Gynecology

Certain medications can indeed reduce the effectiveness of birth control pills. That is because they slightly reduce the hormone amounts absorbed by the system.

Among the suspect antibiotics are those in the penicillin family, including penicillin, amoxicillin, and ampicillin, as well as the antibiotics tetracycline, doxycycline, and erythromycin. Certain epilepsy drugs, tranquilizers, barbiturates, anti-inflammatories, and laxatives may also reduce the effectiveness of oral contraceptives.

Also called a tubal pregnancy, an ectopic pregnancy develops outside of the uterus. It usually occurs in the fallopian tube, but it can occur anywhere in the immediate area. A fetus cannot survive outside of the uterus.

Due to the restricted area in the fallopian tube, fetal growth cannot occur normally. As a result, the fetus may burst through the fallopian tube and cause internal bleeding. This is a medical emergency. If not treated promptly, ectopic pregnancy can result in the death of the mother.

Once diagnosed, there are treatment options for an ectopic pregnancy. Regardless of what type of treatment you and your physician choose, some form of treatment must be undertaken promptly.

If your ectopic pregnancy meets certain criteria, your physician may recommend treatment with methotrexate. This medicine is frequently used to treat cancer and arthritis, because it stops cells from dividing. When treating an ectopic pregnancy, methotrexate is given in doses much lower than those used to treat cancer, and therefore has few side effects.

The physician will give you an injection of methotrexate, then follow your hormone levels closely to be certain that the pregnancy resolves. If the levels do not decrease appropriately, you may need a second injection or surgery.

If you do not meet the criteria for use of methotrexate, your physician may recommend surgery.

Two surgical approaches can be used, depending on the seriousness of the situation. The first option is known as Laparoscopy. With laparoscopy, a small incision is made in or around your navel (belly button), and a small light is inserted into your abdomen. The fallopian tube can then be examined.

If necessary, your physician will make a few small incisions lower on your abdomen through which he or she can insert instruments and either remove the ectopic pregnancy or remove the entire fallopian tube. (You have two fallopian tubes, so one would remain.)

The second surgical option, although very uncommon in our practice, is known as a laparotomy. This involves making a large incision lower on the abdomen and removing the ectopic pregnancy or the fallopian tube. If the ectopic pregnancy has already ruptured (burst through the fallopian tube), this will be the quickest way to remove the fallopian tube and stop the bleeding.

If you suspect an ectopic pregnancy, it is important that you contact your doctor immediately.