Ectopic pregnancy is one of the violations of the early terms of the gestation process. A feature of the pathology is the absence of symptoms, so it is often found in complications - rupture of the fallopian tube and tubal abortion .
What is ectopic pregnancy?
From the definition, you can guess that this is a pregnancy outside the womb. There is a pathology in 2% of all pregnancies. There is a violation in the early stages, when the zygote starts its progression through the uterine tubes towards the uterus, but does not reach it. More often it remains in the fallopian tube, attaching to its wall. This is possible, and another option - ejection of the fetal egg in the opposite direction. In this case, implantation occurs in the ovary or abdominal cavity. The situation requires medical intervention and surgical treatment.
Ectopic Pregnancy - Species
Depending on where the implantation of the fetal egg took place, the following types of ectopic pregnancy are distinguished:
- Abdominal - fixation of the future embryo occurs in the cavity of the peritoneum (0.3% of all cases of ectopic pregnancy).
- Ovary - introduction of the fetal egg occurs in the wall of the sexual gland (0.2%).
- Pipe pregnancy is the most common option, when implantation occurs in the cavity of the fallopian tube (98% of cases).
- Neck - the fetal egg is localized in the cervical area of the uterus (0.01%).
- In the rudimentary horn of the uterus - pregnancy develops in women with pathology of the genital organ (0.25%).
- In the body of the uterus - 0.25%.
Causes of ectopic pregnancy
Women who face this pathology are often interested in the question: why develops an ectopic pregnancy? The answer to it physicians begin to search right after the course of therapy. This helps to prevent the re-development of the violation. Among the common factors provoking ectopic pregnancy, it is worth mentioning:
- presence of a history of abortion;
- endometriosis ;
- long-term use of hormonal contraceptives;
- use of intrauterine contraceptives;
- use of assisted reproductive methods (stimulation of ovulation);
- tumor-like processes in the uterus and appendages;
- transferred adnexitis ;
- malformations of the uterus ( saddle , two-horned);
- delay in the process of puberty.
How to determine an ectopic pregnancy?
It is almost impossible to independently determine a violation of a woman in her position. With such a pathology as an ectopic pregnancy, early signs are absent, and often it is masked by a normal physiological process. The woman fixes all the same changes as with normal gestation: a delay in menstruation, swelling of the mammary glands, a change in mood. In most cases, pathology is diagnosed when an abortion occurs-tubal abortion. For this state are characteristic:
- bleeding from the uterine cavity;
- pain in the lower abdomen;
- nausea;
- vomiting;
- blanching of the skin;
- increased heart rate;
- lowering of blood pressure.
Ectopic pregnancy lasts for a long time without manifestations. Symptoms of an ectopic pregnancy in the early term appear more often at 5-6 weeks. Suspect a violation of a woman can on the following grounds:
- pain in the lower abdomen, in the side, giving in the lower back and anus;
- hemorrhages - small in volume of vaginal discharge of bloody nature;
- a sudden change in health - dizziness, headaches, a slight increase in body temperature.
Does the test indicate ectopic pregnancy?
HGH hormone in ectopic pregnancy is also produced, so the usual pregnancy test will show a positive result. This device determines the relative level of the hormone in the urine. To determine whether an ectopic pregnancy is or not, you need to resort to a hardware examination - ultrasound.
However, in some cases, the result of an ordinary pregnancy test may indicate a violation. This is due to a slow rise in the concentration of hCG in ectopic pregnancy, therefore at 6-8 weeks of gestation the second band may be hardly noticeable. This fact should be the reason for contacting a doctor.
Pain in ectopic pregnancy
Calling the signs of an ectopic pregnancy, among the first doctors note painful sensations. They are localized in the lower abdomen, they often have a clear localization - depending on which oviduct in which implantation took place. The pains are noisy, have a variable intensity and are intensified with physical activity. Often, irradiation in the lower back, the area of the rectum can be fixed. Subsequently, the painful sensations are joined by spotting.
Monthly for ectopic pregnancy
After conception there is a reorganization of hormonal system, therefore in norm or rate monthly do not come. Synthesized in the body of pregnant progesterone stops ovulatory processes - the egg does not ripen, does not enter the abdominal cavity, so menstruation is not observed. This happens with normal pregnancy, but with an ectopic another picture is possible.
Often, women with this violation note the appearance of menstruation. At the same time, the character of menstruation changes - they are uninspired, of an ointment character, last 1-3 days. In addition, a woman may notice the appearance of bloody discharge, not associated with the menstrual cycle, which are accompanied by soreness. They are treated by doctors as symptoms of an ectopic pregnancy and are an indication for a referral to a specialist.
Ectopic pregnancy on ultrasound
Wishing to avoid a recurrence of pathology, women are often interested in doctors how to determine an ectopic pregnancy in the early stages. If there is suspicion, an ultrasound is assigned. It can be performed at 6-7 weeks (through the anterior abdominal wall) and even at 4-5 weeks (intravaginally). When conducting a doctor examines the uterine cavity for the presence of a fetal egg. With ectopic pregnancy, it is found in the tube, ovary, peritoneum, but not in the uterus. Among other symptoms indicative of ectopic pregnancy during ultrasound, the following:
- the size of the uterus does not match the deadline;
- there is liquid in the anterior space;
- there is a compaction in the intended place of implantation of the fetal egg.
Ectopic pregnancy - what to do?
The detected ectopic pregnancy in the early stages requires urgent medical intervention. If any of the signs described above are identified, a suspicion of a violation should be addressed to specialists. The choice of method of treatment depends on the time of treatment, the gestation stage and the period of pregnancy. With ectopic pregnancy, therapeutic interventions may include:
- reception of abortive medicines;
- surgical removal of the fetal egg;
- removal of fallopian tubes and appendages.
Ectopic pregnancy - operation
The method and scale of surgery is determined by the location of the fetal egg. The removal of the ectopic pregnancy that occurs in the tube involves a laparoscopy, which can be performed by two methods:
- Tubectomy - surgical intervention, accompanied by the removal of the uterine tube with a fetal egg.
- Tubotomy - removal of only the embryo, the fallopian tube remains.
When choosing a method, the doctors, in addition to the above, take into account the following factors:
- the patient's desire to have children in the future;
- degree of structural changes in the wall of the pipe;
- The presence of an adhesion process in the pelvic cavity, which increases the risk of repeated development of ectopic pregnancy.
Ectopic pregnancy - consequences
This violation leaves an imprint on the work of the reproductive system. When the first ectopic pregnancy is detected on time, the therapeutic measures are carried out correctly and on time, the woman has a high chance of repeatedly conceiving and normally taking out a healthy child. However, ectopic pregnancy, early signs of which are absent, is more often determined at the end of the first trimester. Detection of pathology in the late term, after 10 weeks, is fraught with the development of complications, unpleasant consequences, among which:
- uterine tube rupture;
- ovarian rupture;
- uterine bleeding.
These complications often require surgical intervention, during which a damaged tube or ovary is removed. This significantly reduces a woman's chances of a subsequent pregnancy. Many patients after a previous ectopic pregnancy face a diagnosis of infertility. The only solution to the problem in this situation is IVF.
Pregnancy after ectopic
Ectopic (tubal) pregnancy always requires interruption. This process negatively affects the reproductive system. A sharp change in the concentration of hormones in the blood leads to disruption of the hormonal system. Given this fact, doctors say that after an ectopic pregnancy it is possible to plan for conception not earlier than in 6 months.
It is worth noting that after the elimination of ectopic pregnancy, the signs and symptoms of which are named above, the chance to become a mother in women is preserved. The probability of conception depends on whether the oviduct or ovary has been removed together with the fetal egg. The removal of one of the organs reduces the probability of conception by 50%. Begin the process of preparation for the next pregnancy doctors recommend with a comprehensive survey and establishing the cause. In general, restorative therapy after an ectopic pregnancy includes:
- Admission of hormonal drugs.
- Course of anti-inflammatory drugs.
- Physiotherapy: UHF therapy, ultratonotherapy, electrostimulation, low-frequency ultrasound, laser stimulation.