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Ectopic pregnancy - Treatment

Alternative Names

Tubal pregnancy; Cervical pregnancy; Abdominal pregnancy

Treatment:

Ectopic pregnancies cannot continue to birth (term). The developing cells must be removed to save the mother's life.

You will need emergency medical help if the area of the ectopic pregnancy breaks open (ruptures). Rupture can lead to shock, an emergency condition. Treatment for shock may include:

  • Blood transfusion
  • Fluids given through a vein
  • Keeping warm
  • Oxygen
  • Raising the legs

If there is a rupture, surgery (laparotomy) is done to stop blood loss. This surgery is also done to:

  • Confirm an ectopic pregnancy
  • Remove the abnormal pregnancy
  • Repair any tissue damage

In some cases, the doctor may have to remove the fallopian tube.

A minilaparotomy and laparoscopy are the most common surgical treatments for an ectopic pregnancy that has not ruptured. If the doctor does not think a rupture will occur, you may be given a medicine called methotrexate and monitored. You may have blood tests and liver function tests.

Expectations (prognosis):

One-third of women who have had one ectopic pregnancy are later able to have a baby. A repeated ectopic pregnancy may occur in one-third of women. Some women do not become pregnant again.

The likelihood of a successful pregnancy depends on:

  • The woman's age
  • Whether she has already had children
  • Why the first ectopic pregnancy occurred

The rate of death due to an ectopic pregnancy in the United States has dropped in the last 30 years to less than 0.1%.

Complications:

The most common complication is rupture with internal bleeding that leads to shock. Death from rupture is rare.

Calling your health care provider:

If you have symptoms of ectopic pregnancy (especially lower abdominal pain or abnormal vaginal bleeding), call your health care provider. You can have an ectopic pregnancy if you are able to get pregnant (fertile) and are sexually active, even if you use birth control.

  • Reviewed last on: 2/21/2010
  • Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Houry DE, Salhi BA. Acute complications of pregnancy. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier;2009:chap 176.

Lobo RA. Ectopic pregnancy: Etiology, pathology, diagnosis, management, fertility prognosis. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier;2007:chap 17.

Barnhart KT. Ectopic pregnancy. N Engl J Med. 2009;361:379-387.

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