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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17 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

  • Maidam I’m pregnant lekin 3days bleeding hovi or Mai scan karai phir bi nai dikha lekin jb mai blood test Kari to positive aaya kya ye pregnancy thk hai ya nai please boliye

  • Hello doctor
    Last week I had my ectopic laproscopic surgery and right tube is removed.
    My doctor suggest that i can try for baby after one month.
    Is it ok to try or should v wait for more months..pls pls suggest.

  • Just had this procedure done for an ectopic pregnancy and also had some tissue removed that was attached to a muscle from a previous c section, I’m so glad I watched this after and not before ��

  • I had surgery 5days ago because of an ectopic pregnancy (baby is in the Fallopian tube) i was excited for having a baby but when I found out that my baby is in my Fallopian tube and had to remove,i was so down and cried even up to now �� that’s why i decided to watch this video jus curious how does the doctor remove my baby ��

  • such a nice presentation sir your skills are so nice its very easy to understood and the way how you do surgery its makes others surgeons life easier if the follow all the steps the way how you do thanks for the such a beautiful and knowledgeable videos.

  • I was in a ectopic pregnancy experience for the first time I get it in the hospital and I was surprised that good news from my doctor and emotional I was so happy after few weeks I come back to the hospital to find out what happening to my left side stomach so much painful and my period suddenly come back the doctor they don’t even know what happening to me they advice me to go to the another hospital to checkup then after ultrasound the doctor surprised me suddenly they prepared my operation on the same day and time I was so surprised I can’t accept it was like a. Nightmare I was crying for the another option just to stop them after all I woke up no clothes �� I can’t even move my body �� they convinced me to accept the operation otherwise I’m gonna die with the baby �� �� �� I accept their opinion and keep my self to stay stronger even my heart really broken �� after few months I decided to go back to work in abroad and now I’m working in Dubai and my wish for the another blessings when I come back home but I really hate now hospital and I’m still Afraid for the past confused life ��

  • April 18, 2019 me and my partner lost our baby because of ectopic pregnancy. She has two surgery during that time Appendicitis and ectopic pregnancy. Is it safe to have a baby again after 5-6months of surgery?

  • To avoid pregnancy of 1month this operation is applicable or not??..and what actually happens during the operation????
    Plzz ans my question sir

  • I had an ectopic my beta kept going up even after methotrexate was I injected thus resulting in laparoscopic surgery at 8 weeks pregnant! ��

  • Thank you. Enjoyed the video and your technique. When confronted with large SSerosal myomas lscopically we’ll frequently lv a few cm ring of serosa to optimize the closure and lv a little more myometrium. Nice work.