Pregnancy miscarriage can be painful regardless of when it occurs. Ectopic pregnancy is considered one of the reasons for miscarriage in some women. However, you can plan your pregnancy after miscarriage by consulting your obstetrician. There may be many reasons associated with miscarriage but we are going to see treatment for ectopic pregnancy in detail and tips for planning the next pregnancy in this blog.
What kind of treatment should you expect when you have an ectopic pregnancy?
The pregnancy that develops outside of your uterus is referred to as an ectopic pregnancy. If your ectopic pregnancy is very early and you understand the risks and need for follow-up, medical management can be tried. Ectopic pregnancy is very often diagnosed before tubal rupture. And depending on the situation, you have the option of getting medical or surgical treatment. Considering medical treatment, methotrexate is the drug of choice.
Usually, a single dose is sufficient but some women may need additional doses of methotrexate if the fall in βHCG is not satisfactory. You might have slight abdominal pain for a few days after having methotrexate. But, if the pain is severe there is a chance of tubal rupture and you need to report to the early pregnancy unit immediately. Usually, the medical treatment is 90-95% effective, in well-chosen candidates. Moreover, it doesn’t affect your next pregnancy.
Factors Determining the Treatment of Ectopic Pregnancy
Ectopic pregnancy treatment options depend on the following factors
- How many weeks of pregnancy
- Level of βHCG
- Your clinical symptoms of pregnancy and condition
- Scan result (Gestational sac size, FH (Fetal cardiac activity))
- Your fertility status
- Your general health
- Your opinion about the future pregnancy plan
- Treatment facility available at your health care facility (hospital)
When surgery is advised for ectopic pregnancy?
Surgery is advised if the gestational sac is larger or the presence of fetal cardiac activity. If there is suspicion of tubal rupture then surgery is the best option. Laparoscopic salpingectomy is usually done if the other tube is healthy. In this laparoscopic procedure, the tube is removed by laparoscopic route (keyhole surgery). Laparoscopic salpingectomy (removal of only a section of the affected tube) is an alternative option. Laparoscopic surgery can be done even if the diagnosis is “ruptured ectopic pregnancy”, but the general condition of the mother is stable.
So, it’s risky to postpone the procedure if your diagnosis is “ruptured ectopic pregnancy”. Follow your obstetrician’s orders and get admitted for management. If the woman’s general condition is unstable and there is a ruptured ectopic pregnancy with internal bleeding, an emergency laparotomy is a quick option. Moreover, you may need a blood transfusion if the blood loss is severe resulting in hemodynamic instability. If the woman is Rh negative, anti-D should be given.
What to do if you plan your next pregnancy?
- If you have no problem conceiving or you don’t have diseases involving your fallopian tube before the ectopic pregnancy, then your fertility will not be affected.
- Even if your one tube is removed, you have a 6 in 10 chance of conceiving in the future. However, there is a risk of almost 7 -10% of future pregnancies being ectopic.
- Hence, it is important that if you had a previous ectopic pregnancy and got pregnant subsequently, consult your obstetrician early and do an early scan to confirm the intrauterine gestational sac. This will give you a good night’s sleep with baby dreams.
- If you take methotrexate, you might be concerned about how it will affect your upcoming pregnancy. However, it doesn’t affect your next pregnancy but you need to avoid pregnancy for at least 3 to 4 months following medical management of ectopic pregnancy.
To Conclude:
Planned treatment for ectopic pregnancy before tubal rupture occurs is the best option. Ectopic pregnancy is common and it will never survive. Perhaps it could be a life-threatening event for the mother. Consider the fact that numerous women go on to give birth to healthy babies after ectopic pregnancy. When you’re prepared, discuss with your doctor how to make sure your upcoming pregnancy a healthier one. Hence pregnancy after miscarriage is still possible if you have an optimistic approach.
