How an Ectopic Pregnancy is Treated

Being diagnosed as having an ectopic pregnancy (often referred to as a tubal pregnancy) can at the least be a scary and confusing thing. Knowing exactly what an ectopic pregnancy is, and how it is treated can help alleviate the emotional distress that can result from this diagnosis. An ectopic pregnancy is a serious health issue among women of childbearing age. The term ectopic pregnancy refers to the implantation of a fertilized egg somewhere other than the uterine cavity of the woman. This can include implantation in the fallopian tubes, cervix, ovaries, or abdominal wall, though usually it is in the fallopian tube. Since only the uterus is designed to expand to accommodate room for the gestation of a fetus as well as provide a normal biological network for the nutrition and growth of a fetus, this can lead to serious health complication including hemorrhaging, infertility and in some cases death. Symptoms of an ectopic pregnancy include abdominal and pelvic pain or tenderness, vaginal bleeding, and common symptoms of normal early pregnancy such as nausea, breast tenderness and fatigue.
Some of the risk factors identified among women diagnosed with an ectopic pregnancy include prior incidents of pelvic inflammatory disease or PID, use of fertility drugs or other reproductive therapy, a history of prior ectopic pregnancy and increased age (women age 35-44 have a higher risk of ectopic pregnancy). Other less common risk factors have also been identified such as smoking, prior abdominal surgery and failure of progestin contraceptives such as the progesterone IUD device.

Since ectopic pregnancies do not develop like normal pregnancies and have little to no chance of survival to term as well as presenting serious health risks to the patient including maternal injury or death, ectopic pregnancies are usually terminated by the treating physician. Depending on whether or not the organ where the fertilized egg has attached itself has ruptured determines the type of treatment which may be performed. If the ectopic pregnancy has not progressed to the point that the organ it has attached to has ruptured, treatment is relatively simple and non invasive. Most commonly, the patient is given an injection of methotrexate, a drug often used in cancer treatments which has medical properties that prevent rapid cell growth. This medication dissolves the embryonic tissue and allows the body to reabsorb it, just as in cases of natural termination of the embryo by the body.

In some instances, the use of methotrexate or similar drugs may not be possible. If the organ the embryo has attached to has ruptured or for any reason the physician feels drug therapy would not be a reliable solution, the patient may undergo laparoscopic surgery. This is a minimally invasive procedure usually performed as an outpatient surgery which allows the surgeon to access the reproductive organs in order to eliminate the ectopic pregnancy by removing the embryonic tissue from the patient. In some cases the physician may also remove the fallopian tube or other affected reproductive organs.

Once the ectopic pregnancy has been removed, the patient receives follow up treatment in order to ensure that their blood hormone levels return to normal. Follow up treatment usually lasts 3-6 weeks after the ectopic pregnancy has been terminated. If the hormone levels do not return to normal, the patient may be treated with additional doses of methotrexate to return their blood levels to normal and ensure that all of the embryonic tissue has been dissolved from the patients system and prevent further health complications.

An ectopic pregnancy can affect a woman's fertility. Patients with a prior tubal pregnancy have a higher percentage chance of having an additional ectopic pregnancy than patients who have not previously been diagnosed with one. In addition, having the fallopian tube or other reproductive organs removed lowers the patients chance of becoming pregnant again. If the tube or other organ ruptured before the ectopic pregnancy was removed, the patient has an increased risk of tissue damage or scarring of the reproductive organs which may also affect the chances of getting pregnant after an ectopic pregnancy. Risk of pelvic infection is also greater in patients who have experienced an ectopic pregnancy which may affect fertility.

Some women may experience emotional distress after the termination of an ectopic pregnancy. This is normal as the patient's hormone levels are elevated as in normal pregnancy (though not as high as normal pregnancy levels). Patients also may experience a sense of loss and depression akin to that experienced after a miscarriage. This is also normal. A physician can recommend mental health treatment as well as continued physical follow up treatment in the form of support groups, seeking the assistance of a mental health professional or seeking advice from the patient's religious authority. Emotional trauma after an ectopic pregnancy should be treated as a medical condition as mental health affects the overall health of the patient.

If a patient has concerns about physical health, fertility issues or emotional health after the treatment of an ectopic pregnancy, they should consult with their health care provider. If a patient suspects or has concerns about a possible ectopic pregnancy, they should seek medical attention immediately as the results of an untreated condition such as this can have devastating effects on the patients overall health. A ruptured ectopic pregnancy is considered a medical emergency and should be treated without delay.