Methods to treat ectopic pregnancy

This is an automatically translated article.

The article is professionally consulted by a doctor of the Department of Obstetrics and Gynecology.
An ectopic pregnancy is when an embryo implants and grows outside of the uterus. A ruptured ectopic pregnancy will cause massive bleeding that threatens the patient's life. The majority of ectopic pregnancy is in the fallopian tube, but can also be encountered in other locations such as: Intra-abdominal pregnancy, pregnancy in the ovary, pregnancy at the old cesarean section,... So, deal with the pregnancy. ectopic like?

1. Treatment of ectopic pregnancy

1.1. Treatment goals

Solve ectopic pregnancy to:
Minimize maternal mortality. Prevent recurrence of ectopic pregnancy. Maintain fertility for the mother.

1.2. Methods in the treatment of ectopic pregnancy

Currently, there are 3 methods used in the treatment of ectopic pregnancy:
Drugs: The most common drug used to treat ectopic pregnancy is Methotrexate. This drug stops the cells from growing, ends the pregnancy, the fallopian tube is preserved.

So, when to use drugs to treat ectopic pregnancy?
Methotrexate can be used as a single or multiple dose if: The pregnancy mass has not caused a fallopian tube rupture. One of the most important factors determining whether a single-dose or multiple-dose regimen is used is blood tests for hCG levels, ultrasound assessment of the size and status of the fetus. Do not use methotrexate if you are breastfeeding or have certain health problems. Open surgery: If an ectopic pregnancy causes a ruptured fallopian tube with massive intra-abdominal bleeding, emergency surgery is needed. Currently, due to early detection of ectopic pregnancy, cases of laparotomy are very rare. These cases often need to be combined with anti-shock resuscitation due to massive blood loss. Laparoscopic surgery: Currently, widely applied in the surgical management of ectopic pregnancy Laparoscopic diagnosis of ectopic pregnancy. Laparoscopy preserves the fallopian tubes in cases where there is still a need to have children. Laparoscopy does not save the fallopian tubes in cases where there is no longer a need for birth or it is not possible to preserve it. The choice of treatment method depends on each specific case:
Ectopic pregnancy ruptured with shock: Resuscitation against shock. Ectopic pregnancy with rupture but no signs of shock can be operated laparoscopically. Hematoma in the cyst wall: If the hematoma is < 8cm: Laparoscopic surgery. If the hematoma is larger than 8cm: Laparotomy to remove the hematoma. Unruptured ectopic pregnancy: Laparoscopy or laparoscopy. Endoscopy in the absence of contraindications. Laparotomy when laparoscopic surgery is contraindicated or laparoscopic is not available. Tubectomy or conservative treatment. Intra-abdominal pregnancy: The fetus is dead, the fetus must be surgically removed. A live fetus requires immediate surgery because of the risk of internal bleeding. At the time of caesarean section, only take the part that is easy to remove, do not try to get the placenta tightly attached to the organs in the abdomen because of the risk of causing a lot of bleeding. The remainder of the pregnancy self-destructed without intervention.

2. Laparoscopic surgery for ruptured ectopic pregnancy at Vinmec Hai Phong

2.1. Advantages and disadvantages of the technique

Advantages: Solve the pathological pregnancy mass. Faster recovery time compared to laparotomy. Minimize antibiotic use due to antibiotic prophylaxis. Cons: The surgeon must be very experienced because if there is an accident, it will be very serious.

2.2. Procedure to proceed

Step 1: Consultation and approval of surgery with the hospital's professional director, Head of Obstetrics Department, doctor. Step 2: Perform surgery in the operating room. Step 3: Post-operative care for the patient.

2.3. Are the postoperative symptoms abnormal and need immediate re-examination?

Having complications: The patient has damage to organs and blood vessels, bleeding after surgery. May require intervention after surgery. The patient was discharged from the hospital on schedule.

2.4. Why should laparoscopic surgery for ruptured ectopic pregnancy at Vinmec?

The hospital is equipped with leading modern equipment in Vietnam in the operating room. The surgical procedures are carried out seriously (before surgery, a full review sheet must be performed before surgery,...), someone is regularly urged to check, at the same time, the procedure is always updated. Latest regulations in the world. The hospital environment is clean, there is no hospital infection, so the patient does not have to be treated with antibiotics after surgery. All information about the pathology and surgical management of ectopic pregnancy is stored in the electronic medical record, easy to look up in cases where it is necessary to retrieve information when it is necessary to treat fertility problems. of the patient. A team of highly qualified and experienced medical professionals. In addition, to reduce complications of ectopic pregnancy, Vinmec offers a comprehensive health care package for couples, pregnant mothers and their unborn babies, including basic pre-marital examination packages, pre-marital examination packages. Advanced staff , maternity package package . Vinmec has a team of experienced doctors in the fields of obstetrics and gynecology, IVF, stem cells, gene technology, capable of synchronously and comprehensively deploying the most advanced assisted reproductive techniques today.
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