The Tubal ectopic pregnancy can be managed depending on the clinical varieties, on the basis of that the management is explained here.

1. Acute (Ruptured)
Resuscitation with laparotomy to be done, and salpingectomy of the damaged tube is the only treatment.

2. Chronic Laparotomy with salpingectomy

3. Unruptured
It depends on the clinical condition of the woman.

A. Expectant management
When beta hCG is less than 1000 IU/L with a continuous declining level of beta hCG.
Gestational sac size is less than 3 c.m.
So only close monitoring of beta hCG is to be done until remain undetectable in serum.

B. Medical Management
Methotrexate (Chemotherapeutic drug)
Can be administered systemically or directly.
I/M 50mg/m2 on day 1
Then check the level of beta hCG, from day 4 to day 7, if the level declines more than equal to 15% then check the level of beta hCG, weekly until undetectable in serum.
If the level is less than15% then repeat the same dose of MTX and monitor in the same manner as done previously.
If still fails stop the medical management and prefer surgical management only.

C. Surgical Management
Either enter through laparotomy / Laparoscopy
Either by Salpingostomy / Salpingectomy depends on certain criteria.

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00:00 Introduction of Ectopic Pregnancy
00:59 Management in Acute variety of Tubal ectopic pregnancy
03:38 Management in Chronic variety of Tubal ectopic pregnancy
05:43 Expectant Management of Unruptured Tubal ectopic pregnancy
08:08 Medical Management of Unruptured Tubal ectopic pregnancy
17:22 Surgical Management of Unruptured Tubal ectopic pregnancy
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