How long does conservative treatment of ectopic pregnancy take?

The impact and harm caused by ectopic pregnancy are relatively large, so it must be discovered as early as possible and treatment measures must be taken as early as possible. Conservative treatment of ectopic pregnancy is also a method, but conservative treatment has major defects and may also cause the risk of pregnancy rupture.

(1) Expectant treatment: no clinical symptoms or mild clinical symptoms; the diameter of the ectopic pregnancy mass is less than 3 cm, there is no fetal heart beat, there is no intra-abdominal bleeding or the estimated internal bleeding is less than 100 ml; blood β-hCG is less than 1000 mIU/ml and continues to decrease. Patients can be advised to rest at home and come to the hospital for weekly blood β-hCG check. If abdominal pain worsens during this period, they can seek medical attention at any time.

(2) Chemotherapy: Patients who wish to have children, especially those whose contralateral fallopian tube has been removed or has obvious lesions. It is suitable for patients with no obvious abdominal pain, maximum diameter of the mass 3.5~5.0cm, β-hCG <2000~3000mIU/ml, stable vital signs, no signs of active intra-abdominal bleeding, and normal liver function and blood count. The commonly used drug is methotrexate 50 mg/m2, injected intramuscularly. If the blood β-hCG drops by less than 15% 4 to 7 days after administration, the drug can be repeated. It takes an average of 35 days for blood β-hCG to drop to normal. Pay attention to monitor blood routine and B-ultrasound. In recent years, some scholars have used mifepristone for the conservative treatment of ectopic pregnancy, but there is no conclusion yet.

(3) Traditional Chinese medicine treatment: It is one of the current methods for treating tubal pregnancy in China. It avoids surgical trauma, preserves the affected fallopian tube and restores its function. The main formula is salvia miltiorrhiza, red peony root and peach kernel, which can be added or subtracted according to the symptoms.

(4) Interventional therapy: After angiography, 50-100 mg of methotrexate is slowly injected into the uterine artery. If the gestational sac is large, 500 mg of 5-Fu is added. After the infusion, the uterine artery is embolized with absorbable gelatin sponge particles. After embolization, the patient's vital signs should be closely observed, and blood β-hCG and ultrasound should be checked weekly. Due to its high cost, it is currently only used in the clinical treatment of some special types of ectopic pregnancy.