2004:200–210. [PubMed: 15731312]
  • Pandian RU. Dydrogesterone in threatened miscarriage: A Malaysian experience. Maturitas. 2009;(1):S47–S50. [PubMed: 20005647]
  • Pang MW, Lee TS, Chung TKH. Incomplete miscarriage: A randomized controlled trial comparing oral with vaginal misoprostol for medical evacuation. Human Reproduction. 2001;(11):2283–2287. [PubMed: 11679505]
  • Paritakul P, Phupong V. Comparative study between oral and sublingual 600 microg misoprostol for the treatment of incomplete abortion. Journal of Obstetrics and Gynaecology Research. 2010;(5):978–983. [PubMed: 20846257]
  • Park H, Rascati KL. Direct costs of pneumonia in the United States: An analysis of 2008 medical expenditure panel survey (MEPS) data. Value in Health. 2011;(7):A492.
  • Parker J, Permezel M, Thompson D. Review of the management of ectopic pregnancy in a major teaching hospital: Laparoscopic surgical treatment and persistent ectopic pregnancy. Australian and New Zealand Journal of Obstetrics and Gynaecology. 1994;(5):575–579.
  • Pennell RG, Needleman L, Pajak T, Baltarowich O, Vilaro M, Goldberg BB, Kurtz AB. Prospective comparison of vaginal and abdominal sonography in normal early pregnancy. Journal of Ultrasound in Medicine. 1991;(2):63–67. [PubMed: 2020050]
  • Petrou S, Trinder J, Brocklehurst P, Smith L. Economic evaluation of alternative management methods of first-trimester miscarriage based on results from the MIST trial. BJOG: An International Journal of Obstetrics and Gynaecology. 2006;(8):879–889. [PubMed: 16827823]
  • Pexsters A, Luts J, Van Schoubroeck D, Bottomley C, Van Calster B, Van Huffel S, Abdallah Y, D'Hooghe T, Lees C, Timmerman D, Bourne T. Clinical implications of intra- and interobserver reproducibility of transvaginal sonographic measurement of gestational sac and crown-rump length at 6-9 weeks' gestation. Ultrasound in Obstetrics and Gynecology. 2011;(5):510–515. [PubMed: 21077156]
  • Plowman R, Graves N, Griffin M, Roberts JA, Swan AV, Cookson B, Taylor L. The socioecomic burden of hospital acquired infection. 1999.
  • Poddar A, Tyagi J, Hawkins E, Opemuyi I. Standards of care provided by Early Pregnancy Assessment Units (EPAU): A UK-wide survey. Journal of Obstetrics & Gynaecology,J Obstet Gynaecol. 2011;(7):640–644. [PubMed: 21973141]
  • Powers DN. Ectopic pregnancy: a five-year experience. Southern Medical Journal. 1980;(8):1012–1015. [PubMed: 7403909]
  • Raziel A, Schachter M, Mordechai E, Friedler S, Panski M, Ron-El R. Ovarian pregnancy-a 12-year experience of 19 cases in one institution. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2004;(1):92–96. [PubMed: 15099878]
  • Rempen A. Diagnosis of viability in early pregnancy with vaginal sonography. Journal of Ultrasound in Medicine. 1990;(12):711–716. [PubMed: 2277400]
  • Rita, Gupta S, Kumar S. A randomised comparison of oral and vaginal misoprostol for medical management of first trimester missed abortion. JK Science. 2006;(1):35–38.
  • Rizzuto MI, Oliver R, Odejinmi F. Laparoscopic management of ectopic pregnancy in the presence of a significant haemoperitoneum. Archives of Gynecology and Obstetrics. 2008;(5):433–436. [PubMed: 17906868]
  • Robin F, Lecuru F, Bernard JP, Mac-Cordick C, Boucaya V, Taurelle R. Methotrexate provides significant cost savings for the treatment of unruptured ectopic pregnancy. Clinical Drug Investigation. 1998;(5):405–411. [PubMed: 18370496]
  • Rocconi RP, Chiang S, Richter HE, Straughn JM Jr. Management strategies for abnormal early pregnancy: a cost-effectiveness analysis. Journal of Reproductive Medicine. 2005;(7):486–490. [PubMed: 16130844]
  • Round JA, Jacklin P, Fraser RB, Hughes RG, Mugglestone MA, Holt RI. Screening for gestational diabetes mellitus: cost-utility of different screening strategies based on a woman's individual risk of disease. Diabetologia. 2011;(2):256–263. [PubMed: 20809381]
  • Rowling SE, Langer JE, Coleman BG, Nisenbaum HL, Horii SC, Arger PH. Sonography during early pregnancy: Dependence of threshold and discriminatory values on transvaginal transducer frequency. American Journal of Roentgenology. 1999;(4):983–988. [PubMed: 10587132]
  • Sahin HG, Sahin HA, Kocer M. Randomized outpatient clinical trial of medical evacuation and surgical curettage in incomplete miscarriage. European Journal of Contraception and Reproductive Health Care. 2001;(3):141–144. [Erratum appears in Eur J Contracept Reprod Health Care 2002 Mar;7(1):iv] [PubMed: 11763977]
  • Saraj AJ, Wilcox JG, Najmabadi S, Stein SM, Johnson MB, Paulson RJ. Resolution of hormonal markers of ectopic gestation: a randomized trial comparing single-dose intramuscular methotrexate with salpingostomy. Obstetrics and Gynecology. 1998;(6):989–994. [PubMed: 9840564]
  • Schurz B, Wenzl R, Eppel W, Reinold E. Early detection of ectopic pregnancy by transvaginal ultrasound. Archives of Gynecology and Obstetrics. 1990;(1):25–29. [PubMed: 1701621]
  • Séjourné N, Callahan S, Chabrol H. The utility of a psychological intervention for coping with spontaneous abortion. Journal of Reproductive and Infant Psychology. 2010;(3):287–296.
  • Sellappan K, Mcgeown A, Archer A. A survey to assess the efficiency of an early pregnancy unit. International Journal of Gynecology and Obstetrics. 2009:S542.
  • Shah N, Azam SI, Khan NH. Sublingual versus vaginal misoprostol in the management of missed miscarriage. Journal of the Pakistan Medical Association. 2010;(2):113–116. [PubMed: 20209697]
  • Shapiro BS, Cullen M, Taylor KJ, DeCherney AH. Transvaginal ultrasonography for the diagnosis of ectopic pregnancy. Fertility and Sterility. 1988;(3):425–429. [PubMed: 3044842]
  • Shaunik A, Kulp J, Appleby DH, Sammel MD, Barnhart KT. Utility of dilation and curettage in the diagnosis of pregnancy of unknown location. American Journal of Obstetrics and Gynecology. 2011;(2):130–130. [PubMed: 21284966]
  • Shelley JM, Healy D, Grover S. A randomised trial of surgical, medical and expectant management of first trimester spontaneous miscarriage. Australian and New Zealand Journal of Obstetrics and Gynaecology. 2005;(2):122–127. [PubMed: 15760312]
  • Sherman D, Langer R, Sadovsky G, Bukovsky I, Caspi E. Improved fertility following ectopic pregnancy. Fertility and Sterility. 1982;(4):497–502. [PubMed: 7067846]
  • Shillito J, Walker JJ. Early pregnancy assessment units. British Journal of Hospital Medicine. 1997;(10):505–509. [PubMed: 10193453]
  • Shwekerela B, Kalumuna R, Kipingili R, Mashaka N, Westheimer E, Clark W, Winikoff B. Misoprostol for treatment of incomplete abortion at the regional hospital level: results from Tanzania. BJOG: An International Journal of Obstetrics and Gynaecology. 2007;(11):1363–1367. [PubMed: 17803714]
  • Silva PD, Schaper AM, Rooney B. Reproductive outcome after 143 laparoscopic procedures for ectopic pregnancy. Obstetrics and Gynecology. 1993;5(1):710–715. [PubMed: 8469458]
  • Simonovits I, Bajtai G, Kellner R, Kerenyl M, Rucz L, Szilvas R, Takacs S. Immunization of RhO(D)-negative secundigravidae whose first pregnancy was terminated by induced abortion. Haematologia. 1974;(1-4):291–298. [PubMed: 4218823]
  • Simonovits I, Timar I, Bajtai G. Rate of Rh immunization after induced abortion. Vox Sanguinis. 1980;(3):161–164. [PubMed: 6770543]
  • Smith LF, Frost J, Levitas R, Bradley H, Garcia J. Women's experiences of three early miscarriage management options: a qualitative study. British Journal of General Practice. 2006;(524):198–205. [PMC free article: PMC1828263] [PubMed: 16536960]
  • Smith LFP, Ewings PD, Quinlan C. Incidence of pregnancy after expectant, medical, or surgical management of spontaneous first trimester miscarriage: Long term follow-up of miscarriage treatment (MIST) randomised controlled trial. BMJ. 2009;(7726):910. [PMC free article: PMC2759436] [PubMed: 19815581]
  • Sonnenberg FA, Burkman RT, Hagerty CG, Speroff L, Speroff T. Costs and net health effects of contraceptive methods. Contraception. 2004;(6):447–459. [PubMed: 15157789]
  • Sotiriadis A, Papatheodorou S, Makrydimas G. Threatened miscarriage: evaluation and treatment. BMJ. 2004;329(7458):152–155. [PMC free article: PMC478228] [PubMed: 15258071]
  • Sowter MC, Farquhar CM, Gudex G. An economic evaluation of single dose systemic methotrexate and laparoscopic surgery for the treatment of unruptured ectopic pregnancy. BJOG: An International Journal of Obstetrics and Gynaecology. 2001;(2):204–212. [PubMed: 11236121]
  • Sowter MC, Farquhar CM, Petrie KJ, Gudex G. A randomised trial comparing single dose systemic methotrexate with laparoscopy for the treatment of unruptured tubal pregnancy. BJOG: An International Journal of Obstetrics and Gynaecology. 2001;(2):192–203. [PubMed: 11236120]
  • Steinkampf MP, Guzick DS, Hammond KR, Blackwell RE. Identification of early pregnancy landmarks by transvaginal sonography: analysis by logistic regression. Fertility and Sterility. 1997;(1):168–170. [PubMed: 9207605]
  • Stewart BK, Nazar-Stewart V, Toivola B. Biochemical discrimination of pathologic pregnancy from early, normal intrauterine gestation in symptomatic patients. American Journal of Clinical Pathology. 1995;(4):386–390. [PubMed: 7726131]
  • Stewart FH, Burnhill MS, Bozorgi N. Reduced dose of Rh immunoglobulin following first trimester pregnancy termination. Obstetrics and Gynecology. 1978;(3):318–322. [PubMed: 415273]
  • Stockheim D, Machtinger R, Wiser A, Dulitzky M, Soriano D, Goldenberg M, Schiff E, Seidman DS. A randomized prospective study of misoprostol or mifepristone followed by misoprostol when needed for the treatment of women with early pregnancy failure. Fertility and Sterility. 2006;(4):956–960. [PubMed: 17027362]
  • Stovall TG, Ling FW, Gray LA. Single-dose methotrexate for treatment of ectopic pregnancy. Obstetrics and Gynecology. 1991;(5):754–757. [PubMed: 2014091]
  • Swanson KM. Effects of caring, measurement, and time on miscarriage impact and women's well-being. Nursing Research. 1999;(6):288–298. [PubMed: 10571496]
  • Swanson KM, Chen HT, Graham JC, Wojnar DM, Petras A. Resolution of depression and grief during the first year after miscarriage: a randomized controlled clinical trial of couples-focused interventions. Journal of Women's Health. 2009;(8):1245–1257. [PMC free article: PMC2825726] [PubMed: 19630553]
  • Tahseen S, Wyldes M. A comparative case-controlled study of laparoscopic vs laparotomy management of ectopic pregnancy: an evaluation of reproductive performance after radical vs conservative treatment of tubal ectopic pregnancy. Journal of Obstetrics and Gynaecology. 2003;(2):189–190. [PubMed: 12745569]
  • Tam WH, Tsui MH, Lok IH, Yip SK, Yuen PM, Chung TK. Long-term reproductive outcome subsequent to medical versus surgical treatment for miscarriage. Human Reproduction. 2005;(12):3355–3359. [PubMed: 16096322]
  • Tang OS, Lau WN, Ng EH, Lee SW, Ho PC. A prospective randomized study to compare the use of repeated doses of vaginal with sublingual misoprostol in the management of first trimester silent miscarriages. Human Reproduction. 2003;(1):176–181. [PubMed: 12525463]
  • Tang OS, Ong CY, Tse KY, Ng EH, Lee SW, Ho PC. A randomized trial to compare the use of sublingual misoprostol with or without an additional 1 week course for the management of first trimester silent miscarriage. Human Reproduction. 2006;(1):189–192. [PubMed: 16155071]
  • Tanha FD, Feizi M, Shariat M. Sublingual versus vaginal misoprostol for the management of missed abortion. Journal of Obstetrics and Gynaecology Research. 2010;(3):525–532. [PubMed: 20598032]
  • Taylor J, Diop A, Blum J, Dolo O, Winikoff B. Oral misoprostol as an alternative to surgical management for incomplete abortion in Ghana. International Journal of Gynaecology and Obstetrics. 2011;(1):40–44. [PubMed: 21122848]
  • Thorburn J, Bryman I, Hahlin M, Lindblom B. Differential diagnosis of early human pregnancies: impact of different diagnostic measures. Gynecologic and Obstetric Investigation. 1992;(4):216–220. [PubMed: 1505809]
  • Thorsen MK, Lawson TL, Aiman EJ, Miller DP, McAsey ME, Erickson SJ, Quiroz F, Perret RS. Diagnosis of ectopic pregnancy: Endovaginal vs transabdominal sonography. American Journal of Roentgenology. 1990;(2):307–310. [PubMed: 2115257]
  • Trinder J, Brocklehurst P, Porter R, Read M, Vyas S, Smith L. Management of miscarriage: expectant, medical, or surgical? Results of randomised controlled trial (miscarriage treatment (MIST) trial). BMJ. 2006;(7552):1235–1240. [PMC free article: PMC1471967] [PubMed: 16707509]
  • Tsai HD, Chen HY, Yeh LS. A 12-year survey of 681 ectopic pregnancies. Chung. 1995 [PubMed: 7634184]
  • Tulandi T, Guralnick M. Treatment of tubal ectopic pregnancy by salpingotomy with or without tubal suturing and salpingectomy. Fertility and Sterility. 1991;(1):53–55. [Erratum appears in Fertil Steril 1991 Jun;55(6):1213-4] [PubMed: 1986973]
  • Tunde-Byass M, Cheung VY. The value of the early pregnancy assessment clinic in the management of early pregnancy complications. Journal of Obstetrics and Gynaecology Canada: JOGC. 2009;(9):841–844. [PubMed: 19941708]
  • Tuomivaara L, Kauppila A. Radical or conservative surgery for ectopic pregnancy? A follow-up study of fertility of 323 patients. Fertility and Sterility. 1988;(4):580–583. [PubMed: 3169281]
  • Turan V. Fertility outcomes subsequent to treatment of tubal ectopic pregnancy in younger Turkish women. Journal of Pediatric and Adolescent Gynecology. 2011;(5):251–255. [PubMed: 21715197]
  • Twigg J, Moshy R, Walker JJ, Evans J. Early pregnancy assessment units in the United Kingdom: An audit of current clinical practice. Journal of Clinical Excellence. 2003;(4):391–402.
  • Vermesh M, Presser SC. Reproductive outcome after linear salpingostomy for ectopic gestation: a prospective 3-year follow-up. Fertility and Sterility. 1992;(3):682–684. [PubMed: 1531468]
  • Vermesh M, Silva PD, Rosen GF, Stein AL, Fossum GT, Sauer MV. Management of unruptured ectopic gestation by linear salpingostomy: a prospective, randomized clinical trial of laparoscopy versus laparotomy. Obstetrics and Gynecology. 1989;3(1):400–40. [PubMed: 2464777]
  • Visscher RD, Visscher HC. Do Rh-negative women with an early spontaneous abortion need Rh immune prophylaxis? American Journal of Obstetrics and Gynecology. 1972;(2):158–165. [PubMed: 4623673]
  • Walsh JJ, Lewis BV. Transplacental haemorrhage due to termination of pregnancy. Journal of Obstetrics and Gynaecology of the British Commonwealth. 1970;(2):133–136. [PubMed: 4986845]
  • Wieringa-de Waard M, Hartman EE, Ankum WM, Reitsma JB, Bindels PJ, Bonsel GJ. Expectant management versus surgical evacuation in first trimester miscarriage: health-related quality of life in randomized and non-randomized patients. Human Reproduction. 2002;(6):1638–1642. [PubMed: 12042291]
  • Wieringa-de Waard M, Vos J, Bonsel GJ, Bindels PJ, Ankum WM. Management of miscarriage: a randomized controlled trial of expectant management versus surgical evacuation. Human Reproduction. 2002;(9):2445–2450. [PubMed: 12202439]
  • Wong E, Suat SO. Ectopic pregnancy--a diagnostic challenge in the emergency department. European Journal of Emergency Medicine. 2000;(3):189–194. [PubMed: 11142270]
  • Wood SL, Brain PH. Medical management of missed abortion: a randomized clinical trial. Obstetrics and Gynecology. 2002;(4):563–566. [Erratum appears in Obstet Gynecol 2002 Jul;100(1):175 Note: Dosage error in published abstract; MEDLINE/PubMed abstract corrected] [PubMed: 12039111]
  • Yao M, Tulandi T, Kaplow M, Smith AP. A comparison of methotrexate versus laparoscopic surgery for the treatment of ectopic pregnancy: a cost analysis. Human Reproduction. 1996;(12):2762–2766. [PubMed: 9021386]
  • You JH, Chung TK. Expectant, medical or surgical treatment for spontaneous abortion in first trimester of pregnancy: a cost analysis. Human Reproduction. 2005;(10):2873–2878. [PubMed: 15979988]
  • Zhang J, Gilles JM, Barnhart K, Creinin MD, Westhoff C, Frederick MM., National Institute of Child Health Human Development (NICHD) Management of Early Pregnancy Failure Trial. A comparison of medical management with misoprostol and surgical management for early pregnancy failure. New England Journal of Medicine. 2005;(8):761–769. [PubMed: 16120856]
  • Zilber U, Pansky M, Bukovsky I, Golan A. Laparoscopic salpingostomy versus laparoscopic local methotrexate injection in the management of unruptured ectopic gestation. American Journal of Obstetrics and Gynecology. 1996;3(1):600–602. [PubMed: 8828420]
Copyright © 2012, National Collaborating Centre for Women's and Children's Health.

No part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK [www.cla.co.uk]. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.

The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use.

Bookshelf ID: NBK132778

Views

  • PubReader
  • Print View
  • Cite this Page
  • PDF version of this title (3.1M)

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...