Ectopic pregnancy: Causes, Signs, and Treatment

Every woman should know about the concept of ectopic pregnancy. This is a very dangerous pathology. According to statistics, it overtakes about 12% of women. This pathology has been described in medical books since the eleventh century. Then the neglected forms of ectopic pregnancy, or rather its late diagnosis, often led to death. Today, modern surgery can easily solve this problem. So, let’s take a closer look at how to recognize

Your menstruation does not come at all, the pregnancy test shows two strips, you feel sick in the morning, pulling the lower abdomen and you want salted cucumbers? However, on the ultrasound, the doctor never saw an embryo in the uterus … What could it be? Most likely, we are talking about ectopic pregnancy. The first signs are therefore insidious because they allow you to perceive your condition as a normal pregnancy.

Ultrasound diagnostics is also used to determine it. It is just that the doctor carefully studies not the uterus, but her neck and tubes — all those places where the embryo could pathologically attach.

Among other things, the reason for referring to a gynecologist may be the appearance of pain in the lower abdomen of unknown etiology or bleeding. All this is uncharacteristic for early terms of normal pregnancy but indicates ectopic. But guaranteed to give an answer only ultrasound.

Among other things, the reason for referring to a gynecologist may be the appearance of pain in the lower abdomen of unknown etiology or bleeding. All this is uncharacteristic for early terms of normal pregnancy but indicates ectopic. But guaranteed to give an answer only ultrasound.

What is an ectopic pregnancy?

Ectopic pregnancy: Causes, Signs, and Treatment

As you know, during normal pregnancy, leaving the fallopian tubes, the ovum is attached in the uterus. There it will develop until the birth. If a pathological pregnancy has occurred, then the fertilized egg just does not enter the uterus. It can settle in the fallopian tubes (tubal ectopic pregnancy), ovaries, and even in the abdominal cavity.

It is important!
Tubal pregnancy accounts for 98% of all ectopic pregnancies.

Most often, egg retention occurs in the tubes. This fact indicates a lack of patency of these same pipes. Why is this dangerous? So, a month after the fertilized egg is attached to the pipe wall, it will increase in size. And can cause a pipe break. This threatens to cause severe bleeding with the ingress of blood into the abdominal cavity. Bleeding after an ectopic pregnancy can cause the death of a woman.

Causes of ectopic pregnancy

Experts state – the main reason for this phenomenon is the pathology of the fallopian tubes. In other words, their patency for some reason was broken. Very often, this is preceded by severe childbirth, abortion, various inflammatory diseases of the genital tract, infections. So, the mucous membrane of the uterus swells sticks together in separate places, and the tubes lose their natural ability to contract.

Also, ectopic pregnancy can occur in case of insufficient development of the fallopian tubes (this phenomenon is called infantilism). Such infantile pipes are very long, winding and narrow, with narrowed lumens. In other words, they cannot fully contract and cannot push the fertilized egg to the uterus.

Nature decreed that at the particular stage of its development, villi appear at the fetal egg. They are needed in order to then attach in the uterus and receive a constant blood supply. If due to some problems, the egg did not arrive in the uterus, it can attach in the place where it was at the moment. Gentle and thin walls of pipes can not stretch like the uterine tissue, and therefore their rupture occurs very quickly. This usually happens on the 5th week. The blood is sent to the abdominal cavity, the woman has nausea and painful sensations in the lower abdomen, which by their nature resemble labor pains. There may be a loss of consciousness.

Does the test show an ectopic pregnancy?

Now we offer to talk about how to diagnose ectopic pregnancy. First, find out if the test will show an ectopic pregnancy. It turns out – yes. It shows an ectopic pregnancy as well as a normal one. The fact is that the level of hCG in ectopic pregnancy increases in the early stages, and such tests respond to the content of this hormone in the urine. Initially, the level of hCG will be slightly lower (the second strip of the test may not seem so bright); later, in an ectopic pregnancy, there is no dynamic that is in normal. Indicators of hCG in ectopic pregnancy weekly differ from similar data in a healthy pregnancy.

Detect ectopic pregnancy in the early stages is possible only after an ultrasound examination. The specialist will not see the fertilized egg in the uterus and will appoint additional checks. Diagnosis of ectopic pregnancy is carried out only in the clinic.

How to determine ectopic pregnancy

We advise you to pay special attention to this section. You should know all these ectopic pregnancy symptoms like the back of your hand.

So, first of all, it is very important to pay attention to any pain in the lower abdomen. Typically, such painful sensations in a woman occur on one side of the abdomen, that is, where the fallopian tube was affected. The pains during ectopic pregnancy can increase with a change in the position of the body, as well as when turning the body and walking.

Also, signs of ectopic pregnancy in the early period include bloody discharge. The so-called “cervical pregnancy”, which is fixed in the cervix of the uterus, leads to long and heavy bleeding from the vagina. Discharges in ectopic pregnancy have a dark red or brown color. In any case, their appearance should be alerted by its uncharacteristic – a woman has never had anything like this before.

Damage to the wall of the fallopian tube is also accompanied by bleeding. Usually, the fertilized egg in this situation is detached spontaneously and a natural tube abortion occurs.

Signs of an ectopic pregnancy

Ectopic pregnancy Causes, Signs, and Treatment

Ectopic pregnancy symptoms in the first days are very similar to the symptoms of a normal pregnancy. These include:

  • delay of menstruation (menstruation during ectopic pregnancy does not occur),
  • irritability,
  • violation of taste preferences,
  • toxicosis and
  • aching pain in the abdomen,
  • various bleeding.

Feelings during ectopic pregnancy are very similar to the feelings of the expectant mother. The signs of ectopic pregnancy in the first days of the delay, before the onset of pain in the lower abdomen, are therefore insidious because they are similar to a normal pregnancy and allow you to start the situation. If you have recorded such signs – immediately go for a pelvic exam. This is important in order to eliminate the pathology in time and maintain health.

Ectopic pregnancy: treatment

The purpose of this treatment is to remove the pathological embryo from the body of a woman. It is not correct to say that such an operation is an abortion in an ectopic pregnancy. Because of such an embryo, localized outside the uterus, it will never develop and a real baby will be born. And the rejection of the operation will only lead to the death of the mother, but not the birth of a new life.

Most often used for this laparoscopy. This modern low-impact method. Doctors make a small size on the skin and inject the necessary instrument. Experts observe the operation on the monitor of the device. This is a safe operation. She guarantees that on the body of a woman there will be neither adhesions nor scars. This operation also prevents injury to the tubes, and after a certain course of treatment, a woman can become pregnant again after a while.

Removal of the tube during ectopic pregnancy is practiced less and less. Today, such a radical method is addressed, if the situation is neglected, and the embryo has already managed to significantly increase in size.

Laparoscopy in ectopic pregnancy is contraindicated only in very severe cases:

  • sepsis,
  • intestinal obstruction
  • oncologic neoplasms,
  • acute infectious inflammations
  • severe diseases of the cardiovascular system
  • bleeding disorder.

Also, do not resort to the laparoscopic method shortly after undergoing abdominal surgery. In this case, the classical surgical treatment

Treatment of ectopic pregnancy without surgery

In principle, treatment of ectopic pregnancy with conservative methods is possible, but it is rarely used in practice. The fact is that it is possible to treat this condition without surgery only at very early stages, and then, as a rule, no diagnosis is made yet, as the woman does not even suspect that she has an ectopic pregnancy. When a fact is discovered, the use of non-surgical treatment is no longer possible.

So, to remove a pathological embryo with the help of conservative therapy is possible only in the following cases:

the size of the ovum does not exceed 2 – 4 cm,
tubal ectopic pregnancy with the tube still unbroken (at the earliest stages),
the concentration of hCG is about 2000 IU / l (which is typical for the onset of pregnancy), while on the ultrasound the ovum is not visualized in the uterus.

If these conditions are met, then methotrexate is used in combination with certain synthetic hormones for medical termination of ectopic pregnancy. Methotrexate is a very toxic drug that has many contraindications and side effects, so along with it, a number of other drugs are prescribed to neutralize its toxic effect.

The main effect of this therapy is that the fertilized egg dies and resolves. Methotrexate can be administered to a woman both intravenously and locally – through a puncture or catheter – into the affected fallopian tube under the control of an ultrasound diagnosis.

Research data says that under all the conditions under which the drug treatment of an ectopic pregnancy is admissible and with all the rules of therapy, the efficiency is 96%.

Treatment with Methotrexate is carried out only in the hospital, as it requires constant monitoring of the patient’s condition. If during the treatment the condition worsens, the woman has a sharp pain in the abdomen, then an emergency operation is prescribed since this means that the tube has ruptured.

Bear in mind that sexual life after an ectopic pregnancy is allowed no earlier than after 3 weeks (if laparoscopy was performed) and not earlier than one month during abdominal surgery. The doctor who prescribed and carried out the treatment will tell you about these terms. The first six months, sex after ectopic pregnancy must be protected (using a condom).

The next pregnancy after ectopic doctors recommends planning no earlier than after 6 months. This is the period the body needs for full recovery until then it is imperative to use contraception.

Ovulation after an ectopic pregnancy occurs the same way as before, but if one of the fallopian tubes is removed or damaged, when planning for conception, it is necessary to track ultrasound ovulation from the healthy tube.

Can ectopic pregnancy recur?
Chances of recurrence of this pathology are almost the same as in the first case: 12%. Everything primarily depends on the woman’s body, and therefore it is almost impossible to ensure against ectopic pregnancy. It is important to get rid of bad habits, pay attention to the treatment of infections and, of course, be regularly observed by specialists.

Ectopic pregnancy effects

Usually, women who have suffered such a problem are most interested in the question: is it possible to get pregnant after an ectopic pregnancy? If the transferred ectopic pregnancy could be recognized and cured in time, thereby preserving the uterine tubes and the uterus intact (for example, during a cervical ectopic pregnancy), the ability to become pregnant, bear and give birth to a healthy child remains the same as before the ectopic pregnancy.

Moreover, even if a woman had to remove one of the fallopian tubes, she still has fertility. Just, in this case, the chances of getting pregnant will be twice lower, but they will still be. And there are many cases where women with a single fallopian tube safely become pregnant and give birth to children. Patients who had to remove one of the fallopian tubes, doctors strongly recommend checking the remaining tube for permeability.

And, as an extreme case, there is IVF, which saves women who are not able to become pregnant naturally. If you observe a healthy lifestyle and the disciplined fulfillment of all the prescriptions of your doctor, a woman is sure to be lucky enough to become a mother.

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