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Hello doctor! I went to the clinic and was diagnosed with an ectopic pregnancy, ultrasound did not have a gestational sac and had a mixed negative mass with size 20 * 17 mm. I would like to ask if ectopic pregnancy can be treated with medicine and how long the treatment will take. Ask your doctor for advice. Thank you.
Anonymous customer
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Hello.
An ectopic pregnancy (Grossesse Extra Uterine - GEU) is a case in which a fertilized egg implants, implants and develops outside the uterus. Your case of an ectopic pregnancy can be treated with medication without a doctor's evaluation and the duration of treatment depends on your body's response.
In addition, you can refer to the following information for a more general overview of the disease:
Fallopian tubes and uterus
Fallopian tubes are not guaranteed for implantation, because the lining of the fallopian tubes is less
changes compared to the uterine lining and the muscular layer of the fallopian tubes is very thin, so the fetus only develops for a short time and then complications will occur.
Uterus due to the influence of pregnancy hormones, the uterus also reacts larger than usual, softens, the uterine lining turns into ectopy.
The progress of pregnancy to implant in the fallopian tubes
Fall of the fallopian tubes: due to the placental spines penetrating deep into the muscle layer to puncture the fallopian tubes, or due to the enlarged fallopian tubes and rupture of the fallopian tubes, at the same time, the vascular branches also ruptured causing bleeding into the abdomen.
The degree of bleeding can be different:
Massive bleeding, flooding the abdomen with blood. Flowing slowly, stagnates in a low area and is localized, creating a hematoma Miscarriage: because of the ectopic pregnancy, it is easy to fall off, causing miscarriage and bleeding. If the bleeding is localized in the fallopian tube, it is called tubal stasis, and the small fetus will die and disappear. If the gestational sac gradually falls off, the blood flows a little, remains in the sac with Douglas or in the side of the uterus and is localized by the intestines, mesentery, and omentum to form a hematoma. If the placenta is aborted, the blood will flow profusely causing the abdominal cavity to overflow. Medical treatment
Conditions:
Unruptured ectopic pregnancy, intra-abdominal fluid volume less than 100ml, fetal diameter less than 4cm. No fetal heart rate was seen on ultrasound. The concentration of ß - hCG does not exceed 6000 mIU/ml. The patient had no contraindications to methotrexate. Drugs used: Methotrexate (MTX Acid amino-4 methyl-10 folique) is the most commonly used anti-proliferative chemical of the antifolic group. Other drugs have been studied but are much less effective. Dosage: MTX 50mg/m2 body skin intramuscularly and can repeat the dose
Things to pay attention to when treating ectopic pregnancy with Methotrexate
For the medical treatment of ectopic pregnancy with Methotrexate drug effectively and Although it is safe, methotrexate injection can have some side effects.
Most patients experience mild abdominal pain. Vaginal bleeding may also occur. Less common side effects include:
Fatigue, loss of appetite Mouth ulcers Nausea and vomiting Diarrhea Hair loss Dizziness, headache Sensitivity to light Increased liver enzymes. Affects blood cell lines. These symptoms are usually mild and transient and will improve on their own after a few days of treatment. If symptoms are more severe, tell your doctor to be monitored and resolved.
Danger signs need to be examined immediately: During treatment, if sudden symptoms become severe, immediately notify your doctor or medical staff. Common dangerous symptoms such as:
Sudden severe abdominal pain. Shoulder pain. Very tired, pale pale, sweating. Vaginal bleeding profusely. For better treatment effect and avoid complications, After injection of Methotrexate should be avoided: Avoid vigorous exercise. Avoid intercourse as it may cause rupture of the fetus. Do not drink alcohol. Avoid drugs and foods containing folic acid because they can reduce the effect of Methotrexate such as: nuts and cereals; dark green leafy vegetables such as spinach and lettuce. Citrus fruits and avocados; Egg yolks also contain folic acid. Do not use pain relievers or anti-inflammatory drugs such as Ibuprofen. If you want to take any medicine, consult your doctor. Avoid sunlight for 3-4 days after treatment to avoid dermatitis. Avoid pregnancy for at least 3 months and monitor treatment as directed by your doctor. If you have surgery, you are advised to wait at least 2 menstrual cycles for the body to recover. During treatment with Methotrexate, it is recommended to wait 3 to 6 months because the drug may affect the fetus.
Therefore, patients are advised to avoid pregnancy for at least 3 months during monitoring and treatment with Methotrexate.
Thank you for trusting and sending questions to Vinmec Health System. Best regards!
Answered by Master, Doctor Le Nhat Nguyen - Doctor of Obstetrics and Gynecology - Department of Obstetrics and Gynecology - Vinmec Da Nang International Hospital
