Ectopic Pregnancy: Conservative Treatment Options
Introduction
Ectopic pregnancy is a life-threatening condition that occurs when a fertilized egg implants outside the uterus. The most common site of ectopic implantation is the fallopian tube, but it can also occur in the cervix, ovary, or abdomen.
Ectopic pregnancy is a medical emergency that requires prompt treatment. The traditional treatment for ectopic pregnancy is surgery to remove the affected fallopian tube. However, in some cases, conservative treatment may be an option.
Conservative Treatment Options
Conservative treatment for ectopic pregnancy involves using medication to stop the growth of the embryo and allow the body to reabsorb it. This treatment is only an option if the ectopic pregnancy is small and there is no evidence of rupture.
The most common medication used for conservative treatment of ectopic pregnancy is methotrexate. Methotrexate is a chemotherapy drug that works by preventing the cells from dividing. This stops the growth of the embryo and allows the body to reabsorb it.
Methotrexate is typically given as a single injection. The dose of methotrexate will depend on the size of the ectopic pregnancy.
Success Rates
The success rate of conservative treatment for ectopic pregnancy is about 70%. This means that about 70% of women who receive methotrexate will have a successful pregnancy.
The success rate of conservative treatment is higher if the ectopic pregnancy is small. The success rate is also higher if the woman has no history of ectopic pregnancy.
Risks of Conservative Treatment
The risks of conservative treatment for ectopic pregnancy include:
- Failure of treatment: In about 30% of cases, methotrexate will not be successful in stopping the growth of the embryo. If this happens, surgery will be necessary to remove the ectopic pregnancy.
- Ectopic pregnancy rupture: In rare cases, the ectopic pregnancy can rupture before methotrexate has had a chance to work. This is a life-threatening condition that requires immediate surgery.
- Side effects of methotrexate: Methotrexate can cause side effects such as nausea, vomiting, diarrhea, and hair loss. These side effects are usually mild and go away after a few days.
Who is a Candidate for Conservative Treatment?
Conservative treatment for ectopic pregnancy is an option for women who meet the following criteria:
- The ectopic pregnancy is small (less than 3 cm in diameter).
- There is no evidence of ectopic pregnancy rupture.
- The woman has no history of ectopic pregnancy.
- The woman is willing to comply with the follow-up care plan.
Follow-Up Care
After receiving methotrexate, women will need to have regular follow-up appointments to monitor their progress. These appointments will include blood tests to check the levels of hCG (human chorionic gonadotropin). hCG is a hormone that is produced by the placenta. The levels of hCG will decrease if the methotrexate is working.
Women will also need to have ultrasound exams to monitor the size of the ectopic pregnancy. The ultrasound exams will be repeated until the ectopic pregnancy has disappeared.
Conclusion
Conservative treatment for ectopic pregnancy is a safe and effective option for women who meet the criteria. This treatment can avoid the need for surgery and preserve the woman’s fertility.
If you are diagnosed with an ectopic pregnancy, talk to your doctor about whether conservative treatment is an option for you.