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Medical management of ectopic pregnancy.

By combining diagnostic modalities such as serial human chorionic gonadotropin titers, transvaginal sonography, and suction curettage, most unruptured ectopic pregnancies can be diagnosed without laparoscopy. When the diagnosis can be made in this manner, methotrexate may be the treatment of choice. It certainly should be considered as an alternative form of treatment in patients with an unruptured ectopic pregnancy. A randomized clinical trial comparing systemic methotrexate with laparoscopic salpingostomy in patients who are methotrexate eligible would be helpful.