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. 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.

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See what others are saying

Comment from: Gray1955, 25-34 Female Published: September 28

Last year I got very sick. I had my son take me to the hospital. After 5 tubes of blood the doctor came in and told me I had sepsis. I almost died. I was also in kidney failure. Then the problem started. He asked me for a urine sample. Urinating before I got to the hospital I did not need to go and I told him I can't urinate on demand. I've been like that all my life. He left and within 10 minutes 2 nurses came in. I asked what was going on and got no answer. They the male registered nurse told my son to leave. I asked again and still got no reply. He then told the other nurse to take my pants off. I started to ask again and I felt the catheter go in me. I gave up after that. He pulled that one out and forced in another one. He was pushing it in and out yelling at me if I have a prostate problem. I told him no, I urinated before I got there. I think he was mad because he never got it in the bladder. My son came in after and I told him what they did and he asked why they did not answer me at all. The second one hurt more than the first and I had blood on my gown. They will never do that to me again. A nurse is supposed to talk to the patient and explain what they are doing. I did not get that. No cleaning, no gel, nothing. I will never let that happen to me again. Sex has never been the same.

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Comment from: Jsjksa, 25-34 Female (Patient) Published: June 24

I had an ectopic pregnancy. I remember it was June 15th, 2012, our ten year anniversary. I was taking a shower getting ready to go out when I felt dizzy with a stomach pain and a severe leg cramp. I went to the emergency room telling all my symptoms. When I asked about the likelihood of an ectopic, the doctor told me he didn't think I fit into that category. I went home with the pain for two days until my obstetrician/gynecologist could see me on Monday. They did emergency surgery but were able to save my tube. My doctor said I had massive internal bleeding and I feel lucky to be alive today. I've been trying for a pregnancy ever since.

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