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Keywords:

  • ectopic pregnancy;
  • expectant management;
  • glucose installation;
  • hCG levels;
  • spontaneous reaction;
  • tubal pregnancy

Objective. To compare expectant management with local instillation of 50% glucose solution for tubal pregnancies with a serum hCG level ≤2500 mlU/mL. Design. Prospective, non-randomized, comparative clinical study.

Setting. Two university departments.

Patients. One hundred and twenty-eight patients with laparoscopically-confirmed tubal pregnancy and serum hCG ≤2500 mlU/mL.

Interventions. Eighty patients in Graz were treated with laparoscopic instillation of 50% glucose solution and 48 patients in Turku were followed expectantly.

Main outcome measures. Resolution of hCG excretion, need for further interventions.

Results. Seventy-four of the 80 patients (92%) in the glucose group (32 of 33 with an initial hCG ≤250 mlU/mL and 42 of 47 with hCG 251-2500 mlU/mL) and 36 of 48 (75%) patients in the expectant group (19 of 23 with an initial hCG ≤250 mlU/mL and 17 of 25 with hCG 251-2500 mlU/mL) had resolution of the pregnancy with no further intervention (p=0.008, chi-square test, odds ratio 0.24).

Conclusions. Glucose instillation is superior to expectant management for patients with early tubal pregnancy.