What to do when abdominal pain starts at a few weeks of ectopic pregnancy

  Ectopic pregnancy, which is a medical term for a fertilized egg that lays outside the uterine cavity, is usually referred to as a tubal pregnancy. The typical symptoms of ectopic pregnancy are abdominal pain and vaginal bleeding after menopause. In the early stage, the embryo growth is restricted to the lumen of the tube, mainly manifesting as vague pain or soreness in one side of the lower abdomen. In case of ectopic pregnancy rupture (mostly seen in tubal isthmus pregnancies around 6 weeks) or ectopic pregnancy miscarriage (mostly seen in tubal jugular pregnancies at 8-12 weeks), there is a sudden tearing pain in one side of the lower abdomen, often accompanied by nausea and vomiting. The abdominal pain of ectopic pregnancy should be treated in hospital as soon as possible. At present, the clinical treatment of ectopic pregnancy is mainly divided into two categories: drug chemotherapy and laparoscopic surgery.  1.Drug chemotherapy: For young patients with early ectopic pregnancy who want to preserve their fertility, if their vital signs are stable, their blood HCG (human chorionic gonadotropin) is low (less than 2000iu/l), their ultrasound indicates that the fetal sac of ectopic pregnancy is not large (not more than 4cm), no rupture has occurred, and there is no obvious internal bleeding, drug chemotherapy is feasible, and methotrexate (MTX) is commonly used in clinical practice for systemic chemotherapy, through which Inhibiting trophoblast proliferation, destroying chorionic villi, causing embryonic necrosis and shedding, and then gradually absorbed; if the blood HCG drops and is negative for 3 times in a row 14 days after the drug is administered, and symptoms such as abdominal pain and vaginal bleeding are relieved or disappear, it is regarded as effective (treatment is more useful). It is worth noting that MTX, a drug that may have toxic side effects, causing abnormal bone marrow hematopoietic function and endangering life in serious cases.2. Surgical treatment: laparoscopic surgical treatment is commonly used, and it is the main clinical treatment for ectopic pregnancy at present. For young patients with fertility requirements, especially those who have had one side of the fallopian tube removed or diseased, conservative surgical options can be used, such as laparoscopic tubal window retrieval: what we often call minimally invasive, in which three small incisions are made in the abdomen to enter the pelvis, cut open the fallopian tube, remove the embryo and then suture it, if the incision is small, suturing is not necessary (<1cm); if the patient has no fertility requirements or is in life-threatening shock from intra-abdominal hemorrhage If the patient has no fertility requirements or is in life-threatening shock from intra-abdominal hemorrhage, immediate radical surgery, i.e. laparoscopic salpingo-oophorectomy, should be performed to effectively and quickly stop the hemorrhage, while actively rehydrating and transfusing blood to correct shock. When the abdominal cavity is bleeding profusely and the conditions for laparoscopic surgery are not available, open surgery is also the most rapid method of resuscitation.  In summary, patients with ectopic pregnancy mostly present with abdominal pain between 6 weeks or 8-12 weeks and need to seek medical attention promptly and choose conservative or surgical treatment according to the patient's own condition and pregnancy tissue.