How is an ectopic pregnancy treated?

Written by Zhao Li Li
Obstetrics
Updated on September 08, 2024
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If symptoms of an ectopic pregnancy are confirmed, further examinations are necessary before symptomatic treatment can be administered. Normally, it is essential to first determine the specific status of the ectopic pregnancy, whether there is any rupture, whether the patient's vital signs are stable, and whether there is significant internal bleeding in the abdominal cavity. If the symptoms are not severe and there is no rupture, localized conservative medicinal treatment can be administered. However, if the symptoms are severe, accompanied by hemorrhagic shock or substantial internal bleeding in the abdomen, emergency surgical treatment is required.

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Written by Zhang Yin Xing
Obstetrics
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How many days will an ectopic pregnancy bleed?

The timing of bleeding caused by an ectopic pregnancy does not have a specific timeframe. Most ectopic pregnancies result in irregular vaginal bleeding after the death of the pregnancy tissue. The color of the blood is usually dark red or deep brown, and generally, the amount of bleeding is less than that of a normal menstrual period. However, a minority have heavier bleeding, similar to menstrual flow. Vaginal bleeding may contain decidual cast and fragments, caused by the shedding of the uterine lining. Vaginal bleeding only stops after the removal of the lesion or during conservative treatment when the trophoblastic cells are completely necrotic and absorbed; thus, bleeding from an ectopic pregnancy generally lasts a long time. Anti-inflammatory treatment might be necessary to avoid secondary infections that could affect future pregnancies.

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Written by Zhang Xiu Rong
Obstetrics and Gynecology
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Ectopic pregnancy medical conservative treatment

Under normal circumstances, the treatment of ectopic pregnancy is generally divided into conservative treatment and surgical treatment. Conservative treatment is usually applied when the ectopic pregnancy has not ruptured, using medication for about a week. After one week, a follow-up examination is done to check blood HCG levels and an ultrasound scan. If blood HCG levels have dropped significantly, the ultrasound shows that the mass has not grown, and the symptoms of abdominal pain have decreased, it indicates that the conservative treatment was successful. The threat is only considered resolved when blood HCG returns to normal levels. Otherwise, the conservative treatment for ectopic pregnancy may fail, and surgery will be necessary to treat the ectopic pregnancy symptomatically. If there is a particularly large amount of bleeding or a rupture has occurred, surgical treatment is the only option.

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Written by Yan Qiao
Obstetrics and Gynecology
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Will an IUD cause an ectopic pregnancy?

IUD insertion can cause ectopic pregnancy because it is a minor gynecological surgery and an invasive procedure. Any invasive operation can potentially trigger pelvic inflammatory disease. The occurrence of pelvic inflammatory disease can lead to inflammation of the fallopian tubes, which is one of the main causes of ectopic pregnancy. Moreover, not every patient is suitable for an IUD. These devices come in many shapes, and there should be an optimal match between the shape of the IUD and the size and form of the uterine cavity. If the IUD does not match the patient's uterine cavity size and shape, it may not effectively prevent pregnancy, thus increasing the risk of pregnancy with the IUD in place, including the occurrence of ectopic pregnancies. In conclusion, IUD insertion can lead to ectopic pregnancies.

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Written by Tang Mei Xiang
Obstetrics and Gynecology
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Ectopic pregnancy causes

Ectopic pregnancy is commonly referred to as such, but it is actually called extrauterine pregnancy. Extrauterine pregnancy refers to the implantation of a fertilized egg outside the uterine cavity, including cervical pregnancy, broad ligament pregnancy, ovarian pregnancy, abdominal pregnancy, and tubal pregnancy, with tubal pregnancy being the most common clinically. The causes of ectopic pregnancy include the recent increase in cesarean section rates, leading to more scar pregnancies, which are also a type of extrauterine pregnancy. Furthermore, abnormalities like uterine malformations also belong to extrauterine pregnancies. Clinically, the most common type is tubal pregnancy, mainly caused by inflammation of the fallopian tubes. Other factors include previous tubal surgeries or history of tubal pregnancy, congenital malformations, and abnormal function of the fallopian tubes. Additionally, the use of assisted reproductive technologies has also increased the chances of extrauterine pregnancies.

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Written by Du Rui Xia
Obstetrics
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What is the best treatment for ectopic pregnancy?

In cases where an ectopic pregnancy is diagnosed, timely treatment is necessary. Generally, around 50 days into the pregnancy, there is a possibility of the ectopic pregnancy rupturing, so early treatment is crucial. If it is discovered before rupture, conservative treatment can be an option. However, if an ectopic rupture has already occurred, surgical treatment is required. The type of surgery depends on the specific situation; women who wish to preserve their fertility may undergo a salpingostomy, whereas those without fertility needs may undergo salpingectomy.