Ectopic Pregnancy Treatment: Do You Need Medication or Surgery?
Normal pregnancies develop inside of the uterus, but an ectopic pregnancy forms somewhere else. “Most ectopic pregnancies are located within the fallopian tube, but other locations include the ovaries, the abdominal cavity, and even inside the scar from a cesarean section,” says Dr. Rachel Fabacher Currault, an Ob-Gyn at the Women’s Specialists of Houston at Texas Children’s Pavilion for Women.
Ectopic pregnancies are often asymptomatic, but some women experience vaginal bleeding and abdominal pain. Doctors use a variety of methods to diagnose ectopic pregnancies, including ultrasound and hCG blood tests, says Dr. Fabacher Currault.
Ectopic pregnancies can’t be carried to term. If left untreated, they can lead to complications like fallopian tube rupture and internal bleeding. “It’s the leading cause of death in women during early pregnancy, but it's extremely rare in the United States,” says Dr. Mark D. Levie, professor of obstetrics & gynecology and women's health at the Albert Einstein College of Medicine. Here’s what you need to know about ectopic pregnancy treatment options.
Methotrexate for Ectopic Pregnancy
“Historically, all ectopic pregnancies were treated with surgical approach,” says Dr. Levie. “But in the past 20 years, we have moved from surgical to medical treatment in a lot of patients.” The medication – an injection called methotrexate (Trexall) – is used for early-stage ectopic pregnancies that don’t have a high risk of complications. It will stop the cells from growing and therefore end the pregnancy. Your body will absorb the cells that have already grown.
Your doctor will keep a close eye on your hCG levels after taking methotrexate. In some cases, women need more than one injection. Common side effects of methotrexate include abdominal pain, nausea, diarrhea, tiredness, chills, and dizziness.
Surgical Treatment of Ectopic Pregnancy
“If a ruptured ectopic pregnancy is detected or there is concern for life-threatening bleeding, surgery to remove the pregnancy is the only option,” says Dr. Fabacher Currault. The surgical procedure is performed through laparoscopy. That means the doctor will make a small incision near your belly button and use a tiny camera to see and remove the ectopic pregnancy from the tube (or, if necessary, remove the entire tube). In severe cases, doctors might perform an emergency surgery with a bigger incision.
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Prognosis After Ectopic Pregnancy Treatment
Whether you receive methotrexate or go through surgery for ectopic pregnancy treatment, you’ll need several weeks of follow-up with your doctor. He’ll monitor your hCG levels and make sure everything checks out. Most women won’t have any lingering side effects.
To catch ectopic pregnancy early, visit the doctor soon after finding out your pregnant – especially if you’ve had a prior ectopic pregnancy. “It is recommended to see a physician between 6 to 8 weeks gestational age (approximately 2-4 weeks following your missed period) to rule out ectopic pregnancy,” explains Dr. Fabacher Currault. “The biggest risk factor for an ectopic pregnancy is having a prior ectopic pregnancy. That means women with a history of an ectopic pregnancy should schedule a visit with their doctor as soon as the pregnancy is realized.”