Does ectopic pregnancy require hysterectomy?

Many people's understanding of ectopic pregnancy may only exist in limited knowledge, and they have not really understood it. Some people think that the uterus must be removed if an ectopic pregnancy occurs, so everyone would rather continue to be serious than go to the hospital for surgery. Ectopic pregnancy does not only require hysterectomy. Several principles must be mastered in treatment. Unless there is severe bleeding and the pregnancy has lasted for a long time, you may face the issue of hysterectomy at this time.

Conservative surgery

Conservative surgery is suitable for young women who want to have children, especially those whose contralateral fallopian tube has been removed or has obvious lesions. In recent years, due to the improvement of diagnostic technology, the number of tubal pregnancies diagnosed before miscarriage or rupture has increased, so the use of conservative surgery has increased significantly compared with the past.

The surgical procedure is selected based on the site of implantation of the fertilized egg and the condition of the fallopian tube lesions. If it is an infundibulum pregnancy, the products of conception can be squeezed out; if it is an ampulla pregnancy, the fallopian tube is opened to remove the embryo and then sutured; if it is an isthmus pregnancy, the diseased segment is resected and end-to-end anastomosis is performed. If the surgery uses microsurgical techniques, the subsequent pregnancy rate can be improved. In addition to laparotomy, conservative surgery can also be performed via laparoscopy.

Surgery

The treatment principle of tubal pregnancy is mainly surgical treatment, which should generally be performed after the diagnosis is confirmed. The surgical method generally adopts total salpingectomy. Those who require sterilization can perform ligation at the same time. Young women who want to have children and whose contralateral fallopian tube has been removed or has obvious lesions can undergo conservative surgery to preserve the fallopian tube and its function.

The surgical procedure is selected based on the patient's general condition, the site of egg implantation, and the degree of fallopian tube lesions. For example, in the case of fimbria pregnancy, the fertilized egg can be squeezed out by surgery; in the case of ampulla pregnancy, the fertilized egg can be removed by incision; in the case of isthmus pregnancy, lesion resection and stump anastomosis can be performed. The use of microsurgical techniques can improve the pregnancy rate. The treatment of tubal interstitial pregnancy can be performed by resection of the affected uterine horn or total hysterectomy depending on the condition of the lesion.

In recent years, laparoscopic diagnosis and treatment of tubal pregnancy have been carried out both at home and abroad. Autologous blood transfusion is one of the effective measures to rescue acute ectopic pregnancy, especially in the absence of blood source. The recovery of intra-abdominal blood must meet the following conditions: gestation < 12 weeks, unruptured membranes, bleeding time < 24 hours, uncontaminated blood, and microscopic red blood cell rupture rate < 30%.

Minimally invasive treatment of ectopic pregnancy

In recent years, minimally invasive laparoscopic technology has become increasingly mature and widely used in the field of obstetrics and gynecology, making the treatment of ectopic pregnancy move from "major invasion" to "minimally invasive". It is easier to preserve the fallopian tubes because of its small surgical trauma, less bleeding, short operation time, quick postoperative recovery, short hospitalization time, almost no scars on the abdomen, less pelvic adhesions, and mild fallopian tube obstruction. Tissue coagulation of the wound surface can prevent the infiltration and deposition of cellulose and significantly improve the patient's quality of life after surgery. Very popular among patients.

Currently the most advanced laparoscope in the world, this technology uses a cold light source to provide lighting, inserts the laparoscope lens (3-10mm in diameter) into the abdominal cavity, and uses digital camera technology to transmit the image captured by the laparoscope lens to the subsequent signal processing system through optical fibers, and displays it in real time on a dedicated monitor. The doctor then analyzes and determines the patient's condition through images of the patient's organs from different angles displayed on the monitor screen, and uses special laparoscopic instruments to perform surgery.

During the operation, only three small holes of 0.5 to 1 cm need to be opened in the patient's abdomen. After recovery, only 1 to 3 linear scars of 0.5 to 1 cm in size are left in the abdominal cavity, which is only the size of a keyhole. It can be said to be a surgery with small incision and little pain.

The development of Stryker laparoscopic surgery has reduced the pain of surgery for patients, shortened their recovery period, and relatively reduced their expenses. The most important thing is that it can effectively preserve the fallopian tubes, with a fallopian tube preservation rate of 95.65%, creating favorable conditions for future childbirth and is very suitable for women who want to have children.

Chinese Medicine

To confirm pregnancy, you need to go to the hospital for a check-up, mainly because you are afraid of ectopic pregnancy. Chinese medicine has a long history and is profound. The use of Chinese medicine to treat ectopic pregnancy also has very good results.