What is the appropriate treatment for a ruptured ectopic pregnancy?

The appropriate treatment for a ruptured ectopic pregnancy is laparoscopic salpingostomy or salpingectomy. In cases of ruptured ectopic pregnancies, there is a risk of significant internal bleeding and the potential for life-threatening complications. Therefore, surgical intervention is usually necessary to remove the ectopic tissue and control bleeding.

Laparoscopic salpingostomy involves making a small incision to remove the ectopic tissue while preserving the fallopian tube if possible, whereas salpingectomy involves complete removal of the affected fallopian tube. The choice between the two surgical methods can depend on the specific clinical situation, including the extent of the rupture and the patient's desire for future fertility.

In contrast, medical management with Methotrexate is typically reserved for unruptured ectopic pregnancies where the patient is stable and there is no significant internal bleeding. Transvaginal delivery is not applicable in the context of an ectopic pregnancy, as ectopic pregnancies cannot be delivered vaginally due to their abnormal location. Observation and follow-up may be suitable for certain conditions, but in the case of a ruptured ectopic pregnancy, immediate surgical intervention is necessary to prevent complications.