How to treat ectopic pregnancy conservatively?

The occurrence of ectopic pregnancy is very harmful to the health of women's uterus. If not treated in time, it may cause heavy bleeding. For conservative treatment of ectopic pregnancy, it still depends on the situation of the ectopic pregnancy, the size of the embryo, the degree of damage to the uterus, etc. Most ectopic pregnancies require surgery.

1. Expectant treatment. This type is only applicable to patients with the following symptoms: one is patients with stable condition and no obvious symptoms; one is patients with ectopic pregnancy mass less than 3 cm in diameter, no fetal heart activity, no intra-abdominal bleeding or bleeding less than 100 ml; and the other is patients with blood β-HCG less than 1000mIU/ml and showing a downward trend. About half of these patients will have a spontaneous abortion. However, such patients should be under the supervision of a doctor. If it is found that the patient's blood β-HCG level does not decrease significantly or increases again, or if symptoms of internal bleeding occur, drug treatment or surgical treatment should be switched promptly.

2. Drug treatment. Applicable patients should have stable vital signs, no obvious intra-abdominal bleeding, tubal pregnancy mass ≤3.5~5cm, rising blood HCG level, normal liver function, normal red blood cells, white blood cells and platelets, etc. Currently, drug treatments include methotrexate (MTX), 5-FU, Radix Trichosanthis and traditional Chinese medicine. In recent years, there have been reports of the successful treatment of ectopic pregnancy with mifepristone. Among them, methotrexate is the most popular treatment. MTX is a folic acid antagonist that inhibits the synthesis of pterin and phophotridine, ultimately inhibiting the synthesis of trophoblast DNA, cell replication and cell growth. MTX can be injected intramuscularly, intravenously, or locally. For patients with early ectopic pregnancy, the success rate of drug treatment is very high, so drug treatment will be the preferred treatment method for patients with early ectopic pregnancy.

How effective is conservative treatment for ectopic pregnancy?

Under normal circumstances, when the embryo implants in the uterine cavity after a woman becomes pregnant, it is called an intrauterine pregnancy. If it implants somewhere outside the uterine cavity, it is called an ectopic pregnancy, which is also called ectopic pregnancy in medicine. The most common site of ectopic pregnancy is the fallopian tube, and a few can also be seen in the ovaries, cervix, etc. If the surviving fertilized egg in a fallopian tube pregnancy falls off into the abdominal cavity and occasionally continues to grow on the abdominal organs such as the greater omentum, an abdominal pregnancy is formed. If the fertilized egg implanted in the fallopian tube separates from the tube wall and flows into the abdominal cavity, it will cause tubal pregnancy abortion; if the fertilized egg villi penetrate the tube wall and rupture, it will cause tubal pregnancy rupture; both can cause intra-abdominal bleeding, but the latter is more serious, often leading to shock due to massive internal bleeding, and even life-threatening.

Conservative treatment methods for ectopic pregnancy and health care for preserving reproductive function. For some patients with mild symptoms, such as those with little internal bleeding and good general condition, a non-surgical treatment plan combining Chinese and Western medicine can be applied. Non-surgical treatment must also be performed in the hospital, and blood pressure and pulse must be closely monitored, and preparations for surgery must be made to prevent accidents from being too late for rescue. If the condition does not improve, surgical treatment should be performed immediately.