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Previous Volume 361:379-387 July 23, 2009 Number 4 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.

A healthy 29-year-old woman who has been trying to conceive presents with vaginal spotting for the past 5 days and intermittent crampy abdominal pain in her left lower quadrant for the past 3 days. Although she normally has regular menstrual cycles, her last menstrual period was 6 weeks and 2 days before presentation. She has had a spontaneous vaginal delivery and an . . . [Full Text of this Article]

The Clinical Problem

Strategies and Evidence

Evaluation

Ultrasonographic Examination

Correlation of Ultrasonographic Findings with hCG Values

Management

Medical Management

Surgical versus Medical Therapy

Areas of Uncertainty

Guidelines

Conclusions and Recommendations

Source Information

From the Department of Obstetrics and Gynecology, University of Pennsylvania Medical Center, Philadelphia.

An audio version of this article is available at NEJM.org.

Address reprint requests to Dr. Barnhart at the Department of Obstetrics and Gynecology, 3701 Market St., 8th Fl., Philadelphia, PA 19104, or at kbarnhart@obgyn.upenn.edu.

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