The first signs of an ectopic pregnancy in the early stages. Ectopic pregnancy: how to determine an ectopic pregnancy on your own, tests, signs, sensations Understand that an ectopic pregnancy is symptoms

Ectopic (or ectopic) pregnancy is found in only a few percent of women. However, not a single representative of the fair sex, waiting for replenishment in the family, is excluded from the risk zone. In other words, the possibility of an ectopic pregnancy always exists.

As you know, after the fertilization of the egg by the sperm, a zygote is obtained, from which the baby subsequently develops. The zygote should be located in the uterine cavity, but sometimes this does not happen, and these are the cases called ectopic pregnancy. Most often we are talking about the fact that the zygote remained in the fallopian tube. Other cases are possible when the zygote is located, for example, in the ovary or in the abdominal cavity, although this happens quite rarely.

What is the risk of an ectopic pregnancy?

Before talking about how long and how to determine an ectopic pregnancy, it is worth mentioning the danger that it creates for a woman. Such a pregnancy, in principle, cannot end with the birth of a baby - for its harmonious development, the zygote must be located exclusively in the uterine cavity. No matter how long the embryo stays in the wrong place, no other options for bearing a fetus in the female body are provided.

Therefore, the main problem of such a situation is precisely the threat to the life and even health of a woman. So, for example, a tubal ectopic pregnancy can cause a rupture of the fallopian tube, or the exit of part of the embryo into the abdominal cavity. Both are emergency situations that provoke internal bleeding and require immediate medical intervention, on the same day and hour. But it is best to detect an ectopic pregnancy early and avoid such incidents.

The main signs of an ectopic pregnancy

If you want to try to independently determine whether you have an ectopic pregnancy, then you should pay attention to the presence / absence of the following symptoms:

1. Delay of critical days in combination with pain in the lower abdomen, dizziness, fainting, general weakness. In other words, if your periods have not started in a timely manner, and you feel as if they are in full swing, this is a reason to be wary.

2. The presence of bloody discharge from the genital tract. This sign, on the contrary, is most noticeable in the period between menstruation. If your cycle has suddenly gone astray, then this, in any case, indicates problems in the body, and an ectopic pregnancy is one of the possible options for such problems.

When the fetus is located in the isthmus of the fallopian tube, such signs may appear as early as 5-6 obstetric weeks. If the fetus is located in a wider part of the tube, pain may appear after 8 weeks. If there is an abdominal or ovarian ectopic pregnancy, then the symptoms will also not appear quickly: at 5-6 weeks or later. Cervical pregnancy (with the location of the zygote in the cervix) can go unnoticed for a long time. However, it is she who can lead to the most profuse bleeding, up to creating a threat to the life of the patient.

Another easy way to determine an ectopic pregnancy at home

It is worth noting separately one more technique, which, in some cases, will help a woman herself diagnose an ectopic pregnancy. It's a faint second line on a pregnancy test. This situation may be associated with an excess of the concentration of the hCG hormone, which is produced in the female body during gestation. During normal pregnancy, the release of this hormone should also increase, but not immediately, but systematically, as the embryo develops. Therefore, a too light second strip is an objective reason for going to the doctor.

Symptoms that indicate the need to call an ambulance

If you feel severe pain in the lower abdomen, if you feel dizzy, you lose consciousness, you are overcome by sudden weakness, your skin turns pale, and bloody discharge comes from the genital tract, you need urgent medical attention. These symptoms suggest that an ectopic pregnancy may have caused a rupture of the fallopian tube, ovary, bladder, or intestines.

How to determine an ectopic pregnancy accurately?

Monitoring your well-being at home is an important guarantee of your health, but you should not limit yourself to it alone. If you are not 100% sure whether a uterine pregnancy is taking place in your body, then you should consult a doctor as soon as possible. He will conduct an ultrasound examination, which will give absolutely accurate information about the position of the fetus.

This is one of the reasons why the first ultrasound is recommended at an early stage of "position". It is better to go to the doctor once again and make sure that the embryo is located in the uterine cavity than to hope in vain for the baby to appear and endanger your health during an ectopic pregnancy.

In some cases, an ultrasound will not determine the exact location of a fertilized egg. So, for example, if it is located in the abdominal cavity, then during the study it may not be visible. However, the absence of a fetus in the uterus will already serve as peremptory evidence of the presence of an ectopic pregnancy.

Why is an ectopic pregnancy formed?

There can be quite a few reasons for such a deviation from the normal development of the fetus. Let's consider the main ones:

• Infantilism- improper development of the fallopian tubes. This is a congenital disease.
• Problems hormonal plan. So, for example, a painful hormonal background can lead to a narrowing of the fallopian tube. Excessive use of hormonal contraceptives or, conversely, means to stimulate ovulation can also cause an ectopic pregnancy.
• Surgical intervention. Any operations performed on the organs of the reproductive system increase the likelihood of incorrect positioning of the zygote.
• Diseases of the uterus(postponed, in the active stage, chronic). It can be both inflammatory processes and, for example, infections. They lead to the fact that the fallopian tubes narrow and cease to cope with their transport function.
• The presence of tumors including benign ones. They also make it difficult for the zygote to pass through the tubes.

Take care of your health and the health of your unborn child, and do it even before conception. And if you find symptoms of an ectopic pregnancy, contact your doctor promptly so as not to bring the situation to the removal of the uterus.

02/04/201802/10/2018 Olga Migunova

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 by doctors. The first signs of an ectopic pregnancy, if you know about them, should alert the woman and encourage her to make an appointment with a specialist.

What is an ectopic pregnancy?

An ectopic pregnancy is an abnormal, abnormal condition for the female body - this pregnancy carries a serious danger, even death. With the correct development of pregnancy, the fetus is in the uterus, this is the location intended for it by nature. If the fetal egg 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 the 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.

The concept of state

The development of the fetus takes place in the uterine cavity. In the normal course of pregnancy in the fallopian tube, the egg merges with the sperm. This is how fertilization occurs. Then it begins to divide and move into the uterus, where it implants and further develops. The gestational age is determined by the size and location of this reproductive organ.

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

If for some reason the egg does not get from the fallopian tube into the uterus, 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. Approximately 20% of women have a recurrence of such a pathological condition, 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. Types of these pregnancies:

• 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 located in the peritoneal cavity);
• cervical (fetus in the cervical canal of the uterus);
• interligamentous (the embryo is attached to the serous membranes of the abdominal cavity);
• implantation in the rudimentary horn of the uterus (one of the most dangerous types of ectopic pregnancy, there is a serious risk of uterine rupture);
• interstitial pregnancy (fetus in the interstitium of the fallopian tubes, a very rare type of ectopic pregnancy).

An ectopic pregnancy, like any pathology, has its own stages of development. Which the farther, the more dangerous it is for the woman's body - so if you notice at least some symptoms of an ectopic pregnancy in the early stages, 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?

Considering the question of what symptoms an ectopic pregnancy gives, what signs in the early stages 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, there may still be allocations. As a rule, they are scarce, 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. Alert, patients often purchase a pregnancy test.

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

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

Stages of an ectopic pregnancy

• progressive (occurs in normal physiological terms); the embryo, as it grows, compresses the tissues surrounding it, rupture of these tissues and bleeding is possible;
• intermittent (interrupts on its own, can cause a rupture of the fallopian tube); the fetus carries an infection, intoxication for the rest of the body. This condition often develops into peritonitis;
• interrupted (up to 6 weeks, medical abortion is possible, then surgery becomes necessary).

An ectopic pregnancy, which at 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, compresses the tissues surrounding it, which entails the possibility of rupture of these tissues and threatens with internal bleeding. After such a pregnancy is spontaneously terminated, the fetus carries with it infection and intoxication for the rest of the body. This condition often develops into peritonitis. 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 detect an ectopic pregnancy in time. The signs of this condition are quite difficult to determine. Therefore, at the slightest suspicion, contact a gynecologist who can literally save your life.

Preservation of appendages

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

But in some situations, doctors decide to keep the tube and perform an operation, which in medical terminology is called a salpingotomy. It involves cutting the tube, removing 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 condition and wants to preserve her childbearing function.

Sometimes segmental removal of the pipe 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 used. To do this, the drug "Methotrexate" is injected into the cavity of the tube, which dissolves the fertilized egg.

Preservation of patency of the pipes after surgery is possible in such situations:

• Early getting out of bed immediately after surgery, that is, the sooner the patient does it, the better (early getting up is the prevention of adhesions).
• Physiotherapy treatment.
• adequate rehabilitation.
• Absence of infectious diseases after surgery.

Signs of an ectopic pregnancy

Trying to independently answer the question: “Ectopic pregnancy at what time does it appear?”, 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 determine an ectopic pregnancy?

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

Danger

Pathological pregnancy is dangerous for its complications. The most common of them:

• Recurrence of pregnancy outside the uterus.
• Intestinal obstruction and postoperative inflammatory process.
• Infertility.
• Spikes.
• Heavy bleeding.
• Fatal outcome.

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

Signs of an ectopic pregnancy in the early stages:

• persistent mild pain in the lower abdomen can tell you about the stretching of the fallopian tube;
• mild menstrual flow in the presence of a positive pregnancy test (as well as any brown and reddish discharge outside of menstruation);
• cramping pain in the abdomen - often indicates a rupture of the oviduct;
• a clear sign of the presence of internal bleeding, due to detachment and death of the embryo, is severe weakness and severe pallor;
• if an ectopic pregnancy is interrupted by itself - the fetus breaks up, which provokes inflammation in the abdominal cavity, a rapid increase in temperature can tell you about this.

Sad consequences

The consequences of an ectopic pregnancy include:

• rupture of the tube with subsequent migration of the fetal egg 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 appendage;
• bleeding due to actual damage to the tube, which can be fatal for a woman;
• the development of peritonitis, if the 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 a pregnancy is only 2% of all pregnancies that occur. It must be borne in mind that for the occurrence of such a pathology as an ectopic pregnancy, there are quite serious prerequisites.

The embryo is attached to a place not intended for it in the female body 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 disrupt 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 promote the zygote to the uterus stop, which prevents the fetal egg 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 work of the thyroid gland can contribute to the cessation of the movement of the oviducts, as a result of which the fetal egg will not be able to reach the uterus);
• non-standard arrangement of organs (deviations from the norm, which are immediately noticeable on ultrasound and include this woman in a high-risk group for the occurrence of an ectopic pregnancy in her, signs in the early stages of which are a reason 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 relating to the female genital organs (including abortions in the past).

Effects

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

Typical consequences:

1. A significant decrease or complete disappearance of the childbearing function due to the removal of the fallopian tube, ovaries or any other important organ for medical reasons;
2. Neuroendocrine and vegetovascular disorders of a wide spectrum;
3. A significant increase in the risk of recurrent ectopic pregnancy in the event of conception;
4. Adhesions in the pelvis;
5. Numerous regular bacterial infections of the genital organs, due to a decrease in the level of local immunity;
6. Lethal outcome in the absence of qualified medical care in case of spontaneous miscarriage or rupture of the fallopian tube.

Pregnancy after an ectopic

If the fair sex had the 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 become completely infertile.

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

Does the test show an ectopic pregnancy?

The mother's body perceives the embryo born in it - only as an alien object that can pose a threat. That is why, in order to protect the embryo from a possible attack on it by the immune system, the body is rebuilt.

HCG during an ectopic pregnancy: how the restructuring occurs

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

During the occurrence of an ectopic pregnancy, the same thing happens. The only clear difference is the fluctuating level of hCG (when the embryo dies, hCG drops sharply). In view of this, menstruation stops with an ectopic pregnancy - just like 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 randomly. This is one of the clear signs of an ectopic pregnancy in the early stages - therefore, you should at least be alerted.

Will the test show the presence of 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 strips will be reflected on the test. Exactly the same as he shows in a standard pregnancy. However, if the ectopic pregnancy froze or terminated, the test may also show a negative result. If you have done tests to detect pregnancy at different periods - and received different results each time, this is an occasion to urgently go to the gynecologist and do an ultrasound of the female organs. A negative test after several positive tests that have been done before can mean the death of the fetus. This is also evidenced by fever, weakness, pallor unusual for you. With an ectopic pregnancy, such a spontaneous termination of the embryo's vital activity often occurs, and if you do not notice this, then you have a serious risk of infection of the body with embryo decomposition products.

When can a pathology be diagnosed?

What period can become 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 ectopic pregnancy is carried out at a certain time

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

What will the test show?

As with the normal development of pregnancy, menstruation in the early stages of an ectopic can be: they have a smearing consistency and color that is unusual for normal menstruation. 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 stripe 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 supersensitive 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 Douglas puncture. What is meant? A small area between the uterus and the anterior surface of the rectum. Piercing the posterior fornix of the vagina, the doctor removes the fluid for further examinations in the laboratory.

Accurate diagnosis can be made only after receiving the results.

Corpus luteum in WB

The corpus luteum is a specific gland that is produced during ovulation, and in turn produces progesterone. After the release 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 helps to 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 during ectopic pregnancy

In the first phase of egg development, there are no differences between ectopic and normal pregnancy: basal temperature indicators vary 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.

Differences can be observed a little later. With normal implantation of the fetal egg in the uterus, which occurs 7-10 days after the release of the cell, a decrease in temperature should occur. In the values ​​of basal temperature during 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 for a period of 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 outflow of blood.

Pathology warning

To prevent the occurrence of pregnancy outside the uterus, the following rules must be observed:

• Prevent the development of inflammation of the organs of the genitourinary system, treat them in time.
• Before planning a pregnancy, undergo an examination, including an analysis for the presence of microbes such as chlamydia.
• Protect yourself from unwanted pregnancies by using high-quality contraceptives.
• Avoid abortion.
• If it is necessary to terminate a pregnancy, sparing methods should be chosen and this should be done at the earliest possible time (up to 8 weeks). Vacuum abortion reduces the time of the operation, after which fewer complications develop.
• You can use medical termination of pregnancy, but the drugs are taken under the supervision of a doctor.
• After a pathological pregnancy, it is necessary to undergo a rehabilitation course, be observed by a gynecologist, and follow all his recommendations. About a year after the operation, you can plan a pregnancy.
• If pregnancy occurs, it is necessary to register in the antenatal clinic as early as possible.

Surgical elimination of ectopic pregnancy

To remove from a woman a fetus that is incorrectly located inside her abdominal cavity or in one of the tubes - alas, is possible only by surgery. The method of promptly eliminating this pathology depends entirely on how long you discovered the presence of 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 in yourself.

Ectopic pregnancy: operation and its options

Most often, a woman is concerned about the question: “If I have an ectopic pregnancy, how long does the operation last?”. The duration of the operation depends on the duration of diagnostic manipulations and the condition of the patient, 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 have not yet been torn, deformed, and serious harm has not yet been done to the body. With this option, a laparoscopic operation is prescribed, in which the incision is made no more than 1.5 cm (the embryo is removed during it, the oviduct is then sutured).
• A less successful option, but not yet the most alarming, is if the fetus has already caused impressive deformations to the body, then the embryo is removed along with the fallopian tube, or even along with the ovary (however, the woman has the opportunity to become pregnant and carry 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 may 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 recovery procedures:

• a course of antibiotics (to avoid the possibility of developing a postoperative infection);
• a course of droppers, where she will be injected intravenously with isotonic solutions to restore the water and 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 termination of pregnancy, the medication is limited to one or two doses. When diagnosing 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 gestation period does not exceed 6 weeks;
• the indicator of the analysis of human chorionic gonadotropin is not higher than 5000;
• no bleeding in the patient (spotting);
• lack of cardiac activity in the fetus during ultrasound;
• there are no signs of rupture of the fallopian tube (there are no intense pains and bleeding, blood pressure indicators are normal).

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

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.

With late detection of an ectopic pregnancy, surgical intervention is performed. A sparing option is laparoscopy, in the absence of the necessary tools, a full-fledged abdominal operation is prescribed.

There are two types of surgery performed by laparoscopy:

1. Salpingoscopy during ectopic pregnancy is one of the sparing operations and retains the possibility of further childbearing. The embryo is removed from the fallopian tube through a small opening. Carrying out the technique is possible with an embryo size of up to 20 mm and the location of the fetal egg at the far end of the fallopian tube.
2. Salpingectomy for ectopic pregnancy is performed with a significant stretching of the fallopian tube and a possible risk of rupture. Excision of the damaged part of the fallopian tube takes place, followed by the connection of healthy areas.

Surgical intervention in pathological pregnancy is carried out urgently or 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 of a general practitioner;
• consultation with a gynecologist.

Recovery 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 extract the fetal egg, a constant check of hemodynamic parameters should be carried out (to exclude internal bleeding). In addition, a course of antibiotics, painkillers and anti-inflammatory drugs is prescribed.

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

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

Primary prevention

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

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

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

• in time to treat various infectious diseases of the genital organs;
• in case of in vitro fertilization, with the necessary frequency, undergo an ultrasound examination and take tests for the content of human chorionic gonadotropin in the blood;
• when changing a sexual partner, be sure to undergo tests for a number of sexually transmitted diseases;
• use combined oral contraceptives to avoid unwanted pregnancy;
• treat pathological diseases of 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 weight 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 the loss of health, but also the occurrence of infertility. The worst option for thoughtless delay can be fatal.

Normal pregnancy after ectopic pregnancy

Due to the fact that the ovaries and oviducts are located in the female body in two, a woman has the opportunity to become pregnant even after the removal of 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 mandatory 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 a future pregnancy);
• it is necessary 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, have an ultrasound scan and carefully monitor the further course of pregnancy until delivery. And pay attention to the possible symptoms of an ectopic pregnancy in the early stages! 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.

• Expert
• Latest Articles
• Feedback

About the expert: +MAMA

We are the friendliest site for moms and your babies. Questions and answers to them, unique articles from doctors and writers - we have it all

• Thrush in the mouth of a baby - 11/29/2019
• How to breathe properly during contractions and childbirth - 11/28/2019
• What to eat while breastfeeding - 11/26/2019
• How to wean a child from breastfeeding - 11/25/2019
• Pregnancy planning - 11/21/2019
• Discharge after childbirth and caesarean section - 11/21/2019
• Uterine tone during pregnancy - 11/20/2019
• Discharge during pregnancy - 11/19/2019
• Umbilical hernia in newborns - 11/15/2019
• Hemorrhoids after childbirth - 11/11/2019

See all

Risk group

There are some factors that can contribute to the development of a pregnancy outside the uterus. Women, whose risks are increased, should be especially careful to monitor the symptoms of the manifestation of such a pathology. Common causes of ectopic pregnancy:

1. genetic predisposition. If there were cases of ectopic pregnancy in the family, the chance of its development increases.
2. Premature sexual intercourse.
3. High sexual activity and promiscuity.
4. Age over 35 years.
5. Venereal diseases.
6. Congenital anomalies of the female genital organs.
7. The use of an intrauterine device as a method of contraception.
8. Inflammatory processes of the ovaries and fallopian tubes, operations. In these cases, adhesions can form, causing obstruction of the fallopian tube.
9. Hormonal disorders.
10. Frequent abortions.
11. Slow partner spermatozoa.
12. Treatment of infertility.
13. IVF procedure.

Optionally, the presence of these factors may cause the development of 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

Diagnosis 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 a qualitative, not a quantitative test, 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 to suggest 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 ensures the 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 normal pregnancy increases by 2 times every 36 hours. Determination of it in the blood is the most reliable in terms of diagnosing its early terms.

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 development of the embryo, the threat of interruption, placental insufficiency, non-developing pregnancy. The information content 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 exactly the localization of the fetal egg. But scanning provides an opportunity, by indirect signs, to suggest the presence of pathology. If necessary, a diagnostic laparoscopy is performed to more accurately determine the site of implantation of a fertilized egg.

Consequences and prognosis

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

The main question that interests a woman after the operation 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 a woman getting pregnant when one ovary is removed are reduced several times. But it is necessary to undergo an examination of the second tube and the other ovary. Cases have been repeatedly recorded when a woman happened to become a happy mother.

Is it possible to 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 infertile.

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

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

After the operation, the tube is sutured, and the onset of pregnancy again becomes possible. 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 in 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:

1. Progressive pregnancy (early stage).
2. Pregnancy at risk of interruption (intermittent). This is a condition in which the fallopian tube bursts or spontaneous rejection of the embryo occurs;
3. 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 a multiple pregnancy, during which one of the fertilized eggs is fixed in the uterus, and at the same time another cell is attached outside it.

At what time does the fallopian tube burst

An ectopic pregnancy requires medical clearance as early as possible. The tubes in which implantation most often occurs are not designed by nature for bearing a child. They are not made up of elastic tissue like the uterus. When the fetus grows, they cannot withstand the load and are torn.
How long can this 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 for an ectopic location of the embryo exists in the very early stages.

What week does the pipe burst? On average, an ectopic or ectopic pregnancy lasts 4 to 12 weeks. From the place of attachment of the fetal egg depends on how long the pathology develops.

Fallopian tube rupture

Early rupture is possible with a small diameter of the tube at the implantation site. So, in its isthmic part, stretching is possible by a maximum of 2 mm. Then the rupture of the tube 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 attachment of the embryo occurred in the lower (interstitial) part of the fallopian tubes. This area directly borders the uterus, so it is the most elastic.

How long will 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 to 12 weeks.

How to interrupt

Interruption of such a pregnancy always occurs, the fetus inevitably dies, this is usually carried out for 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.

Medical interruption

Drug therapy is effective in the early stages and involves the use of drugs, the action of which provokes spontaneous abortion. The fetus safely exits the body on its own. Such treatment does not adversely affect 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 remove the embryo.

Is it possible to keep the pregnancy

Most doctors, when asked whether it is possible to give birth with an ectopic pregnancy, whether it is possible to save it, give a negative answer. 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, this 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 sites outside the uterus grows, stretches, and injures nearby tissues, causing internal bleeding.

It is necessary to carry out the operation as soon as possible. In this case, there is a chance to save the fallopian tube, although basically the oviduct is amputated along with the fetal egg - this is a necessary measure.

It is important to remember that an ectopic pregnancy cannot pass into a uterine one.

Surgery

Previously, laparotomy was used in most cases. To do this, it was necessary to open the anterior abdominal wall. Recently, this method is used very rarely only in a critical case or when there is no other equipment in the clinic.

The main goal of the operation is the elimination of the embryo. It is impossible to save the fetus, since it cannot develop into a child. But it is possible to harm the health of a woman 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 tool is inserted. The doctor monitors the progress of the operation on the monitor of the apparatus. 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 with laparoscopy the operation is performed without injuring the tubes. After rehabilitation, after a short time, a woman can become pregnant again.

In recent years, the operation to remove the tubes is 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.

Surgery can be done in several ways:

1. Tubotomy. The tube is cut where the fertilized egg is located. It is removed, and the pipe itself is sewn. If there is a large embryo, part of the tube is removed, but the woman still has the opportunity to become pregnant.
2. extrusion. If there is a fruit close to the pipe, it is simply squeezed out. Do this only if the fruit is whole and is close to the exit.
3. Tubectomy. In the case when it is impossible to eliminate the fetus, but it is impossible to leave the tube, it must be removed.

What to do

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

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 is resorbed. The drugs have serious side effects, primarily the liver and kidneys suffer, and alopecia may appear.

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

Which method of surgical intervention

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 the extrusion method.

1. Laparotomy. It is used in especially acute cases, if there is a threat to life. A rupture was diagnosed, a large blood loss. A longitudinal incision is made in the abdominal wall under general anesthesia. The fetus is removed along with the tube.
2. Laparoscopy. Low-traumatic procedure, childbearing function 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 tube, there is an adhesive process, the doctor simultaneously restores patency.
3. Milking. Not commonly used method. Represents the extrusion of an egg from an intact, with normal patency, tube. The method is considered less traumatic, the childbearing function 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 organ rupture.

Note!

It is possible to get rid of the pathology by medication, but only at an early stage, when the egg 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 has and how to feel the pathology.

With ectopic signs in the early days are very similar to the manifestations of ordinary conception. These include aching pains in the lower abdomen, lack of menstruation, the appearance of spotting, the breast increases in size, toxicosis is felt.

A woman who takes 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 reacts specifically to it.

Only a gynecologist can accurately establish the diagnosis.

Can abnormal attachment of the fetal egg occur during IVF?

Infertile women using reproductive technologies are wondering if there can be an ectopic pregnancy with IVF?

Statistics state that the probability of abnormal implantation of the embryo 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.

An ectopic pregnancy in IVF often occurs due to the same cause that caused infertility.

Reasons for development

There are different 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. Causes and risk factors are as follows:

1. congenital disorders.
2. Tumors. In the presence of benign tumors, the patency of the uterine tubes worsens.
3. Chronic salpingitis. With this disease, adhesions form in the pipes. This leads to an inflammatory process due to an infectious disease.
4. Chronic or previous diseases of the ovaries, bladder and uterus. They can be caused by such types of infections as chlamydia, mycoplasma, ureaplasma.
5. Congenital tubal pathology. In medicine, this disease is called infantilism of the fallopian tubes: they are irregular in shape, can be very long or winding, which prevents a fertilized egg from reaching the uterus.
6. ECO. With artificial insemination, the egg is injected into the uterus, but it can penetrate further. This happens quite often. The statistics are relentless, but this is often the only way for women who have had their tubes removed or with various forms of infertility.
7. Contraception. Use of 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 matter. It is this hormone that "blocks" ovulation. The problem is that drugs that contain estrogen are prescribed to women over 35 and who are breastfeeding 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 received wide distribution. Today, the main method of treatment is laparoscopy.

Who is at risk

An ectopic pregnancy can be caused by a number of reasons. The study 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 pathologies of the genital organs, which are inherited;
• transferred operations in the small pelvis;
• infections and inflammation;
• sedentary lifestyle.

Types of ectopic pregnancy

Preventive measures

An ectopic pregnancy cannot be predicted - 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;
• plan pregnancy - for example, before conception, undergo a full examination by doctors of general and subspecialties.

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

More details about ectopic pregnancy - in the video review:

Tsygankova Yana Alexandrovna, medical observer, therapist of the highest qualification category.

• Cerebral palsy: causes and forms

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

Conditions for the origin of ectopic pregnancy

This is a dangerous case

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

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

The cell, thanks to the ciliated epithelium lining the inner surface of the fallopian tubes, moves deep 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 conception process.

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

1. The ability to reduce the fallopian tubes, which makes it difficult for the passage of spermatozoa. This leads to too early or late meeting of the female cell with the male. This means that all subsequent mechanisms of implantation can be violated.
2. Movement of the ciliated epithelium due to hormonal failure (activation begins under the action of estrogen produced by the ovaries). There is a finding of a zygote in a pipe or its movement back.
3. Spasmodic contractions of the tube due to disruption of progesterone production. The cell cannot move into the uterus, and is looking for where to gain a foothold.
4. Secretions of the epithelium in the tubes, which slows down the process of egg advancement.

Since the fetal egg is attached ectopically, the normal course of pregnancy and the formation of the 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 come out on its own. But there is a high probability that the growing fetus will provoke a pipe rupture 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:

• tumor of the appendages and uterus;
• abdominal surgery;
• the impact of hormonal drugs;
• disorders of the transport functions of the fallopian tubes;
• adhesive processes;
• hormonal disbalance.

The main reason is the slow progress of the fetal egg through the tube, the high activity of the trophoblast.

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

Algorithm for providing emergency first aid to a patient

The standard of medical care for patients with rupture of the tube and bleeding is to carry out urgent surgical intervention, remove an ectopic pregnancy, and stop blood loss. Before the arrival of the ambulance, it is necessary to ensure the patient's rest and a horizontal position of the body.

A rupture of the tube 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 does a woman feel

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

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

How do the first symptoms appear?

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

Is the uterus enlarged

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

Bleeding

Abundant bleeding is the first sign of danger. The development of the embryo in the tube inevitably leads to its rupture, which causes life-threatening internal bleeding. A miscarriage when fixing the fetal egg in the tube can occur at 10-12 weeks. There may be no discharge from the vagina, or they may be meager, 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. Before the arrival of the car, the patient is required to lie down. After confirming the diagnosis, medical treatment or surgery is performed to remove the embryo and stop bleeding.

How to avoid later

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 the hormonal background, individual contraception is selected. Before planning motherhood, a woman needs to be treated, check the tubes.

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

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

Consequences of late removal

If a woman after an ectopic tubal pregnancy decided to have a baby again, this should 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%, tubal pregnancy twice - 20%, infertility - 30%. The numbers are serious, so you can’t let your health take its course, but plan everything.

Go for an ultrasound

Conservative treatment

Methotrexate is a drug to suppress cell growth, is actively used by oncologists.

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

• the size of the fetal egg 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 tubal rupture - evidence of tubal rupture is an absolute contraindication

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

A woman must 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 determine a pathological 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 a 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.

Increase in basal body temperature

Many representatives of the fair half are accustomed to monitoring their basal body 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, BBT 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.

Absence 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 a delay. These can be such provoking factors as a nervous shock, hormonal failure, serious illnesses, including oncology. In addition, one cannot be one hundred percent sure that there is no pregnancy during the onset of menstruation, since many girls have menstruation after conception.

morning sickness

You can recognize the onset of conception at an early date by morning sickness. Many women know about this ailment during pregnancy. Often this symptom also appears in the daytime and evening. This is due to hormonal changes in the body, a drop in sugar and some other reasons. Noticing such signs, you should do a pregnancy test. The most accurate test is considered digital. If he showed two stripes, it is important to undergo a medical examination as soon as possible.

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

Changes in the mammary glands

When pregnancy occurs, many girls already in the early stages notice such signs from the chest:

• darkening of the nipples, increasing their sensitivity;
• pain in the chest, it becomes as if bumpy;
• breast swelling;
• veins in this area become clearly visible;
• darkening of the areolas;
• the bumps on the areolas become more noticeable, their number often increases.

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

Increased vaginal discharge

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

Fast fatiguability

When pregnancy occurs, it doesn’t matter if it is ectopic or proceeds normally, the woman’s body already undergoes 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 rapid fatigue. Girls note a constant desire to sleep, motor activity is significantly reduced. In addition, the role of a relaxing factor is the hormone progesterone, 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 experience such a phenomenon as frequent urination. The fact is that when pregnancy occurs in the body, human chorionic gonadotropin begins to be produced. HCG is the so-called pregnancy hormone. As a result, the blood supply to the pelvic organs increases. At the same time, the urge to urinate is observed even with a slight filling of the bladder. This symptom intensifies at night.

Pain 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. Cramps can also be observed during normal pregnancy. In this case, pain is considered quite normal, because the uterus is constantly contracting, and with the development of the fetus, its spasms are observed.

Sound the alarm should be in the event that the pain is accompanied by bleeding. Such a sign as the appearance of blood can indicate both an ectopic pregnancy and a threatened miscarriage. In such a situation, you need to contact the gynecologist as soon as possible. If we consider the question of when the 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 period. Do not confuse these two states. Every woman knows when she has her period and what is the nature of the discharge.

Indigestion

In connection with hormonal changes, the usual work of the intestinal tract is disrupted. The walls of the stomach and intestines under the influence of progesterone relax, 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 ectopic.

You might be interested in: 6 weeks pregnant

Increased sensitivity to odors

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

Nasal congestion

When conception occurs, immunity decreases. This is a normal physiological process that ensures the acceptance of the fetus 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 pimples 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. Along with inflammation, acne can appear on the skin.

Change in 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. In this case, the mood can change several times a day. A woman can laugh, and after five minutes cry. Such "swings" are observed due to changes in the hormonal balance of the body.

Positive pregnancy test

And, of course, the surest way to determine pregnancy at an early stage, which can be done at home, is a test. The test will show the onset of an ectopic pregnancy or not? To date, there are many 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 fuzzy, and the second clear line, you should hurry to the doctor. From the first days of conception, the test may show a negative result.

The earlier an ectopic pregnancy is diagnosed, the greater the chance of maintaining health and eliminating dangerous consequences.

Prevention

Prevention of pathological attachment of the fetal egg 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 if signs such as increased vaginal discharge, a change in their color, smell, the appearance of pain during intercourse, itching in the vaginal area appear;
• exclusion of bad habits (smoking, drinking alcohol);
• regular preventive examination by a gynecologist.

Compliance with these simple measures will help prevent the onset of an 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 discuss below.

Why does an ectopic pregnancy occur?

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 weakly expressed. As a rule, they coincide with the signs of a normal pregnancy.

Without tests and examination by a gynecologist, it is impossible to diagnose WB in the early stages.

Is it possible to have sex with such a diagnosis

This question should be addressed to a doctor. 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?

Organ removal 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 save the organ.

How long can you not have sex after surgery

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

Does implantation bleeding occur 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 WB possible with ligated tubes

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 get pregnant quickly 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 sufficiently, and the scars have not healed, the likelihood of a second ectopic pregnancy is quite high.

Can this pregnancy come out on its own?

Cases of miscarriage with WB are indeed recorded. In this case, as a rule, a woman has bleeding that is life-threatening. If you suspect such a condition, you should immediately go to the hospital.

What threatens such a state

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

Can an ectopic pregnancy turn into a uterus?

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

Why does the egg attach itself outside the uterus?

Why does an ectopic pregnancy syndrome occur? As we have already found out, unlike intrauterine, with ectopic, the 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 very diverse. Let's consider the most common of them.

Physical disorders in the body

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

• adhesive processes;
• cysts;
• scar formation;
• oncological diseases of the reproductive system;
• transferring an abortion;
• various inflammatory processes;
• sexual infections.

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 medical treatment and minimally invasive surgical techniques.

Congenital diseases of the uterus and appendages

The etiology of ectopic pregnancy often hides the reasons, which are 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 life of the patient.

Some types of contraception

No matter how it sounds, but some contraceptives can actually cause an ectopic pregnancy. The fact is that they protect the uterus from the attachment of a fertilized egg, but 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 is valid for no more than five years. If it is in the body longer, the spiral no longer performs 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 become pregnant who cannot do this naturally for various reasons. It would seem that this procedure should completely exclude 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, there are such factors that provoke cases of ectopic attachment of a fertilized egg. The pathogenesis includes:

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

Bad habits are a common cause of ectopic pregnancy.

Specialists pay attention to the fact that patients who once encountered an ectopic pregnancy are much more likely to recur this pathological condition.

According to statistics, four out of 100 women have a pregnancy that does not have any pronounced differences from a normal pregnancy in the early stages. Seeing the usual two strips on a pregnancy test, not a single woman even suspects that after a while she may end up on the operating table or even die from blood loss ...

Of course these days the medicine has come a long way, and the risk of death in cases exists only in case of incorrect and late diagnosis, whereas in the past, only one in six women with ectopic pregnancy survived. An ectopic pregnancy is a very dangerous condition and one of the most common causes of infertility in women who terminate a pathological pregnancy in the first trimester of pregnancy.

Women who have undergone ectopic pregnancy, experience a strong fear of the onset of a new pregnancy and pass it on to everyone around them. They are catastrophically afraid of not getting pregnant at all or that the pregnancy will again be ectopic. In fact, during the period of conception, a woman needs to be calm and relaxed so that it is easier for a fertilized egg to reach the uterus.

For this reason, we decided to divert women from dark thoughts and educate them about the symptoms of an ectopic pregnancy so that they can understand and consult a gynecologist for help in early pregnancy. After all, the longer the duration of an ectopic pregnancy, the less chance a woman has to maintain her childbearing function. First you need to know what kind of pregnancy doctors call ectopic?

Any pregnancy begins after fertilization eggs, which for subsequent proper development must move into the uterine cavity and attach to its wall. Sometimes, due to the presence of various obstacles and failures, the fetal egg is not able to reach the place and is attached to the fallopian tube, cervix, ovary, and even to the abdominal cavity. Such a pregnancy is called an ectopic.

Dr. DeMuro is a board-certified pediatric emergency surgeon based in New York City. Graduated from Stony Brook University School of Medicine in 1996.

Number of sources used in this article: . You will find a list of them at the bottom of the page.

An ectopic pregnancy is one in which a fertilized egg is invaded (attached) not in the uterus, but in the fallopian tubes or other anatomical structures. If left untreated, as well as with an undiagnosed uterine pregnancy, this condition may require emergency medical care. That is why it is so important to recognize the symptoms of an ectopic pregnancy in time, as well as consult a doctor who will make an accurate diagnosis and prescribe treatment if necessary.

Steps

Part 1

Notice the absence of menses. If you don't have a period and have had unprotected sex, take a pregnancy test.

Try to identify other pregnancy symptoms. If you are pregnant, whether the egg has invaded the uterine wall (as it should normally) or whether it has invaded, for example, the fallopian tubes or somewhere else (with an ectopic pregnancy), you will most likely still notice some common symptoms (if not most):

Try to see if you have any abdominal pain. If you have already received confirmation that you are pregnant, or if you are still in doubt but experience frequent abdominal pain, an ectopic pregnancy may be the cause.

Pay attention to any vaginal bleeding. Light bleeding can occur due to irritation of the fallopian tubes when they are subjected to mechanical stress, such as scratching, more profuse and serious bleeding can occur if the fetus has already grown to such a size that it can damage (simply tear) the fallopian tubes. Vaginal bleeding in any case (even with a normal pregnancy) is a warning sign that you need to see a doctor. Especially if we are talking about heavy and constant bleeding - in this case it is best to seek emergency help (and the sooner the better).

The doctor will prescribe drugs that will allow you to terminate the ectopic pregnancy. The most common drug in such cases is the drug "Methotrexate". It is introduced into the body by intramuscular injection (one or more, depending on the urgency of successfully terminating the pregnancy).

Normally, pregnancy develops as follows: the most active sperm reaches the female egg and penetrates into it, as a result of which the latter is covered with a special protective shell that is impermeable to other sperm. The zygote formed as a result of the fusion of two cells sets off on a “journey” to the uterus and, having penetrated into its cavity, is fixed there. Usually, implantation occurs in the area of ​​the bottom or posterior wall of the female uterus. In the presence of certain deviations, the embryo may not reach the uterus and gain a foothold in the fallopian tube or elsewhere, for example, in the ovary. In this case, an ectopic pregnancy develops.

The considered deviation, although it is relatively rare - approximately 2-3% of all cases of pregnancy - cannot be ignored, because, unfortunately, no one is immune from such a situation. The exact causes of the occurrence of such a pathology have not been established to this day, but the consequences are known to every specialist, and they are not the most favorable and comforting.

It is extremely difficult to determine that pregnancy develops outside the uterine cavity without the use of appropriate diagnostic measures, but there are a number of signs that allow us to draw tentative conclusions on this matter. It is with information regarding this occasion that you are invited to read further. You will get a basic understanding of an ectopic pregnancy, learn how it can manifest itself and what you can expect if such a pathology is diagnosed.

In accordance with the place of fixation of the fertilized egg, ectopic pregnancy is further classified into 4 main groups. Information about this is given in the following table.

Table. Types of ectopic pregnancy

Thus, the main reasons for the development of an ectopic pregnancy are, firstly, endometrial dysfunction (it is to this tissue that a fertilized egg is attached), and secondly, low patency of the fallopian tubes. In turn, various diseases and external injuries most often lead to the occurrence of these disorders, including:

• neoplasms;
• congenital pathologies;
• endometriosis;
• salpingitis;
• artificial termination of pregnancy;
• operations on the pelvic organs or fallopian tubes that have undergone complications;
• the use of low-quality or simply inappropriate intrauterine contraceptives;
• unsuccessful artificial insemination.

How to recognize an ectopic pregnancy: the first signs

The first signs of an ectopic pregnancy usually do not differ in any way from the signals of normal fertilization: menstruation stops, breasts fill up, toxicosis occurs, etc.

Later, when it comes to internal damage to the implantation site of the embryo, the manifestations become much more unpleasant, namely:

If you experience any of the above symptoms, be sure to consult a doctor.

Also, the following method can be attributed to the means of home diagnosis of ectopic pregnancy. So, you have noted signs of pregnancy in yourself and suspect that you are in an “interesting position”. To see if this is the case, buy a special test at the pharmacy, or rather several, from good and different manufacturers.

Use the test as instructed. If the characteristic “2 stripes” appear, you are pregnant and everything is developing normally. If there is only one “stripe”, you are either not pregnant, or the fertilized egg is fixed outside the uterus. Under any circumstances, seek the assistance of a qualified professional to clarify the situation.

The essence of the above test is as follows: after the embryo is fixed at its destination, the female body begins to intensively produce a hormone called hCG.
It is on its content in the urine that the previously mentioned pregnancy test reacts. If the fertilized egg is fixed outside the uterus, the hormone is either not produced or produced in a much smaller amount, as a result of which the second strip on the test may not be colored or be extremely mild.

The prognosis for maintaining pregnancy is extremely unfavorable. With ectopic fixation, the fetus does not have the conditions for normal development: the embryo lacks space and nutrients, but for some time it continues to grow, increasing pressure on the place of fixation, as a result of which the latter simply breaks. This leads to very severe pain and bleeding. In this case, the patient needs urgent medical attention.

In general, the likelihood of fetal survival during an ectopic pregnancy is extremely small. To avoid infertility or even more serious consequences, experts in most cases recommend that women resort to the procedure of artificial termination of pregnancy. The rest of the procedure is determined by the individual characteristics of a particular situation.

Treatment Options for Ectopic Pregnancy

Only a qualified specialist can deal with the issues of the need and expediency of using any therapy for ectopic pregnancy. It is extremely reckless to resort to independent uncontrolled treatment in such a situation - you can aggravate the situation even more seriously and provoke the most adverse consequences.

In general, in the early stages, doctors prescribe special drugs, the intake of which provokes an independent rejection of the fetus by the female body. For the patient herself, such treatment, as a rule, is completely safe.

At a later date, it is often necessary to resort to surgical resolution of an ectopic pregnancy using the laparoscopy method. During this procedure, the doctor removes the fetal egg before it begins to destroy the fixing organ. The essence of the procedure is as follows: 3 holes are made in the patient's abdominal cavity. They introduce special tools and a camera that allows you to control the process. As a result, the doctor manages to get rid of the fetal egg with relatively little harm to the patient's body.