Ectopic pregnancy medical conservative treatment

Written by Zhang Xiu Rong
Obstetrics and Gynecology
Updated on September 26, 2024
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Under normal circumstances, the treatment of ectopic pregnancy is generally divided into conservative treatment and surgical treatment. Conservative treatment is usually applied when the ectopic pregnancy has not ruptured, using medication for about a week. After one week, a follow-up examination is done to check blood HCG levels and an ultrasound scan. If blood HCG levels have dropped significantly, the ultrasound shows that the mass has not grown, and the symptoms of abdominal pain have decreased, it indicates that the conservative treatment was successful. The threat is only considered resolved when blood HCG returns to normal levels. Otherwise, the conservative treatment for ectopic pregnancy may fail, and surgery will be necessary to treat the ectopic pregnancy symptomatically. If there is a particularly large amount of bleeding or a rupture has occurred, surgical treatment is the only option.

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How to check for an ectopic pregnancy?

The examination for an ectopic pregnancy is divided into two steps, the first step is to confirm whether one is pregnant. Then, pregnancy can be detected either by a pregnancy test strip or the most accurate method, which is through a blood test. Once pregnancy is confirmed, the second step involves an ultrasound examination. A blood test only indicates whether or not one is pregnant, but an ultrasound can specifically determine whether it is an intrauterine pregnancy or an ectopic pregnancy. If it is an intrauterine pregnancy, the pregnancy can simply continue. If it is an ectopic pregnancy, surgical or medical treatment is necessary. On an ultrasound, an ectopic pregnancy is indicated by the absence of a gestational sac within the uterine cavity, but a gestational sac or mass is found outside the uterus, which confirms the diagnosis of an ectopic pregnancy.

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Ectopic pregnancy abdominal pain symptoms

Let's first discuss what an ectopic pregnancy is. An ectopic pregnancy occurs when the fertilized egg implants outside of the uterus, such as in any part of the fallopian tubes, the corners of the uterus, or the abdominal cavity. Due to the different implantation sites, the symptoms of abdominal pain vary. A very small number of people feel no symptoms at all, experiencing only vaginal bleeding. Additionally, some people may feel severe discomfort in the abdomen. The last type involves severe, intense abdominal pain, resembling a tearing sensation, accompanied by nausea, vomiting, and hypotension shock.

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ectopic pregnancy symptoms

Ectopic pregnancy is not a normal state of pregnancy. Normally, the gestational sac should be located in the middle of the uterine cavity. An ectopic pregnancy refers to the implantation of the gestational sac outside the uterine cavity. Common types of ectopic pregnancy include tubal pregnancy, ovarian pregnancy, and abdominal pregnancy, with over 99% of ectopic pregnancies being tubal pregnancies. The symptoms of an ectopic pregnancy include the following aspects: 1. In the early stages of an ectopic pregnancy, there are no clinical symptoms because the early gestational sac is relatively small and does not stimulate the fallopian tube or the local area, thus causing no symptoms. 2. When the gestational sac grows to a certain size, it compresses the tube cavity, causing mild abdominal pain. This pain intensifies as the gestational sac grows and can lead to tearing pain, indicating a ruptured tubal pregnancy. 3. During an ectopic pregnancy, because the gestational sac cannot develop normally, the levels of estrogen and progesterone in the body are relatively low, leading to endometrial withdrawal bleeding, which manifests as a small amount of bright red vaginal bleeding.

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Can an ectopic pregnancy cause a fever?

Ectopic pregnancy generally does not cause fever symptoms unless there is an infection. The typical signs of an ectopic pregnancy include a history of missed menstruation, minor vaginal bleeding, and abdominal pain. When the ectopic pregnancy in the fallopian tube has not ruptured, the pain is characterized by swelling pain in the lower abdomen. If the fallopian tube pregnancy ruptures, there will be tearing pain, followed by tenderness in the lower abdomen, rebound pain, and abdominal muscle tension, and then fainting and shock can occur. During a gynecological examination, it is possible to feel a mass in the abdomen. Ectopic pregnancies generally require surgical treatment. After surgery, there might be a temporary fever known as "absorption fever," but this type of fever is short-lived and the body temperature does not exceed 38 degrees Celsius. This is a normal physiological reaction after surgery and is not considered a pathological fever.

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Early symptoms of ectopic pregnancy

The early symptoms of an ectopic pregnancy, where the pregnancy test shows implantation outside the uterine cavity, indicate an ectopic pregnancy. Depending on the type of ectopic pregnancy, whether there is a miscarriage at the site where the fertilized egg attaches, or whether there is a rupture, as well as the timing, duration, and volume of bleeding, the clinical manifestations can vary. In early tubal pregnancies, if there is no miscarriage or rupture, there are generally no specific clinical symptoms, meaning there is neither abdominal pain nor vaginal bleeding. However, as the condition progresses, some typical symptoms may appear, beginning with the cessation of menstruation. Then, abdominal pain may occur. If there is no rupture, the pain or soreness is typically localized to one side of the lower abdomen. If a rupture occurs, tearing pain will be followed by lower abdominal pain, abdominal tenderness, and rebound pain, potentially leading to a shock state.