ABSTRACT
Unruptured ectopic pregnancy is evolving into a medical disease. With timely diagnosis, this condition can now be identified and treated without surgery in its early stages – even before symptoms. In many cases, systemic methotrexate, a strategy targeted directly at proliferating trophoblasts, is now preferred to surgery as the first-line intervention. Surgery is always first choice for cases where there is hemorrhage and hemodynamic instability. It is the default strategy for medical failures, neglected cases, and circumstances where methotrexate is contraindicated.
