Treatment & beyond
There are several ways of treating or managing an ectopic pregnancy.
Management of ectopic pregnancy
If you are very unwell, the only safe option may be an urgent operation to remove the ectopic and stop any internal bleeding.
In most cases, though, there may be several options, which your doctor will discuss with you. All will depend on your condition, the scan results and any additional blood tests. They will also depend on current advice being given by experts during the coronavirus pandemic.
- Conservative or expectant management
- also called ‘watchful waiting’
- no active treatment but regular checks to make sure the ectopic pregnancy is ending naturally. These checks are very important and should not be affected by the coronavirus pandemic.
- Medical management
- treatment with a drug called methotrexate
- needs regular blood tests to make sure pregnancy hormone levels are falling. As above, these checks are very importamnt and should not be affected by the coronavirus pandemic.
- Surgical management (an operation)
- removing the affected tube, with the ectopic pregnancy inside: a salpingectomy OR
- removing the ectopic pregnancy from the tube and leaving the tube behind: a salpingotomy.
- Almost all non-tubal ectopics are dealt with surgically.
You can find more detailed information about treatment in our leaflet on ectopic pregnancy. And the Ectopic Pregnancy Trust is another helpful source of information on ectopic pregnancy and coronavirus.
Pregnancy after ectopic
The chances of having a healthy pregnancy are still good after an ectopic, even if your tube is removed.
About two thirds of women will get pregnant again naturally. Some will need fertility treatment to conceive and others will decide not to try again.
The overall chance of you having another ectopic is between 7% and 10%. This will depend on the kind of treatment you had and the health of your remaining tube/s. If you had surgical treatment of a tubal ectopic surgery but the tube was not removed, the risk of another ectopic is slightly higher, at around 15%.
The chance of having another non-tubal ectopic is very low.
If you do get pregnant again, it’s very important to find out early if the pregnancy is developing in the right place. So once you have a positive pregnancy test, it’s best to consult your GP to arrange an ultrasound scan at 6 or 7 weeks. During the coronavirus pandemic, it might be best to contact your hospital’s Early Pregnancy Assessment Unit or Emergency Gynaecology unit directly. See here for a list.
However, if you have pain or bleeding, it is best to go to your local Early Pregnancy Unit or Accident and Emergency unit (Casualty) for assessment, even if it is before 6 weeks. We understand that this might make you anxious at a time when we are being encouraged to self-distance, but it is still the best option when there is a risk of ectopic pregnancy.
There is more information about ectopic pregnancy in our leaflet, and also in the patient information produced by the Royal College of Obstetricians and Gynaecologists RCOG). The RCOG also have regularly updated guidance on pregnancy and coronavirus. You may also find it helpful to visit the Ectopic Pregnancy Trust’s website.
The surgery was the easy part and I recovered quickly. It was the emotional recovery that was the hardest.
Ectopic pregnancy can be extremely distressing. You may feel very relieved to be alive and free of pain or just in a state of shock. Either way, you may feel deeply sad at the loss of your baby and feel very uncertain about the future. We talk more these feelings and where to find support here. And Jessica shares some of her feelings here.