Ectopic pregnancy therapy

Synonyms

Tube pregnancy, Tubar pregnancy, Medical: Graviditas tubaria

The therapy of an ectopic pregnancy depends on how long the pregnancy has already existed and how acute the situation is. Surgical therapy focuses on the removal of the pregnancy parts. If the ectopic pregnancy is older, i.e. it is in an advanced stage, surgical intervention becomes necessary.

In this case, the fallopian tube as such can also be functionally preserved. During the operation, either the fallopian tube is cut lengthwise and the embryonic material is removed, or the embryo and placenta are both expressed in the direction of the uterus or in the direction of the fringe. However, this can only be done if the size and position of the embryo allow it.

If the ectopic pregnancy is not advanced and the pregnancy is not expected to regress on its own, the drug Methotrexate can be used. Active substance: Methotrexate disodium

  • Lantarel ® from Wyeth Pharma GmbH
  • Metex ® from medac
  • MTX

Methotexate has many applications as a drug. Low-dose methotrexate, has become one of the most prescribed long-acting anti-inflammatory drugs.

Methotrexate can also suppress reactions of the immune system (immunosuppressant) and is therefore used in diseases where there are disorders of the body’s own defenses. In a further field of application, Methotrexate is used in the treatment of various malignant tumor diseases. As mentioned above, Methotrexate is also used in cases of a non-advanced ectopic pregnancy.

Methotrexate is an antagonist of folic acid (folic acid antagonist) and inhibits the proliferation of rapidly dividing cells. This is the starting point for the therapy of ectopic pregnancy. In addition, methotrexate weakens unwanted endogenous defence reactions and also has an anti-inflammatory effect.

Therapy with methotrexate is generally longer-term. The side effects of Methotrexate depend on the duration of use and the dosage. It is possible that the side effects occur during the entire period of use, with the side effects occurring most frequently within the first 6 months.

Below is a list of the different side effects, in order of decreasing frequency of occurrence:

  • Loss of appetite
  • Nausea
  • Vomiting
  • Abdominal pain
  • Diarrhea
  • Inflammations and ulcers in the mouth and throat
  • Increase of liver values (GOT, GPT, alkaline phosphatase)
  • Disturbances in blood cell formation with a pathological reduction of red blood cells (erythrocytes) and white blood cells (leukocytes) and blood platelets (thrombocytes)
  • Allergic inflammation of the lung skeleton and pulmonary alveoli (pneumonitis, alveolitis)
  • Increased tendency to hair loss
  • Skin redness
  • Skin rash
  • Itching
  • Headaches
  • Tiredness
  • Dizziness

Methotrexate is an antagonist of folic acid and therefore these complaints can be at least partially improved by taking folic acid at the same time. However, the use of folic acid preparations should always be clarified with a physician, as too high doses of folic acid could possibly impair the effectiveness of Methotrexate. Methotrexate is either swallowed as a tablet or injected as a liquid by the doctor into the vein (intravenous), subcutaneous fatty tissue (subcutaneous) or muscle (intramuscular). The choice between the different dosage forms is individual.