Treatment Methods for Tubal or Ectopic Pregnancy

 

How is an ectopic pregnancy treated?

Video taken from the channel: HCA West Florida


 

The Imelda Transvaginal Approach to Ectopic Pregnancy

Video taken from the channel: Fertility & Sterility


 

Laparoscopic Approach to cornual ectopic a step by step demonstration F&S

Video taken from the channel: Fertility & Sterility


 

Ectopic Pregnancy Reasons, Symptoms and Treatment

Video taken from the channel: FirstCry Parenting


 

Ectopic Pregnancy or Tubal Pregnancy Laparoscopic Surgery

Video taken from the channel: MedFreelancers


 

Ectopic Pregnancy: Symptoms, Causes and Treatment

Video taken from the channel: Medicover Fertility


 

Laparoscopic Management of Ruptured Ectopic Pregnancy

Video taken from the channel: DR RK Mishra


Treatment Approaches for Tubal or Ectopic Pregnancy Watchful Waiting for a Tubal Pregnancy. If blood tests show that the hCG level in the blood is falling, chances are that Medical Management With Methotrexate. If doctors detect the ectopic pregnancy early enough before it threatens to Surgery.

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. Laparoscopic procedures Salpingostomy and salpingectomy are two laparoscopic surgeries used to treat some ectopic pregnancies. In these procedure, a small incision is made in the abdomen, near or in the navel. Next, your doctor uses a thin tube equipped with a camera lens and light (laparoscope) to view the tubal area.

Most cases of tubal ectopic pregnancy that are detected early can be treated successfully either with minimally invasive surgery or with medical management using methotrexate. However, tubal ectopic pregnancy in an unstable patient is a medical. Surgical treatment: (2) Tubectomy or salpingectomy is performed only in severely damaged or ruptured tubes or if the patient does not desire further pregnancies. Most cases of tubal ectopic pregnancy that are detected early can be treated successfully either with minimally invasive surgery or with medical management using methotrexate. However, tubal ectopic pregnancy in an unstable patient is a medical.

Treatment of diagnosed ectopic pregnancy includes medical management with intramuscular methotrexate, surgical management via salpingostomy or salpingectomy, and, in rare cases, expectant. Treatment approaches include expectant, medical (methotrexate), or surgical (salpingectomy or salpingostomy). Can be complicated by rupture, in which case may present in shock from blood loss and with unusual patterns of referred pain from intraperitoneal blood.

Primary treatment success and reduced risk of future pregnancy (intrauterine and/or ectopic) are prioritised outcomes for women with ectopic pregnancy not desiring future fertility. However, treatment success and repeat intrauterine pregnancy are the prioritised outcomes for women with ectopic pregnancy desiring future fertility. Treatment approaches include expectant, medical (methotrexate), or surgical (salpingectomy, salpingostomy).

Can be complicated by rupture, in which case may present in shock from blood loss and with unusual patterns of referred pain from intraperitoneal blood.

List of related literature:

Surgical management of a tubal pregnancy that is unruptured may involve a linear salpingostomy, removal of the ectopic pregnancy from the tube in an effort to salvage the tube or a salpingectomy—removal of the tube.

“Foundations of Maternal-Newborn and Women's Health Nursing E-Book” by Sharon Smith Murray, Emily Slone McKinney
from Foundations of Maternal-Newborn and Women’s Health Nursing E-Book
by Sharon Smith Murray, Emily Slone McKinney
Elsevier Health Sciences, 2017

Interventions for tubal ectopic pregnancy.

“Emergency Medicine E-Book: Clinical Essentials (Expert Consult Online)” by James G. Adams
from Emergency Medicine E-Book: Clinical Essentials (Expert Consult Online)
by James G. Adams
Elsevier Health Sciences, 2012

Women with fallopian tube blockages can use in vitro fertilization (IVF) to bypass the oviducts in an attempt to achieve pregnancy; IVF (see later) is now more common than tubal surgery.

“Human Reproductive Biology” by Richard E. Jones, Kristin H Lopez
from Human Reproductive Biology
by Richard E. Jones, Kristin H Lopez
Elsevier Science, 2013

For a woman with an unruptured ectopic pregnancy, surgical options include tubesparing salpingostomy or removal of the fallopian tube (salpingectomy).

“Conn's Current Therapy 2020, E-Book” by Rick D. Kellerman, KUSM-W Medical Practice Association, David Rakel
from Conn’s Current Therapy 2020, E-Book
by Rick D. Kellerman, KUSM-W Medical Practice Association, David Rakel
Elsevier Health Sciences, 2019

The treatment of tubal ectopic pregnancy is based on the clinical findings at the time of evaluation (rupture, tubal abortion, viability of the tube), with consideration of the patient’s desire to conceive in the future.

“Modern Surgical Pathology E-Book” by Noel Weidner, Richard J. Cote, Saul Suster, Lawrence M. Weiss
from Modern Surgical Pathology E-Book
by Noel Weidner, Richard J. Cote, et. al.
Elsevier Health Sciences, 2009

According to NICE guidelines, for women with proximal tubal obstruction, selective salpingography plus tubal catheterisation, or hysteroscopic tubal cannulation, may be treatment options because these treatments improve the chance of pregnancy.

“Obstetrics & Gynaecology: An Evidence-based Text for MRCOG, Third Edition” by David M. Luesley, Mark Kilby
from Obstetrics & Gynaecology: An Evidence-based Text for MRCOG, Third Edition
by David M. Luesley, Mark Kilby
CRC Press, 2016

Studies on nonsurgical therapy of tubal pregnancy.

“Comprehensive Gynecology E-Book” by Rogerio A. Lobo, David M Gershenson, Gretchen M Lentz, Fidel A Valea
from Comprehensive Gynecology E-Book
by Rogerio A. Lobo, David M Gershenson, et. al.
Elsevier Health Sciences, 2016

Less commonly, the tubal pregnancy may undergo spontaneous regression and resorption, or may be extruded through the fimbriated end of the tube into the abdominal cavity (tubal abortion).

“Robbins & Cotran Pathologic Basis of Disease E-Book” by Vinay Kumar, Abul K. Abbas, Jon C. Aster
from Robbins & Cotran Pathologic Basis of Disease E-Book
by Vinay Kumar, Abul K. Abbas, Jon C. Aster
Elsevier Health Sciences, 2020

Sometimes, the ectopic pregnancy can be dislodged from its tubal attachment by manipulating the tube, and then expressing the ectopic pregnancy from the tube through the fimbriated end.

“An Introduction to Human Disease: Pathology and Pathophysiology Correlations” by Leonard V. Crowley
from An Introduction to Human Disease: Pathology and Pathophysiology Correlations
by Leonard V. Crowley
Jones and Bartlett Publishers, 2004

Women with extensive tubal disease have a greater chance of conceiving with an IVF procedure, so the extent and location of the intrinsic and extrinsic tubal disease should be ascertained by HSG and possibly laparoscopy in an effort to determine whether tubal reconstruction or IVF offers the better prognosis.

“Comprehensive Gynecology” by Gretchen M. Lentz, David M. Gershenson
from Comprehensive Gynecology
by Gretchen M. Lentz, David M. Gershenson
Elsevier Mosby, 2012

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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7 comments

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  • Hello Doc what will i do if my both fallopian tubes are blocked my OB told me maybe because of chocolate cyst but she is not sure. I’ve done undergo HSSG procedure, just an ultrasound. How can i make sure if my fallopian tubes are both blocked? I am trying to conceive for 11months. What procedure can i take doc? Please notice me. Thank you God Bless..

  • Great video! It particularly inspired me because I also want to be a doctor. Thanks Dr. Mishra for sharing this video of Laparoscopic Management of Ruptured Ectopic Pregnancy.

  • Dr. i had never seen the doctor like you who have such a great skills and you always share you skills because nobody wants to share skills you are the one best Dr.

  • Nice demonstration sir. Last month did two tubal ectopics laparoscopically. It took 40 minutes for me to complete procedure. But you took not more than 10 minutes skin to skin.������ Is that skill or experience?��

  • Sir kindly tell me after this laproscopy surgery is periods or bleeding after few days come or not if that comes what should we do

  • I had an ectopic pregancy in 2013 and it was the most traumatic experience of my life. I talked and prayed with my pastor, and God brought me through it.

  • Hello Dr plz tell me Meri 4 sezer hoi hn mery 3 boys hn baby mari hui paida hui 8 month hogae hn Meri tubal ligation sezer k dohran karwadi ghr walon ne per m apni beti k ly abhi tak roti hon plz batae Meri tubal ligation reversal hosakti hai Kiya m dubara pregnant ho sakti hon plz mam rply