Marla Moriarity,a 32-year-old recently unemployed and uninsured college professor,is diagnosed with an early ectopic pregnancy.Her obstetrician has given her the option of surgical or medical therapy.She is well-informed about the details of each medical and surgical option,but her primary concern about her condition is that her decision will be based upon her strong cultural belief system that will not sanction the destruction of the fetus.Marla's treatment decision will most likely be:

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Ectopic pregnancy,a devastating complication that affects up to 2% of all pregnancies,may be treated medically with methotrexate or surgically through salpingostomy,segmental resection,fimbrial expression,and salpingectomy.Methotrexate destroys rapidly dividing cells and is often administered in conjunction with the surgical procedure to destroy any residual trophoblastic cells that might remain (Research Highlight)(Genovese,2007).Laparoscopic and/or ultrasound-guided application of methotrexate to the extrauterine gestational sac may also be used as an alternative therapy.The more cost-effective medical treatment for ectopic pregnancy is considered a front-line therapy in many major medical centers.Ruptured ectopic pregnancy is considered a surgical emergency and is associated with severe abdominal pain,tachycardia,and hypotension.

Marla Moriarity,a 32-Year-Old Recently Unemployed and Uninsured College Professor,is Diagnosed