Single dose methotrexate is best used for those are asymptomatic, whose -hCG is ultrasonography , and will come in to be followed closely. It cannot be used if there is a heterotopic pregnancy . Despite low and declining -hCG levels, tubal rupture can still occur with methotrexate treatment. With severe pelvic pain, monitoring of vital signs and hematocrit can help differentiate between tubal abortion and tubal rupture . Rare side effects include dermatitis and pleuritis.
Surgery is done only if transvaginal ultrasonography shows an ectopic pregnancy .
Laparoscopic surgery has been found to be superior to laparotomy and can treat most patients. Persistent ectopic pregnancy refers to the continued growth of trophoblastic tissue after surgery. Special attention should be given the proximal portion during surgery and the ectopic pregnancy should be flushed out with suction irrigation.