Herausforderungen in der Diagnostik und Therapie ektoper Schwangerschaften

The current issue of the European Journal of Ultrasound includes a number of articles discussing various types of ectopic pregnancies. Ectopic pregnancies develop partially or completely outside the uterine cavity, and due to the fetal growth in an abnormal anatomical location, these pregnancies are potentially associated with hemorrhagic morbidity [1].

Publication History

Article published online:
09 February 2026

• References

• 1 Farren J, Al Wattar BH, Jurkovic D. The diagnosis and management of extrauterine and uterine ectopic pregnancy. Hum Reprod Update 2025;
• 2 Helmy-Bader S, Koch M. Ultrasound assessment and management of different forms of ectopic pregnancy. Ultraschall in Med 2025; 10
• 3 Barnhart KT. Clinical practice. Ectopic pregnancy. N Engl J Med 2009; 361: 379-387
• 4 Farquhar CM. Ectopic pregnancy. Lancet 2005; 366: 583-591
• 5 Hoopmann M. Sonographic and intraoperative image of a heterotopic pregnancy in 6+3 weeks of gestation. Ultraschall in Med 2023; 44: 232-232
• 6 Möllmann U, Möllers M, Kiesel L. et al. Fallbericht Ektope Tripletgravidität im Bereich einer Sectionarbe nach ICSI. Ultraschall in Med 2012; 33: A720
• 7 Wamsler M, Rehn M, Rieger L. et al. Diagnostik und Therapie einer intakten Zervikalgravidität in der 11. SSW. Ultraschall in Med 2008; 29: V117
• 8 Schäfer MT, Henrich W. Eine vitale unilaterale Gemini-Tubargravidität – Sonographische Diagnostik und laparoskopische Sanierung. Ultraschall in Med 1999; 20: 171-173
• 9 Bonilla-Musoles F, Pardo G, Sampaio M. et al. Vaginale Endosonographie bei extrauteriner Gravidität. Ultraschall in Med 1989; 10: 215-221
• 10 Burns RD, Sorrels C, Keomany J. et al. Heterotopic pregnancy presenting with intra-abdominal haemorrhage and shock. BMJ Case Rep 2025; 18: e268477
• 11 Kirk E, Ankum P, Jakab A. et al. Terminology for describing normally sited and ectopic pregnancies on ultrasound: ESHRE recommendations for good practice. Hum Reprod Open 2020; 2020: hoaa055
• 12 Timor-Tritsch IE. A Cesarean scar pregnancy is not an ectopic pregnancy. Ultrasound Obstet Gynecol 2022; 59: 424-427
• 13 Cai P, Zheng M, Wang Q. et al. Diagnosis and management of heterotopic intramural pregnancy after in vitro fertilization: an eight-case series. Ultraschall in Med 2024;
• 14 Betran AP, Ye J, Moller AB. et al. Trends and projections of caesarean section rates: global and regional estimates. BMJ Glob Health 2021; 6
• 15 Jurkovic D, Hillaby K, Woelfer B. et al. First-trimester diagnosis and management of pregnancies implanted into the lower uterine segment Cesarean section scar. Ultrasound Obstet Gynecol 2003; 21: 220-227
• 16 Timor-Tritsch IE, Monteagudo A, Cali G. et al. Cesarean scar pregnancy is a precursor of morbidly adherent placenta. Ultrasound Obstet Gynecol 2014; 44: 346-353
• 17 Kaelin Agten A, Cali G, Monteagudo A. et al. The clinical outcome of cesarean scar pregnancies implanted “on the scar” versus “in the niche”. Am J Obstet Gynecol 2017; 216: 510.e511-510.e516
• 18 Miller R, Timor-Tritsch IE, Gyamfi-Bannerman C. Society for Maternal-Fetal Medicine (SMFM) Consult Series #49: Cesarean scar pregnancy. Am J Obstet Gynecol 2020; 222: b2-b14
• 19 AWMF. Early pregnancy loss in the 1st trimester. Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry No. 015/075, August 2024). http://www.awmf.org/leitlinien/detail/ll/015-076.html
• 20 Timor-Tritsch IE, Monteagudo A, Cali G. et al. Cesarean Scar Pregnancy: Patient Counseling and Management. Obstet Gynecol Clin North Am 2019; 46: 813-828
• 21 Kaelin Agten A, Jurkovic D, Timor-Tritsch I. et al. First-trimester cesarean scar pregnancy: a comparative analysis of treatment options from the international registry. Am J Obstet Gynecol 2024; 230: 669.e661-669.e619
• 22 Marret H, Fauconnier A, Dubernard G. et al. Overview and guidelines of off-label use of methotrexate in ectopic pregnancy: report by CNGOF. Eur J Obstet Gynecol Reprod Biol 2016; 205: 105-109
• 23 [Anonymous]. Early pregnancy loss in the 1st trimester. In, Guideline of the DGGG, OEGGG and SGGG; August 2024.
• 24 Miller R, Gyamfi-Bannerman C. Society for Maternal-Fetal Medicine Consult Series #63: Cesarean scar ectopic pregnancy. Am J Obstet Gynecol 2022; 227: b9-b20
• 25 Mitsui T, Mishima S, Ohira A. et al. hCG values and gestational sac size as indicators of successful systemic methotrexate treatment in cesarean scar pregnancy. Taiwan J Obstet Gynecol 2021; 60: 454-457
• 26 Tanaka K, Coghill E, Ballard E. et al. Management of caesarean scar pregnancy with high dose intravenous methotrexate infusion therapy: 10-year experience at a single tertiary centre. Eur J Obstet Gynecol Reprod Biol 2019; 237: 28-32
• 27 Zhang J, Zhang Y, Gan L. et al. Predictors and clinical features of methotrexate (MTX) therapy for ectopic pregnancy. BMC Pregnancy Childbirth 2020; 20: 654
• 28 Maheux-Lacroix S, Li F, Bujold E. et al. Cesarean Scar Pregnancies: A Systematic Review of Treatment Options. J Minim Invasive Gynecol 2017; 24: 915-925