Ectopic pregnancy, also known as tubal pregnancy, develops outside the uterus, usually in the fallopian tube. Due to the restricted area in the fallopian tube, fetal growth cannot occur normally. As a result, the fallopian tube becomes distended. If the rapidly growing pregnancy gets too large, it may burst through the fallopian tube and cause internal bleeding. This is a medical emergency. If not treated promptly, ectopic pregnancy can result in the death of the mother.
Once diagnosed, there are both medical and surgical options for treatment of ectopic pregnancy. Regardless of what type of treatment you and your physician choose, some form of treatment must be undertaken promptly.
If your ectopic pregnancy meets certain criteria, your physician may recommend treatment with methotrexate. This medicine is normally used to treat cancer and arthritis. When treating an ectopic pregnancy, it is used in doses much lower than those used to treat cancer, and therefore has few side effects. The physician will give you an injection of methotrexate; then follow your hormone levels closely to be certain that the pregnancy resolves. If the levels do not decrease appropriately, you may need a second injection or surgery.
If you do not meet the criteria for use of methotrexate, your physician may recommend surgery. Two approaches can be used depending on the seriousness of the situation. The first option is known as laparoscopy. With laparoscopy, a small incision is made under your navel and a small light inserted into your abdomen. The fallopian tube can then be examined. If necessary, your physician will make a few small incisions lower on your abdomen through which he or she can insert instruments and either remove the ectopic pregnancy or remove your entire fallopian tube.
The second surgical option is known as a laparotomy. This involves making a large incision lower on the abdomen and removing the ectopic pregnancy or the fallopian tube. If the ectopic pregnancy has already ruptured (burst through the tube) this will be the quickest way to remove the fallopian tube and stop the bleeding.
If you suspect an ectopic pregnancy, it is important that you contact your doctor immediately.