Pregnancy After Care: Non-tubal ectopic pregnancy

OMNI offers expertise in the diagnosis and management of these rare forms of ectopic pregnancy. Non-tubal ectopic pregnancies account for only 5% of all ectopic pregnancies. Treatment of these ectopic pregnancies has to be individualised based on the location of the non-tubal ectopic pregnancy, the level of pregnancy hormone or serum hCG and the viability of the pregnancy.

Non-tubal pregnancies include:

• interstitial or cornual pregnancies
• cervical pregnancies
• ovarian pregnancies
• caesarean section scar pregnancies

As a rule, interstitial and cervical pregnancies should be managed non-surgically. In these cases, high dose methotrexate and close follow-up is the mainstay of treatment.

Ovarian pregnancies are even rarer and these pregnancies can be difficult to diagnose on ultrasound as they mimic ovarian cysts. Laparoscopic (keyhole) surgery is usually the most appropriate way to treat this type of non-tubal ectopic pregnancy.

Caesarean section scar pregnancies are becoming more common and this is related to the increase in caesarean section rates. The mainstay of treatment for women with this type of ectopic pregnancy is ultrasound-guided dilatation and curettage (D&C). This means having a general anaesthetic and emptying the womb under ultrasound vision.