An obstetrician (pregnancy doctor) will advise you on the most suitable treatment for your ectopic pregnancy.
This 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:
- medical treatment
- surgical treatment
- expectant management
Medical treatment
Medical treatment is the injection of a drug called methotrexate. This prevents the ectopic pregnancy from growing.
You may need to return to the clinic or the ward a few days after the injection. You'll be advised on who to contact if you have any symptoms.
The main advantage of having methotrexate treatment is that you do not need to have surgery or take a general anaesthetic.
It may be the safest option if:
- your body mass index (BMI) is very high
- you've had previous surgery on your tummy
Side effects of medical treatment for ectopic pregnancy
Having treatment with methotrexate will mean you will have to wait longer to try to get pregnant again.
Methotrexate is also used in chemotherapy. It stays in your cells for 12 weeks. You should not try to get pregnant again for 12 weeks after getting methotrexate. Use contraception during this time.
Medical treatment also takes longer to remove the pregnancy than surgery. You'll usually have a follow-up appointment with your obstetrician within 30 days.
Research shows that:
- 15% of women will need a second injection of methotrexate
- 7% of women with an ectopic pregnancy will need surgery following methotrexate
Surgical treatment
Surgical treatment will treat the ectopic pregnancy more quickly than medical treatment.
This is normally a laparoscopy, which is a type of keyhole surgery. A small cut is made in your tummy and the ectopic pregnancy is removed. The fallopian tube, or part of the fallopian tube, is often removed too.
The pregnancy may sometimes be located in other areas such as the ovary, bowel or abdomen. This can make it more difficult to remove. You may need another surgery.
The recovery time from laparoscopy surgery is usually 4 to 6 weeks.
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 surgery to a laboratory to test. Talk to your doctor about what happens after this.
Expectant management
There's a good chance the pregnancy will dissolve by itself if:
- you have no symptoms or mild symptoms
- the pregnancy is very small or cannot be found
In this case, you may only need to be closely monitored.
This is known as expectant management.
You'll have regular blood tests to check that the level of hCG in your blood is going down. These will be needed until the hormone is no longer found.
You may also:
- need further treatment if your hormone level doesn't go down or it increases
- have some vaginal bleeding - use pads or towels, rather than tampons, until this stops
- have some tummy pain - take paracetamol to relieve this
You'll be told what to do if you develop more severe symptoms.
The main advantage of monitoring is that you will not get any side effects of treatment.
A disadvantage is that there's still a small risk of 1 of your fallopian tubes splitting open (rupturing). You may eventually need treatment.
Discuss your treatment with your doctor
After you've been diagnosed with an ectopic pregnancy, your doctor should discuss your treatment options with you. This will help 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 pregnancies
Ask for more information if there is something you do not understand.
Disposing of pregnancy remains
Hospital staff should explain the options available for disposal of the pregnancy remains.
This will be done in a sensitive manner. They will help you make a decision that is right for you.
If you do not wish to make a decision about your pregnancy remains, the hospital can make a decision for you. They can dispose of the remains.
Getting support
Support is available from:
