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Fertil Steril. 2012 Nov;98(5):1061-5. doi: 10.1016/j.fertnstert.2012.09.018.

Early pregnancy failure: beware of the pitfalls of modern management.

Author information

  • Departments of Obstetrics and Gynecology and Epidemiology, Perelman School of Medicine at the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA. kbarnhart@obgyn.upenn.edu

Abstract

The evolution of the diagnosis and management of women with an early pregnancy loss has been a success story. The mortality from ectopic pregnancy has objectively been decreased in the past few decades. However, modern management has resulted in a new set of issues. Over-interpretation of a single ultrasound, misunderstanding of the utility of serial hCG values, and inappropriate use of methotrexate can result in iatrogenic complications. Modern management has successfully improved the diagnosis of ectopic pregnancy before rupture; it should now also focus on ensuring that an intrauterine pregnancy is not interrupted as a result of diagnosis and treatment. This article reviews some of the pitfalls of the modern management of early pregnancy failure and introduces a series of articles on the subject.

Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

PMID:
23084007
[PubMed - indexed for MEDLINE]
PMCID:
PMC3479658
Free PMC Article
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