Ectopic Pregnancy

How Is Ectopic Pregnancy Treated?

It is important to realize that an ectopic pregnancy can never grow into a normal baby. Furthermore, it cannot be transplanted into the womb and survive. If the ectopic pregnancy is not very far along, it may be able to be removed with an injection of a drug called methotrexate. Methotrexate dissolves the fertilized egg and allows your body to reabsorb it. This nonsurgical treatment technique preserves the fallopian tube.

An ectopic pregnancy that is larger and further along requires surgery. The extent of the surgery depends on how far along your pregnancy is and whether or not the fallopian tube has been damaged or ruptured.

• When the tube is ruptured and seriously damaged, the entire fallopian tube is removed along with the pregnancy.
• When the fallopian tube is whole and not severely damaged, the pregnancy tissue may be removed while the tube is left in place to heal.
• The present trend is to leave the tube in place when possible so as to improve the chance for future fertility.
• When future fertility is not desired, removal of the tube and pregnancy is preferable.

Surgery

There are two approaches to surgery. One involves treatment by laparoscopy through a small incision at the belly button. The other, called a laparotomy, requires a much larger surgical cut (incision) of about four to five inches across the lower abdomen, generally attempting to keep the scar hidden even beneath a bikini, and so sometimes called a “bikini cut”. Occassionally, a larger abdominal incision down the abdomen is required.

Most ectopic pregnancies can be removed through laparoscopy, which allows patients to have less pain after surgery, to go home on the same day, and to resume normal activities in a week or so.

A larger incision is only required when the ectopic pregnancy is large or severely ruptured, both being conditions which make removal by laparoscopy more difficult. Patients treated by laparotomy are hospitalized for three to five days and cannot resume full activity for up to six weeks.

After surgery, the doctor will want to check your hCG levels regularly for up to 12 weeks. This ensures that all the ectopic tissue was removed. If hCG tests show that there was ectopic tissue left behind, further surgery or injections with methotrexate may be necessary.

For more detailed information about laparoscopic surgery, go to Laparoscopy.