Your doctor has diagnosed you with an ectopic pregnancy. We understand that this can be distressing for you. Unfortunately, with an ectopic pregnancy, it is not possible to save the pregnancy.
Our doctors have assessed you, and they recommend surgical management of your ectopic pregnancy.
About surgical management
Surgical management means performing an operation to remove the ectopic pregnancy using general anaesthetic (while you are asleep).
We recommend surgery in the following situations.
- If your pregnancy hormone (bHCG) is high, your health may be at risk. This means we may not be able to consider using non-surgical treatments.
- If your ultrasound scan shows there is bleeding into your abdomen. We will need to treat this with surgery.
We may also recommend surgery if other treatment options have not worked. (These other options may include monitoring the ectopic pregnancy or using medication.)
Keyhole surgery: different types
Laparoscopy
Most women have a type of keyhole surgery called a laparoscopy. This involves inserting a tiny camera through your belly button, and inserting instruments through two small cuts in your lower abdomen.
We add a small amount of gas to your abdominal cavity to inflate it. This enables the surgeon to see inside and assess what treatment you need.
Women who have a laparoscopy usually stay in hospital for 1 or 2 days.
Laparotomy
Sometimes we need to perform a type of keyhole surgery called a laparotomy. This involves a larger cut on the lower abdomen. This is rare, and only needed in complex or emergency situations.
Women who have a laparotomy usually stay in hospital for 2 to 3 days.
Removal of the ectopic pregnancy
There are two possible surgical options to remove an ectopic pregnancy and, if necessary, remove the affected fallopian tube. These types of surgery are called:
- salpingectomy
- salpingotomy.
We will choose the most appropriate option, depending on the location of your ectopic pregnancy and the damage to the affected area of your body.
Salpingectomy
Most ectopic pregnancies occur in the fallopian tube. If there is a lot of damage or bleeding, we will need to remove the affected tube. This is called a salpingectomy.
Salpingotomy
If your other fallopian tube does not look normal, we will make every effort to save your affected tube and leave it in place. This is called a salpingotomy.
If you have a salpingotomy, there is a small risk (15%) that some of the pregnancy tissue will remain in the tube. After your surgery, we will advise you to have weekly blood tests to monitor your levels of bHCG (pregnancy hormone). You may need to take a medication called methotrexate, or you may need further surgery, but both of these outcomes are rare.
Recovery after surgery
Washing
Keep your wound dry and clean for 48 hours.
After 48 hours you can shower or bath (unless we advise you otherwise).
If possible, have someone with you, in case you need help while you shower or take a bath.
Pain
Most women experience pain during the first few weeks after surgery. You can treat this with the painkillers we prescribe for you.
If you have a laparoscopy, you are likely to feel bloated for the first week. You will experience pain (similar to trapped wind). This is caused by the gas we use to inflate your abdomen during surgery.
Tiredness
You will feel tired, particularly if you lost a lot of blood during surgery. If we gave you a blood transfusion, we may offer you a course of iron tablets.
Wound care and stitches
We will show you how to look after your wound and stitches before we discharge you home.
- If we have used dissolvable stitches, they usually disappear with 1 to 2 weeks.
- If we have used removable stitches, we will let you know when we will need to take them out.
Exercise
In the first days after surgery it is important to continue with regular, gentle movement, such as walking. You can increase your level of movement gradually.
When your wound site has healed, you can try gentle swimming.
For the first 2 weeks after surgery, avoid heavy lifting and heavy housework.
Emotional recovery
For many women, having treatment for an ectopic pregnancy is physically stressful and emotionally upsetting. This is normal.
You may still 'feel' pregnant until your bHCG levels go down. This can take several weeks. Once your pregnancy hormone levels fall and we confirm that your pregnancy has ended, it is not unusual to feel sad and depressed.
We advise you to give yourself time to recover.
Anyone can experience an ectopic pregnancy. Unfortunately, there is nothing you could have done to avoid it.
Follow-up
Most women do not need a follow-up appointment. We will answer any questions you have when we discharge you home.
We advise most women to take a urinary pregnancy test 3 weeks after surgery. This is likely to show a negative test result. If the test is positive, contact us and we will make an appointment to see you.
If you had a salpinogotomy (see above), we may invite you to come into Jasmine Unit for a blood test, 1 or 2 weeks after your surgery.
Future pregnancy
We recommend you wait at least 2 months before you try for a baby again. This will allow your body to resume its normal cycle. You may not have another period for 6 to 8 weeks.
If we have given you methotrexate (see salpingotomy, above), we will recommend you wait 3 months before trying for another baby.
If you have had one ectopic pregnancy, you are at risk of having another. For this reason, we will monitor your next pregnancy from an early stage.
Get in touch with Jasmine Unit as soon as you have a positive result for a pregnancy test. We will arrange for you to have an ultrasound scan at around 5 weeks.
Contact information
Kingston Hospital Jasmine Unit (6th floor, Esher Wing)
Monday to Friday, 9am to 5pm
If you need help out of hours, call NHS 111 or go to your nearest Emergency Department (A&E).
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