Treatment for choice for tubal pregnancy with no evidence of bleeding or rupture: September 2005

Ans. C: Observation There is spontaneous resolution in two third of early cases so wait and watch policy is employed in following cases: Falling hCG titre Ectopic mass less than 4 cm No evidence of bleeding or rupture Early treatment of an ectopic pregnancy with methotrexate is a ble alternative to surgical treatment. If administered early in the pregnancy, methotrexate terminates the growth of the developing embryo; this may cause an aboion. If hemorrhage has already occurred, surgical intervention may be necessary. Surgeons use laparoscopy or laparotomy to gain access to the pelvis and can either incise the affected Fallopian and remove only the pregnancy (salpingostomy) or remove the affected tube with the pregnancy (salpingectomy).