What are the principles for managing ectopic pregnancy?

Generally speaking, if a female friend has an ectopic pregnancy, she must seek timely treatment, otherwise the disease will cause further damage to the body and may cause heavy bleeding. The treatment principles for ectopic pregnancy can generally be divided into two types, one is salpingectomy, and the other is conservative fallopian tube surgery. Both surgeries require attention to postoperative care.

1. Salpingectomy: If the woman has given birth after tubal pregnancy, salpingectomy is generally performed, which is especially suitable for emergency patients with internal bleeding and shock. For patients with milder conditions or those who meet the conditions, laparoscopic surgery can be performed, and the treatment can be determined based on the condition of the contralateral fallopian tube and whether the patient has fertility requirements.

For interstitial pregnancy in the fallopian tube, surgery should be performed before rupture to avoid potentially life-threatening bleeding. The surgery should include wedge resection of the uterine horn and removal of the affected fallopian tube, and removal of the uterus if necessary. For those who need to preserve their fertility, the affected area can be removed and the fallopian tube transplanted to the uterine cornu. If the interstitial pregnancy ruptures, surgical rescue should be performed as soon as possible, often while counteracting shock. First, clamp the pelvic infundibulum ligament and uterine cornu to stop bleeding, and then remove the interstitial pregnancy. Attention should be paid to adequate hemostasis and suturing. Leave no gaps.

2. Conservative fallopian tube surgery (fallopian tube-preserving surgery): Suitable for young women who want to have children, especially those with obvious lesions in the contralateral fallopian tube. The surgical procedure should be selected according to the site of implantation of the fertilized egg and the condition of the fallopian tube lesions. If it is a fimbria pregnancy, squeezing can be performed; if it is an ampulla pregnancy, salpingotomy and embryo retrieval can be performed; if it is an isthmus pregnancy, the diseased segment can be resected and end-to-end anastomosis can be performed. The use of microsurgical techniques can improve the postoperative pregnancy rate. In addition to laparotomy, conservative surgery can also be performed through laparoscopy.