What are the treatment options for ectopic pregnancy?
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Ruptured ectopic pregnancy
Emergency surgery is needed if a fallopian tube ruptures with heavy bleeding. The main aim is to stop the bleeding. The ruptured fallopian tube and remnant of the early pregnancy are then removed. The operation is often life saving.
Early ectopic pregnancy - before rupture
Ectopic pregnancy is often diagnosed before rupture. Your doctor will advise on the treatment options, which may include the following.
Ectopic pregnancy is most often diagnosed before rupture. Your doctor will discuss the treatment options with you and in many cases you are able to decide which treatment is best for you. These may include the following:
- Surgery: Removal of the tube (either the whole tube or part of it) and the ectopic pregnancy is most commonly performed by a laparoscopic operation (keyhole surgery). Salpingectomy (removal of the fallopian tube containing the ectopic) is performed if the other tube is healthy. Salpingotomy (removal of only a section of the tube with the ectopic pregnancy in) is performed if the other tube is unhealthy (for example scarred from a previous infection). However, many women with ectopic pregnancies do not need to have an operation.
- Medical treatment: Medical treatment of ectopic pregnancies is now more common and avoids the need for surgery. A medicine called methotrexate is often given, usually as an injection. It works by killing the cells of the pregnancy growing in the fallopian tube. It is normally only advised if the pregnancy is very early. The advantage is that you do not need an operation. The disadvantage is that you will need close observation for several weeks with repeated blood tests and scans to check it has worked. Women usually have a blood test for hCG (human chorionic gonadotropin) every 2-3 days until the levels are low. Scans are usually repeated weekly. Methotrexate can cause side-effects which include nausea and vomiting in some women. It is very common for women to experience some abdominal pains 3-7 days after having methotrexate.
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