Expectant Management in Ectopic Pregnancy

Topic Overview

Some early ectopic pregnancies are watched closely to see whether the embryo will become reabsorbed by the body. (This is also called expectant management.)

If an ectopic pregnancy ends on its own, a woman will not need medicine or surgical treatment. But an ectopic pregnancy that does not end on its own can cause heavy bleeding that could be deadly. This is why you have frequent checkups during expectant management.

To be a good candidate for expectant management, you must:

• Have no symptoms, such as abdominal pain or vaginal bleeding.
• Understand that there is a remote risk of fallopian tube rupture and excessive bleeding (hemorrhage).
• Have decreasing levels of the blood pregnancy hormone called human chorionic gonadotropin (hCG), which suggests that your body is reabsorbing the ectopic pregnancy.
• Be able to see your doctor for frequent checkups.

Increasing abdominal (belly) pain or pelvic pain, tubal rupture that causes internal bleeding, and high serum hCG levels are reasons to stop expectant management and consider other treatment options. In these cases, medicine or surgery or both are needed. Symptoms such as shoulder pain, dizziness, lightheadedness, or fainting could be signs of internal bleeding with tubal rupture.