How to treat ectopic pregnancy

  Ectopic pregnancy, which is a medical term for a fertilized egg that has lodged outside the uterine cavity, is usually referred to as a tubal pregnancy. When a woman of childbearing age in the early stages of pregnancy or with a normal sexual life experiences abdominal pain with vaginal bleeding after menopause, she should be alerted to ectopic pregnancy, which should be immediately treated by a doctor because of its rapid development. At present, its clinical treatment is mainly divided into two categories: conservative treatment and surgical treatment, with laparoscopic and open surgery.  1.Conservative treatment: For young patients with early ectopic pregnancy who want to preserve their fertility, if the vital signs are stable, the blood HCG (human chorionic gonadotropin) is low (less than 2000iu/l), the ultrasound indicates that the fetal sac of ectopic pregnancy is not large (not more than 4cm), rupture has not occurred, and there is no obvious internal bleeding, drug chemotherapy is feasible, and methotrexate (MTX) is commonly used clinically for systemic chemotherapy, through which MTX is commonly used for systemic chemotherapy to inhibit trophoblast proliferation, destroy the chorionic villi, and cause necrosis of the embryo, which will be gradually absorbed. If the blood HCG decreases 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 considered effective. However, MTX may have toxic side effects, which may cause abnormal bone marrow hematopoietic function and endanger life in serious cases.  2.Laparoscopic surgical treatment: It is the main clinical treatment method for ectopic pregnancy. For young patients with fertility requirements, especially those with one fallopian tube removed or lesioned, conservative surgical solutions can be used, such as laparoscopic tubal window retrieval, which is 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, or no suture is necessary if the incision is small (<1cm). If the incision is small, no sutures are necessary (<1cm). If the patient has no fertility requirements, or is an emergency patient with life-threatening intra-abdominal hemorrhage and shock, immediate radical surgery, such as laparoscopic salpingo-oophorectomy on the affected side, should be performed to effectively and quickly stop the bleeding, while actively rehydrating and transfusing blood to correct shock.  Because it is difficult to completely remove the embryo during conservative surgery, postoperative chemotherapy is still required. Regardless of the treatment option, the patient is at a significantly higher risk of reoccurrence of ectopic pregnancy if she wants to conceive again.