I have heard that ectopic pregnancy is more likely after tubal reversal, what can you tell me about that?

An ectopic pregnancy is a pregnancy that develops when the fertilized egg settles and starts to grow in the fallopian tube rather than in the uterus. You are more likely to have an ectopic if you have a tubal ligation reversal than if you never had a tubal ligation in the first place. We have just finished an analysis of all our patients from 2010. Our ectopic rate was less than 2%. Some facilities have posted their ectopic rates at 6% or higher. It may be because we close the tube in layers, which sews the tube together from the inside out; sewing them open as well as joining them together, but I really do not know.

The reason we emphasize this is that we don’t want you to ruin any of the lovely work we are going to do on your fallopian tubes when we reverse your tubal ligation. Ectopic pregnancy can be dangerous to you, even fatal, but that is a very rare thing. The idea is that we want you to save your tube so that you can get pregnant again. It should not be a problem if you will remember what we tell you or at least remember to call us if you forget what we tell you to do when you come for reversal of your tubal ligation.

When you think you may be pregnant after tubal ligation reversal you need to use one of the pregnancy tests that you can buy in the drug store or supermarket and test your urine. If the test is positive, you need to get a blood pregnancy test. The blood pregnancy test will not just be a yes or no, it will give a number. The number increases with time and when it reaches a certain level you need to get a vaginal ultrasound exam. Usually, when the blood pregnancy test is at a level of 1 to 2 thousand units [varies with different labs] the baby should be able to be seen with a vaginal ultrasound exam. Your doctor will know what to do to make sure everything is okay. We hope you come to Lakeshore for your tubal reversal, but even if you go somewhere else remember “urine, blood, vaginal ultrasound, right away”.

If it is determined that you have an ectopic pregnancy you can have one or possibly two doses of a medicine that will cause your body to absorb the ectopic so it will not continue to grow and ruin your fallopian tube.

We know from experience with patients that have only one tube reversed that this saves the tube. When a patient has only one tube for reversal, and gets an ectopic treated with medicine, they have only that tube to get pregnant with in the future. These patients prove the medicine works and saves the tube for another pregnancy.

The most important thing is speed. You cannot wait 3 weeks to get a blood pregnancy test. If an ectopic pregnancy is left that long the medicine may not work for you and you will need surgery to fix the problem and that will usually mean that you will lose a fallopian tube. Bottom line, you think you might have an ectopic and you forget this, you just call me.

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