Ectopic pregnancy

Ectopic pregnancy - signs, causes, treatment

In fact, ectopic attachment of the fetal egg is not such a rarity: although it is not pleasant in this, but because of the frequency of occurrence, doctors have already learned how to quickly determine an ectopic pregnancy and take the necessary measures to prevent risks and minimize the consequences . However, forecasts for the future for women will depend on a number of factors.

Of great importance is, at what time the extrauterine pregnancy makes itself felt, and how. Unfortunately, in 5-10% of all cases a woman really can not have children anymore. But in time the undertaken actions help to avoid many troubles, including, to preserve the functionality of the female reproductive system. So, the main thing is not to miss the time.

Why is the egg not in the uterus?

When the sperm fertilizes the egg, the sperm begins to move along the fallopian tube and is attached to the uterine wall at the end of the path for further development and growth - implantation takes place. This is how a normal pregnancy begins, during which the egg is improved, constantly divided, the fruit is formed, from which by the end of the term a full-fledged child grows ready for life outside the womb of the mother. For this complex process to proceed, you need a certain "dwelling" for the egg and a space for its growth. The uterine cavity is an ideal option.

However, it happens, that the egg does not reach its destination and settles earlier. In 70% of cases it is attached to the fallopian tube, but other variants are also possible: to the ovaries, to the cervix, to any of the organs of the abdominal cavity.

Causes of ectopic pregnancy

There are several reasons why an egg can not reach the uterus:

  • Disorders in the condition of the walls and functioning of the fallopian tubes when they are poorly contracted and unable to move the egg further). This often happens because of previous diseases of the pelvic organs, as well as chronic inflammatory diseases of the genital organs, in particular STDs.
  • Anatomic features of the fallopian tube (for example, infantilism): too narrow, convoluted, scarring or scarred tube impedes and slows the progress of the egg.
  • Previously surgical operations on the fallopian tubes.
  • Previous abortions, especially if the woman's first pregnancy was interrupted by artificial means.
  • Slowness of sperm: the egg "waits" for fertilization, because of what does not have time to reach the right place in time, that is, to the uterus - hunger compels her to settle earlier.
  • Hormonal disorders in the body of a pregnant woman.
  • Tumors on the uterus and appendages.
  • Change in the properties of the fetal egg.
  • Wearing a female contraceptive intrauterine device.
  • Some technologies of artificial insemination.
  • The constant nervous overexcitation of a woman, in particular, the fear of becoming pregnant and unreliable methods of prevention, does not allow her to relax, which causes spasms of the fallopian tubes.

Of course, ideally, you should try to exclude all possible causes of ectopic pregnancy at the planning stage.

Symptoms of an ectopic pregnancy

How do you know that the pregnancy that has occurred is an ectopic pregnancy? In fact, "to see" it is not easy. Symptoms of this pregnancy are exactly the same as normal physiological: the next monthly does not come, the breast is poured, the uterus is increased and can sip, toxicosis is possible, the appetite and taste preferences are changed, and so on. But something can still cause certain suspicions.

With ectopic pregnancy, from the first days there may be spotting bloody discharge of dark color. It happens that the next menstruation comes at the appointed time or with a slight delay, only the allocation is weaker than usual. In this case, the pulling pain in the lower abdomen gives into the anus, and if the fallopian tube is torn - it becomes unbearably strong, acute, until the loss of consciousness, bleeding begins. With internal bleeding, weakness and pain are accompanied by vomiting and low blood pressure. In such cases, the woman must be rushed to the hospital urgently for an urgent operation.

Ectopic pregnancy is most easily confused with the threat of miscarriage. But it is this that makes it felt: it begins to interrupt, which usually takes place at 4-6 weeks. So that the worst does not happen, it is necessary to make a diagnosis on time. And therefore, as soon as you find out that you are pregnant, immediately go to the gynecologist and ultrasound. This will allow you to sleep peacefully, because in such cases, the location of the fetal egg immediately becomes known (in most cases).

How to determine an ectopic pregnancy?

Successful resolution of the situation with ectopic pregnancy will depend on the stage of its development. On account of pregnancy become in the second-third month, and it's already a little late & hellip; Therefore, as soon as you have the slightest suspicion of something wrong - you must immediately make sure of the existence of the problem or exclude it. This happens by inspection.

First, you need to make sure that the pregnancy has really come. It is easier and faster to do a home pregnancy test. However, it is not necessary to rely on the test in any case: the gynecologist will be able to confirm the conjectures about the conception that has taken place during the internal examination. However, this is not always the case: if the period is not large enough or the egg is too small, the only way to reliably ascertain whether pregnancy has come or not will be a pelvic ultrasound with the introduction of a transvaginal sensor and a blood test for hCG.

If it's too late to guess - there are all signs of a pipe rupture or abdominal bleeding - immediately call an ambulance: this condition is dangerous for life! And in no case do not take any action yourself: do not drink painkillers, do not put ice-warmers, do not put an enema!

Basal temperature in ectopic pregnancy

Women who have a basal temperature schedule may at the earliest possible time suspect a pregnancy. After conception in the body of the future mother, progesterone begins to be intensively developed, which is necessary to ensure the vital activity of the egg and create favorable conditions for its further development. It is the increase in the level of this hormone that causes the growth of basal temperature. Indicators can be guided only in the event that the measurements are made from month to month according to all rules, at least for 4-6 consecutive cycles.

With the onset of pregnancy, basal temperature rises to an average of 37, 2-37, 3юб (for different women, these indicators may differ slightly) and is held at this level. This happens regardless of whether the pregnancy is developing uterine or outside the uterus. Basal temperature with ectopic pregnancy is no different, since progesterone is produced in any case.

Decrease in basal temperature (below 37 А C) occurs only with fetal fading, which often happens with ectopic pregnancy. But even this is not necessary: ??often BT indicators remain on the same levels in this case too.

Does the test show an ectopic pregnancy?

This question can not be given an exact unambiguous answer. First, not any test and does not always show a normal pregnancy. Secondly, in the case of fixing a fetal egg outside the uterus, there may indeed be nuances.

So, almost all pregnancy tests show the fact of fertilization. It does not matter where the egg stopped: the level of the hormone of human chorionic gonadotropin (hCG) will necessarily increase (as it begins to produce the forming placenta), which, in fact, the test system reacts.

In principle, there are expensive cassettes, which in most cases are able to detect not only pregnancy at the earliest dates, but also its ectopic development (read about this in the article Ectopic pregnancy and pregnancy test). But if we talk about ordinary home tests, then they can establish only the fact of pregnancy, and even with reservations.

The test for an ectopic pregnancy can "work" later than with a physiological one. That is, at a time when normally developing pregnancy can already be diagnosed with a home test, pathological pregnancy is sometimes "hidden". Ectopic pregnancy can often be determined by a test with a delay, that is, 1-2 weeks after the usual situation. Or the second test strip is very weak. What is the reason for this?

The level of hCG in ectopic pregnancy

It's all about HCG. Wherever the fetal egg is fixed, its shell (chorion) still begins to produce this hormone. That's why a pregnancy test will show a positive result even with an ectopic pregnancy. But doctors say that in the latter case, the level of hCG is lower than in uterine pregnancy, and it grows less dynamically. Therefore, at the time, when a routine pregnancy home test already shows, with an ectopic hCG level may still be inadequate to determine.

In the blood, the concentration of the human chorionic gonadotropin hormone increases earlier and faster than in the urine. Therefore, a more informative blood test for hCG. If a woman has unpleasant suspicions and a gynecologist after examination and consultation does not exclude the possibility of an ectopic pregnancy, it is better to pass this analysis and have an ultrasound.

By itself, a blood test for hCG can not be the reason for setting a definitive diagnosis, but in conjunction with ultrasound can clarify the picture. HCG in ectopic pregnancy, although it increases, but not so rapidly and dynamically. Regular monitoring of hCG in the blood (with a break every 2-3 days) allows us to draw preliminary conclusions: in normal pregnancy, it will increase by half, with pathological - only slightly.

Does the US show an ectopic pregnancy?

Transvaginal ultrasound allows you to see the location of the fetal egg in the second week of pregnancy, although surely reliable data can be obtained approximately from the fourth week. If the embryo is not found in the uterine tube or uterus cavity (when there is still too little time and the fetal egg is not visible because of the extremely small size), and there are suspicions of an ectopic pregnancy, the procedure is repeated after a while or the woman is immediately hospitalized and examined by a doctor. According to the indications, even laparoscopy is possible: the pelvic organs are examined under anesthesia during an operation, which, when confirming an ectopic pregnancy, immediately turns into a medical procedure.

Ultrasound with intravaginal administration of the sensor is considered the most reliable method for diagnosing ectopic pregnancy. However, he does not give an absolute guarantee that the diagnosis will be correct. In 10% of all cases, when an ectopic pregnancy is carried out ultrasound, it is not installed because the fetal egg receives fluid or a clot of blood located in the uterine cavity. Therefore, even such a high-precision diagnosis is recommended to be combined with other methods for greater reliability, in particular, with the analysis of blood on hCG.

Ectopic pregnancy: predictions

None of the organs of the female body is intended to carry a child other than the uterus. Therefore, the embryo attached to the "wrong place" must be removed. If this is not done in advance, there may be, for example, a rupture of the fallopian tube (if the ovum is fixed here) or it can enter the abdominal cavity when the bleeding is opened. Both situations are extremely dangerous for a woman and require immediate surgical intervention. With a rupture of the fallopian tube, a woman experiences severe acute pain, shock, fainting, intra-abdominal bleeding is possible.

It is very important to identify ectopic pregnancy in time to successfully solve the problem. Previously, in such cases, the uterine tube was removed, which meant that it was impossible to conceive and give birth in the future. Today this is an extreme measure. In most cases, with ectopic pregnancy, an operation is performed, during which the fetal egg is removed and the uterine tube is sewn to preserve reproductive capacity.

More and more doctors are studying and practicing the medical treatment of ectopic pregnancy with the help of hormones. However, even if you have removed one damaged fallopian tube, you have every chance of becoming pregnant and bearing the baby, if the other is preserved.

True, in the beginning you need to undergo a recovery treatment course. And also to a woman who survived an ectopic pregnancy, one can not become pregnant again, at least for six months. Be extremely careful when choosing a contraceptive method. You should understand that there are still quite high chances of repeating such an incorrect pregnancy. And to prevent this, be sure to find out the reason that the fetal egg in your case can not reach the uterus. Well, it is clear, to eliminate it.

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