The possibilities of modern medicine did not allow to save the life of the embryo in the ectopic pregnancy. Treatment of an ectopic pregnancy occurs under the watchful supervision of a physician.

If an ectopic pregnancy was diagnosed before it ruptured fallopian tube, can be used the following treatments:

• Active surveillance - treatment is not started immediately, but there is a regular patient at the doctor.
• Drug treatment - to stop the development of the embryo, using a drug called methotrexate.
• Surgery is used to remove the embryo.

If necessary, the gynecologist can tell the patient in detail about the risks and benefits of different treatments.

Active surveillance

If the patient is observed only mild symptoms, it is likely that after a while the ectopic pregnancy will cease to develop itself. In this case, the fertilized egg will die, and then is absorbed into the surrounding tissue. If this occurs, treatment is not necessary. The probability of such termination of ectopic pregnancy is greatest when a blood test showed a low level of hCG in the patient.

If your doctor will opt for active surveillance, the patient will need to undergo regular ultrasound, and to donate blood for analysis to experts could observe pregnancy. When the tests do not show a stable decrease in hCG levels, it is necessary to use other treatments (this occurs in approximately one out of three cases, when doctors prefer active surveillance).

The advantage of active surveillance is that the patient will not be side effects associated with medical or surgical treatment - unless, of course, an ectopic pregnancy is really completed itself. The main drawback of this treatment is that the patient still retains a small risk of rupture of the fallopian tube - even if the tests show a reduction in the level of hCG.

Methotrexate

If an ectopic pregnancy does not end without medical help, but is diagnosed early enough, it can be interrupted by a drug called methotrexate, which stops the development of the cells of the embryo. Methotrexate can be used, if the diameter of the embryo does not exceed 3.5 cm. This medication should not be prescribed to patients who have a one or more of the following offenses:

• Diseases that weaken the immune system, such as diabetes;
• Any blood diseases that lead to a decrease in the level of certain types of blood cells, such as anemia;
• Liver disease;
• Kidney disease.

If the patient was appointed methotrexate, after receiving it must be seen by a doctor, in particular, regularly donate blood for analysis. This is necessary to determine how effective was the drug, and timely detect possible complications.

Usually, the patient is administered a single dose of methotrexate; injections made in the buttock. In some cases, you may need a second dose.

During the period of three to six months (depending on the amount of dose) after administration of methotrexate patient must use reliable contraception. If pregnancy occurs during this period there is an increased chance of developing serious birth defects in the unborn child. It is also very important to avoid alcohol, while the doctor did not say that they can be used safely. This is due to those alcohol shortly after administration of methotrexate can lead to liver damage.

The most common side effects of methotrexate is abdominal pain, which usually occurs in one or two days after administration. Typically, this pain, slight or moderate, and it runs for 24-48 hours. In addition, methotrexate may cause the following side effects:

• Malaise, nausea;
• Nausea;
• Diarrhea;
• Dizziness;
• Sores in the mouth.

Between the fourth and seventh days after the injection of methotrexate is necessary to do a blood test. If the analysis does not show a significant reduction in the level of hCG may need surgery. But even after medical treatment hCG levels, as expected, decreased, it is possible rupture of the fallopian tube (about 1 to 14). Therefore, patients must be aware of the symptoms of this condition, and when they appear seek immediate medical help.

Surgical intervention

Surgery to remove a fertilized egg from the fallopian tube - is the most common way to treat ectopic pregnancy. This typically applies a laparoscopy. This operation is performed using a laparoscope, which we mentioned above, but in this case, the doctor not only examines the state of the fallopian tubes, but also removes them from one of embryo. If the fallopian tube is damaged, it is also necessary to delete - this operation is called a salpingectomy.

To do two operations within a short period of time, removal of the embryo or the entire fallopian tube is often performed immediately after using the laparoscopy was confirmed ectopic pregnancy. Before the start of laparoscopy physician should explain to the patient that may be required such an operation, as well as give her to sign a document in which it confirms its agreement on the removal of the fallopian tube, if necessary.

Most patients are discharged from the hospital within a few days after the operation, although it may take at least one month before the body is fully restored.

If the patient ruptured fallopian tube, it needs emergency surgery. The surgeon holds a laparotomy - makes an incision in the abdominal wall - to stop the bleeding and, if possible, restore the fallopian tube.

After surgery for the treatment of ectopic pregnancy patients with Rh-negative are administered anti-D immunoglobulin. If pregnancy occurs in the future, this will prevent a variety of problems related to Rhesus conflict.

Follow-up

A few weeks after the treatment of ectopic pregnancy patients were recommended to go to the doctor, to discuss the following questions:

• As an ectopic pregnancy affected the fertility of the patient?
• When the patient can be back to try to get pregnant?
• What should I do wish to become pregnant How to Get Pregnant: Recommendations to help   Patients who have removed the fallopian tubes?
• If the patient after treatment of ectopic pregnancy is experiencing these or other emotional problems, to what expert can seek to resolve them?

Depending on the condition of the patient, and also on whether she wants to have children in the future, your doctor may refer her for further examination or treatment.

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