How to treat an ectopic pregnancy?

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Ectopic pregnancies occur when the fertilised egg nests outside the uterus. It is a situation that is currently taking place in approximately 0.66% of all cases.

However, in the last few decades there has been an increase in the number of ectopic pregnancies as a result of the proliferation of some of the following risk factors:

– Use of Intrauterine Device (IUD)

– Sexually transmitted diseases

– Smoking

– Assisted reproduction: in these cases the likelihood of an ectopic pregnancy is up to 5%

In the vast majority of cases, the egg is implanted in the fallopian tubes, although it can also be implanted in the patient’s cervix, ovaries or even in places in a much more residual fashion.

We must bear in mind that one of the characteristics of ectopic pregnancies is that the first symptoms – variable abdominal pain or loss of blood – do not show up until the second month of gestation.

In some situations such pregnancies can be tricky to diagnose. It is necessary to carry out an ultrasound and, if it is not decisive, it must be complemented by an assessment of the patient’s pregnancy hormone.

What are the options for treating ectopic pregnancies?

Ectopic pregnancies cannot go full term because the life of the mother could be put at risk.  Depending on the specific circumstances of each case, the situation may be addressed with different solutions:

–         Laparoscopic surgery: it is required to remove the tube where the fertilised egg has nested. This type of surgery is performed in a minimally invasive manner through a small incision in the abdomen close to the navel, and with the aid of an optical lens that allows the surgeon to observe the operation through a monitor.

–        In some cases, other instruments may be introduced though an incision that can help to, for example, repair the fallopian tube, which, in the event of being particularly damaged, would have to be removed.

–        Injection of methotrexate: it is an intramuscular injectable drug whose function is to stop the ectopic pregnancy and cause its reabsorption by the woman’s body.

–        Finally, if major bleeding takes place or the fallopian tube breaks as a result of an ectopic pregnancy, emergency surgery may be essential.

Fortunately, in most cases women who have undergone this type of situation can become pregnant again, although a first ultrasound should be performed in the early weeks of pregnancy in order to confirm the good progress of gestation.

At Best Doctors we encourage all couples that are going through a pregnancy of these characteristics to put themselves in the hands of their gynaecologist. As always, if you need a second opinion from the best specialists in the world, you can rely on us.

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