Surgical treatment of an
ectopic pregnancy
Information for patients
Gynaecology
What is an ectopic pregnancy?
An ectopic pregnancy is a pregnancy that develops outside of the uterus
(womb). The most common site is within a fallopian tube. The cause is
not always known but it may follow damage to the fallopian tube after
a pelvic infection or previous surgery.
The doctor has advised that a laparoscopy (key-hole surgery) is the most
appropriate treatment to locate and remove the ectopic pregnancy.
What is a laparoscopy?
A laparoscopy is performed under a general anaesthetic, where you are
put to sleep. When you are under anaesthetic an internal examination
will be performed and your bladder will be emptied. A small cut is made
in your skin at the umbilicus (navel/belly button) and a needle or port is
passed through the skin into your abdominal cavity, which is then filled
with gas (carbon dioxide). The laparoscope (telescope) is inserted
through this umbilical cut to look inside the abdomen. A second cut is
often made above your pubic hair line to allow a second instrument to
be inserted. Further small cuts may be made on either side of your
abdomen.
If an ectopic pregnancy is found, the fallopian tube is usually removed.
Occasionally the tube is opened and the ectopic pregnancy is taken out
of the tube, but this is in exceptional circumstances. This may be done
using the laparoscope or occasionally by performing a laparotomy (open
surgery).
Your doctor and nurse will be happy to explain the type of surgery you
will need or have had.
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What are the risks of having a laparoscopy?
A laparoscopy is generally a safe procedure but as with any operation
there are associated risks. These include:
• Damage to your internal organs (bowel, bladder, and ureter) from
the insertion of gas or instruments into your abdomen during the
operation. This may happen during 1 in 500 operations but the
risk may be slightly higher if you have had abdominal surgery
before.
• Infection is rare but may occur in your urinary tract, abdominal
wounds or gynaecological organs.
• Internal bleeding may happen as a result of accidental damage to
a pelvic organ and in severe cases a blood transfusion may be
required.
• Blood clots in the veins in your legs or lungs. Please also read the
leaflet 'Preventing blood clots while you are in hospital and after
you leave'.
• A laparoscopy may be difficult to perform if you are obese or if you
have lots of scar tissue from previous operations in your abdomen
and you may require a laparotomy. This may happen during 2 to
3 in 1000 operations.
What will happen after my operation?
You will be taken to the recovery room and monitored until you are
ready to go back to the ward.
Will I have any pain?
You may have some discomfort in your abdomen and sometimes
shoulder tip pain following the operation. The pain should be relieved
by taking simple pain relief such as paracetamol and ibuprofen. The
pain should settle within 5 days.
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Will I feel sick?
You may feel sick after your operation, which could be because of the
operation itself or as a side effect of the anaesthetic or pain relief you
may have been given. Medication is available to help with this.
When will I be able to go home?
Occasionally some women may need to stay in hospital overnight
following this operation. Please be prepared for this and make any
necessary arrangements before your admission.
What can I do when I go home?
This will depend on the type of operation you have had. When you go
home you should try to rest and increase your level of activity gradually
until you are back to normal.
How do I look after my wound(s)?
Your wound(s) should remain uncovered and it is important to keep
them clean. Daily showers are a good idea. You must make sure you dry
your wound(s) well afterwards.
Your stitches should dissolve or fall out within a couple of weeks of the
operation. If you have stitches that need removing this will be explained
to you by the nurse before you go home.
How long will I bleed for after my operation?
You may have some vaginal bleeding for up to 2 weeks following your
operation. Please wear sanitary towels and NOT tampons.
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When can I return to work?
If you have had a laparoscopy you should be ready to return to work
after 1 to 2 weeks and if you have had a laparotomy you will need 6
weeks off work. Your nurse will discuss this with you before you go
home.
When can I drive?
After 3 to 6 weeks, depending on the type of operation you have had
and how comfortable you feel. You must be able to perform an
emergency stop effectively. It is important that you check your insurance
covers you to drive after your surgery.
When can I resume sexual intercourse?
Sexual intercourse can be resumed when any vaginal bleeding or
discharge has settled and you feel comfortable and pain free.
Is it possible to become pregnant straight away?
Yes. It is advisable to wait until your next period if you wish to try to
become pregnant again.
If you plan on becoming pregnant again you should consider taking 400
micrograms of folic acid every day ideally for three months before
conceiving, but at least from the time you stop taking contraception. If
you want any advice on contraception the nurses will be happy to
discuss this with you.
Could I have another ectopic pregnancy?
It is expected that about 10 to 15% of subsequent pregnancies will be
outside the uterus.
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How will I feel afterwards?
Women may experience a wide range of emotions following an ectopic
pregnancy. If you require emotional support following your ectopic
please contact G Floor Reception on 0114 226 8590 to make an
appointment to speak to a nurse. The aim of the appointment is to give
you the opportunity to discuss your feelings and emotions and if
necessary to check your physical well-being. Your partner is welcome to
attend.
I have been told I am Rhesus negative. What does this
mean?
If your blood group is Rhesus negative we recommend that you have an
anti-D immunoglobulin injection.
Further information can be found in the leaflet ‘Anti-D immunoglobulin
injection’ (PIL2687). Please ask the nurse or doctor to provide you with
this leaflet.
What happens to the pregnancy tissue?
The pregnancy tissue is usually sent to the laboratory to check that it is
pregnancy tissue and that there are no obvious abnormal changes. You
will need to give written consent for this investigation and the nurses
will discuss this with you.
The hospital will arrange a cremation in a sensitive and respectful
manner at one of the Sheffield Crematoria.
Alternatively, you may wish to arrange a personal burial. This will
depend on the amount of pregnancy tissue and the investigations
performed. The nurse will discuss this with you.
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Is there anything I should look out for when I go
home?
You should contact the gynaecology ward or your GP if you have any of
the following:
•
•
•
•
•
Your vaginal bleeding is heavy
You have an offensive vaginal discharge
Your wound becomes red, swollen or starts oozing
You begin to feel feverish or unwell
Your pain is not controlled by simple pain relief such as
paracetamol or ibuprofen
Who can I contact if I have any questions?
If you have any concerns or need any further information then please do
not hesitate to contact:
• Gynaecology Ward G1: 0114 226 8225
• Gynaecology Ward G2: 0114 226 8367
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Issue Date: February 2017. Review Date: February 2019