Is an ectopic pregnancy possible? How to identify an ectopic pregnancy in the early stages, recognize the signs and symptoms, what are the causes and how to exclude it in the future. Genital anomalies

An ectopic pregnancy is a pathology in which the embryo is fixed outside the uterus and continues to develop.

The physiology of a woman is a surprisingly well-oiled mechanism in which all processes are closely interconnected and smoothly flow along the path outlined by nature. So, a mature egg leaves its follicle and rushes to the funnel of the fallopian tube. If here she meets a sperm, then they merge - fertilization occurs.

The embryo of a new life travels a long three-day journey through the fallopian tube before it reaches the uterus and is implanted into its wall. The peristaltic movements of the oviducts and the villi of their mucous membrane help him in overcoming this distance, carefully moving him to a place that will become the home of a developing and growing baby for the next 40 weeks.

But sometimes a malfunction occurs in this well-oiled process: the zygote never reaches the uterus and attaches itself in the wrong place - this phenomenon is called an ectopic pregnancy.

What is it and how is it dangerous

By the location of the embryo, ectopic pregnancy is classified into 6 types:

abdominal, when the embryo is attached to the peritoneum;
tubal - the most common option with the fixation of the embryo inside the oviduct;
cervical - with implantation of a zygote in the cervical region;
interconnection, with the location of the ovum on the serous membranes of the abdominal cavity;
ovarian;
with a pathological two-horned uterus, the embryo is able to anchor in one of its horns.

Developing according to the scenario of a normal pregnancy, an ectopic is capable of causing significant damage to women's health: the growing ovum compresses the surrounding tissues, which often leads to their rupture and internal bleeding. An interrupted ectopic pregnancy becomes a source of infection and intoxication, triggers the development of peritonitis. Therefore, identifying it in the early stages can literally save a woman's life.

Symptoms

Signs of early pregnancy are always individual, including the ectopic. As with normal conception, in the first 5-6 weeks a woman may feel malaise, nausea and dizziness associated with early toxicosis, but the most powerful argument is the absence of menstruation and a positive pregnancy test.

Signs of ectopic pregnancy are complemented by a number of alarming symptoms:

aching and pulling pain in the lower abdomen signals a stretching of the fallopian tube;
Lean menstruation with a positive pregnancy test, and sometimes bloody or brown discharge outside the cycle;
pain during an ectopic pregnancy can take on an acute, cramping character - and this is a very alarming sign, indicating a ruptured oviduct;
an integral symptom of internal bleeding, provoked by the detachment and death of the embryo, becomes weakness, pallor of the mucous membrane of the mouth and lips;
with an interrupted ectopic pregnancy, the ovum begins to disintegrate and provokes an inflammatory process in the abdominal cavity, therefore, a sharp increase in body temperature can become one of the signs.

The question of how to determine an ectopic pregnancy in the early stages, when it has not yet caused significant damage, remains open. After all, her symptoms are nonspecific and largely coincide with the early signs of a normal pregnancy.

The only way to reliably diagnose an ectopic pregnancy is an ultrasound of the genitals and abdominal cavity. With the help of the equipment, the specialist will see the location of the ovum, assess its size and be able to draw up a plan to get rid of the pathology.

Menstruation and ectopic pregnancy on the test

For the maternal organism, the embryo is a foreign body with a different genotype. Therefore, in order to protect it from the attack of the immune system, the body makes a number of rearrangements:

from the very moment of conception, the level of chorionic gonadotropin (hCG) rises in the blood - a hormone under the influence of which the corpus luteum of pregnancy ripens in the ovary;
the progesterone produced by this temporary formation inhibits ovulation and completely stops the cycle - which is why menstruation stops during pregnancy.

The same processes occur with an ectopic pregnancy. The only difference is that the level of hCG often fluctuates, and when the embryo dies, it decreases. Therefore, menstruation with an ectopic pregnancy can stop, as in the usual process of bearing a fetus. Much less often there are scanty spotting that does not correspond to the woman's calendar cycle.

Whether the test shows an ectopic pregnancy is an ambiguous question. In most cases, the hCG level by 5-6 weeks is high enough to clearly stain two strips of test. But in cases of an interrupted or frozen ectopic pregnancy, the result may be negative. Therefore, if 2-3 weeks ago the test was positive, but today it is negative and the body temperature is elevated, this is a good reason to contact a gynecologist.

Causes

Ectopic pregnancy is rare. It happens in only 2% of the total number of conceptions. And it is quite logical that there are prerequisites for its development, which must be taken into account along with the symptoms for an early diagnosis.

The fertilized egg is fixed in the fallopian tube or peritoneum only if it is not able to move further into the uterus - anatomical or physiological obstacles stand in its way:

Inflammation of the appendages and fallopian tubes. At the same time, their inner surface is covered with mucous exudate, the villi are partially destroyed and lose sensitivity. As a result, the processes that normally move the zygote to the uterus freeze, excluding the process of implantation of the embryo into the uterus.
Inflammatory processes experienced in the past. As a result, adhesions often form in the fallopian tubes, disrupting their patency.
Tumors. Benign and malignant, they are able to block the lumen of the oviducts and prevent the zygote from entering the uterus, or even completely push it back into the abdominal cavity.
Anatomical abnormalities. A bicornuate uterus, branched in two, and double fallopian tubes are developmental pathologies that are perfectly visible on ultrasound and serve as a reason for attributing a woman to a high-risk group.
Hormonal dysfunctions. Polycystic ovary disease, hormonal failure in the regulation of the cycle, and even a pathology of the thyroid gland can lead to a stop of the peristaltic movements of the oviducts, as a result of which the embryo will lose the ability to move into the uterus.

An additional risk factor is past illnesses and operations "on the female side". Any intervention and inflammatory processes can lead to the formation of adhesions and impaired patency of the fallopian tubes.

Elimination and rehabilitation

It is possible to get rid of an embryo located in the abdominal cavity or in the lumen of the oviduct only by an operative method. At the same time, the prognosis and treatment regimen largely depend on how long the pathology was detected:

With early detection, when the fallopian tubes are not yet deformed or ruptured, the prognosis is favorable. The patient is assigned a laparoscopic operation, during which the embryo is removed and the oviduct is sutured.
With significant deformities, the embryo is removed along with the fallopian tube, and sometimes the ovary. But the woman still has a chance for quick rehabilitation and childbirth.
The most unfavorable prognosis for a ruptured fallopian tube is that severe internal bleeding can be fatal. One of the negative scenarios is the development of peritonitis: inflammation of the peritoneum, in the absence of proper treatment, can lead to sepsis.

After the operation to remove the embryo, the woman is prescribed a course of antibiotics to prevent surgical infection, the introduction of isotonic solutions intravenously to restore the water-mineral balance, as well as enzymatic therapy to prevent the formation of adhesions in the operated tube.

Pregnancy after an ectopic pregnancy

Fortunately, the ovaries and oviducts are paired organs, so a woman will be able to give birth to a child and experience the joy of motherhood after an ectopic pregnancy, even after having survived the removal of one of the tubes. But surgical intervention, even if it was performed laparoscopically and did not leave scars on the body, has certain consequences for the body. The restoration of the epithelium and hormonal levels after the operation lasts about 6-12 months, therefore, during this period, repeated attempts at conception cannot be made categorically.

undergo a course of physiotherapy, which prevents the formation of adhesions and strengthens the health of the woman as a whole;
4-6 months after the operation, go to a sanatorium-resort treatment in a specialized institution;
protect yourself for 12 months after an ectopic pregnancy.

If you re-conceive a year later, you should immediately go to the gynecologist, undergo an ultrasound scan and register for pregnancy.

Ectopic pregnancy is a rare and dangerous pathology, in order to avoid complications of which you should consult a doctor immediately after the cessation of menstruation and receiving a positive pregnancy test. Early ultrasound diagnostics and registration will dispel your doubts.

An ectopic pregnancy is an abnormal condition that poses a serious threat to a woman's life. The place of localization of a fertilized egg is normally the uterus. If fixation occurs in any other place, this is a pathology and requires immediate intervention from doctors. The first signs of an ectopic pregnancy, if you know about them, should alert the woman and stimulate to make an appointment with a specialist.

During ovulation, a mature and fully formed egg leaves the ovary. It enters the tube, where the process of direct fertilization takes place. After the completion of conception, the zygote migrates into the uterine cavity. This phenomenon is facilitated by measured peristaltic contractions of the fallopian tubes and undulating swaying of the villi of the mucous membrane.

The journey is long, migration lasts about 3 days. This time is enough for the embryo to form special cells responsible for the secretion of a number of enzymes. With their help, the process of attachment to the mucous membranes of the formed zygote takes place.

If at one of the stages listed above, the zygote encounters mechanical or hormonal obstacles, the fertilization algorithm will be disrupted. The main reasons for the development of an ectopic pregnancy in the early stages are discussed in the table below.

The main reason	Pathophysiological aspects of the problem
Inflammatory processes of the uterine appendages	If one tube or both appendages were previously exposed to inflammatory processes, their functional qualities will be impaired. In the lumen of the hollow organs, adhesions, fibrous cords, scars are formed, which act as specific barriers at the time of the passage of the fertilized egg to the uterus. The pipes are not able to fully provide peristalsis for the advancement of the zygote. As a result, cells with enzymes for attachment are formed, and the egg is forced to attach at another location.
Inflammatory processes of the fallopian tubes	The reason is similar to the inflammatory processes in the appendages. The zygote cannot move to the uterus, since the nerve endings are lost, and the villi is partially destroyed. The transport function is impaired, which means that the egg cannot move to the uterus.
Anomalies of anatomy and development of organs, tissues, structures	Problems with anatomy or functional potential can arise even during intrauterine development. The most common form of deviations is "extra" pipes, additional holes in the appendages. The development of anomalies is due to a negative effect on the fetus during pregnancy - smoking and alcoholism of the mother, taking illegal drugs, harm to ionizing radiation.
Operative interventions	Any surgical interventions, like inflammatory processes, lead to the appearance of an adhesion process. If a woman has repeatedly undergone surgery, the patency of the tubes can be completely impaired.
Hormonal dysfunction	Unfavorable hormonal background adversely affects the functioning of all structures. The menstrual cycle malfunctions, the muscles become immobilized, the ability of the egg itself to the implantation process suffers. This pathology is considered the most common among young women capable of normal conception and childbirth.
Missing one of the pipes	If ovulation occurs on the side where the appendage is absent, the zygote must travel a longer path to the uterus. The main type of complications in women who have undergone the procedure for removing one tube is the risk of an ectopic pregnancy.
Tumors	If there is a malignant or benign neoplasm in the uterus or one of the appendages, it will also prevent the zygote from migrating normally into the uterus. Moreover, hormone-dependent tumors can cause significant hormonal imbalances throughout the body, further exacerbating the problem. Often, small tumors were detected only when the ectopic pregnancy itself occurred.

The development of an ectopic pregnancy may be due to localized tuberculosis or external endometriosis. Moreover, long-term treatment of infertility with hormonal drugs can also cause this specific problem.

Classification of ectopic conditions

Ectopic pregnancy is divided into several categories based on its signs and symptoms. The classification is arbitrary, but rather complicated.

Types of pathological conditions for the localization of the ovum:

pipe;
ovarian (intrafollicular and developing on the surface of the glandular organ);
abdominal (primary and secondary);
interlinking;
cervical;
implantation in the rudimentary uterine horn;
interstitial pregnancy.

By the stages of the course and how exactly the ectopic pregnancy manifests itself:

progressive pregnancy;
interrupted pregnancy;
an interrupted pregnancy.

Signs of an ectopic pregnancy

The early period (5-6th week) does not allow a woman to independently determine whether an ectopic pregnancy has occurred.

Primary signs are typical for everyone:

delayed pregnancy;
enlargement of the mammary glands, soreness;
first trimester toxicosis (nausea, accompanied by vomiting).

Most often, the diagnosis of an ectopic pregnancy is made when the symptoms already indicate the development of tubal abortion or other abortion scenarios. Progressive ectopic pregnancy, in which the fetus develops relatively normally in the initial stages, is established during the ultrasound examination.

At the same time, the task of the diagnostician was not always to find exactly "signs of pregnancy." The abnormal location of the ovum is most often detected during diagnostic measures to identify completely different pathological conditions.

If the pregnancy was not in the uterus and abruptly terminated, the symptoms will be as follows.

- the first dangerous sign by which it is possible to recognize various forms of ectopic pregnancy. If the pain is dull and persistent, a progressive tubal pregnancy may be suspected. The fruit grows, and over time it will be too cramped. The risk of pipe rupture will increase every day. Constant cramping pain, radiating to the lower back, indicates that the rupture has occurred.
The first signs of a progressive ectopic pregnancy that has already been interrupted is often associated with specific pain or discomfort in the anus. Women experience unusual pressure, as at the start of labor or before having a bowel movement;
Bloody issues appear at the moment when the roof from the pipe found a way out. Small smearing discharge of scarlet, brown, beige, which cannot be described as menstruation, is a formidable symptom. A woman should see a doctor immediately;
Signs of rapid progression internal bleeding, - pallor of the skin, hypotension up to the development of collapse, severe weakness, severe dizziness. There is no time to determine the exact cause of this condition - you must immediately call an ambulance.

If, among other things, the patient develops hyperthermia prone to progression, there is every reason to believe that an inflammatory process has begun in the body. This is a particularly difficult case requiring immediate treatment and long-term rehabilitation.

What will the test show?

Considering the question of what symptoms an ectopic pregnancy gives, what early signs are characteristic of this condition, it is worth considering separately the nuances associated with the use of the test. This type of fertilization causes a delay in menstruation. In the first expected cycle, allocations may still be. As a rule, they are scanty, of a specific color. "Pseudo-mentruation" comes at the wrong time and lasts only a couple of days.

This alarms the woman, since a normal cycle, in any case, cannot look like this. Alerted, patients often purchase a pregnancy test.

The test will be positive. However, with ectopic localization of the ovum, the second strip is usually indistinct, blurred. Experts attribute this to the fact that the level is lower if the zygote is attached to the tissues of the tube.

However, there are tests that help to recognize the abnormal pregnancy, as well as assess the risk of tube rupture. However, in order to acquire and conduct such a specific test, a woman needs to be on the alert, distinguishing between the usual and abnormal variants of the course of pregnancy.

Sad consequences

The consequences of an ectopic pregnancy include:

rupture of the tube with subsequent migration of the ovum into the peritoneal cavity;
termination of an abnormal pregnancy in any other way;
massive bleeding due to detachment of the fetus from the walls of the epididymis;
bleeding due to actual damage to the pipe, which can be fatal for a woman;
development of peritonitis if blood enters the abdominal cavity with the subsequent development of inflammatory processes.

Patient treatment

Treatment of an interrupted abnormal pregnancy is carried out exclusively by the method of salpingoectomy. The deformed tube is removed if the gestation period is relatively early. There are two reasons for this:

stop massive bleeding that cannot be controlled in any other way;
get rid of an organ that has completely lost its functional potential.

Distinguish between laparoscopic and laparotomic scheme of surgical intervention. The intervention itself is quite traumatic and requires the appropriate qualifications of a doctor.

If the tube has retained its integrity, treatment of an ectopic progressive pregnancy is carried out in other ways. A chemical substance is injected into the ovum for the subsequent medical hardening of tissues. Then, the walls of the tube are excised, followed by the removal of the fetus.

The fabrics are carefully sewn up. No specialist gives a guarantee that the pipe will ultimately retain at least a minimum permeability. As for scars and fibrous cords, they are formed as a natural reaction of the body to surgical interventions.

Rehabilitation and subsequent preparation for pregnancy

All rehabilitation measures are presented below.

Immediately after the operation, intensive infusion therapy is prescribed in order to correct the water-electrolyte balance.
Antibiotic therapy to prevent a number of postoperative complications.
Stabilization of hormonal levels.
Contraception 6 to 12 months after surgery.
Prevention of adhesions using enzyme preparations.
Physiotherapy treatments for general health improvement.

Provided that the woman has at least one tube with optimal patency, the likelihood of getting pregnant in the future is quite high. The optimal period for re-conception is 1 year after surgery. In general, the prognosis is favorable, but on condition that the ailment was identified quite quickly and really professional help was provided.

02/04/2018 02/10/2018 Olga Migunova

What is an ectopic pregnancy?

An ectopic pregnancy is an abnormal, abnormal condition for the female body - this pregnancy carries with it a serious danger, up to and including death. With the correct development of pregnancy, the fetus is in the uterus, this is a location conceived by nature for it. If the ovum is fixed in some other organ, then this is always a pathology that requires immediate surgical intervention. That is why if you notice signs of an ectopic pregnancy in your early stages, then you definitely need to make an appointment with a gynecologist. After all, the more the fetus develops in this state, the worse it will affect your health.

State concept

The development of the fetus takes place in the uterine cavity. During the normal course of pregnancy in the fallopian tube, the egg is fused with the sperm. This is how her fertilization takes place. Then it begins to divide and move into the uterus, where it is implanted and further developed. The gestational age is determined by the size and location of this genital organ.

In the absence of pregnancy, the uterus is located in a small pelvis, its size is 5 cm wide and about 7 cm long. During pregnancy at 8 weeks, it reaches the size of a woman's fist. In addition, it shifts upward in the abdominal cavity. So at 40 weeks, its bottom is fixed just above the navel.

If, for some reason, the egg does not enter the uterus from the fallopian tube, a tubal pregnancy develops. It is extremely rare that other forms of pathology are diagnosed - in the abdominal cavity or in the ovary.

Recently, an increase in the number of cases of the development of such a disease has been recorded. In about 20% of women, the recurrence of such a pathological condition is noted, which leads to absolute infertility. Scientists have proven that women from 25 to 40 years old most often develop a right-sided ectopic pregnancy.

Types of ectopic pregnancy

Ectopic pregnancies are named according to where the fetus is located. The types of these pregnancies are:

ovarian (the fertilized egg is not in the uterus, but remains in the space of the follicle);
tubal (due to poor patency of the fallopian tubes, the embryo remains in one of the tubes);
abdominal (the embryo is in the peritoneal cavity);
cervical (the fetus is in the cervical canal of the uterus);
intersligamentous (the embryo is attached to the serous membranes of the abdominal cavity);
implantation in the rudimentary uterine horn (belongs to the most dangerous types of ectopic pregnancy, there is a serious risk of uterine rupture);
interstitial pregnancy (a fetus in the interstitium of the fallopian tubes, a very rare type of ectopic pregnancy).

Ectopic pregnancy, like any pathology, has its own stages of development. Which the further, the more dangerous it is for the woman's body - therefore, if you notice at least some symptoms of an ectopic pregnancy at an early stage, then urgently go to an appointment with a specialist. This is a deadly anomaly for a woman's body, so caution should not be neglected.

What will the test show?

This alarms the woman, since a normal cycle, in any case, cannot look like this. Alerted, patients often purchase a pregnancy test.

The test will be positive. However, with ectopic localization of the ovum, the second strip is usually indistinct, blurred. Experts attribute this to the fact that the level of hCG is lower if the zygote is attached to the tissues of the tube.

Stages of an ectopic pregnancy

progressive (occurs at normal physiological terms); the embryo, as it grows, squeezes the surrounding tissues, rupture of these tissues and bleeding is possible;
intermittent (interrupted on its own, can cause rupture of the fallopian tube); the fetus carries an infection, intoxication for the rest of the body. Peritonitis often develops from this state;
interrupted (up to 6 weeks, medical abortion is possible, then an operation becomes necessary).

An ectopic pregnancy, which in the beginning proceeds in the same way as a standard pregnancy - as the fetus grows, it can cause serious damage to the female body: the embryo, as it grows, squeezes the surrounding tissues, which entails the possibility of rupture of these tissues and threatens with internal bleeding. After such a pregnancy is spontaneously interrupted, the fetus carries with it infection and intoxication for the rest of the body. Peritonitis often develops from this condition. That is why it is so important not too late to identify the signs of an ectopic pregnancy in the early stages - this can save your life in the truest sense of the word.

It is very important to identify an ectopic pregnancy in time. Signs of this condition are difficult to determine. Therefore, at the slightest suspicion, contact a gynecologist who can literally save your life.

Preservation of appendages

An ectopic pregnancy requires urgent surgery. The most common surgery is to remove the fallopian tube, called salpingectomy, because the tube is so damaged that a subsequent pregnancy may be ectopic again.

But in some situations, doctors decide to save the tube and perform an operation, which in medical terminology is called salpingotomy. It involves cutting the tube, retrieving the fertilized egg, and suturing. Such an operation is performed when the egg does not exceed 5 cm in diameter, and the patient is in a normal state and wants to preserve fertility.

Sometimes a segmental pipe removal is performed, that is, only the part that has been damaged is removed.

If an ectopic pregnancy was established in the early stages, then drug treatment can be applied. To do this, the drug Methotrexate is injected into the tube cavity, which dissolves the fertilized egg.

Maintaining the patency of the tubes after the operation is possible in the following situations:

Getting out of bed early immediately after the operation, that is, the sooner the patient does it, the better (early getting up is the prevention of adhesions).
Physiotherapy treatment.
Adequate rehabilitation.
The absence of infectious diseases after surgery.

Signs of an ectopic pregnancy

Trying to independently answer the question: "How long does an ectopic pregnancy manifest itself?", A woman is trying to find the distinctive features of this condition. However, this is quite difficult to do.

And yet, there are some symptoms of an ectopic pregnancy that may prompt you to urgently see a gynecologist for up to 5-6 weeks:

delayed pregnancy;
painful enlargement of the mammary glands;
toxicosis of the first trimester (severe nausea, accompanied by vomiting).

How to identify an ectopic pregnancy?

If you have an ectopic pregnancy, symptoms will indicate that tubal abortion is already developing or other scenarios. Progressive ectopic pregnancy, in which the fetus develops relatively normally in the initial stages, is established during the ultrasound examination. The abnormal location of the ovum is most often detected during diagnostic measures to identify completely different pathological conditions.

Danger

Pathological pregnancy is dangerous for its complications. The most common ones are:

Re-emergence of pregnancy outside the uterus.
Intestinal obstruction and postoperative inflammatory process.
Infertility.
Adhesions.
Heavy bleeding.
Death.

The most common treatment is for a woman with an ectopic pregnancy to have a tube removed during surgery. She is advised not to become pregnant for six months, to undergo tests for the presence of infections, to treat them (if found). But not even 6 months have passed, and some patients return to the hospital with pregnancy outside the uterus, but in a different tube.

Early signs of an ectopic pregnancy:

persistent mild pain in the lower abdomen can tell you about the stretching of the fallopian tube;
mild menstrual flow with a positive pregnancy test (like any brown or reddish discharge outside of menstruation);
cramping pain in the abdomen - often indicates a ruptured oviduct;
a clear sign of the presence of internal bleeding, due to the detachment and death of the embryo, this is severe weakness and severe pallor;
if the ectopic pregnancy is interrupted by itself - the fetus disintegrates, which provokes inflammation in the abdominal cavity, this may be reported to you by a rapid rise in temperature.

Sad consequences

The consequences of an ectopic pregnancy include:

rupture of the tube with subsequent migration of the ovum into the peritoneal cavity;
termination of an abnormal pregnancy in any other way;
massive bleeding due to detachment of the fetus from the walls of the epididymis;
bleeding due to actual damage to the pipe, which can be fatal for a woman;
development of peritonitis if blood enters the abdominal cavity with the subsequent development of inflammatory processes.

Causes of an ectopic pregnancy

The very fact of an ectopic pregnancy is a rather infrequent occurrence. Such pregnancies account for only 2% of all pregnancies that occur. It is imperative to bear in mind that there are quite serious prerequisites for the occurrence of such a pathology as an ectopic pregnancy.

The embryo is attached to a place of the female body that is not intended for it only if there are some physiological obstacles on the way to the uterus.

The variations of these obstacles are quite extensive:

inflammation of the female organs that you have encountered before (their consequence is adhesions that interfere with their patency);
inflammatory processes in the fallopian tubes and appendages, which is why their inner side is covered with mucous secretions, from which the villi are destroyed and begin to lose sensitivity (as a result, the processes that normally move the zygote to the uterus freeze, which prevents the ovum from entering the uterus);
tumors of a different nature (they can block the path of the embryo to the uterus, pushing it to the abdominal cavity);
any hormonal abnormalities (polycystic ovary syndrome, hormonal disorders of the cycle and the thyroid gland can help stop the movement of the oviducts, as a result of which the ovum will not be able to reach the uterus);
non-standard arrangement of organs (deviations from the norm, which are immediately noticeable on an ultrasound scan and place this woman in a group of increased risk for the occurrence of an ectopic pregnancy in her, signs in the early stages of which are an occasion to urgently come for an examination to a specialist);
transferred sexual diseases (they disrupt the normal functioning of the body and often have their own unpleasant consequences, such as the appearance of adhesions in the fallopian tubes);
operations involving female genital organs (including past abortions).

Effects

An ectopic pregnancy can seriously affect a woman's health.

Typical consequences:

A significant decrease or complete disappearance of fertility due to the removal of the fallopian tube, ovaries or any other important organ for medical reasons;
Broad spectrum neuroendocrine and vascular disorders;
A significant increase in the risks of the formation of a second ectopic pregnancy in case of conception;
Adhesion processes in the small pelvis;
Numerous regular bacterial infections of the genital organs, due to a decrease in the level of local immunity;
Death in the absence of qualified medical care in case of spontaneous miscarriage or rupture of the fallopian tube.

Pregnancy after ectopic

If a woman has her first ectopic pregnancy without complications, then the chances of a subsequent successful normal conception in the uterus are estimated by modern statistics at 50 percent - while every fifth woman is diagnosed with a second ectopic pregnancy, and a third becomes completely infertile.

In the case of complications, poorly transferred operations, the presence of scars and adhesions, direct removal of one fallopian tube and other negative aspects, the chances of subsequent childbirth are rapidly falling.

Does the test show an ectopic pregnancy?

The mother's body perceives the embryo that has been born in it - nothing more than a foreign object that can pose a threat. That is why, to protect the embryo from a possible attack on it from the side of immunity, the body is rebuilt.

HCG in ectopic pregnancy: how is the restructuring

from the moment of conception, the level of chorionic gonadotropin (hCG), a hormone that directly affects how exactly the corpus luteum of pregnancy matures in the ovary, increases in the blood;
the hormone progesterone, which the corpus luteum produces, stops ovulation and stops the cycle (which is why menstrual flow during pregnancy is interrupted);

During the occurrence of an ectopic pregnancy, the same thing happens. The only clear difference is the fluctuating level of hCG (with the death of the embryo, hCG sharply decreases). In view of this, menstruation stops with an ectopic pregnancy - just as it happens with a standard pregnancy. Sometimes there may be small spotting, but they will not coincide with the days of the expected menstruation, but appear chaotically. This is one of the clear signs of an ectopic pregnancy in the early stages - therefore, you should, at least, alert you.

Will the test show an ectopic pregnancy? It depends on many factors. In most cases, hCG rises to a very high level by 5-6 weeks - for this reason, the classic two stripes will be reflected in the test. Exactly the same as it shows in a standard pregnancy. However, if the ectopic pregnancy is frozen or interrupted, the test may show a negative result. If you did tests to detect pregnancy in different periods - and each time you got different results, this is a reason to urgently go to the gynecologist and do an ultrasound of the female organs. A negative test after several positive tests that were carried out before can mean the death of the fetus. This is also evidenced by a fever, weakness, pallor unusual for you. With an ectopic pregnancy, such a spontaneous cessation of the life of the embryo often occurs, and if you do not notice this, then you have a serious risk of infecting the body with the decomposition products of the embryo.

When can pathology be diagnosed

How long can be critical for a patient with an ectopic pregnancy? The most unpleasant and dangerous period is considered to be from 3 to 6 weeks. If an abortion (spontaneous) occurs, the disease becomes apparent.

Diagnosis of an ectopic pregnancy is carried out at a certain time

An alarming bell in determining pregnancy when analyzed for hCG can be called the absence of any signs indicating pregnancy during an ultrasound scan. If the ovum is located in the embryonic horn of the uterine cavity, the definition of pathology is much more difficult and it can only be detected at 10 - 16 weeks.

What will the test show?

As in the normal development of pregnancy, menstruation in the early stages of the ectopic can be: they have a smearing consistency and unusual for normal menstruation, color. As a rule, they do not last long - only a couple of days, although they come on time. This is the first sign, because with normal menstruation this cannot be.

The first thing most girls do is buy a test. In any case, its result will be positive, but in our case, the second strip will be a little blurry and without clear contours. This is due to the fact that the level of hCG is still much lower, since the zygote is localized to the tubal tissues.

There are specially designed hypersensitive tests that differ in the recognition of various pathologies. However, it must be done on time and it has a rather high price.

Differential diagnosis

Recall that the most effective way to determine WB is to conduct an ultrasound examination. To distinguish it from appendicitis or ovarian apoplexy, it is necessary to draw up a whole protocol, which indicates the main characteristics and features of the pathology.

Puncture

Another reliable way to check for an ectopic pregnancy is to take a puncture of the Douglas space. What is meant? A small area between the uterus and the anterior surface of the rectum. By piercing the posterior fornix of the vagina, the doctor removes the fluid for further examination in the laboratory.

Accurate diagnosis can only be made after the results are obtained.

Corpus luteum with WB

The corpus luteum is a specific gland that is produced during ovulation, and in turn produces progesterone. After the exit of the corpus luteum for 14 days, the egg must be fertilized. If this does not happen, the VT dies.

In the event of conception and pregnancy, they continue to produce progesterone. If, after ovulation, after 14 days menstruation does not occur, and the ultrasound examination does not show the presence of pregnancy, the latter can be determined by the presence of this gland. Thus, an ectopic pregnancy can also be determined.

Use of laparoscopy

Laparoscopy is one of the most effective modern medical techniques that help identify a fairly large number of women's health problems. This technique belongs to the category of minimally invasive, with its help you can not only determine, but also remove the embryo. This is one of the safest ways to treat pathologies, including ectopic pregnancy.

Basal temperature in an ectopic pregnancy

In the first phase of oocyte development, there are no differences between an ectopic and a normal pregnancy: basal temperature indicators range from 36.2 to 36.5 ° C. The indicators during the periods of ovulation and conception also do not differ: first there is a decrease, and then - an increase to 37-37.5 ° C.

The differences can be seen a little later. With normal implantation of the ovum in the uterus, which occurs 7-10 days after the release of the cell, a decrease in temperature should occur. In basal temperature values during an ectopic pregnancy, this does not happen. However, this is a weak argument for comparison, since everything depends on the individual characteristics of the woman.

However, you should be aware that a decrease in temperature indicates a decrease in the level of progesterone in the blood and may be a sign of a frozen fetus at 1 month or 5 weeks. In case of detachment of the fetus or rupture of the place of its attachment, in addition to severe pain in the lower abdomen and dark discharge, an increase in temperature readings above 37.5 ° C, and sometimes up to 38 ° C, is recorded. This is due to the inflammatory process due to the flow of blood.

Prevention of pathology

To prevent pregnancy outside the uterus, the following rules must be followed:

Prevent the development of inflammation of the organs of the genitourinary system, treat them on time.
Before planning a pregnancy, undergo an examination, including an analysis for the presence of microbes such as chlamydia.
Protect yourself from unwanted pregnancy by using quality contraceptives.
Avoid abortion.
If it is necessary to terminate a pregnancy, you should choose gentle methods and do it at the optimum early time (up to 8 weeks). Vacuum abortion shortens the operation time, after which fewer complications develop.
You can use medical termination of pregnancy, but drugs are taken under the supervision of a physician.
After a pathological pregnancy, it is necessary to undergo a rehabilitation course, be observed by a gynecologist, and follow all his recommendations. A pregnancy can be planned about a year after the operation.
If pregnancy occurs, it is necessary to register with a antenatal clinic in the early stages.

Prompt elimination of ectopic pregnancy

To remove from a woman an embryo that is incorrectly located inside her abdominal cavity or in one of the tubes - alas, it is possible only by surgery. The way to quickly eliminate this pathology entirely depends on how long you have discovered that you have an ectopic pregnancy, which is why try to pay attention to all the signs of an ectopic pregnancy in the early stages that you notice.

Ectopic pregnancy: surgery and its options

Most often, a woman is worried about the question: "If I have an ectopic pregnancy, how long does the operation take?" The duration of the operation depends on the duration of the diagnostic manipulations and the patient's condition, but on average it ranges from 15 to 60 minutes.

The most successful option is if an ectopic pregnancy is detected at an early stage, when the fallopian tubes are not yet ruptured, deformed and serious harm to the body has not yet been done. With this option, a laparoscopic operation is prescribed, in which an incision is made no more than 1.5 cm (the embryo is removed in the process, the oviduct is then sutured).
A less successful option, but not yet the most alarming, is if the fetus has already inflicted impressive deformations on the body, then the embryo is removed along with the fallopian tube, or even together with the ovary (however, the woman has the opportunity to become pregnant and bear the baby normally).
The most unfavorable option is if the fallopian tube has already ruptured - after all, severe internal bleeding can lead to death. There is also a significant risk of peritonitis, which can result in sepsis. That is why it is so important to notice the symptoms of an ectopic pregnancy at an early stage in time!

After the operation, the woman must be prescribed restorative procedures:

a course of antibiotics (to avoid the likelihood of postoperative infection);
a course of droppers, where she will be injected intravenously with isotonic solutions to restore the water-mineral balance in the body;
a course of enzyme preparations (in order to avoid the possible formation of adhesions in the tube that was operated on).

Treatment

With early diagnosis of pathology (before rupture or damage to the walls of the fallopian tube), medications are prescribed. Methotrexate is recommended for abortion and is limited to one or two doses. When diagnosed in the early stages, surgical intervention is not required; after taking the drug, a second blood test is performed.

Methotrexate terminates pregnancy under certain conditions:

the gestational age does not exceed 6 weeks;
the indicator of the analysis of human chorionic gonadotropin is not higher than 5000;
absence of bleeding in the patient (smearing discharge);
lack of cardiac activity in the fetus during ultrasound examination;
there are no signs of rupture of the fallopian tube (no intense pain and bleeding, blood pressure readings are normal).

The medicine is administered intramuscularly or intravenously, the patient is under observation during the entire period. The effectiveness of the procedures performed is assessed by the level of human chorionic gonadotropin. A decrease in hCG indices indicates a successful treatment option; along with this analysis, the functions of the kidneys, liver and bone marrow are studied.

The use of methotrexate can cause side effects (nausea, vomiting, stomatitis, diarrhea, etc.) and does not guarantee the integrity of the fallopian tubes, the impossibility of tubal abortion and massive bleeding.

If an ectopic pregnancy is detected late, surgery is performed. A gentle option is laparoscopy; in the absence of the necessary instruments, a full-fledged abdominal operation is prescribed.

Two types of surgical intervention are performed by laparoscopy:

Salpingoscopy during ectopic pregnancy is one of the sparing operations and preserves the possibility of further childbirth. The embryo is removed from the fallopian tube through a small opening. The technique is possible when the embryo size is up to 20 mm and the ovum is located at the far end of the fallopian tube.
Salpingectomy for ectopic pregnancy is performed with significant stretching of the fallopian tube and the possible risk of rupture. Excision of the damaged part of the fallopian tube takes place, followed by connection of healthy areas.

Surgery for pathological pregnancy is carried out urgently or as planned. In the second option, the patient is prepared for surgery using the following diagnostic procedures:

blood test (general analysis);
identification of the Rh factor and blood group;
consultation with a therapist;
consultation with a gynecologist.

Rehabilitation period

The period after the operation, normalizes the general condition of the woman's body, eliminates risk factors and rehabilitates the reproductive functions of the body. After the operation to remove the ovum, a constant check of hemodynamic parameters should be carried out (to exclude internal bleeding). In addition, a course of antibiotics, pain relievers and anti-inflammatory drugs is prescribed.

Monitoring the level of chorionic gonadotropin is carried out weekly and is due to the fact that with incomplete extraction of particles of the ovum and accidental introduction to other organs, a tumor may develop from chorionic cells (chorionepithelioma). With normatively performed surgical intervention, the level of chorionic gonadotropin should be reduced by half in relation to the initial data. In the absence of positive dynamics, Methotrexate is prescribed, and with continuing negative results, a radical operation with the removal of the fallopian tube is required.

In the postoperative period, physiotherapeutic procedures with the use of electrophoresis and magnetotherapy are recommended for the fastest restoration of the functionality of the patient's reproductive system. Combined oral contraceptives are prescribed to prevent pregnancy (for at least six months) and to establish a normal menstrual cycle. Re-pregnancy, which occurred in a short time after a pathological ectopic pregnancy, carries a high level of a high level of re-development of this pathology.

Primary prevention

A constant partner and safety of sex (use of personal protective equipment) reduces the risk of sexually transmitted diseases, and with them possible inflammation and scarring of the tissues of the fallopian tubes.

It is impossible to prevent ectopic pregnancy, but a dynamic visit to a gynecologist can reduce the risk of death. Pregnant women included in the high-risk category should undergo a full examination to exclude a belated determination of an ectopic pregnancy.

To reduce the risk of an ectopic pregnancy, you should:

to deal with the treatment of various infectious diseases of the genital organs in time;
in case of in vitro fertilization with the required frequency, undergo an ultrasound study and take tests for the content of chorionic gonadotropin in the blood;
when changing a sexual partner, it is imperative to undergo tests for a number of sexually transmitted diseases;
use combined oral contraceptives to avoid unwanted pregnancy;
treat pathological diseases of the internal organs in due time, preventing the disease from flowing into a chronic form;
eat right, adhering to the most suitable diet for the body (without being carried away by excessive weight loss and spasmodic gain or weight loss);
correct existing hormonal disorders with the help of specialized specialists.

At the slightest suspicion of an ectopic pregnancy, an urgent appeal to the gynecological department is required. The slightest delay can cost a woman not only loss of health, but also the occurrence of infertility. The worst case for rash delay can be death.

Normal pregnancy after ectopic pregnancy

Due to the fact that the ovaries and oviducts are located in the female body in two, the woman has the opportunity to become pregnant even after removing one of the fallopian tubes. However, any surgical intervention (even an operation that does not leave noticeable marks on the body) is a serious stress for the female body. For a normal recovery, he will need from six months to a year - and during this period, categorically repeat the attempt to get pregnant. The body needs time to restore the level of the epithelium and adjust the hormonal background disturbed by the operation.

it is imperative to conduct a course of physiotherapy, which helps to prevent the formation of adhesions and helps to strengthen women's health;
six months after the operation, it is recommended to go to a sanatorium or a recreation center (fresh air and vivid emotions will create a favorable background for future pregnancy);
it is imperative to strictly protect yourself for at least a year after the elimination of an ectopic pregnancy.

The next conception should occur at least a year later, after which you should immediately go to the doctor's office, do an ultrasound scan and closely monitor the further course of pregnancy until delivery. And watch out for possible early ectopic pregnancy symptoms! Remember that it is at an early stage that this pathology is the easiest to eliminate, and you can avoid serious harm to the body.

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Risk group

There are several factors that can contribute to the development of pregnancy outside the uterus. Women whose risks are increased should be especially carefully monitored for the symptoms of such a pathology. Common causes of ectopic pregnancy:

Genetic predisposition. If there have been cases of ectopic pregnancy in the family, the chance of its development increases.
Premature sexual intercourse.
High sexual activity and promiscuous communication.
Over 35 years old.
Venereal diseases.
Congenital anomalies of the female genital organs.
The use of an intrauterine device as a method of contraception.
Inflammatory processes of the ovaries and fallopian tubes, operations. In these cases, adhesions may form, causing obstruction of the fallopian tube.
Hormonal Disorders.
Frequent abortions.
Slow partner sperm.
Infertility treatment.
IVF procedure.

The presence of these factors may not necessarily lead to the development of an ectopic pregnancy. But even in their absence, its occurrence is not excluded. It happens that the embryo develops outside the uterus for no apparent reason.

Diagnostics

Diagnostics of the developing process of pathological localization at the initial stages is difficult, due to the absence of obvious specific symptoms. An ectopic pregnancy may be suspected when:

the presence of risk factors;
delayed menstruation and the presence of dubious and reliable signs of pregnancy itself;
even a slight soreness over the bosom, or, even more so, the appearance of bloody discharge.

Will the test show an ectopic pregnancy? There are various rapid tests designed for home use. They are based on the determination of hCG (human chorionic gonadotropin) in the urine. But the "home" express method is only qualitative, not quantitative testing, that is, it only determines the presence of an increased amount of hCG, and not its numerical value. Therefore, this method cannot serve as a source that suggests the presence of ectopic implantation of the ovum.

Conducting a quantitative blood test for hCG during an ectopic pregnancy can serve as an important objective confirmation of its development. Human chorionic gonadotropin is a hormone produced by the fetal membrane of the embryo and provides a relationship between a woman and her unborn child. Normally, its concentration in the blood is less than 5 IU / L. It begins to rise in the very early stages of pregnancy. From the 6-8th day after fertilization, by the end of the third week, hCG increases from 5.8 to 750 IU / L, reaching 155,000 IU / L by the 8th week.

The amount of the hormone between the second and fifth weeks of a normal pregnancy doubles every 36 hours. Determination of it in the blood is the most reliable in terms of diagnosing its early stages.

If the initial content of the hormone in the blood is below the norm corresponding to the gestational age, or the increase in its concentration in 3 studies is slower than normal, then this most likely suggests the presence of ectopic implantation and the development of the embryo, the threat of interruption, placental insufficiency, undeveloped pregnancy. The informativeness of the method is 96.7%.

To clarify the diagnosis, an ultrasound examination is carried out, with the help of which it is still impossible to determine the localization of the ovum. But scanning provides an opportunity for indirect signs to suggest the presence of pathology. If necessary, a diagnostic laparoscopy is performed, which makes it possible to more accurately determine the place of implantation of a fertilized egg.

Consequences and prognosis

The risk of this pathology appearing again is quite high, but much depends on the woman's health. A good prevention can be a rejection of bad habits, regular examination by a gynecologist.

The main question that interests a woman after surgery is whether she will be able to have children. The most important thing in this case is to establish the presence of pathology in a timely manner. If after the operation all internal organs are preserved, then there is a chance to give birth to a healthy child.

The chances of getting pregnant in a woman with the removal of one ovary are reduced several times. But it is necessary to undergo examination of the second tube and the other ovary. Cases have been repeatedly recorded when a woman had a chance to become a happy mother.

Can I get pregnant after?

Not all women know if it is possible to get pregnant after an ectopic pregnancy. Many people think that after it they become sterile.

In order to preserve fertile function, an incision of the fallopian tube is performed to extract the fetal tissue. Conditions for manipulation:

fetal egg up to 5 cm;
no pipe rupture;
HCG up to 15 thousand international units.

After the operation, the tube is sutured, and pregnancy becomes possible again. In case of rupture, the affected organ is removed. Even after such an intervention, a healthy fallopian tube remains on the opposite side.

Infertility occurs after extirpation of the uterus in order to eliminate massive bleeding, but the need for this arises mainly with the cervical localization of the embryo.

Stages of development

Such branches of medicine as obstetrics and gynecology are engaged in ectopic pregnancy. For the convenience of making a diagnosis, doctors divide WB into several stages of development.

The dynamics of development can be as follows:

Progressive pregnancy (early stage).
Pregnancy at risk of termination (interrupted). This is a condition in which the fallopian tube bursts or the embryo spontaneously rejects;
Completely terminated ectopic pregnancy.

In addition, there is a condition in which there is a pathological attachment of two fertilized eggs at once in different parts or multiple pregnancy, during which one of the fertilized eggs is fixed in the uterus, and at the same time another cell is attached outside of it.

How long does the fallopian tube burst?

An ectopic pregnancy requires the earliest possible medical approval. The tubes in which implantation most often occurs are not designed by nature for carrying a child. They are not made of elastic tissue like the uterus. When the fruit grows, they cannot withstand the stress and are torn.
How long does it take for this to happen? Most women think that in the first days, weeks, even months after conception, this cannot happen, so they are in no hurry to see a doctor. But the risk of an ectopic embryo exists at the earliest possible date.

What week does the pipe rupture occur? On average, an ectopic or ectopic pregnancy lasts 4 to 12 weeks. From the place of attachment of the ovum depends on how long the pathology will develop.

Rupture of the fallopian tube

Early rupture is possible with a small diameter pipe at the site of implantation. So, in its isthmic part, stretching is possible by a maximum of 2 mm. Then the rupture of the pipe occurs at 4-6 weeks. A tubal abortion can happen even earlier. This interrupts the ectopic conception itself.

The lowest risk for a woman in a situation where the embryo is attached to the lower (interstitial) part of the fallopian tubes. This area is directly adjacent to the uterus, so it is the most elastic.

How long does it take to break in this case? Sometimes the pipe does not burst even when stretched up to 5 mm. On average, the time when it ceases to withstand the growth of the embryo is 8 - 12 weeks.

How interrupt

The termination of such a pregnancy always occurs, the fetus inevitably dies, this is carried out, as a rule, for a period of up to 10 weeks. There are two ways: medical and surgical. Laparotomy (removal of the embryo after opening the abdominal wall) is used in emergency cases. It all depends on the duration of pregnancy, the presence of complications and other factors.

Medication interruption

Drug therapy is effective in the early stages and involves the use of drugs, the action of which provokes a spontaneous abortion. The fetus exits the body safely on its own. Such treatment does not have a negative effect on the successful further conception.

Surgery

Surgical intervention is indicated for developing and interrupted ectopic pregnancy, rupture of the fallopian tube, internal bleeding. Laparoscopy is the most accurate way to retrieve an embryo.

Is it possible to keep the pregnancy

Most doctors give a negative answer to the question of whether it is possible to give birth with an ectopic pregnancy, whether it is possible to maintain it. In a woman's body, only the uterus is designed for the full development of the embryo. If the process is carried out outside of it, it is a pathology, a complication of pregnancy, which leads to sad consequences if it is not eliminated in time.

A zygote implanted in the oviduct, ovary or other places outside the uterus grows, stretches and injures nearby tissues, and this provokes internal bleeding.

You need to carry out the operation as early as possible. In this case, there is a chance to save the fallopian tube, although basically the oviduct is amputated along with the ovum - this is a necessary measure.

It is also important to remember that an ectopic pregnancy cannot go into a uterine pregnancy.

Surgery

Previously, in most cases, laparotomy was used. For this it was necessary to open the anterior abdominal wall. Recently, this method has been used very rarely only in an emergency or when there is no other equipment in the clinic.

The main purpose of the operation is to remove the embryo. The fetus cannot be saved, since it cannot grow into a child. But it is possible to harm a woman's health or even lead to death.

The most commonly used is laparoscopy. To do this, a small incision is made on the skin and a special instrument is inserted. The doctor monitors the progress of the operation on the monitor of the device. After that, no scars remain on the woman's body, since the incision is very small. And if during laparotomy the embryo was removed along with the tubes or ovaries, now during laparoscopy the operation is performed without trauma to the tubes. After rehabilitation, after a short time, a woman can become pregnant again.

In recent years, pipe removal surgery has been used less and less and is practiced only in advanced cases. It is prohibited to carry out it in the presence of the following complications:

oncology;
intestinal obstruction.
acute inflammatory process;
problems with blood clotting;
diseases of the cardiovascular system.

Surgical intervention can be performed in several ways:

Tubotomy. The tube is cut where the ovum is located. It is removed, and the pipe itself is stitched. In the presence of a large embryo, part of the tube is removed, but the woman still has the opportunity to become pregnant.
Extrusion. If there is a fruit close to the pipe, it is simply squeezed out. This is done only if the fruit is whole and is close to the exit.
Tubectomy. In the case when it is impossible to eliminate the fetus, but it is impossible to leave the pipe, it is necessary to remove it.

What to do

The fertilized egg from the fallopian tube travels to the uterus, where it develops normally. If there are any abnormalities in a woman's body, the embryo is attached outside the uterus, most often on the wall, on the cervix. There he cannot develop normally due to the anatomical structure of organs that are not intended for this. Therefore, in order to prevent complications threatening the mother's life, medical intervention required

If the diagnosis is confirmed, the woman will have to undergo surgery or take special medications under the supervision of a doctor.
As a result of taking the pills, the ovum dissolves. The drugs have serious side effects, primarily the liver and kidneys are affected, and alopecia may appear.

The surgical method is considered more effective, followed by rehabilitation and restoration of fertility.

Which surgical method

use, the doctor must decide, based on the degree of damage to the fallopian tube. Today it can be laparotomy, laparoscopy and, in some cases, extrusion.

Laparotomy. It is used in especially acute cases if there is a threat to life. A rupture, large blood loss was diagnosed. A longitudinal incision is made in the abdominal wall under general anesthesia. The fruit is removed along with the tube.
Laparoscopy. Low-traumatic procedure, fertility does not suffer. It is also performed under general anesthesia. Instead of a longitudinal incision, the surgeon makes only three small punctures in the abdominal wall. Through punctures a special video camera is introduced
... The surgeon sees the embryo attached to the wall and removes it. If patency is impaired in the pipe, there is an adhesive process, the doctor simultaneously restores patency.
Milking. Not a commonly used method. Represents the extrusion of an egg from an intact tube with normal patency. The method is considered less traumatic, fertility almost does not suffer. This is the main advantage of the method. It is used only if the egg is close to the exit and there is no threat of rupture of the organ.

Note!

It is possible to get rid of the pathology by medication, but only at an early stage, when the egg cell has grown to no more than 4 cm, there is no rupture and bleeding
.

Main manifestations

Every woman-to-be mother wants to know how to understand what kind of pregnancy she is and how to feel pathology.

With an ectopic, signs in the early days are very similar to the manifestations of ordinary conception. These include aching pains in the lower abdomen, the absence of menstruation, the appearance of bloody discharge, the chest increases in size, and toxicosis is felt.

A woman who does a pregnancy test at the same time will see two stripes on it. This is due to the fact that with an ectopic, just like with an ordinary one, a hormone is released, and the test responds precisely to it.

Only a gynecologist can make a precise diagnosis.

Can an abnormal attachment of the ovum occur during IVF?

Infertile women using reproductive technologies are wondering if IVF can lead to an ectopic pregnancy?

Statistics claim that the probability of abnormal embryo implantation during in vitro fertilization is twice as high as during physiological conception. Due to the high risk, the patient should be carefully examined for the presence of inflammatory diseases of the internal genital organs, endocrine pathology and endometriosis. All identified pathologies must be cured in advance.

Ectopic pregnancy with IVF often occurs due to the same reason that caused infertility.

Reasons for development

There are various explanations for why an ectopic occurs. Only a completely healthy woman can hope that this problem will not affect her. Every year, the violation occurs more and more often. The reasons and risk factors are as follows:

Congenital disorders.
Tumors... In the presence of benign tumors, the patency of the tubes of the uterus worsens.
Chronic salpingitis. With this disease, adhesions are formed in the pipes. This is caused by the inflammatory process due to an infectious disease.
Chronic or previous diseases of the ovaries, bladder and uterus... They can be caused by such types of infections as chlamydia, mycoplasma, ureaplasma.
Congenital tube abnormalities... In medicine, this disease is called infantilism of the fallopian tubes: they have an irregular shape, can be very long or tortuous, which prevents the fertilized egg from reaching the uterus.
ECO. In artificial insemination, the egg is injected into the uterus, but it can penetrate further. This happens quite often. The statistics are unforgiving, but this is often the only way for women to have their tubes removed or for various forms of infertility.
Contraception. Using birth control pills or an intrauterine device. The problem is that the spiral is able to protect a woman from a normal pregnancy, but not from an ectopic one. The main task of the spiral is to prevent the development of the zygote in the uterus. Also, if the element is not removed in a timely manner, then an ectopic may also occur. Contraceptives that do not contain estrogen are important. It is this hormone that "blocks" ovulation. The problem is that drugs that contain estrogen are prescribed for women over 35 years old, as well as those that feed the baby for the first 6 months.

What causes an ectopic pregnancy, the doctor says:

Recent advances in this area

In recent years, conservative treatment of ectopic pregnancy in girls and adolescents has become very popular. For this purpose, drugs are used that stop the development of the embryo. These include Methotrexate, Mifepristone, etc. However, it has been established that they have a lot of side effects: hair loss, kidney and liver damage. In this regard, they can only be used by healthy women.

Abroad, drug tactics, although considered promising, have not become widespread. Today, the main method of treatment is laparoscopy.

Who is at risk

An ectopic pregnancy can be triggered for a number of reasons. Research by its specialists made it possible to identify risk factors:

previous ectopic pregnancies;
IVF (in vitro fertilization);
age over 35;
infertility or its treatment earlier;
many sexual partners;
smoking;
hormonal contraceptives;
stimulation of ovulation;
stress, neuroses;
congenital abnormalities of the genital organs, which are inherited;
undergone operations in the small pelvis;
infections and inflammations;
sedentary lifestyle.

Varieties of ectopic pregnancy

Preventive measures

An ectopic pregnancy is impossible to predict - there are too many factors that can lead to such a development of events. But doctors have developed specific preventive measures:

from the moment of the onset of sexual activity, regularly visit a gynecologist for preventive examinations and early diagnosis of inflammatory / infectious diseases;
keep a calendar of the menstrual cycle and, in case of minor violations, consult a gynecologist;
timely and fully treat any pathology of the organs of the reproductive system, including inflammatory and infectious diseases;
planning a pregnancy - for example, before conception, undergo a full examination by doctors of general and narrow specialties.

Ectopic pregnancy is considered a rather complex and dangerous pathology. But if medical measures were carried out at an early stage of the pathology or when the fallopian tube ruptured, competent measures were taken, then the prognosis will be favorable. Modern advances in medicine make it possible not only to save a woman's life, but also provide her with the opportunity to have children in the future.

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Conditions of origin of ectopic pregnancy

This is a dangerous case

For a better understanding of the mechanism of ectopic development of the fetus, you need to understand how conception occurs.

In simple words, fertilization is the process of fusion of the female and male germ cells. It is possible after ovulation, i.e. the moment when the mature egg left the follicle. If intercourse is performed with a man, she meets with a sperm, they connect.

The cell, thanks to the ciliated epithelium lining the inner surface of the fallopian tubes, moves deeper into the organ. It travels through the fallopian tube to the uterus, where it is implanted. This is how an intrauterine pregnancy occurs. See photos of the process of conception.

During the period of advancement, the cell goes through several stages of division. It is being prepared for introduction into the epithelium. This happens 5 to 7 days after fertilization, the cell is implanted in the uterine cavity. Once attached, it multiplies to form the placenta and embryo. An ectopic pregnancy occurs as a result of a failure in the process of promoting a fertilized egg or the impossibility of its introduction into the endometrium. This is due to a violation.

Ability to contract the fallopian tubes, making it difficult for sperm to move. This leads to too early or late meeting of the female cell with the male. This means that all subsequent implantation mechanisms can be violated.
Movement of the ciliated epithelium due to hormonal disruption (activation begins under the action of estrogen produced by the ovaries). There is a finding of the zygote in the pipe or its movement back.
Spastic tube contractions due to disruption of progesterone production. The cell cannot move to the uterus, and is looking for where to gain a foothold.
Secretion of the epithelium in the tubes, which slows down the process of oocyte movement.

Since the ovum is attached ectopically, the normal course of pregnancy and the formation of an embryo is impossible. The placenta, which develops in the lumen of the fallopian tubes or on other organs, destroys the vessels. This is a condition that leads to the development of hematosalpinx - the accumulation of fluid (blood) in the tube and intra-abdominal bleeding.

In many cases, this leads to the termination of an ectopic pregnancy, that is, the cell can exit on its own. But there is a high probability that the growing fetus will provoke a rupture of the pipe or damage to internal organs.

Causes

It is difficult to determine the exact cause of the development of the process, however, there are factors that provoke such an outcome:

swelling of the appendages and uterus;
abdominal surgery;
exposure to hormonal drugs;
disorders of the transport functions of the fallopian tubes;
adhesive processes;
hormonal disbalance.

The main reason is the slow movement of the ovum through the tube, the high activity of the trophoblast.

The cervical fastening of the embryo with pain is rarely accompanied by pain and goes unnoticed for a long time. There is a high probability that with such an embryo implantation, the uterus will have to be removed completely to save the woman's life.

Algorithm for providing emergency first aid to a patient

The standard of providing medical care to patients with tube rupture and bleeding is to perform urgent surgical intervention, remove ectopic pregnancy, and stop blood loss. Before the arrival of an ambulance, it is necessary to ensure that the patient is calm and in a horizontal position of the body.

Pipe rupture can occur at an early stage or already with a fairly long development of the fetus. Self-medication in this situation is prohibited, as it often leads to the death of the patient. If you suspect an ectopic pregnancy, you should call an ambulance as soon as possible, take the patient to the hospital. After the arrival of a team of doctors, even an ordinary paramedic can easily make a preliminary diagnosis.

What a woman feels

Stitching pains in the lower abdomen, intensifying at the site of fetal development, are signs of an incorrectly developing pregnancy.

A woman may feel pains, the nature of which is unfamiliar to her; during a gynecological examination, the discomfort increases. Signs of a normal pregnancy appear: nausea, vomiting, dizziness, but with a clear progression.

How do the first symptoms appear?

The first symptoms are characterized by a delay in menstruation, the onset of toxicosis, drowsiness, and swelling of the mammary glands. Everything is as in the development of a normal pregnancy, with the exception of severe painful sensations in the lower abdomen and profuse, prolonged bleeding. The temperature rises, since an ectopic pregnancy is an inflammatory process.

Is the uterus enlarged

When a fetus develops outside of the uterus, it does not grow. Its slight increase is due to inflammatory processes, and not to the growth of the embryo. Such a pathology is determined only with an ultrasound examination. At the same time, on examination, an accumulation of blood is found in the uterine space.

Bleeding

Profuse bleeding is the first sign of a threat. The development of the embryo in the tube inevitably leads to its rupture, which causes life-threatening internal bleeding. A miscarriage when the ovum is fixed in the tube can also occur at 10-12 weeks. There may be no discharge from the vagina, or they are scanty, smearing.

What to do

A woman with severe pain in the lower abdomen, bleeding and other signs of a dangerous condition must be immediately taken to the hospital by calling an ambulance. The patient needs to lie down before the car arrives. After confirming the diagnosis, medical treatment or surgery is performed to remove the embryo and stop bleeding.

How to avoid further

Restoration of reproductive function will be complete if enough attention is paid to postoperative rehabilitation.

During this period, anti-inflammatory therapy is prescribed to reduce the risk of adhesions. To restore hormonal levels, individual contraception is selected. Before planning motherhood, a woman needs to be treated, check the pipes.

It is worth remembering that abdominal pain during pregnancy is a good reason to see a doctor.

If there is a chance of conception, and it is with regular sexual intercourse, you must definitely tell the gynecologist about this and about your doubts that the pregnancy is proceeding normally.

Consequences of late deletion

If a woman, after an ectopic tubal pregnancy, decides to have a baby again, this must be approached thoughtfully and carefully. It is important to be observed by a gynecologist both during the planning period and from the first days of pregnancy, to make sure that everything is in order.

According to statistics, the chance of getting a normal uterine conception after an ectopic is 50%, a tubal pregnancy twice - 20%, infertility - 30%. The numbers are serious, so you can't let the state of health take its course, but plan everything.

Go for an ultrasound

Conservative treatment

Methotrexate is a drug for suppressing cell growth, which is actively used by oncologists.

Intramuscular injection of methotrexate causes the death of the ovum and its organization in the female body. Such treatment is carried out under the following conditions:

the size of the ovum is not more than 3.5 cm;
no signs of internal bleeding;
hCG level less than 5000 mIU / ml, higher levels are a relative contraindication;
no evidence of pipe rupture - evidence of pipe rupture is an absolute contraindication

After the injection, the patient can immediately go home, but the doctor will order regular blood tests to assess the effectiveness of the drug.

A woman needs to use reliable contraception for at least 3 months after treatment. This is because methotrexate can be harmful to the fetus if a uterine pregnancy occurs at this time.

Early signs

How to define an abnormal pregnancy? In the early stages, it is quite difficult to recognize an ectopic pregnancy. The fact is that the body of each girl is individual and the signs of such pregnancy can manifest themselves in different ways. So, what manifestations can indicate the fixation of a fertilized egg outside the uterus? Let's figure it out.

Increased basal temperature

Many women are accustomed to monitoring their basal temperature (BT). By measuring the temperature in the anus, you can determine the onset of ovulation or early pregnancy. Due to the increased amount of progesterone, BT will remain high throughout the cycle. If conception did not occur, BT decreases. It is worth noting that this indicator can be used to determine the onset of pregnancy in general, but not specifically ectopic conception.

Lack of menstruation

The absence of menstruation is the surest way to determine the onset of conception at an early stage. Despite this, we must not forget that other reasons can lead to the delay. These can be provoking factors such as a nervous shock, hormonal imbalance, serious illness, including oncology. In addition, one cannot be one hundred percent sure that there is no pregnancy at the onset of menstruation, since many girls have their periods after conception.

Morning sickness

You can recognize the onset of conception at an early stage by morning sickness. Many women know about this ailment when they become pregnant. Often this symptom also manifests itself in the daytime and evening. This is due to hormonal changes in the body, a drop in sugar and some other reasons. If you notice such signs, you should do a pregnancy test. The most accurate test is digital. If he shows two stripes, it is important to get a medical examination as soon as possible.

In the event of an ectopic pregnancy, it will be possible to diagnose it early and prevent complications.

Breast changes

With the onset of pregnancy, many girls already in the early stages note the following signs from the breast:

darkening of the nipples, increasing their sensitivity;
painful sensations in the chest, it becomes like a lumpy;
swelling of the breast;
veins in this area become clearly visible;
darkening of the areolas;
the bumps on the areoles become more noticeable, their number often increases.

It so happens that some of these manifestations, such as soreness, occur at the onset of menstruation. This should be taken into account when evaluating such changes.

Increased vaginal discharge

Normally, girls produce cervical mucus. With the onset of pregnancy, the concentration of the hormone progesterone increases in the body. In this regard, a woman may already in the early stages feel that the amount of mucus has increased. Not all girls can notice this sign. For many women, the amount of secretion may be quite insignificant.

Fast fatiguability

When pregnancy occurs, it does not matter if it is ectopic or proceeds normally, the woman's body suffers various changes in the early stages. At the same time, metabolic processes are enhanced to maintain the normal development of the fetus. This often leads to fatigue. Girls note a constant desire to sleep, physical activity is significantly reduced. In addition, the hormone progesterone acts as a relaxing factor, which has a sedative effect. All this leads to disability, a constant desire to lie down and sleep.

Frequent urination

Another common sign of early pregnancy is increased urination. Already 7-10 days after the onset of conception, a girl may encounter such a phenomenon as frequent urination. The fact is that when pregnancy occurs, human chorionic gonadotropin begins to be produced in the body. HCG is the so-called pregnancy hormone. As a result, the blood supply to the pelvic organs is increased. In this case, the urge to urinate is observed even with a slight filling of the bladder. This symptom intensifies at night.

Painful sensations in the lower abdomen

Will the stomach hurt during a pathological pregnancy? Spasms are often observed with the onset of an ectopic location of the fetus already at an early stage. This is due to the fact that the fetus grows and develops. Cramping can also occur during normal pregnancies. In this case, painful sensations are considered quite normal, because the uterus is constantly contracting, and with the development of the fetus, its spasms are observed.

The alarm should be sounded if the pain is accompanied by bleeding. A sign such as the appearance of blood can indicate both an ectopic pregnancy and a threat of miscarriage. In such a situation, you need to contact the gynecology as soon as possible. If we consider the question of when pain begins during an ectopic pregnancy, it should be noted that most often a woman experiences discomfort when the embryo reaches about 5 cm in diameter, that is, at 12-16 weeks.

Many girls experience cramps during their periods. These two conditions should not be confused. Every woman knows when she is having her period and what is the nature of the discharge at the same time.

Indigestion

Due to hormonal changes, the usual work of the intestinal tract is disrupted. The walls of the stomach and intestines under the influence of progesterone relax, and peristalsis decreases. This can lead to excessive gas production, constipation, or, conversely, diarrhea and other symptoms. Such manifestations often indicate the onset of pregnancy, including an ectopic one.

You may be wondering: 6 weeks pregnant

Increased sensitivity to odors

Another early sign of the onset of conception is a change in the acuity of the sense of smell. Girls are keenly aware of all the smells. Many women find it difficult to even carry out everyday food preparation. Any smells can cause disgust.

Nasal congestion

With the onset of conception, immunity decreases. It is a normal physiological process that ensures that the fetus is accepted by the body. Along with this, many girls are faced with colds and nasal congestion. In addition, swelling of the nasal passages is also associated with changes in hormonal levels.

The appearance of acne

Another early sign of pregnancy is the formation of acne and acne on the body. Of course, this is not a mandatory sign of conception, but many girls who have not previously suffered from acne may experience this phenomenon. Acne can develop along with inflammation of the skin.

Changing taste preferences

Due to hormonal changes, some ladies may experience different tastes in their mouths. Often girls talk about the appearance of a metallic taste. In addition, stories about the desire to eat completely incompatible foods during pregnancy are far from myths.

Emotional outbursts

Violation of the emotional background is a common early sign of pregnancy, including ectopic pregnancy. In this case, the mood can change several times a day. A woman can laugh and cry after five minutes. Such "swing" is observed due to changes in the hormonal balance of the body.

Positive pregnancy test

And, of course, the surest way to determine early pregnancy, which can be done at home, is a test. Will the test show the onset of an ectopic pregnancy or not? Today there are a lot of such tests. Many of them accurately determine the increase in hCG from the first weeks of conception. If you see 2 clear stripes or one indistinct, and the second clear line, you should rush to the doctor. From the first days of conception, the test may show a negative result.

The sooner an ectopic pregnancy is diagnosed, the more chances you have to maintain health and eliminate dangerous consequences.

Prophylaxis

Prevention of pathological attachment of the ovum is the maximum elimination of factors that can provoke an ectopic pregnancy.

Prevention includes the following activities:

prevention and timely treatment of genital infections in the early stages;
timely access to a doctor when signs such as increased vaginal discharge, changes in their color, odor appear, the appearance of pain during intercourse, itching in the vaginal area;
exclusion of bad habits (smoking, drinking alcoholic beverages);
regular preventive examination by a gynecologist.

Compliance with these simple measures will help prevent the onset of ectopic pregnancy and keep the female organs in a healthy state.

Answers to common questions

On the forums, you can find numerous conversations and reviews about ectopic pregnancy. Women are interested in answers to various questions, which we will talk about below.

Why does an ectopic pregnancy happen?

The reasons for this condition have already been discussed in the article. The most common among them are congenital and acquired diseases of the female organs, smoking, taking contraceptives.

Is it possible to recognize the condition in the early stages without tests

In the early stages, the signs of WB are poorly expressed. They usually coincide with the signs of a normal pregnancy.

It is impossible to diagnose WB in the early stages without tests and examination by a gynecologist.

Is it possible to have sex with this diagnosis

You should consult your doctor with this question. To give an answer, a specialist must examine the patient, take into account the peculiarities of the course of pregnancy in a particular patient.

Is the fallopian tube always removed

Removal of an organ is not performed in all cases. As a rule, if the signs of WB were noticed at an early stage and a diagnosis was made, it is possible to preserve the organ.

How long can you not have sex after surgery

It is recommended to engage in sexual intercourse after surgical treatment after complete healing of the surgical sutures with the permission of the attending physician.

Is there implantation bleeding with WB?

The course of an ectopic pregnancy is often accompanied by the release of blood, even in the early stages. Bleeding is one of the most common signs of this condition.

Is it possible for WB with bandaged pipes?

The onset of an ectopic pregnancy after organ ligation is a fairly common occurrence. This happens due to damage to the surface of the organ, the appearance of flaws on it.

Is it possible to quickly get pregnant after WB

After removal of the WB, the next conception should be carefully planned. It is really possible to get pregnant, but if the body has not recovered enough and the scars have not healed, the likelihood of repeated ectopic pregnancy is quite high.

Can such a pregnancy come out on its own

Cases of miscarriage in case of IB are indeed registered. In this case, as a rule, a woman experiences bleeding, which carries a threat to her life. If you suspect such a condition, you should urgently go to the hospital.

What is the threat of such a state

An ectopic pregnancy, the signs of which could not be detected at an early stage, carries a threat of bleeding, infertility and even death.

Can an ectopic pregnancy go to the uterine

Such cases have not been registered in medical practice. An ectopic pregnancy is a direct indication for termination.

Why the egg is attached outside the uterus

Why does the syndrome - ectopic pregnancy occur? As we have already found out, in contrast to the intrauterine, when the ectopic fetus is attached in most cases in the fallopian tube and only in 5% of cases in the abdominal cavity or ovary. In this case, the fertilization of the egg by the sperm occurs in an absolutely natural way.

The reasons for this violation are of the most varied nature. Let's consider the most common ones.

Physical disorders in the body

Due to various diseases affecting the female organs, a fertilized egg can be retained outside the uterus. The most common causes of ectopic pregnancy are the following conditions in a woman:

adhesive processes;
cysts;
scarring;
oncological diseases of the reproductive system;
transfer of an abortion;
various inflammatory processes;
genital infections.

In order to prevent the formation of adhesions and scars, you should visit a female gynecology every six months. In the early stages, such diseases are successfully treated with the help of drug treatment and minimally invasive surgical techniques.

Congenital diseases of the uterus and appendages

The etiology of ectopic pregnancy often hides the reasons, which consist in the presence of congenital diseases of the female reproductive system. Often, the patient learns about congenital pathologies after an ectopic pregnancy has been diagnosed. If it was possible to identify this dangerous condition in a timely manner, treatment in the early stages, as a rule, is carried out without negative consequences for the patient's life.

Some types of contraception

No matter how it sounds, some contraceptives can actually cause an ectopic pregnancy. The fact is that they protect the uterus from the attachment of a fertilized egg, but they do not act in the same way on other parts of the reproductive system.

If a woman uses a spiral, it is important to remember that this type of protection lasts no more than five years. If it stays in the body longer, the spiral no longer fulfills its functions fully. In this case, the fetus can attach to the cervix.

Artificial insemination

Artificial insemination is a method that allows a woman to get pregnant, who cannot do it naturally for various reasons. It would seem that this procedure should completely eliminate any risks. Despite this, according to medical statistics, cases of ectopic pregnancy during IVF are observed quite often. The doctor is obliged to warn the couple who decided to conceive a child in this way about such risks.

Other reasons

In addition to congenital and acquired diseases of the female organs, the use of contraceptives and IVF, it is possible to distinguish such factors that provoke cases of ectopic attachment of a fertilized egg. Pathogenesis includes:

hormonal disorders of the body;
smoking. This is due to the fact that nicotine lowers the level of female hormones;
douching treatment;
woman's age after 30 years.

Bad habits are a common cause of ectopic pregnancy.

Experts pay attention to the fact that patients who have once encountered an ectopic pregnancy are much more susceptible to the likelihood of a recurrence of this pathological condition.

In the normal course of pregnancy, the fertilized egg attaches to the wall of the uterus, where the further development of the embryo takes place.

Implantation of the ovum into the lining of the ovary, fallopian tube, or abdominal cavity is called an ectopic (ectopic) pregnancy.

Types of ectopic pregnancy

At the site of attachment of the fertilized egg, ectopic pregnancy is tubal, ovarian, cervical and abdominal.

Types of ectopic pregnancy

Tubal ectopic pregnancy

Tubal pregnancies occur in 98% of ectopic pregnancies.

This type of ectopic pregnancy occurs due to the fact that the fertilized egg does not move along the fallopian tube to enter the uterine cavity and gain a foothold there, but is introduced into the wall of the tube itself.

A tubal pregnancy can develop in different parts of the fallopian tube, and according to this it is divided into ampullar (80% of all cases of tubal pregnancies), isthmic (13% of the total number of tubal pregnancies), interstitial (2%) and fimbrial (is 5%).

In ampullar tubal pregnancy, the rupture of the fallopian tube usually occurs somewhat later than in other cases, somewhere in 8-12 weeks, since this part of the tube is the widest and the fetus can reach large sizes before it becomes cramped and burst the fallopian tube. Less often, but still another outcome is possible - a tubal abortion.

Isthmic tubal pregnancy most often ends with rupture of the tube at an early stage, at about 4-6 weeks of pregnancy, since the isthmus of the fallopian tube is its narrowest part. After the tube ruptures, the egg is released into the abdominal cavity.

With an interstitial tubal pregnancy, pregnancy can develop up to 4 months (14-16 weeks), since the myometrium of this section of the fallopian tube can stretch to a large size. It is this section of the fallopian tube that connects directly to the uterus, it has a developed blood supply network, so the rupture of the tube is accompanied by large blood loss, which can be fatal. With significant damage to the uterus, its extirpation (removal) is prescribed.

With fimbrial tubal pregnancy, the fetus develops at the exit from the fallopian tube (in the fimbriae - the villi).

Any type of tubal ectopic pregnancy ends in interruption and is expressed by rupture of the fallopian tube or detachment of the ovum from the wall of the fallopian tube and expelling it into the abdominal cavity, followed by fetal death (this process is called tubal abortion).

Ovarian ectopic pregnancy

Ovarian pregnancy occurs in approximately 1% of women among all women with an ectopic pregnancy.

An ovarian ectopic pregnancy occurs when a sperm has fertilized an egg that has not yet emerged from the dominant follicle or the fertilized egg has attached to the ovary instead of moving through the tubes towards the uterine cavity.

Thus, ovarian pregnancy is divided into two forms: intrafollicular - when implantation occurs inside the follicle, and epiophoral - when implantation occurs on the surface of the ovary.

Cervical pregnancy

Pregnancy in the cervical canal of the uterus happens quite rarely, namely 0.1% of all cases of ectopic pregnancy. In a cervical pregnancy, a fertilized egg enters the lining of the cervix.

There is also a cervical-isthmus type of pregnancy, when the ovum is attached to the isthmus of the uterus.

Cervical pregnancy can develop up to the 2nd trimester of pregnancy.

Abdominal pregnancy

This is a rare case of ectopic pregnancy. Abdominal (abdominal) pregnancy can be primary or secondary.

In primary abdominal pregnancy, fertilization of the egg and the implantation of the ovum itself occurs in the abdominal cavity.

In a secondary abdominal pregnancy, fertilization occurs in the fallopian tube, and then the fertilized egg is thrown into the abdominal cavity, where it attaches to the internal organ of the peritoneum (liver, spleen, etc.). A secondary abdominal pregnancy is a consequence of a tubal abortion, thus, an interrupted tubal pregnancy becomes another type of ectopic pregnancy.

An abdominal pregnancy is extremely rarely carried out before the due date, but if the fetus succeeds in attaching itself to tissues with good blood circulation, the child is born as a result of such a pregnancy, but with defects and soon dies.

As a result of abdominal pregnancy, the organs of the mother, adjacent to the developing fetus, are also greatly affected, which is extremely dangerous for a woman's life.

Ectopic pregnancy in the rudimentary horn of the uterus

Pregnancy in the rudimentary uterine horn is a rather rare occurrence, which is also commonly referred to as an ectopic species, since the fetus attaches to the wall of the defective uterus and leads to miscarriage with rupture of the uterine horn.

This happens only in women with a congenital anomaly of the anatomical structure of the uterus, when, even during the laying and development of her own reproductive system, while in the womb of her mother, there was a failure in the formation of internal genital organs (this happened somewhere around 13-14 weeks of her embryonic development ).

Each of the types of pregnancy described above cannot end with the birth of a healthy child, since the fetus cannot develop normally and reach its full maturity, it lacks either nutrients or room for development.

An ectopic pregnancy ends either with an abortion (spontaneous or mechanical), or, in case of untimely diagnosis, with surgery and / or rupture of the tissues of the reproductive organs.

Ectopic pregnancy symptoms

Usually, with an ectopic pregnancy, all the signs of a normal pregnancy remain: delayed menstruation, nausea in the morning, the chest is full and sore, there is an unusual taste in the mouth, weakness in the body is felt, and the pregnancy test shows two stripes. Moreover, the hCG level can grow at a normal pace, but if the dynamics of the hCG level show a slow increase in the hCG level (i.e., the hCG level increases more slowly than by 50% every 2 days), then this is the first sign of an ectopic pregnancy.

In general, the first signs of an ectopic pregnancy at an early stage are prolonged spotting bleeding, as well as pinpoint pain in the place where an ectopic pregnancy develops, pulling pain in the lower abdomen or cramps, which are given to the lower back or anus.

At a later date, the main signs of an ectopic pregnancy include pain of an increasing nature that cannot be tolerated, an increase in body temperature, and loss of consciousness from painful shock. This condition is typical for rupture of organs and profuse blood loss.

It is possible to accurately determine whether a pregnancy is ectopic is possible only with the help of an ultrasound scan.

A diagnostician, using special equipment for scanning the pelvic organs, will examine the uterine cavity to determine whether a fertilized egg has anchored in it. If the ovum was not found in the uterus, visualization of fluid in the abdominal cavity and / or in the postuterine space, blood clots is noted, then such a pregnancy will be designated as ectopic.

Causes of an ectopic pregnancy

An ectopic pregnancy can develop for a variety of reasons. The following are the causes of an ectopic pregnancy according to a specific type of ectopic pregnancy.

Causes of tubal pregnancy

This usually occurs due to a violation of the peristalsis of the fallopian tube, that is, due to a violation of its ability to contract, or due to other processes that complicate the patency of the fallopian tubes (with adhesions, tumors, a violation of the structure of the fimbriae, bending of the tube, underdevelopment of the tubes (genital infantilism ), etc.)

So untimely treatment of inflammatory diseases of the tubes (salpingitis, hydrosalpinx, for example) or previous operations on the fallopian tubes are usually the reasons for the development of tubal pregnancy.

Ovarian pregnancy reasons

After the rupture of the dominant follicle, the egg meets the sperm while still in the ovary. Further, the fertilized egg, for one reason or another, does not continue its movement to the uterine cavity, but attaches to the ovary.

The reason for such a failure during pregnancy may be an infectious disease of the uterine appendages or inflammation of the endometrium, obstruction of the fallopian tubes, endocrine and genetic disorders, etc.

Causes of cervical pregnancy

Cervical pregnancy occurs when the fertilized egg cannot attach to the wall of the uterus. The implantation of the ovum to the wall of the cervical canal occurs due to a previously transferred mechanical abortion or cesarean section, the formation of adhesions in the uterine cavity, fibroids and due to various abnormalities in the development of the uterus.

Causes of abdominal pregnancy

Abdominal pregnancy develops with obstruction of the fallopian tubes and with other acquired or congenital pathology.

Usually, an abdominal pregnancy is a consequence of the release of a fertilized egg into the abdominal cavity after a ruptured fallopian tube (after a tubal abortion).

The consequences of an ectopic pregnancy

An untimely diagnosed ectopic pregnancy can lead to rupture of the fallopian tube and further surgical removal (in a tubal pregnancy), an ovary (in an ovarian pregnancy), large blood loss and removal of the uterus (in a cervical pregnancy), and even death.

Ectopic pregnancy treatment

There are two ways to treat ectopic pregnancy: medical and surgical.

Drug treatment is understood as taking a drug (usually an injection of Methotrexate), which causes the death of the fetus with its further resorption. This way you can save the fallopian tube or ovary, which will make it possible to get pregnant and give birth to a child normally in the future.

Surgical treatment means scraping the fetus and / or removing its attachment site (fallopian tube, ovary, or uterine horn).

There are two ways to access the pelvic organs - laparoscopic and laparotomy.

Laparotomy- this is an incision of the anterior abdominal wall, as in a conventional operation, and laparoscopy is a small puncture of the abdomen, through which all manipulations take place.

Laparascopy- this is a modern type of surgical intervention, after which no scars remain, and the postoperative recovery period is minimized

With a tubal ectopic pregnancy, two types of surgical intervention by laparoscopic access are possible - these are salpingotomy or tubotomy (a conservative type of operation in which the ovum is removed while preserving the fallopian tube) and salpingectomy or tubectomy (a radical type of operation in which the fallopian tube is removed together with the fetus ).

But the preservation of the fallopian tube is possible only at the progressive stage of ectopic pregnancy, that is, when the attachment of the ovum has occurred, but rupture or strong stretching of the tube wall is not yet.

Also, in deciding whether to leave the fallopian tube, the surgeon must take into account the following factors:

Does the patient want more children in the future (usually women who already have children do not want to risk in the future, and the likelihood of a second ectopic pregnancy is very high, they tell the doctor that this pregnancy was not desired anyway and they do not intend to have more children) ;
the presence and degree of structural changes in the wall of the fallopian tube (for example, strong stretching of the tube wall by a growing fetus), the state of the epithelium and fimbriae of the tube, the severity of the adhesions (most often the condition of the tube is so bad that it will not be able to fully perform its functions in the future, such a tube cannot participate in the normal course of pregnancy, and the likelihood of an ectopic is so great that it makes no sense to leave it);
whether an ectopic pregnancy is repeated for a given tube (as a rule, with a repeated ectopic pregnancy in the same fallopian tube, it is removed, since the subsequent development of an abnormal pregnancy in the same tube is inevitable);
whether a reconstructive plastic operation was previously performed to restore the patency of this fallopian tube (if "yes, such an operation was once performed on this tube," then its preservation is not carried out, it is already unusable);
the area where the ovum is fixed (when a fertilized egg is introduced into the wall of the interstitial section of the fallopian tube - the narrowest part - usually the operation to save the tube is not performed);
the condition of the second fallopian tube (in the absence of a second tube or in a worse condition than that of the operated one, a decision is made to leave the tube so that in the future the woman has a chance to become pregnant).

With profuse internal bleeding, the only way to save a woman's life is laparotomy (removal of the fallopian tube).

After removal, the restoration of the fallopian tube is not carried out, since the tube tends to contract, which contributes to the movement of the fertilized egg from the ovary towards the uterine cavity, which is not possible with the implantation of an artificial section of the tube.

With an ovarian ectopic pregnancy, treatment includes the removal of the ovum and wedge-shaped resection of the ovary (while the ovary is preserved and restores its functions over time) or, in a critical case, oophorectomy (removal of the ovary).

Cervical pregnancy is the greatest danger to women. Previously, the only way to treat cervical pregnancy was considered to be extirpation or hysterectomy (removal of the uterus), since the tissues in this area contain many blood vessels and nodes, and any operation is fraught with large blood loss, and the risk of death is very high. But modern medicine is aimed at preserving the uterus, therefore, sparing methods of treatment are used - medical abortion (with the help of methotrexate injection) when an ectopic pregnancy is detected at an early stage, and with late diagnosis of ectopic pregnancy and severe bleeding that has begun, hemostatic measures are performed (tamponade of the cervix with a Foley catheter, the imposition of a circular suture on the cervix or ligation of the internal iliac arteries, etc.), and then the removal of the ovum.

Treatment for an abdominal pregnancy is a complex operation to remove the fetus from the peritoneum. Depending on the complexity of the case, surgical intervention can be either laparoscopic or laparotomy.

Take a urine test for hCG to confirm pregnancy, and after 2-3 days, take this test again to track the change in hCG;
Contact a gynecologist with a complaint of bleeding from the genital tract or abdominal pain (if any), providing the results of a urine test for hCG, as proof of your pregnancy;
Get an ultrasound scan to determine the type of pregnancy (uterine or ectopic);
In case of an ectopic pregnancy, come back to the gynecologist for medical treatment (early) or referral for surgery (in an emergency, when an ectopic pregnancy was detected late).

A case from obstetric practice

In my obstetric practice, there was a case when menstruation seemed to come on time or with a slight delay, and before menstruation the test showed a negative result, but immediately after it, the pregnancy test shows, albeit pale, but a second strip, and the hCG level also confirms pregnancy. And after a while, an ectopic is determined by a woman on an ultrasound scan.

It is assumed that the first test has not yet been able to detect pregnancy, and the bleeding was not a regular monthly menstruation, it was a reaction of the endometrium to an irregular pregnancy.

Pregnancy developed in the fallopian tube and, unfortunately, the surgeon had to remove it, it was of little use for further use. Two years after this incident, this young woman came to see me again; she was carrying a child under her heart, who is now briskly running up the ladder on the playground.

And there are dozens or even hundreds of such cases of pregnancy in the presence of only one pipe (even if it is impassable) in my practice, and this is great!

A. Berezhnaya, obstetrician-gynecologist

Self-diagnosis and self-medication for ectopic pregnancy are unacceptable.

This leads to its untimely detection, and as a result, to extensive internal bleeding and even death.

A woman can only assume that the pregnancy is ectopic, but not to carry out her own treatment without the help of specialists.

At the first signs or suspicions, for the sake of your own health, contact your gynecologist. This will save you the opportunity to become a happy mom in the future.

Be healthy and reasonable!

What is an ectopic (ectopic) pregnancy? This is the name of a pathological condition in which a fertilized egg is attached not in the uterus (the only possible place for the successful development of the fetus), but outside its cavity. This condition is dangerous for a woman. With an incorrect diagnosis or untimely access to a doctor, you can die. It is important to know the signs of an ectopic pregnancy.

According to statistics, the incidence of pathology is about 1.5%. The mortality rate due to complications is in the order of 1-5%. The most common cause is tube rupture and life-threatening blood loss.

Meanwhile, ectopic pregnancies are successfully treated thanks to early diagnosis and minimally invasive therapy. The earlier the problem is identified, the more favorable the prognosis.

Conditions of origin of ectopic pregnancy

This is a dangerous case

For a better understanding of the mechanism of ectopic development of the fetus, you need to understand how conception occurs.

An ectopic pregnancy occurs as a result of a failure in the process of promoting a fertilized egg or the impossibility of its introduction into the endometrium. This is due to a violation.

Ability to contract the fallopian tubes, making it difficult for sperm to move. This leads to too early or late meeting of the female cell with the male. This means that all subsequent implantation mechanisms can be violated.
Movement of the ciliated epithelium due to hormonal disruption (activation begins under the action of estrogen produced by the ovaries). There is a finding of the zygote in the pipe or its movement back.
Spastic tube contractions due to disruption of progesterone production. The cell cannot move to the uterus, and is looking for where to gain a foothold.
Secretion of the epithelium in the tubes, which slows down the process of oocyte movement.

Who is at risk

An ectopic pregnancy can be triggered for a number of reasons. Research by its specialists made it possible to identify risk factors:

previous ectopic pregnancies;
IVF (in vitro fertilization);
age over 35;
infertility or its treatment earlier;
many sexual partners;
smoking;
hormonal contraceptives;
stimulation of ovulation;
stress, neuroses;
congenital abnormalities of the genital organs, which are inherited;
undergone operations in the small pelvis;
infections and inflammations;
sedentary lifestyle.

Varieties of ectopic pregnancy

Why is an ectopic pregnancy dangerous?

One of the main dangers is damage to the internal genital organs and the development of bleeding, which can lead to death. That is why it is important not to confuse and recognize the symptoms of an ectopic pregnancy in time, and go to the hospital.

Other complications:

inflammation of the pelvic organs, abdominal cavity;
the development of adhesions, leading to infertility, since the pipes become inaccessible;
increased risk of conception outside the uterus subsequently.

According to medical statistics, removing one fallopian tube increases the likelihood of developing an ectopic pregnancy by 5 percent. If the doctors managed to keep it, the risk rises to 20%.

Nausea is one of the signs

Signs of an ectopic pregnancy

For a period of 2 weeks, the condition may be asymptomatic. You can suspect something was wrong with the following complaints:

cessation of menstruation;
swelling, breast tenderness;
toxicosis (nausea, vomiting);
exacerbation of smell, change in taste.

A number of symptoms that appear during an ectopic pregnancy are similar to early signs of a healthy conception, but only at first.

The woman may experience pain. This pathology is characterized by a small amount of bloody discharge, this is the difference between a spontaneous abortion.

Symptoms of an ectopic or ectopic pregnancy at 5 to 6 weeks depend on how quickly the events develop. With tubal abortion occur.

Periodic, cramping, brief pain in the lower abdomen. Sharp pains that last for a long time mean bleeding into the abdomen.
Discharge of blood. They occur with endometrial rejection and vascular damage.
Signs of internal bleeding: dizziness, weakness, fainting, nausea, drop in blood pressure, enlargement or bloating.

An ectopic pregnancy can cause the tube to rupture under the influence of the growing fetus. This condition is accompanied by a clear clinical picture that occurs suddenly:

Pain. How does it hurt? It starts on the side of the damaged tube and spreads to the groin and rectum.
Loss of consciousness, weakness, fever. They arise due to hypoxia of the brain due to a sharp drop in blood pressure.
Frequent urge to defecate, diarrhea. Due to irritation of the peritoneum.
Nausea, vomiting.
Symptoms of hemorrhagic shock. Occur with profuse blood loss. Manifested by pallor of the skin, apathy, lethargy, shortness of breath, cold sweat, increased heart rate.

Ectopic pregnancies are divided into whole groups by signs and symptoms.

Frequency of occurrence

Types of ectopic pregnancy

They are divided into two types:

ectopic progressive;
broken.

The first is very scary, as it is difficult to detect in the early stages, because it proceeds without symptoms. The size of the uterus is normal for this period of pregnancy, there is no bloody discharge.

A disturbed or interrupted ectopic pregnancy is accompanied by obvious signs:

paroxysmal abdominal pain;
the uterus is enlarged;
bleeding;
painful and soft mass to the touch (located on the left or right side).

If you had such manifestations, you felt unwell, began to smear, consult a doctor. Most likely, there was a breakdown or it is an old or undeveloped ectopic pregnancy. This condition must be treated.

There are the following options for attaching the ovum, classification of pregnancy:

pipe - 98-99%;
abdominal - 0.3% of cases;
ovarian - 0.2%;
cervical - 0.01%.

Tubal pregnancy

The most common type is the attachment of the egg in the fallopian tube, most often the right one. The cell is located in the area of the ampoule. In this case, an ectopic pregnancy can go unnoticed for up to 8-12 weeks and end in a tubal abortion.

If the egg is attached in narrower parts, after 6 weeks there is a violation of nearby vessels and tissues, a tube rupture and intra-abdominal bleeding are possible.

Ovarian pregnancy

It may be primary, when the egg is retained in the ovary, and is fertilized there. Or secondary - re-implantation of the egg after tubal abortion.

Ovarian tissue is lined with vessels that quickly break down, causing internal bleeding.

In the abdominal cavity

Abdominal pregnancy

It occurs as a result of the attachment of the ovum after a tubal abortion, there may be a third pregnancy. So there are three ectopic. Implantation takes place on the peritoneum or intestines. This rare pathology is fraught with infection and bleeding.

It is theoretically possible to give birth with an abdominal ectopic pregnancy. In medical practice, cases are described when a woman who was diagnosed with such a diagnosis carried and gave birth to a child. But most of the fruits die.

Cervical pregnancy

A rare case, but the most dangerous for a woman's life due to the large number of blood vessels in this area.

The limited space of the cervical canal prevents the development of an ectopic pregnancy. If the ovum does not move into the cavity of the reproductive organ, vascular destruction and massive bleeding from the birth canal quickly occur.

Pathologies are facilitated by malformations of the uterus, operations, benign tumors and numerous miscarriages.

Causes of an ectopic pregnancy

Hormonal imbalance is one of the reasons

One, strictly defined reason, from which there is a pathology, does not exist. It usually manifests itself under the influence of a number of factors, many of which are still unclear.

The most common reason is a failure in the transport of a fertilized cell due to strong blastocyst activity or a violation of the movement through the fallopian tubes. As a result, the implantation process begins when the ovum has not yet reached the uterus.

What is the reason for the disruption of the cage movement along the pipe?

Inflammatory processes in the appendages: acute and chronic salpingitis, infectious agents that cause functional changes in the tubes, chlamydia and other STDs.
Operations. Even minimally invasive interventions carry the risk of altering the structure and functioning of organs. Connective tissue is formed at the site of the incision and suture. This affects the ability of the tube to contract, its mobility is impaired, and adhesions prevent the cell from passing to the uterus. An ectopic pregnancy occurs.
Hormonal imbalance. In the presence of any endocrine diseases, ovulation, fertilization and cell advancement through the tubes are disrupted.
Endometriosis Pathology in which the mucous layer of the endometrium extends outside the uterine cavity. This leads to structural changes in the reproductive organs, the risk of developing an ectopic or ectopic pregnancy increases.
Congenital and acquired anomalies of the genital organs: genital infantilism (the fallopian tubes are longer than usual), stenosis, diverticulitis.
Neoplasms in the small pelvis. They affect the work of internal organs, change the size and diameter of the tubes, and disrupt the function of the epithelium. Promote ectopic embryo attachment.
The action of toxic substances contained in heavy metal salts, tobacco smoke, industrial dust, poisonous vapors.
ECO. One of the ways to deal with infertility is when conception occurs outside the woman's body, and then the embryos are placed in the uterus. The risk is associated with the fact that with indications for IVF, there are pathologies of the fallopian tubes and other parts of the reproductive system.

Diagnostics and definition of ectopic pregnancy

Need a diagnosis from specialists

You can find out the pathology in the early stages by conducting a clinical and instrumental examination. Progressive ectopic pregnancy outside the reproductive organ is most difficult to detect, since there are no signs of it.

Modern research methods make it possible to detect conception as early as 3 weeks, to prevent complications such as rupture of the fallopian tube and abortion.

Ultrasound - reliably diagnoses an ectopic pregnancy and determines the place of attachment of the egg.
Checking the level of hCG. Its concentration increases with the onset of pregnancy. If it is ectopic, the growth is much slower.
Study of the level of progesterone. A concentration below 25 ng / ml is a sign of ectopic pregnancy, and a decrease to 5 ng / ml indicates the nonviability of the fetus.
Culdocentesis (puncture of the posterior vaginal fornix). It is carried out at the clinic of the acute abdomen with suspicion of ectopic pregnancy.
Cleaning of the uterus (diagnostic curettage). It is prescribed for established ectopic pregnancy.
Laparoscopy. Allows you to carefully examine the internal organs. In case of detection of an ectopic pregnancy, it is immediately terminated.

Manifestation of ectopic pregnancy

Tell us about your feelings

How does an ectopic tubal pregnancy begin to manifest? What are its initial signs, can it be confused with full-term? The first symptoms of ectopic development, which should alert a woman, are felt 2-3 weeks after a delay in menstruation. It:

cramping pain in the corner of the abdomen, radiating into the rectum;
scanty, dark discharge from the genitals.

When these symptoms appear, an ambulance should be called, as this may cause internal bleeding. Trying to treat an ectopic pregnancy at home is a mistake. Lethal outcome is not excluded.

It is easy to understand whether a woman conceived or not, even if an ectopic pregnancy does not make itself felt. It is enough to make a test on the days of the delay. If it is positive, the maximum period when you need to see a doctor is 1-2 weeks. When the test is negative, you should wait a couple of days and take another one.

The nature of the pain

The first, how pathology manifests itself is pain syndrome. But how to distinguish pain during an ectopic pregnancy from other diseases, such as peritonitis?

Pain is often a symptom

A woman is worried about pain in the lower abdomen on the right or left, in the uterus. With massive bleeding, pain radiates to the rectum and lower back. Unpleasant sensations with ectopic development of the fetus are expressed in paroxysms, each time the state of health worsens.

How long does the pain appear? It depends on the place of implantation of the ovum. Since the most common ectopic tubal pregnancy, it has been extensively studied. When a fertilized egg is located in a narrow part of the tube, pain occurs almost immediately after conception.

How long does the fallopian tube burst?

How long does it take for this to happen? Most women think that in the first days, weeks, even months after conception, this cannot happen, so they are in no hurry to see a doctor. But the risk of an ectopic embryo exists at the earliest possible date.

What week does the pipe rupture occur? On average, an ectopic or ectopic pregnancy lasts 4 to 12 weeks. From the place of attachment of the ovum depends on how long the pathology will develop.

Rupture of the fallopian tube

Timely treatment of ectopic pregnancy

Today, there is no way to preserve a fetus that develops outside the uterus. There is evidence when, with ectopic pathology, it was possible to carry and give birth to a child. But this is possible only under extreme circumstances, it is fraught with a very high risk to the life of the mother. With ectopic development, the likelihood of fetal pathologies is high.

There were rare cases when a woman had a double pregnancy at the same time: intrauterine and extra matte. What is done with a pregnancy that is pathological? The ectopic embryo is disposed of as soon as it is found.

Previously, the treatment was surgical. Modern medicine offers non-surgical techniques. At the heart of drug therapy is the use of Methotrexate, a drug that can delay cell division. The medicine is widely used in oncological practice and in organ transplants to suppress immunity.

Methotrexate promotes rejection of the abnormality

In an ectopic pregnancy, methotrexate acts on the tissues of the fetus and embryonic organs, stopping their development. The result is subsequent rejection.

Drug treatment reduces the risk of bleeding, minimizes organ trauma, and shortens the rehabilitation period. But there are also disadvantages: dizziness, nausea, vomiting, stomach diseases, rupture of the fallopian tube, progressive ectopic pregnancy.

The use of Methotrexate is possible when the size of the ovum is not more than 4 cm, good analyzes, no bleeding. Be sure to exclude the presence of other pathologies. In other cases, surgical treatment is indicated.

The choice of the method of surgery depends on the age of the patient, the location and size of the embryo, and the state of health. In case of massive blood loss, which becomes dangerous, the doctor will perform an emergency laparotomy - an intervention with a wide incision. It allows the surgeon to quickly correct blood loss and stabilize the condition.

In all other cases, preference is given to laparoscopic methods.

Salpingotomy. Preserves the fallopian tube and its reproductive capacity. The operation is feasible only with small egg sizes. It is associated with an increased risk of repeated ectopic pregnancy in the future.
Salpingectomy. Removal of the organ with the implant. It is carried out with repeated ectopic conception, the egg size is more than 5 cm. In some cases, the tube is not completely removed, partially preserving its function.

In the postoperative period, it is important to ensure that there is no bleeding in the uterus. The administration of antibiotics and pain relievers, NSAIDs is indicated. The woman is discharged 1-2 days after laparoscopic intervention, 10-14 days after laparotomy.

Normal HCG levels

To make sure that the ectopic ovum has been completely removed, the woman monitors the level of hCG in the blood for some time. Chorionic cells can develop a tumor - chorionepithelioma.

How long should you protect yourself after surgery? Within 6 months in order to stabilize reproductive function.

What does an ectopic pregnancy look like on ultrasound

Ultrasound examination diagnoses pathology in the early stages. Her signs:

enlargement of the uterus;
compaction of the mucous layer of the uterus with undetected ovum;
heterogeneous formation in the area of the uterine appendages;
an egg with an embryo outside the uterus.

See the signs of pathology on the ultrasound video, diagnosis example.

Transvaginal ultrasound has diagnostic value, which reveals ectopic pathology as early as 3 weeks after a delay in menstruation. With the help of examination, it is possible to determine the rupture of the fallopian tube, bleeding in the abdominal cavity.

Consequences of late deletion

Go for an ultrasound

Prophylaxis

To reduce the risk of repeated ectopic tubal pregnancy, it is recommended to follow these measures:

timely treat infections and inflammations of the uterus and other organs;
periodically do an ultrasound scan and determine the level of hCG in the blood;
when changing a partner, get tested for STDs;
enrich the diet with vitamins and minerals;
correct hormonal disorders.

To prevent ectopic or ectopic pregnancy, avoid:

promiscuous sex;
stress;
sedentary lifestyle;
genital infections;
smoking and alcohol abuse;
multiple abortions and uterine cleansing;
the use of progestin-only contraceptives.

Recent advances in this area

Abroad, drug tactics, although considered promising, have not become widespread. Today, the main method of treatment is laparoscopy.

: Borovikova Olga

gynecologist, ultrasound doctor, geneticist

What is it and how is it dangerous

Symptoms

Menstruation and ectopic pregnancy on the test

Causes

Elimination and rehabilitation

Pregnancy after an ectopic pregnancy

Classification of ectopic conditions

Signs of an ectopic pregnancy

What will the test show?

Sad consequences

Patient treatment

Rehabilitation and subsequent preparation for pregnancy

What is an ectopic pregnancy?

State concept

Types of ectopic pregnancy

What will the test show?

Stages of an ectopic pregnancy

Preservation of appendages

Signs of an ectopic pregnancy

How to identify an ectopic pregnancy?

Danger

Early signs of an ectopic pregnancy:

Sad consequences

Causes of an ectopic pregnancy

Effects

Pregnancy after ectopic

Does the test show an ectopic pregnancy?

When can pathology be diagnosed

What will the test show?

Differential diagnosis

Puncture

Corpus luteum with WB

Use of laparoscopy

Basal temperature in an ectopic pregnancy

Prevention of pathology

Prompt elimination of ectopic pregnancy

Ectopic pregnancy: surgery and its options

After the operation, the woman must be prescribed restorative procedures:

Treatment

Rehabilitation period

Primary prevention

Normal pregnancy after ectopic pregnancy

About the expert: + MAMA

Risk group

Diagnostics

Consequences and prognosis

Can I get pregnant after?

Stages of development

How long does the fallopian tube burst?

How interrupt

Medication interruption

Surgery

Is it possible to keep the pregnancy

Surgery

What to do

Main manifestations

Can an abnormal attachment of the ovum occur during IVF?

Reasons for development

Recent advances in this area

Who is at risk

Preventive measures

Cerebral palsy: causes and forms

25 week of pregnancy: what happens to the baby, the well-being of the expectant mother

Conditions of origin of ectopic pregnancy

Causes

Algorithm for providing emergency first aid to a patient

What a woman feels

How do the first symptoms appear?

Is the uterus enlarged

Bleeding

What to do

How to avoid further

Consequences of late deletion

Conservative treatment

Early signs

Increased basal temperature

Lack of menstruation

Morning sickness

Breast changes

Increased vaginal discharge