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Treatments and drugs
By Mayo Clinic staffA fertilized egg can't develop normally outside the uterus. To prevent life-threatening complications, the ectopic tissue must be removed.
Sometimes if the ectopic pregnancy is detected early, an injection of the drug methotrexate may be used to stop cell growth and dissolve existing cells. After the injection, your health care provider will monitor your blood for the pregnancy hormone human chorionic gonadotropin (HCG). If the HCG level remains high, you may need another injection of methotrexate.
If the ectopic pregnancy doesn't respond to medication or is too large, or you're unable to use methotrexate or return for monitoring, you may need laparoscopic surgery. In this procedure, the doctor makes a small incision in the abdomen, near or in the navel. Then he or she uses a thin tube equipped with a camera lens and light (laparoscope) to view the area. Other instruments can be inserted into the tube or through other small incisions to remove the ectopic tissue and repair the fallopian tube. If the fallopian tube is significantly damaged, it may need to be removed.
If the ectopic pregnancy is causing heavy bleeding or the fallopian tube has ruptured, you may need emergency surgery through an abdominal incision (laparotomy). In some cases, the fallopian tube can be repaired. Typically, however, the ruptured tube must be removed.
In a few cases, an injection of methotrexate is needed after surgery.
- Lobo RA. Ectopic pregnancy: Etiology, pathology, diagnosis, management, fertility prognosis. In: Katz VL, et al., eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa.: Mosby; 2007. http://www.mdconsult.com/das/book/body/171922449-3/0/1524/108.html?tocnode=53759261&fromURL=108.html#4-u1.0-B978-0-323-02951-3..50020-0_541. Accessed Nov. 4, 2009.
- Danakas GT, et al. Ectopic pregnancy. In: Ferri FF. Ferri's Clinical Advisor 2010. St. Louis, Mo.: Mosby; 2009. http://www.mdconsult.com/das/book/body/171922449-4/918378390/2088/207.html#4-u1.0-B978-0-323-05609-0..00014-9--sc0020_4196. Accessed Nov. 4, 2009.
- Gurel S. Ectopic pregnancy. Ultrasound clinics. 2008;3:331.
- Tulandi T. Clinical manifestations, diagnosis, and management of ectopic pregnancy. http://www.uptodate.com/home/index.html. Accessed Nov. 4, 2009.
- Tulandi T. Incidence, risk factors, and pathology of ectopic pregnancy. http://www.uptodate.com/home/index.html. Accessed Nov. 4, 2009.
- Medical management of ectopic pregnancy. National Guideline Clearinghouse. http://www.guideline.gov/summary/summary.aspx?doc_id=12625&nbr=6533&ss=6&xl=999. Accessed Nov. 4, 2009.
- Tulandi T. Methotrexate treatment of tubal and interstitial ectopic pregnancy. http://www.uptodate.com/home/index.html. Accessed Nov. 4, 2009.
- Tulandi T. Surgical treatment of ectopic pregnancy and prognosis for subsequent fertility. http://www.uptodate.com/home/index.html. Accessed Nov. 4, 2009.
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 6, 2009.
