What should I do if an ectopic pregnancy occurs in the fallopian tube?

If a woman wants to become pregnant successfully, the fertilized egg must be transported to the uterine cavity through the fallopian tube, and then the fertilized egg will implant in the uterine cavity. Next, an embryo will be formed, and then it will slowly develop into a fetus. However, due to some special reasons, the fertilized egg may not enter the uterine cavity smoothly, but remain in the fallopian tube to implant. This will cause an ectopic pregnancy in the fallopian tube. This type of ectopic pregnancy is also very harmful. So how to solve it?

What should I do if an ectopic pregnancy occurs in the fallopian tube?

Conservative treatment:

1. Chemotherapy: Chemical drugs are injected into the fertilized egg under direct laparoscope vision, or injected into the uterine canal through hysteroscopy to kill the embryo.

2. For patients with mild internal bleeding and stable condition, or old ectopic pregnancy, Chinese medicine mainly for promoting blood circulation, removing blood stasis and stopping bleeding can be used for treatment.

Surgical treatment:

1. Salpingectomy: Regardless of whether it is a miscarriage-type or ruptured tubal pregnancy, salpingectomy can stop bleeding in time and save lives. For women who already have children and no longer plan to have children, the contralateral fallopian tube can be tied at the same time. In women who need to preserve their fertility, salpingectomy should be performed if the fallopian tube lesion is too large, the rupture is too long, the fallopian tube mesentery and blood vessels are damaged, and/or vital signs are in a serious state. If tubal bleeding cannot be controlled during conservative surgery, the fallopian tube should be removed immediately.

2. Conservative surgery: The so-called conservative surgery, in principle, is to remove the extrauterine pregnancy, preserve the anatomy and function of the fallopian tube as much as possible, and create conditions for future intrauterine pregnancy.

3. Laparoscopic surgery: Under laparoscopy, first use a flusher to flush and suck out the blood in the pelvic cavity to find the implantation site of the fertilized egg.

Postoperative care:

1. Pregnancy test: Urine hCG shows positive. The blood β-hCG value of patients with ectopic pregnancy is generally lower than that of normal pregnancy. It can be detected by radioimmunoassay or monoclonal antibody enzyme labeling method.

2. Ultrasound examination: In case of tubal pregnancy, ultrasound examination can show that the uterus is enlarged, but no gestational sac is seen in the uterine cavity, and low echo areas can be seen beside the uterus or in the fallopian tube, which is an ectopic pregnancy.

3. Endometrial pathological examination: When vaginal bleeding is heavy, the patient can undergo a diagnostic curettage to see whether it is an intrauterine or ectopic pregnancy. If villi can be seen in the slice, it is an intrauterine pregnancy. If there is no chorionic tissue, it may be an ectopic pregnancy.

4. Posterior fornix puncture: When an ectopic pregnancy ruptures, blood can accumulate in the rectouterine fossa. When performing posterior fornix puncture, non-coagulated blood can be drawn from patients with ectopic pregnancy.

5. Laparoscopic examination: Insert a laparoscope through the abdominal wall into the abdominal cavity (pelvic cavity) to observe the morphology and location of the lesion. If necessary, relevant tissues can be taken for pathological examination to confirm the diagnosis.