When people first think of ectopic pregnancy, they probably think of the worst case scenario -- a ruptured fallopian tube and emergency surgery.
Although the latter is certainly possible and can occur in ectopic pregnancies that develop undetected for too long, not all newly diagnosed ectopic pregnancies are automatically considered medical emergencies. When the diagnosis comes early enough in the process, other possible treatments exist. Here's a quick look at what a doctor may suggest after diagnosing an ectopic pregnancy:
Waiting
If blood tests show that the hCG level in the blood is falling, chances are that the ectopic pregnancy is already in the process of miscarrying and the doctor may merely monitor the woman's hCG to make sure it continues to drop.
Medical Management with Methotrexate
If the hCG level is below a certain limit and there is no risk of imminent rupture, the doctor may prescribe a drug called methotrexate to treat the ectopic pregnancy. Methotrexate is also used in chemotherapy and works to stop rapidly growing cells from multiplying. The drug is administered as an injection.
Research has found methotrexate to be an effective treatment for early ectopic pregnancies, preventing the need for surgery about 90% of the time when the woman is a candidate for the treatment. When using methotrexate to treat ectopic pregnancy, doctors usually continue to monitor a woman's hCG levels also in order to make sure that the ectopic pregnancy is not continuing to develop.
Surgery
Surgery is the final possibility in treatment of an ectopic pregnancy. If the ectopic pregnancy is continuing to develop and is posing a threat of rupture, or if it has already ruptured, surgical treatment is the default and unavoidable. In addition, in non-emergency situations, some women may prefer surgical treatment over using methotrexate in cases when the doctor offers a choice.
In surgical treatment of an ectopic pregnancy, the doctor operates to remove the pregnancy tissue from the fallopian tube. The surgery may involve laparascopy. Sometimes there is no way to repair the damage to the fallopian tube and the doctor must remove the affected tube.
Trying Again After Ectopic Pregnancy
Regardless of treatment method, women who have had an ectopic pregnancy are at increased risk for having another ectopic pregnancy, so it's important to check in with a doctor early along in the next pregnancy.
Sources
Hajenius, P.J., F. Mol, and B.W.J. Mol, "Interventions for tubal ectopic pregnancy." Cochrane Reviews Nov 2006. Accessed 23 Jun 2008.
Lipscomb, Gary H., Marian L. McCord, Thomas G. Stovall, Genelle Huff, S. Greg Portera, and Frank W. Ling, M.D. "Predictors of Success of Methotrexate Treatment in Women with Tubal Ectopic Pregnancies." NEJM Dec 1999. Accessed 23 Jun 2008.
