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What To Expect With An Ectopic Pregnancy

a blog by Grey Fox, July 11, 2013

Ectopic pregnancy can be terrifying for the woman experiencing it. And for her partner as well. On top of that fear is the fact that ectopic pregnancies can also be difficult to diagnose. And they can be wily. All this uncertainty makes them all the more scary. But once your doctor has made that diagnosis...then what?

Your world has just been shattered. Not only will you not be taking this baby home with you, but your life may be in danger. The emotions surrounding ectopic pregnancy are very complex. But that’s another post. This one is to tell you what will happen next.

Treatment for ectopic pregnancies generally consists of two options:

  1. Methotrexate (also known as MTX) is a chemotherapy drug given in low doses to halt and reverse cell growth. It is usually given as an IM (intramuscular) shot in the buttocks in an exam room by a nurse. Dosage is determined by your weight and is far less than what a cancer patient might receive. It can, however, still cause typical chemo side effects like fatigue and nausea but they generally do not last very long.


  2. Surgery to remove the pregnancy itself and/or any organs (such as the fallopian tube) that it may be attached to or contained within. Surgery is often performed laparoscopically and can be same-day surgery not requiring an overnight stay. If the location of your ectopic pregnancy is atypical (i.e. not in the fallopian tube) surgery could be more extensive and require admission to the hospital.

In some cases both options may be necessary but generally one or the other is chosen based on your particular situation. Surgery is usually, but not always, recommended for those with higher beta HCG levels (> 5000).

If you and your doctor (yes, sometimes you will have a choice) decide to treat you with MTX it is very important that you keep all of your appointments for follow up beta HCG tests. Just seeing an initial drop is not enough. Your doctor should follow your beta HCG until it reaches ZERO (or less than 3 or whatever threshold the laboratory deems "undetectable"). Remember that part where I said ectopics can be wily? Well... they can be.

MOST ectopics occur in the fallopian tube. And MOST ectopics only require one dose of MTX. But not all. Just because your beta drops does not mean it will continue to do so. Sometimes you may need additional doses of MTX or surgical intervention. You and your doctor should work together to determine the right treatment for you and your specific situation. Not all ectopics are equal. Unfortunately, because they all differ, there is no set time frame for how long it will take to return to beta=0. It could be weeks or months.

Ectopic pregnancy can be terrifying. No amount of information can change that. But having a little bit of knowledge might make it a little less scary.

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