Nonsurgical and Surgical Ectopic Pregnancy Treatment
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Medically reviewed by Sanaz Ghazal, MD
In an ectopic pregnancy, a fertilized egg implants and grows in the wrong place—somewhere outside of the uterus (womb). More than 90% of the time, it’s a tubal ectopic pregnancy in a fallopian tube, one of the delicate structures that eggs move through when they leave the ovaries and travel to the uterus.
The main risk of an ectopic pregnancy is that it may rupture and cause serious internal bleeding, which can be life-threatening for the pregnant person. A rupture needs to be treated with emergency surgery.
This article explores the treatments for ectopic pregnancy, including the surgical and nonsurgical options, the risks of not treating ectopic pregnancies, and where you can go for help.
Tubal Ectopic Pregnancy Cannot Survive
While an embryo may develop in a tubal ectopic pregnancy, it cannot survive. It doesn’t have the space or necessary blood supply, and moving it into the uterus is impossible. In rare cases, the pregnancy may last through most of the first trimester. However, if left alone, it will eventually rupture, and the pregnancy will be lost.
When the embryo implants in the abdomen (which is rare), there is a high risk of death for both the pregnant person and the fetus. Extremely rarely, this has resulted in a live birth. The rate of fetal malformations is high.
Ectopic Pregnancy Treatment Without Surgery
You don’t always need surgery for an ectopic pregnancy. If it’s caught early, your healthcare provider may monitor you to see if your body reabsorbs the cluster of cells. That’s less common than treatment with medication, though.
The drug methotrexate is the first-line treatment for ectopic pregnancy. It prevents cells from growing and dividing, which allows the pregnancy to then be reabsorbed by your body.
This process takes between four and six weeks. During this time, you’ll need blood tests to check your levels of the pregnancy hormone hCG.
Methotrexate isn’t safe for everyone, though. You shouldn’t take it if you:
Also have a pregnancy inside the uterus that you want to continue
Are breastfeeding
Have an infection, liver disease, or kidney disease
Have had ulcers in the stomach or bowel
Have had severe mouth ulcers
Were recently vaccinated
Your healthcare provider may monitor your liver function with blood tests while you’re taking methotrexate.
Related: Ectopic Pregnancy Treatment Is Not Abortion
Possible Interactions on Ectopic Pregnancy Drug Treatment
Methotrexate can have negative interactions with other drugs. These include:
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil (ibuprofen), Aleve (naproxen), aspirin, and combination formulas containing these drugs
Some antibiotics such as trimethoprim, cotrimoxazole, tetracycline, ciprofloxacin, and some forms of penicillin
Some asthma medications
Epilepsy medications, including Dilantin (phenytoin) and levetiracetam
Diuretics (water pills) such as indapamide and bendroflumethiazide
Check with your healthcare provider and/or pharmacist before combining methotrexate with any of these drugs, a new medication, or supplements/herbal remedies.
Emergency Surgery Is a Possibility
A rupture due to an ectopic pregnancy is a medical emergency. It can cause severe bleeding and shock, which can be life-threatening. For a pregnant person, ectopic pregnancy is the leading cause of pregnancy-related death in the first trimester.
Ectopic Pregnancy Treatment With Surgery
A ruptured fallopian tube due to ectopic pregnancy needs to be treated with emergency surgery. In a nonemergency situation, you may need surgery to remove the ectopic pregnancy from the tube and possibly remove the tube itself.
Surgery is usually laparoscopic, meaning the surgeon uses small incisions to access and open the fallopian tube, then remove the pregnancy. It’s rare for a larger incision to be needed.
Risks of Untreated Ectopic Pregnancy
If you suspect an ectopic pregnancy or have been diagnosed with one, it’s important to get prompt treatment and follow your healthcare provider’s instructions. Left untreated, your ectopic pregnancy can be fatal.
When an ectopic pregnancy forms in someone who wants to have a baby, it may be especially hard to face a treatment that prevents an embryo from growing and developing. However, with tubal ectopic implantation, there’s no chance of a successful pregnancy.
Given the risks, it’s better to get proper treatment and prevent a potentially life-threatening rupture.
Taking Care of Yourself During Ectopic Pregnancy Treatment
It’s important for you to take care of yourself during treatment for an ectopic pregnancy. This includes both your physical and mental health.
First, remember that the risk of rupture is very real until the ectopic pregnancy is gone. Get immediate medical treatment if you have sudden abdominal or shoulder pain.
Second, you and your healthcare provider can discuss whether medication or surgery is the best option for you.
Methotrexate
While taking methotrexate, you should avoid:
Heavy exercise
Sex
Alcohol
Exposure to sunlight
You may experience some common methotrexate side effects, including:
Nausea
Vomiting
Diarrhea
Dizziness
Bleeding
Let your healthcare provider know if you have side effects that are severe or don’t go away over time.
Surgery
After laparoscopic surgery, you should expect to be in pain for several days. You may also be tired and possibly experience nausea or fever. Be sure to:
Follow your postsurgical instructions.
Keep follow-up appointments.
Rest, especially when you feel fatigued.
Try to get moderate activity every day but avoid strenuous exercise.
Everyone recovers at their own pace. Listen to your body and give it the time it needs to heal.
Learn More: What to Expect During Pelvic Laparoscopy
Your Mental Health
An ectopic pregnancy can be emotionally traumatic and stir up a lot of emotions. That’s true whether you do or don’t want a baby. Accept these feelings as normal and allow yourself time to work through them.
Where to Get Ectopic Pregnancy Treatment: Resources and Support
For non-emergency ectopic pregnancy treatment, start with your regular healthcare provider or obstetrician-gynecologist (ob-gyn). They can treat you or refer you to a specialist or surgeon.
You can also look into specialty clinics in your area, such as Planned Parenthood. They may be able to treat you or direct you to community resources.
For emergency treatment, go straight to a hospital emergency room. Urgent care facilities aren’t equipped to handle emergency surgery.
If you’re experiencing difficulties emotionally, you may want to see a mental health counselor or seek out support groups (locally or online) where you can talk to other people who’ve had ectopic pregnancies.
You may also want to turn to friends or family members who’ve lost pregnancies.
Summary
Ectopic pregnancies grow outside of the uterus, most often in the fallopian tube. They can’t survive and develop there into a baby, and the risk of a life-threatening rupture makes treatment necessary in most cases.
Treatment involves a drug, such as methotrexate, that stops cells from growing and dividing, or laparoscopic surgery. Emergency surgery is essential in the case of a rupture.
See your healthcare provider if you suspect an ectopic pregnancy. Be sure to follow their instructions for treatment and get emergency treatment if you have sharp pain or other possible signs of rupture.
