Semin Reprod Med 2007; 25(2): 117-122
DOI: 10.1055/s-2007-970050
Copyright © 2007 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Surgical Treatment of Ectopic Pregnancy

Mohammed Al-Sunaidi1 , Togas Tulandi1
  • 1Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
Further Information

Publication History

Publication Date:
22 March 2007 (online)


In most cases of ectopic pregnancy, medical treatment with methotrexate is successful. However, some cases still require surgery and laparoscopy is an effective approach. The candidates for surgical treatment include women who are not suitable to or have failed methotrexate treatment, those with heterotopic pregnancy, or those who are hemodynamically unstable. In women of reproductive age with tubal pregnancy, salpingostomy is the preferred surgical method. Conversely, salpingectomy is a better treatment for women with severely damaged fallopian tube, recurrent ectopic pregnancy in the same tube, uncontrolled bleeding after salpingostomy, large tubal pregnancy (> 5 cm), heterotopic pregnancy, and for those who have completed their family. Similar to treatment of a tubal pregnancy, cervical and interstitial pregnancy could be treated medically first. Most abdominal pregnancies are diagnosed late in pregnancy. However, when the diagnosis is made early, laparoscopic removal of the pregnancy should be performed.


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Togas TulandiM.D. 

Department of Obstetrics and Gynecology, McGill University

687 Pine Ave. West, Montreal, Quebec, Canada H3A 1A1