©PregnancyBliss 2008-2011

Home | Pregnancy overview | Reproductive Health | Complications | Labor & Birth

Continues from previous page

Medical treatment for ectopic pregnancy

Where it is deemed safe, medical management may be offered as a treatment option. A cytotoxic drug called methotrexate is employed. Methotrexate is commonly used for cancer treatment

Methotrexate is given as a single dose in the form of an intramuscular injection. Conditions deemed conducive for treating ectopic pregnancy using medication are:

· Minimal symptoms i.e. the woman has to be almost pain-free and overall stable.

· Pregnancy hormone levels in the blood have to be relatively low. The recommended cut-off point is 3000 iu/l but the doctor has discretion on this.

· Since this is an outpatient treatment option, easy accessibility to hospital for the woman is essential, should need for emergency intervention arise.

Success of Methotrexate treatment for ectopic pregnancy

When the above conditions are observed, the success rate is quite good. However, roughly 1 in 10 of such patients will require a second dose of the drug. More important, about 1 in 15 actually do go on to require surgical intervention anyway.

There are also side-effects from the drug itself. These include gastro-intestinal upset, soreness of the mouth (stomatitis) and conjunctivitis (red and sore eyes).

When methotrexate has been used, the woman should use a reliable form of contraception for at least three months afterwards. This is because this drug is known to carry a teratogenic risk and if conception ensues soon after the treatment, the baby will be at risk.

Consequences of ectopic pregnancy

Delay in presentation or diagnosis may lead to rupture of the fallopian tube, with potentially serious bleeding within the abdominal cavity. This will cause severe pain sometimes leading to fainting.

The more enduring effect is that of reduced fertility. Following an ectopic pregnancy, chances of a normal pregnancy through natural conception are reduced to varying degrees.

Following an ectopic, there is also an increased risk of a repeat ectopic pregnancy.

Heterototic pregnancy

Heterotopic pregnancy describes a situation where a normal pregnancy in the womb co-exists with an ectopic pregnancy. In essence, this will be a twin pregnancy with one baby in the normal location and the other outside.

This used to be rare but is relatively more common now. This is because of increased use of assisted conception (IVF). Figures of 1 in 3000 are sometimes quoted.

When this occurs, the ectopic pregnancy has to be removed to allow the normal pregnancy to continue.

Ectopic pregnancy at Term

An ectopic pregnancy can and has been known to grow to term. However, this will not happen if it is in the tube. Continuing tubal pregnancies inevitably cause a rupture (of the tube) in the first seven to ten weeks.

Cases of abdominal pregnancies (where there is plenty of room) which went unrecognized to the late third trimester have been reported, from time to time. When recognized, delivery (inevitably by surgery) is carried out immediately. Because of the environment in which they grow (which is not ideal), these babies tend to have major limb deformities. A few have managed to be delivered in a surprisingly good physical state.

Ectopic pregnancy transplantation into the womb

Over the years there has been a lot of interest in this subject. Whether a pregnancy which is discovered while still viable can be successfully moved and implanted in the womb. Attempts at doing this have been done and none has been successful anywhere in the world. Whether this will change in the future nobody can say.

Preterm labor: Next Page