The authors present a report of three cases of early ectopic pregnancy (EP) managed conservatively (nonsurgical management); one case with expectant management (EM), and two cases with intratubal injection of a 3 ml, solution containing 40 mg methotrexate (MTX) after partially aspirating the contents of the gestational sac and under high resolution (6.5 MHz) transvaginal sonographic (TVS) guidance. The case managed expectantly (EM), and the first case that received an intratubal injection of MTX were completely resolved. In the third case a second injection of 40 mg MTX was administered 16 days later, followed by emergency laparotomy with left salpingectomy. It is worth noting that the nonsurgical management of EP is still under investigation. We propose and discuss selection criteria and guidelines for management of early EP with the integration of EM, medical and surgical treatments.
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