Ectopic Pregnancy - Treatments

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What was the treatment for your ectopic pregnancy?

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What treatment options are available for ectopic pregnancy?

Treatment options for ectopic pregnancy include observation, laparoscopy, laparotomy, and medication. Selection of these options is individualized. Some ectopic pregnancies will resolve on their own without the need for any intervention, while others will need urgent surgery due to life-threatening bleeding. However, because of the risk of rupture and potential dire consequences, most women with a diagnosed ectopic pregnancy are treated with medications or surgery.

For those who require intervention, the most common treatment is surgery. Two surgical options are available; laparotomy and laparoscopy. Laparotomy is an open procedure whereby a transverse (bikini line) incision is made across the lower abdomen. Laparoscopy involves inserting viewing instruments into the pelvis through tiny incisions in the skin. For many surgeons and patients, laparoscopy is preferred over laparotomy because of the tiny incisions used and the speedy recovery afterwards. Under optimal conditions, a small incision can be made in the Fallopian tube and the ectopic pregnancy removed, leaving the Fallopian tube intact. However, certain conditions make laparoscopy less effective or unavailable as an alternative. These include massive pelvic scar tissue and excessive blood in the abdomen or pelvis. In some instances, the location or extent of damage may require removal of a portion of the Fallopian tube, the entire tube, the ovary, and even the uterus.

Medical therapy can also be successful in treating certain groups of women who have an ectopic pregnancy. About 35% of women with ectopic pregnancies are candidates for medical rather than surgical treatment. Medical treatment method involves the use of an anti-cancer drug called methotrexate (Rheumatrex, Trexall). This drug acts by killing the growing cells of the placenta, thereby inducing miscarriage of the ectopic pregnancy. Some patients may not respond to methotrexate, and will require surgical treatment. Methotrexate is gaining popularity because of its high success rate and low rate of side effects. There are certain factors, including the size of the mass associated with the ectopic pregnancy and the blood beta HCG concentrations that help doctors decide which women are candidates for medical rather than surgical treatment. The optimal candidates for methotrexate treatment are women with a beta-subunit (HCG) concentration less than or equal to 5000 mIU/mL. In a properly selected patient population, methotrexate therapy is about 90% effective in treating ectopic pregnancy. There is no evidence that the use of this drug causes any adverse effects in subsequent pregnancies. Additional tests (HCG) are usually ordered to confirm that methotrexate treatment is effective.

Although there have been a few reported cases of women giving birth by cesarean section to live infants that were located outside the uterus, this is extremely rare. The chance of carrying an ectopic pregnancy to full term is so remote, and the risk to the woman so great, that it can never be recommended. It would be ideal if an ectopic pregnancy in the Fallopian tube could be saved by surgery to relocate it into the uterus. This concept has yet to become accepted as a successful procedure.

Overall, there have been great advances in the early diagnosis and treatment of ectopic pregnancy, and the mortality from this condition has decreased dramatically.

Return to Ectopic Pregnancy

See what others are saying

Comment from: Hopeful One, 25-34 Female (Patient) Published: September 21

I had an ectopic pregnancy back in 2006. I found out I was pregnant at the doctor's office after having flu like symptoms and breast tenderness/soreness. It was my 1st pregnancy and I was 21 years old. My then husband and I were very excited. One night I got up to use the bathroom and saw blood on the tissue. I didn't think too much of it because I heard from family members women can spot while pregnant, but I also noticed a knot formation on the lower left side of my abdomen. I guess it was wishing thinking, but I wanted to be pregnant so bad I ignored these warnings signs. The following afternoon I felt the worse pain I had ever felt in my life on the left side of my lower abdomen. It was a terrible shooting pain; it felt like someone was stabbing me with a knife. After an hour or so the pain subsided. My then husband came home from work I knew we had to go to the ER. The doctor asked me a few questions and I told him about the symptoms and pain I was experiencing. He looked at me with concerned eyes and left the room. Then the ER nurse came to my bed with an IV and about 12 hours later I was in surgery having my left fallopian tube removed. I was extremely saddened by the ordeal. And I became depressed. But it was truly a miracle that my fallopian tube didn't burst because I was far along in my pregnancy, about eight weeks. Now today my breasts have that same tenderness I felt five ago, I am going to go take a pregnancy test after work. If I am pregnant, I'm going straight to urgent care just to be on the safe side. I just want to encourage each and every one of you, life isn't over if you have an ectopic pregnancy or even a double one. I told myself if can't get pregnant I will adopt so that I can give a child all the love its needs even if I didn't give birth to them.

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Comment from: sanetra, 19-24 Female (Patient) Published: December 07

I had a ectopic pregnancy Dec 2011 I woke up to use the restroom I had the worst cramping ever could hardly stand I had blurred vision so I asked my boyfriend to call for me an Ambulance when I arrived at the ER I had an exam done blood work urine was tested went to ultrasound I got up out the bed to empty my bladder to get a vaginal ultrasound cause I wad early in my pregnancy so I passed out and woke up they took me back to my room my dr came in with fluids and explaining that I needed emergency surgery my tube had ruptured I was nervous but I went on to surgery recovery wasn't so bad but I'm blessed to be ok now that I'm home I'm having some of the worst cramping ever.

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