page_title: Ectopic pregnancy
section_title: Surgery
hierarchical_section_title: Ectopic pregnancy / Treatment / Surgery
caption_attribution_description: English: Laparoscopic view of an ectopic pregnancy and hematosalpinx of the left Fallopian tube, the right tube is normal
context_page_description: Ectopic pregnancy is a complication of pregnancy in which the embryo attaches outside the uterus. Signs and symptoms classically include abdominal pain and vaginal bleeding, but fewer than 50 percent of affected women have both of these symptoms. The pain may be described as sharp, dull, or crampy. Pain may also spread to the shoulder if bleeding into the abdomen has occurred. Severe bleeding may result in a fast heart rate, fainting, or shock. With very rare exceptions the fetus is unable to survive.
  Risk factors for ectopic pregnancy include pelvic inflammatory disease, often due to chlamydia infection; tobacco smoking; prior tubal surgery; a history of infertility; and the use of assisted reproductive technology. Those who have previously had an ectopic pregnancy are at much higher risk of having another one. Most ectopic pregnancies occur in the fallopian tube, which are known as tubal pregnancies, but implantation can also occur on the cervix, ovaries, cesarean scar, or within the abdomen. Detection of ectopic pregnancy is typically by blood tests for human chorionic gonadotropin and ultrasound. This may require testing on more than one occasion.
context_section_description: If bleeding has already occurred, surgical intervention may be necessary. However, whether to pursue surgical intervention is an often difficult decision in a stable patient with minimal evidence of blood clot on ultrasound.
  Surgeons use laparoscopy or laparotomy to gain access to the pelvis and can either incise the affected Fallopian and remove only the pregnancy (salpingostomy) or remove the affected tube with the pregnancy (salpingectomy). The first successful surgery for an ectopic pregnancy was performed by Robert Lawson Tait in 1883. It is estimated that an acceptable rate of PULs that eventually undergo surgery is between 0.5 and 11%. People that undergo salpingectomy and salpingostomy have a similar recurrent ectopic pregnancy rate of 5% and 8% respectively. Additionally, their intrauterine pregnancy rates are also similar, 56% and 61%.
  Autotransfusion of a woman's own blood as drained during surgery may be useful in those who have a lot of bleeding into their abdomen.
  Published reports that a re-implanted embryo survived to birth were debunked as false.
caption: Surgical treatment: Laparoscopic view of an ectopic pregnancy located in the left Fallopian tube, hematosalpinx is present on the left, the right tube is of normal appearance
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