Every woman should know about a dangerous pathology, which, according to statistics, overtakes 10-15% of women - an ectopic pregnancy. In order to avoid complications, it is necessary to have some knowledge about its occurrence and course. First of all, you need to understand that the occurrence of an ectopic pregnancy is quite unpredictable.
This pathology is described in medical manuals dating back to the 11th century. Until recently, neglected forms exclusively led to death. Today, with the help of modern surgery, this problem is solved much easier. Functional medical equipment allows operations and reduces the risks during operations to almost zero. However, gynecologists around the world report an increase in average cases that are difficult enough to diagnose.
What is an ectopic pregnancy and how does it occur?
During normal pregnancy, the ovum, leaving the fallopian tubes, attaches to the uterus, where it continues to develop until birth. In a pathological pregnancy, a fertilized egg does not enter the uterus. This common pathology never ceases to amaze doctors. Where did they not have to extract the incorrectly attached fetal egg. It can be fallopian tubes, ovaries, abdominal cavity. The most common ectopic tubal pregnancy.
Egg retention in the tubes indicates their insufficient patency. A month after attaching a fertilized egg to the wall of the pipe, increasing in size, it can lead to rupture of the pipe. In this case, there is a very high probability of bleeding with blood entering the abdominal cavity. The life of a woman from that moment is at risk. That is why it is so important when planning a pregnancy to undergo a full examination and eliminate possible violations.
Causes of Ectopic Pregnancy
Why does this occur? How does an egg go astray and end up in a place not intended for development? The thing is in the fallopian tubes, the patency of which is impaired as a result of any factors. Almost always, this is preceded by abortion or a difficult birth, previous or ongoing inflammatory diseases of the genitals, infections. The uterine mucosa in a swollen state sticks together in some places, the tubes lose the ability to contract.
An ectopic pregnancy can occur in the event of insufficient development (infantilism). The infantile tubes are long, narrow and winding, with narrowed gaps. They are not able to contract and push the fetal egg forward to the uterus. At a certain stage, the villi begin to develop villi in order to attach to development and receive constant blood supply. If at a certain time the egg did not arrive in the uterus, it is fixed in the place where it is. The thin and delicate walls of the pipes do not stretch like the uterine tissue, so they soon break. This happens around the 4-6th week. As a result of the rupture, blood rushes into the abdominal cavity, nausea and severe pain in the lower abdomen, resembling contractions, occur. Often there is a loss of consciousness. Ruptured large vessels can be fatal.
Sometimes the scenario occurs in a different direction, and the fetal egg, bursting, flows into the abdominal cavity. And with it a certain amount of blood, nausea and spotting can also be observed. Tubal abortion is accompanied by severe pain, which subsides after a while. A woman can relax, thinking that everything is behind. However, it’s too early to rejoice. In any case, it is urgent to contact specialists in order to exclude the possible development of peritonitis - purulent inflammation of the abdominal cavity.
Does the test show an ectopic pregnancy?
The test shows an ectopic pregnancy as well as a normal pregnancy! You can detect the difference only as a result of ultrasound examination. All will simply not be a fertilized egg in the uterus, and if specialists do not find it on an ultrasound, they will conduct additional checks and will be able to diagnose the pathology at an early date. Already in the second week of pregnancy, the deviation can be diagnosed by introducing an ultrasound probe into the vaginal cavity. Next, a diagnostic laparoscopy is prescribed that gives the most accurate results. Another way is a hormonal blood test. After a significant increase, the level of chorionic hormone (hCG) at this time may decrease.
What are the signs (symptoms) of an ectopic pregnancy?
Among the first signs are spotting from the vagina (may be minor). Then painful sensations in the lower abdomen, growing with the development of pathology to very strong, sometimes cramping.
Is it possible to determine an ectopic pregnancy?
It is difficult to make an accurate diagnosis for yourself, but you can suspect something is wrong based on the above symptoms. If even mild aching pains in the lower abdomen and at least small spotting are added to the usual symptoms of pregnancy (delayed menstruation, irritability, toxicosis, violation of taste preferences, etc.), immediately RUN for a gynecological examination to exclude pathology.
At the slightest suspicion of an ectopic pregnancy, specialists offer in-patient monitoring. This should not be abandoned, since the necessary examinations to determine the place of implantation of the embryo are easier to carry out in a hospital. In the early stages of detection, doctors will be able to interrupt it with gentle methods.
Ectopic Pregnancy Treatment
There are several treatment methods used at different stages. At the slightest suspicion of an ectopic pregnancy, specialists offer in-patient monitoring. This should not be abandoned, since the necessary examinations to determine the place of implantation of the embryo are easier to carry out in a hospital. In the early stages of detection, doctors will be able to interrupt it with gentle methods.
A low-traumatic method (laparoscopy) is offered in the case when the fetal egg still retains the container. Through a small incision on the skin, the desired instrument is introduced. The laparoscope device has an optical system, so all manipulations and the surgical field are displayed on the monitor of the device. This is a fairly safe operation. The surrounding tissues and organs do not hurt, there is no risk of adhesions and scars, and deaths practically do not exist. The device "sucks" the fetal egg, acting like a mini-abortion. A great consolation for a woman is that such an operation prevents injury to the tube, and after a course of treatment, after a while, the woman can become pregnant again.
Save or remove pipe?
You can save the pipe if the break has not yet occurred, or is insignificant. With salpingotomy, it is a closed surgical operation. After it, recovery occurs much faster, less blood flows out, and the patient is in the hospital much less time, and the procedure itself is less painful. Removal of the tube during the examination is called salpingectomy. This procedure greatly reduces the risk of re-deviation in bearing a child.
In some women (4-8%), pregnancy tissues remain in the cavity of the tubes, so the doctor may suggest the introduction of a drug that stops tissue growth. This is methotrexate, a drug sometimes used as an alternative to surgery. It is used in the very early stages of pregnancy, while pregnancy hormones are still slightly increased. This drug leads to the absorption of pregnancy tissue by the body. Several injections are required, after which bleeding occurs within a few weeks. With early diagnosis of the disease and early surgery, this procedure may not be necessary. The best decision on the appointment of treatment is made by the doctor.
Is pregnancy possible after an ectopic pregnancy and what are its features?
After liberation from an ectopic pregnancy, monitoring and "expectant management" are carried out. If only one of the tubes is damaged or removed, the chances of a new pregnancy are quite high. However, the unremediated cause of the disease can reduce them. It may be an infection or inflammation. They must be cured. With one working tube, you can get pregnant and have a great baby. Within approximately 18 months, 6 out of 10 women become pregnant again.
How long should I wait?
Gynecologists recommend waiting at least three months before retrying. After serious surgery, you should wait six months to heal all the scars. After using methotrexate, you must wait three cycles to make sure that the drug is completely excreted.
What are the chances of a repeat ectopic pregnancy?
The chances of repeating an ectopic pregnancy are almost the same as with the first violation: 10-15%. The forecast is rather vague, since everything depends on the specific organism of the woman and the circumstances. It is almost impossible to insure against this. However, special attention should be paid to the treatment of infections, for example, chlamydia, in order to exclude further damage to the fallopian tubes. If a new pregnancy is detected, it is best to consult a doctor as soon as possible so that he sends for an ultrasound examination. Make sure this time the embryo is developing correctly.
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