An ectopic pregnancy occurs when a fertilized egg implants itself outside of the uterus. They’re also called “tubal pregnancies” because most of them happen in the fallopian tubes. Whether there’s a problem with the egg or the tube, the egg gets stuck on its journey to the uterus.
A pregnancy can’t survive outside of the uterus, so all ectopic pregnancies must end. It used to be that about 90% of women with ectopic pregnancies had to have surgery. Today, the number of surgeries is much lower, and many more ectopic pregnancies are managed with medication that prevents them from progressing.
If you’re diagnosed with an ectopic pregnancy, how your doctor will treat it depends on how far the pregnancy has progressed, where the embryo is, and how severe your symptoms are.
Medication
An early ectopic pregnancy may be managed with medicine. If you have low levels of hCG -- a hormone your body makes when you’re pregnant and there’s no damage to the fallopian tube -- your doctor can give you an injection of a drug called methotrexate (Trexall).
Methotrexate stops the cells from growing and allows your body to absorb the pregnancy.
But the drug does have some side effects, like nausea, vomiting, dizziness, diarrhea, and stomatitis (mouth and lip ulcers). And most women have abdominal pain a couple of days after the injection.
Women used to stay in the hospital for a series of methotrexate injections. Now it’s an outpatient procedure, but your doctor will monitor your hCG levels closely during the few weeks after to make sure they get back to zero.
One injection could do the trick, but if the numbers don’t drop like they should, you might have more injections.
Surgery
If methotrexate therapy doesn’t work, surgery is the next step. It’s also the only option for women with high hCG levels, severe symptoms, and ruptured or damaged fallopian tubes.
You may have laparoscopic surgery that involves a very small cut and a tiny camera. Surgeons prefer to use this method rather than doing surgery with a larger cut. But sometimes that’s not possible, especially if it is an emergency surgery. If your tube has ruptured or been severely damaged, the surgeons might have to remove your fallopian tube. Sometimes, the tube may be saved if damage is minimal. After surgery, your doctors will watch your hCG levels to make sure they’re going down and the pregnancy was removed properly. Some women also need a methotrexate injection so everything returns to normal.
