Treatment for Ectopic Pregnancy

After your physician confirms the diagnosis of an ectopic pregnancy, you may be put under observation. Treatment for ectopic pregnancy includes laparoscopy, laparotomy and medication depending on your personal preferences. Some ectopic pregnancies resolve by themselves without the need for any medical intervention. Others may require emergency treatment because of bleeding which can be life threatening. Due to the potential risk of rupture and its life threatening consequences, most women are treated with either medication or surgery.

Surgical intervention is generally the preferred option. There are two surgical procedures which can be used. They are:

  • Laparoscopy: This is the preferred alternative as it leaves negligible scars and recovery is speedy. It involves tiny incisions made in the lower abdomen through which viewing and surgical tools may be inserted. A tiny incision is made in the fallopian tube through which the ectopic pregnancy can be removed.
  • Laparotomy: This is an open procedure whereby a bikini line (transverse) incision is made across the lower abdomen. This procedure is generally used in cases where there is excessive blood in the abdomen or pelvis or massive pelvic scar tissue. In some cases, the entire fallopian tube or portions thereof, the ovary and the uterus may have to be removed.
Medication can work in certain cases and approximately 35% of all ectopic pregnancies can be treated in this manner. Medical treatment uses an anti-cancer drug known as methotrexate, which acts by killing the cells of the placenta thereby inducing a miscarriage. The use of methotrexate is increasing owing to its high success rate and few side effects. It is suitable for use in cases where the beta HCG blood levels are less than 5000 mIU/ml. The size of the mass of the ectopic pregnancy will also determine the suitability of using this medication. There is no evidence to indicate that this medication has any adverse effect on subsequent pregnancies, making it safe to use.

There have been rare cases of women actually giving birth by cesarean section to live infants. However, the chances of carrying an ectopic pregnancy to full term are extremely remote and with the potential risk to the mother’s life, it can never be recommended.