Can an ectopic pregnancy be born?

Ectopic pregnancy sounds scary and serious, and it can cause many problems for patients. The first is heavy bleeding. You should know that the human body only has a limited amount of blood. If there is heavy bleeding, it will cause people's lives to be affected by ischemia, and they may even go into shock. Most patients with ectopic pregnancy will choose surgical treatment and cannot continue the pregnancy, because if they continue the pregnancy, the baby will not be able to develop normally without being in the uterus.

Treatment

Surgery

Open or laparoscopic surgery is possible.

1. For patients with severe internal bleeding and shock, surgical rescue should be performed while actively correcting the shock and replenishing blood volume. The abdominal cavity was opened quickly, the diseased fallopian tube was brought out, the mesosalpinx was clamped with an oval forceps to quickly control bleeding, the infusion was accelerated, and the operation was continued after the blood pressure rose.

2. Surgical procedure: Routine salpingectomy on the affected side is performed. Young women who want to have children can undergo conservative surgery. Depending on the site of implantation of the fertilized egg, the fallopian tube can be incised to remove the embryo and then opened after local suture or electrocoagulation to stop bleeding, or the fimbria can be squeezed out to remove the embryo to preserve the function of the fallopian tube. Careful observation should be made during the operation and attention should be paid to monitoring vital signs and abdominal condition after surgery. Blood β-HCG should be checked 24 hours, on the 3rd day, and on the 7th day after surgery. If the decrease is not satisfactory, methotrexate or traditional Chinese medicine should be used to prevent the occurrence of persistent ectopic pregnancy. Thereafter, blood β-HCG should be checked every week until it returns to normal. Those who wish to be sterilized can have the contralateral fallopian tube tied at the same time.

3. Autologous blood transfusion is one of the effective measures to rescue ectopic pregnancy, especially in the case of lack of blood source. The recovery of intra-abdominal blood must meet the following conditions: pregnancy less than 12 weeks, unruptured fetal membranes, bleeding time <24 hours, uncontaminated blood, and microscopic red blood cell destruction rate <30%; each time 100ml of blood is transfused, add 10ml of 3.8% sodium citrate for anticoagulation, and the blood can be transfused back into the body after being padded with 6 to 8 layers of gauze in a transfusion funnel or filtered through a 20μm microporous filter; 400ml of autologous blood transfusion should be supplemented with 10ml of 10% calcium gluconate.

Nonsurgical treatment

These include expectant treatment, chemotherapy, traditional Chinese medicine treatment and interventional treatment, and should be carefully selected based on the condition of the disease.

1. Expectant treatment: no clinical symptoms or mild clinical symptoms; the diameter of the ectopic pregnancy mass is less than 3 cm, there is no fetal heart beat, there is no intra-abdominal bleeding or the estimated internal bleeding is less than 100 ml; blood β-hCG is less than 1000 mIU/ml and continues to decrease. Patients can be advised to rest at home and come to the hospital for weekly blood β-hCG check. If abdominal pain worsens during this period, they can seek medical attention at any time.

2. Chemotherapy: Patients who want to have children, especially those whose contralateral fallopian tube has been removed or has obvious lesions. It is suitable for patients with no obvious abdominal pain, maximum diameter of the mass 3.5~5.0cm, β-hCG <2000~3000mIU/ml, stable vital signs, no signs of active intra-abdominal bleeding, and normal liver function and blood count. The commonly used drug is methotrexate 50 mg/m2, injected intramuscularly. If the blood β-hCG drops by less than 15% 4 to 7 days after administration, the drug can be repeated. It takes an average of 35 days for blood β-hCG to drop to normal. Pay attention to monitor blood routine and B-ultrasound. In recent years, some scholars have used mifepristone for the conservative treatment of ectopic pregnancy, but there is no conclusion yet.

3. Traditional Chinese medicine treatment: It is one of the current methods for treating tubal pregnancy in my country. It avoids surgical trauma, preserves the affected fallopian tube and restores its function. The main formula is salvia miltiorrhiza, red peony root and peach kernel, which can be added or subtracted according to the symptoms.

4. Interventional therapy: After angiography, slowly inject 50-100 mg of methotrexate into the uterine artery. If the gestational sac is large, add 5-Fu 500 mg. After the infusion, embolize the uterine artery with absorbable gelatin sponge particles. After embolization, the patient's vital signs should be closely observed, and blood β-hCG and ultrasound should be checked weekly. Due to its high cost, it is currently only used in the clinical treatment of some special types of ectopic pregnancy.