The nature of the operation is determined by many factors: the localization of the ovum, the severity of pathological changes in the affected and in the opposite tube, the general condition of the patient, the degree of blood loss, age, and desire to have a future pregnancy.
When a diagnosis of impaired ectopic pregnancy is established or if it is suspected, an urgent hospitalization in hospital (gynecological, surgical) is indicated. It is necessary to provide patient peace and strict bed rest. Before being examined by a doctor, you should not use painkillers in order not to change the clinical picture of the disease; you should not also do an enema, apply cold or heat on the lower abdomen.
A comprehensive approach to the treatment of ectopic pregnancy includes:
- elimination of bleeding, hemorrhagic shock, blood loss;
- management of the postoperative period;
- rehabilitation of reproductive function.
The most common method of surgical treatment of ectopic pregnancy is salpingectomy. Most of all, this operation is suitable for the treatment of interrupted tubal pregnancy with the addition of massive bleeding. The operation and blood transfusion, in this case, is carried out simultaneously. After opening the abdominal wall, blood reinfusion can be applied.
If a patient has a progressing tubal pregnancy for a short period, it is possible to use more gentle treatment methods, that is, the removal of the ovum and the subsequent plastic of the uterine tube.
The following conditions are necessary to perform conservative plastic surgery on the tube: a satisfactory condition of the patient and compensated blood loss, minimal changes in the uterine tube, the woman’s desire to preserve reproductive function, if the patient’s health condition does not prevent future nursing of pregnancy and birth.
It is desirable to restore the integrity of the uterine tube with the help of microsurgical techniques. However, in most of the cases, the patency of the uterine tube is preserved, but its epithelium is disturbed, which subsequently makes it impossible to restore reproductive function.