Treatment for ectopic pregnancy
A senior obstetrician will advise you on the treatment that's most suitable for you.
The treatment that is best for you will depend on:
- how many weeks into your pregnancy you are
- your symptoms, and what the doctor finds during the examination
- the results of your ultrasound scan and blood tests
- your personal views and preferences
- the options available at your hospital
Treatment options might include:
- expectant management ('wait and see' approach)
- medical treatment
- surgical treatment
Expectant management ('wait and see' approach)
This means waiting and seeing if the ectopic pregnancy will end on its own. You'll be carefully monitored with frequent blood tests. This option is only suitable if the ectopic pregnancy is in the very early stages.
Contact your doctor urgently if you develop any symptoms. You'll usually be given a direct contact number for the emergency or gynaecology ward at your maternity hospital in case you get any symptoms.
If expectant management does not work, your doctor will suggest medical or surgical treatment options.
Medical treatment is the injection of a drug called methotrexate. This prevents the ectopic pregnancy from growing. You don't have to have your fallopian tube or part of the tube removed, and you don't need a general anaesthetic.
You may need to return to the clinic or the ward a few days later. You'll be advised on who to contact if you experience any symptoms.
The main advantage of having methotrexate treatment is that you don't have to have surgery. It may be safest options for you if your BMI is very high or if you have had previous surgery on your abdomen (tummy).
The disadvantages include that you need to be followed up by your obstetrician for a longer period of time, possibly three weeks. Also 15% of women will need a second injection of methotrexate. Seven in 100 women (7%) will need to have surgery.
This means having an operation under general anaesthetic to remove the ectopic pregnancy. This is normally a laparoscopy, which is a type of keyhole surgery. A small cut is made in your tummy and the fertilised egg is removed. The fallopian tube, or part of the fallopian tube, is normally removed too.
Open surgery (known as a laparotomy) may be needed if there is internal bleeding or in an emergency situation. This is done through a larger cut in your tummy.
The medical team will send any tissue removed during an operation to a laboratory to test. Speak to the maternity hospital about what happens after this.
The advantages of surgical treatment is that it will treat the ectopic pregnancy more quickly and you may not need to be followed up for as long of a period of time. However it does mean having an operation. The recovery time from laparoscopy surgery is usually 4 to 6 weeks.
Discussing your treatment with your doctor
After you've been diagnosed with an ectopic pregnancy, unless it is an emergency situation, your doctor should discuss your treatment options with you to allow you to make an informed decision.
Make sure you understand:
- all of the treatment options that are available to you
- any risks of a particular treatment
- the effects of a particular treatment on future pregnancy
Don't be afraid to ask for more information if there is something you do not understand.