What are the signs of an ectopic pregnancy in the early stages. Ectopic pregnancy in the cervix. When to See a Doctor

Ectopic pregnancy, what is it?

An ectopic pregnancy is a pregnancy in which the fetal egg begins its development not in the uterine cavity, but outside it. Most often, the embryo develops in the fallopian tube, abdominal and ovarian pregnancies are much less common. There are also quite exotic options for the location of the fetus, for example, in the cervix or in the uterine ligament, the essence is the same, the embryo is attached in a place not suitable for bearing, and the uterus ectopic pregnancy remains empty.

How does an ectopic pregnancy happen?

Ovulation, the release of an egg ready for fertilization, usually occurs in the middle menstrual cycle. Then the egg is picked up by the fallopian tube, and with the delicate villi of its mucous membrane, the peristaltic movements of the tube itself, the fluid flow is directed into the uterine cavity. This long haul, usually taking about a week.

During this time, the egg is fertilized, turns into a zygote, and makes the first divisions. As a rule, by the end of the menstrual cycle, the embryo has already reached the uterine cavity and is implanted (immersed) in the endometrium. If for some reason it is not possible to reach the uterine cavity by this time, the unborn child is forced to attach where he managed to get, since his own strength and reserves nutrients he is completely exhausted.

Most often, with an ectopic pregnancy, it is attached in the fallopian tube. It cannot expand like a uterus, has too thin a wall and a delicate lining, and is not able to support the development of the fetus.

According to the obstetric calendar, the period when an ectopic pregnancy begins is 4 weeks (that is, it is impossible to determine an ectopic pregnancy before the delay, and during a normal pregnancy, the fetus is not yet in the uterus).

Thus, if an ectopic pregnancy has occurred, the signs will appear later, at 6-8 weeks, as the embryo grows, and the consequences may manifest themselves at all, by 10-12 weeks, when a tube rupture occurs during an ectopic pregnancy.

Sometimes there is a uterine pregnancy and an ectopic pregnancy at the same time. This happens in cases where ovulation occurred in both ovaries, but one of the embryos failed to overcome the path to the uterus, while the other reached safely.

The embryo, delayed and fixed in the fallopian tube, begins to develop, as laid down by nature. The fertilized egg grows and stretches the wall of the fallopian tube until the limits of its strength are exhausted and it breaks. The result is bleeding during an ectopic pregnancy, which can be so significant that it puts a woman on the brink of death.

Termination of an ectopic pregnancy almost always occurs, fetal death is inevitable, and most often this occurs in the first trimester, for a period of 6 to 10 weeks.

It is impossible to give birth during an ectopic pregnancy. The literature describes isolated cases of carrying an ectopic (abdominal) pregnancy before late dates, 27-28 weeks, when the fetus was already viable. He was born surgically, while doctors had to remove parts of the internal organs of the mother over a fairly large extent, resection of the intestines, uterus, fallopian tubes, omentum, and even the liver and spleen, since the placenta germinated them like a malignant tumor, through and through, and another way to separate she wasn't there. It is clear that these women never had good health in the future.

ectopic tubal pregnancy happens in 99% of cases, it never develops until late. In some cases, a tubal abortion occurs during an ectopic pregnancy. The fallopian tube itself pushes the fetal egg, usually after that it enters the abdominal cavity. If this is not a frozen ectopic pregnancy, the embryo is still alive, it can be fixed in the mother's abdominal cavity again, and then an abdominal ectopic pregnancy develops. But still, most often there is a rupture of the pipe.

Blood during an ectopic pregnancy after a rupture of the tube is poured into the abdominal cavity, intra-abdominal (internal bleeding) develops.

There may not be any discharge from the genital tract, but more often there is discharge during ectopic pregnancy, bloody, scanty, smearing, prolonged, due to inadequate levels of pregnancy hormones.

The diagnosis of ectopic pregnancy is most often made at a period of 6-8 weeks, this is subject to timely contact with the antenatal clinic. Considering that the frequency of ectopic pregnancy reaches 2 cases per 100 conceptions, it is very important to register for early dates, since the absence of symptoms is very for a long time up to the development of complications.

Considering how an ectopic pregnancy occurs, count on normal level hormones with the corresponding pregnancy clinic is not necessary, which means that the picture will be blurry.

A woman may not even be aware of the conception that has taken place; menstruation during an ectopic pregnancy is a common thing. At the same time, even a suspicion of an ectopic pregnancy is a reason for an early examination and treatment, it is desirable that the terms be measured not even in days, but in hours. The sooner such a pregnancy is terminated, the more likely it is to give birth to a healthy full-fledged child in the future.

Ectopic pregnancy, causes

To prevent an ectopic pregnancy, any woman needs to know the reasons for its onset. There are not many of them, and almost all of them can be eliminated.

Statistics show a multiple increase in the incidence of ectopic pregnancy over the past decade. This is largely due to the development of technologies that interfere with human reproductive health.

In 30-50% of women who have an ectopic pregnancy, pelvic inflammatory disease, both acute and chronic, is found. The main culprits are gonorrhea, trichomoniasis and ureaplasmosis. Inflammation causes swelling of the fallopian tubes, the formation of adhesions, and a violation of both peristalsis and the work of the villi. This leads to the fact that the egg cannot enter the uterine cavity and is forced to attach in the wrong place.

Surgical sterilization has become widespread today. This operation involves the complete intersection of the fallopian tubes. However, sometimes a woman who previously did not want children decides to become pregnant at any cost, and reconstructive operations are performed to restore the patency of the fallopian tubes.

It is also possible to develop an ectopic pregnancy after IVF, after laparoscopy and operations on the genital organs, after taking drugs such as postinor and escapelle. Postcoital contraceptives significantly increase the incidence of ectopic pregnancy in women with pelvic inflammatory disease.

Ectopic pregnancy signs and symptoms

Does an ectopic pregnancy have signs that would allow you to immediately say that it is she, even before consulting a doctor?

Unfortunately, there are no clear symptoms, it can be hidden for a long time. If a woman has an ectopic pregnancy, the symptoms may resemble a normal pregnancy, or they may be completely absent, even menstruation comes at the usual time.

However, there are still some early signs of an ectopic pregnancy, allowing you to guess about its possible onset.

First of all, it is, of course, pain. The first sign of an ectopic pregnancy is a missed period or unusually scanty menstruation and pain.

Menstruation can have the character of incomprehensible spotting that lasts too long, and the pain is most often localized on one side above the pubis on the side, on the right or on the left (as with appendicitis, everyone knows where a person hurts with appendicitis, only with ectopic pain not necessarily on the right, maybe on the left).

What are the pains in an ectopic pregnancy?
Most often it is a feeling of constant, dull or aching pain, sometimes it has a piercing character. Pain during an ectopic pregnancy before complications is not so strong that a woman gives them great importance. Similar pains may simply be due to the fact that during early pregnancy, the rapidly growing uterus stretches the uterine ligaments. If this is the first ectopic pregnancy, and the woman has no experience, she is unlikely to recognize the first signs ...

Even bleeding during menstruation, exactly the same as with an ectopic, can also be normal. However, menstruation during an ectopic pregnancy lasts a long time, and with implantation bleeding, which is normal when an embryo is implanted into the endometrium, it is literally a couple of drops of literally 2 days and no more.

Other early symptoms of an ectopic pregnancy, such as pain, also have important feature: pain and discomfort on one side only, while pain due to an increase in the size of the uterus occurs on both sides.

If a woman keeps a schedule basal body temperature, then the temperature during an ectopic pregnancy rises and no longer decreases while the embryo is alive, only a frozen ectopic pregnancy leads to a decrease in rectal temperature, therefore, BT is not a sign of an ectopic pregnancy.

Why do menstruation occur during an ectopic pregnancy?
The reason is the critically low amount of pregnancy hormones. Although corpus luteum is and functions, the placenta cannot form normally in an uncharacteristic place, which leads to a reduced amount chorionic gonadotropin in the blood and disorder hormonal background characteristic of a physiologically proceeding pregnancy.

How does an ectopic pregnancy manifest itself if a tube ruptures?
When the fallopian tube ruptures, a woman feels increased pain in the abdomen, lightheadedness and severe weakness may lose consciousness. Disturbed by dizziness, in the supine position, the condition improves somewhat. On examination, the doctor detects symptoms of internal bleeding: palpitations, decreased blood pressure, pale skin. If timely assistance for ectopic pregnancy is not provided, death threatens every third woman.

What signs of an ectopic pregnancy help to recognize it in time?
Clinic of ectopic pregnancy is all the symptoms normal pregnancy expressed in one way or another. , there is fatigue, loss of appetite and mood swings, hypersensitivity to odors and even advanced early toxicosis.

What symptoms of an ectopic pregnancy can indicate its presence?
These are pains, prolonged spotting (during the period of menstruation), or a delay in menstruation. Only a doctor can correctly recognize the symptoms, distinguish them from a normal pregnancy, and a standard examination is not enough, an examination is necessary. It is important to register at the consultation early, even if you do not suspect an ectopic pregnancy.

Ectopic pregnancy, diagnosis
If an ectopic pregnancy occurs, the timing of the inevitable catastrophe forces a diagnosis to be made as early as possible, a rupture of the tube can happen as early as 6 weeks, and this is only 2 weeks from the delay.

An ectopic pregnancy in the early stages can be diagnosed by a doctor using a blood test for hCG, ultrasound of the pelvic organs, a clinical picture and gynecological examination data.

Many are interested in whether the test shows an ectopic pregnancy?
If we talk about tests for express diagnosis of ectopic pregnancy, it must be said that there are no such tests. There is a regular pregnancy test, an ectopic pregnancy is determined by it in the same way as a normal one.

Another thing is that the second strip may appear later in time and be weaker, which is due to the fact that the level of hCG during ectopic pregnancy increases more slowly, since the chorion of the embryo cannot normally consolidate and develop.

Chorion is the future placenta of the fetus, its connection with the mother, it produces hCG in the early stages, chorionic gonadotropin, which is necessary for the development of pregnancy, and just the presence of this hormone determines the pregnancy test.

Thus, despite the fact that a woman's ectopic pregnancy test is positive, in some cases it can be negative within 1-2 weeks from the delay.

The test determines an ectopic pregnancy, like any other, but does not determine that it is an ectopic pregnancy.

But in this case, how to determine an ectopic pregnancy?
It helps to diagnose that the level of hCG during an ectopic pregnancy in a woman's blood increases more slowly than during a normal one.
A woman donates blood for analysis, and if the hCG level in the blood is more than 1500 mIU / ml, the fetal egg should already be clearly visible on the ultrasound. If it is not seen on ultrasound, and the blood test for hCG has a level below 1500 mIU / ml, the analysis is repeated after two days. With a progressive uterine pregnancy, its level during this time will increase by more than one and a half times, but if hCG increases more slowly, or even falls or does not grow at all, this may be an ectopic pregnancy.

At what time can an ectopic pregnancy be suspected according to transvaginal ultrasound?
A normally proceeding pregnancy is visible on ultrasound within a week from the delay, that is, at a 5-week obstetric period. If there is no fertilized egg, and a blood test indicates pregnancy, there is a high probability that it is ectopic.

If tests and analyzes, ultrasound do not allow to exclude an ectopic pregnancy, last way to determine it is a diagnostic laparoscopy. When the diagnosis is confirmed, it becomes a medical procedure.

Ectopic pregnancy, treatment

If an ectopic pregnancy is diagnosed, surgery is not the only way out. In the early stages, it is possible to use methotrexate, mifegin, mifepristone for conservative treatment, without surgery.

If the term does not allow to terminate an ectopic pregnancy in this way, surgical removal of the ectopic pregnancy is required.

As a rule, laparoscopy is performed. Before the tube ruptures, it is possible to save it, but this is not always correct, since a second ectopic pregnancy may develop in the saved tube in the future. Removal of the tube during an ectopic pregnancy in most cases is the most rational solution.

The operation to remove the tube during an ectopic pregnancy can be performed directly during laparoscopy.

Ectopic pregnancy, consequences

An ectopic pregnancy carries quite serious consequences. Even with timely and complete treatment, repeated pregnancy after an ectopic pregnancy in some women it turns out to be also ectopic. This is due to the fact that the fallopian tube, on the other hand, is also in most cases affected by the pathological process, and if a hemorrhage occurs in the abdominal cavity, the formation of multiple adhesions here may be a consequence.

However, the first ectopic pregnancy is not a sentence, half of the women continue to bear and give birth to children. You can get pregnant after an ectopic pregnancy no earlier than 6 months, but it is better to wait for a year.

After the operation of an ectopic pregnancy, you should strictly follow all the recommendations of the doctor, rehabilitation is always quite long and complicated, includes physiotherapy, taking drugs to strengthen general condition health and the fight against spikes, treatment of the underlying disease.

The chance of a second ectopic pregnancy is lower in women who have received drug treatment and were not operated on for the first ectopic.

Planning pregnancy after an ectopic pregnancy should be responsible, since failure is the loss of the second tube, pregnancy after two ectopic pregnancy is not possible on its own, which means that in further pregnancy will be possible only by IVF. Reliable contraception is vital.

How does pregnancy end up outside the uterus, and what does it mean? How to recognize it and what to do if a pathology is detected? How will it affect fertility in the future? The article below will help answer such questions, but full information provided by a gynecologist.

Ectopic or is a dangerous pathology that threatens the life of the mother. Unfortunately, there is no question of saving the life of the future baby, since the full growth, formation and development of the fetus in inappropriate conditions is impossible.

As it is easy to understand from the name, this term refers to the attachment (implantation) of the fetal egg anywhere except the uterus: the right or left fallopian tube, ovarian follicle, less often - the cervix, intestinal loops, peritoneum.

Unlike the uterus, all these organs do not have an endometrium - the inner lining that ensures the development of the placenta. In addition, their walls are not able to stretch after the growing embryo, which threatens to rupture. In the international classification of diseases, ectopic pregnancy is designated by the code O00 with clarifications for various localizations of the fetal egg.

When it makes itself known

In the early stages, it is almost impossible to distinguish from normal. In the body of a woman, hormonal, physiological and emotional changes, and the size of the unborn baby is not yet large enough to lead to dangerous consequences.

How long does it take for the pathology to show up?

It depends on where exactly the fertilized egg is located. Most frequent variant- pipe connection. It manifests itself in the interval between 6 and 9 obstetric weeks. Cervical pregnancy may appear a little later, ovarian or abdominal - a little earlier.

Most exact method diagnostics - ultrasound, at such an early date it is done only if there are complaints. (hormone produced by the child's part of the placenta) is not accurate enough - this indicator does not allow distinguishing the norm from pathology.

When the signs appear

The first ones are exactly the same as in healthy expectant mothers - there is a delay in menstruation, engorgement of the mammary glands, nausea appears. They occur approximately 2–3 weeks after conception (4–5 obstetric week). Define the pathology subjective feelings impossible.

Nevertheless, normal signs pregnancy very quickly (after 2-5 weeks) are replaced by symptoms " acute abdomen"- severe pain, sharp deterioration well-being, nausea and vomiting. Without ultrasound, such a pathology is often mistaken for appendicitis, intestinal obstruction, or ovarian apoplexy.

Complaints

There are no subjective sensations characteristic of this particular pathology. A woman experiences the same sensations as a healthy one. future mom, with a rupture of the pipe - symptoms of "acute abdomen".

How does it manifest

It is almost impossible to independently determine this pathology in yourself. Even a specialist can make a diagnosis, only having the only accurate and quick diagnostic method.

First signs

The very first sure sign the onset of pregnancy - a delay in menstruation. It occurs regardless of which area is "chosen" for attachment future baby. A delay means that conception occurred about 2 weeks ago, but since the length of the cycle is different for all women, the period is considered from the first day of the last period before conception (obstetric period).

Which determine a specific hormone in the urine - human chorionic gonadotropin, will show two strips with any attachment of the fetal egg. Thus, the first signs make it possible to determine the onset of conception, but not to distinguish normal attachment from ectopic.

Symptoms in the early days

In the most early days after conception (before the delay), a woman most often does not know about the onset of pregnancy. Tests, even designed for early diagnosis may give incorrect results. However, there are several indirect signs, which indicate that conception has recently occurred:

engorgement of the mammary glands;
spotting discharge from the genitals that occurs before the expected onset of menstruation;
pulling pains in the groin (mild);
some deterioration in well-being, nausea.

Toxicosis

Toxicosis - normal condition in the first trimester. If the fetal egg is attached outside the uterus, full-fledged toxicosis does not have time to develop - signs of organ rupture appear much earlier.

The early onset of toxicosis is not pregnancy, it can be caused by a number of reasons. Without ultrasound, the diagnosis of ectopic attachment of the fetal egg is unreliable.

Bleeding

Bleeding occurs when the organ in which the pregnancy occurred, or the fetal egg, ruptures. This situation calls for immediate surgical intervention. The intensity depends on many factors, but is always associated with a threat to the health of the mother.

Blood can accumulate in the uterine cavity. In this case, the discharge from the vagina will be weak with a high intensity of bleeding. With abdominal or ovarian attachment, there may be no discharge, blood will accumulate in the abdominal cavity.

Symptoms depending on the location

Features of symptoms in ectopic pregnancy depend on the place of attachment of the fetal egg. Tubal pregnancy is more common, but other localizations are more dangerous and more difficult to diagnose.

Trubnaya

Tubal pregnancy is a common type of ectopic location of the fetal egg. It is in the fallopian tube that the fertilization of the egg occurs - this explains the frequency of occurrence of pathology.

The first weeks of tubal pregnancy do not differ from normal ones, but due to the small diameter of the organ, the growth of the fetal egg quickly leads to a rupture of the tube wall. Signs of a break:

Severe pain in the groin on the side of the injury (more often the right tube is affected);
Bloody discharge from the vagina;
A sharp deterioration in well-being;
Paleness, low blood pressure;
Nausea, vomiting, less often - constipation or diarrhea;
Acute retention of urine.

Ovarian

The appearance of a fetal egg in the ovary is due to the fact that the mature egg did not leave the follicle, and fertilization occurred there. ovarian pregnancy close to the manifestations of tubal, but has features:

Pain occurs not only in the groin, but also gives across the entire half of the abdomen;
Allocations are weak or absent;
There are signs of internal bleeding;
Often preceded by early toxicosis.

Cervical

This rare view abnormal attachment of the embryo. It occurs if there are anatomical anomalies that do not allow the egg to gain a foothold in the uterus. At risk are women over 35 years of age who have already had several pregnancies (regardless of their outcome).

A fertilized egg is able to attach only to that part of the endometrium where such attachment did not occur before. That is, with each pregnancy, the number of " free space» for future babies decreases. Whether the pregnancy ended in childbirth, miscarriage or abortion does not matter.

Features of cervical pregnancy:

Severe pulling pains in the lower abdomen;
Copious discharge;
Slow deterioration of well-being;
Relatively late development of signs of pathology (10–11 obstetric weeks).

Abdominal

The fallopian tubes communicate directly with the peritoneal cavity - this explains the possibility of the fetal egg entering the abdominal cavity. It attaches to intestinal loops or peritoneal mesothelium, less often to other internal organs. This is a rare and dangerous type of ectopic pregnancy.

Peculiarities:

Abdominal pains have different localization.
There may be no vaginal discharge.
There are signs of internal bleeding.
The woman's condition is deteriorating rapidly.

With this arrangement, it is most difficult to detect a fetal egg.

Signs of an ectopic pregnancy with a coil

Intrauterine is considered a risk factor for ectopic pregnancy. It prevents the attachment of the fetal egg in the uterus, but does not always prevent conception. This is especially true in cases where the contraceptive was not replaced on time.

If, with the installed intrauterine device there was a delay in menstruation, you should immediately consult a doctor, without waiting for the symptoms of a gap. The coil is then removed.

Symptoms after IVF

During an IVF procedure, multiple embryos are implanted in a woman to increase her chances of success. However, they may be outside the uterine cavity.

Often, an ectopic pregnancy after is combined with a uterine one, and the symptoms of its onset are nonspecific. The manifestations of a ruptured tube are the same as during pregnancy, which has come naturally. The way out in this situation is a partial abortion - abnormally located embryos are removed, and those in the uterus are preserved.

Is the belly growing

The classic sign of an onset pregnancy - a growing belly - is not observed with an abnormal location of the fetal egg. An ectopic pregnancy leads to spontaneous miscarriage too early for external changes to take place.

Is the uterus enlarged

An increase in the size of the uterus does not occur, since the fetal egg does not develop in it. The growth of the fetal egg outside the uterus leads to stretching of the walls of the organ where the attachment occurred, and subsequent rupture.

Symptoms requiring immediate medical attention

pregnancy in the rapid development of complications, so you need to see a doctor as soon as possible. You need to seek medical help if:

Suddenly there was pain in the abdomen.
Discharge appeared or intensified.
The state of health has sharply worsened, signs of internal bleeding have appeared.

Self-treatment of such a pathology is impossible; only timely medical care can save life and health.

Symptoms of a missed ectopic pregnancy

- this is the cessation of fetal development and its intrauterine death. At the same time, for about two more weeks, no noticeable changes in the woman's condition occur (this is true only for early periods). Exodus - spontaneous interruption with bleeding and a high risk of infection.

Manifestations of a frozen ectopic pregnancy:

Gradual deterioration of health, increasing symptoms of general intoxication;
Temperature increase;
Bleeding or bloody issues;
severe pain in the abdomen;
Possible loss of consciousness.

A miscarriage occurs at 8-11 weeks, accompanied by a high risk of necrosis of the uterine wall or infection of the genital tract.

Consequences

Among possible complications- inflammatory diseases of the genital organs, bleeding, necrosis. In these cases, the surgeon may decide the uterus or ovary in order to save the patient's life. If indicated, sterilization is carried out.

Timely medical care is extremely important to save a woman's life, and, if possible, reproductive function. A woman planning to conceive should be aware of this risk and register at the antenatal clinic in time.

Video

In contact with

An ectopic pregnancy is a pathology in which the attachment of a fertilized female cell does not occur in the uterine cavity. The disease is dangerous to health and life, and therefore women of reproductive age who are sexually active should be aware of its signs and course.

Only an attentive attitude to one's well-being and timely appeal to medical care avoid serious consequences.

What is it and what happens in a woman's body?

An ectopic pregnancy is pathological, due to the “irregularity” of the process, or rather the “missing” of a fertilized egg (fetal egg) into the uterus. For some reason, the egg after fertilization is fixed outside the uterus, where it continues its short development.

Depending on the place where the fetal egg is attached, an ectopic pregnancy can be:

tubal (fixed in the fallopian tube);
ovarian (fixed in the ovary);
abdominal (attached in the abdominal cavity);
ectopic pregnancy developing in the rudimentary horn of the uterus (rare).

The order in this list of types corresponds to the frequency at which occurrences of deviations occur. In addition, there is another rare (fortunately) type of ectopic pregnancy in medicine, called heteroscopic pregnancy. In this case we are talking about uterine - normal, and ectopic pregnancies at the same time. That is, a woman ovulated two eggs at once in one menstrual period, and both were fertilized. But one of the fetal eggs was fixed in the uterus, as it should be, and the second - in a place not intended for it, a tube, an ovary or another.

What are the reasons for the abnormal location of the fetus?

No doctor can name the exact reasons why conception happens this way, but there are risk groups that may have an ectopic pregnancy:

Violation of the properties of the fetal egg itself;
Unreliable contraception against the background of diseases of the female band of the system;
Hormonal imbalance;
Anatomical features of the fallopian tubes - excessively tortuous, long, "obstruction";
Early conducted surgical operations on the organs of the abdominal cavity and small pelvis;
Often signs of ectopic pregnancy after the work of modern reproductive technologies - in vitro fertilization;
Tumor formations on the uterus and its appendages, abdominal organs, disrupting the patency of the fallopian tubes;
Chronic inflammatory processes female reproductive system. They contribute to the violation of the functionality and anatomy of the fallopian tubes, for example, a decrease in their contractility, which means that their ability to push the egg that has found the sperm is reduced. Therefore, implantation will be in some part of the tube or in the abdominal cavity, and an ectopic pregnancy occurs.

In 30-50% of ectopic pregnancies, the causes remain unknown. Risk factors include:

Surgical interventions in the abdominal cavity.
contraception.
Hormonal failure or hormonal deficiency.
Inflammatory diseases and infections of the female genital organs.
Violation of the transport function in the fallopian tubes.
Tumors of the uterus and its appendages.
Anomalies in the development of the genital organs.

The symptoms of an ectopic pregnancy can be exactly the same as those of a normal one.

Symptoms and first signs

A fertilized egg can stop at any point along the way from the ovary to the uterus. This may be the abdominal cavity, the ovarian region or the fallopian tube. This pathology occurs due to an inflammatory or adhesive process in reproductive organs and abdominal cavity.

In this case, the very first symptoms of an ectopic pregnancy correspond to the early signs of uterine attachment of the embryo:

There will be a delay in menstruation;
The mammary glands will become tender, slightly sore and enlarged;
Urination becomes more frequent;
The test will show a positive result in the form of two strips;
There may be signs of toxicosis;
The mood will become changeable;
The basal temperature will be elevated, which happens with physiological pregnancy; if the rectal temperature is below 37 degrees, then it is likely that the embryo has frozen;
The general body temperature can also rise to subfebrile values - 37.2–37.5 degrees.

In addition to the general signs in the early stages, specific symptoms are characteristic of an ectopic pregnancy:

Characterized by general weakness, malaise, chills.
Body temperature may rise. The basal temperature is higher than the general values, mostly subfebrile.
The appearance of bloody discharge from the genital tract by the type of menstruation. They may be dark brown or brownish. It is important not to confuse them with menstruation if there was a long delay. It must be remembered that there may not be visible bleeding if blood accumulates in the abdominal cavity.
Along with the discharge, there are severe pains in the abdomen of a cutting nature. In this case, the localization of pain depends on in which part the embryo develops. Pain syndrome aggravated by movement, change of position of the body.
If there is a large blood loss, dizziness and fainting appear. This lowers blood pressure.

With such symptoms, it is necessary to rush to the doctor, otherwise the exfoliated fetal egg will cause irreparable damage to the woman's health.

A sensitive hormonal test is positive, there is constant pain on the right or left, spotting after a delay, a preliminary diagnosis is an ectopic pregnancy. Formerly women with such a diagnosis, they were immediately operated on for health reasons, since it was impossible to establish the cause of the symptoms before 8 weeks. Fortunately for our generation, now it is possible to find out such a diagnosis earlier. Hormonal tests, ultrasound, diagnostic laparoscopy help in this.

Symptoms depending on the type

For each type of pathological fixation of the fetal egg, there are characteristic symptoms.

Ovarian ectopic pregnancy for a long time is not manifested by any pathological symptoms. This is due to the fact that the follicle can stretch to fit the size of the embryo. But when the limit of elasticity is reached, a strong point pain appears in the lower abdomen, gradually it spreads to the lower back and the region of the large intestine. Defecation becomes painful. The attack lasts from several minutes to hours and is accompanied by dizziness, pre-syncope.
Tubal ectopic pregnancy is manifested by pain on the left or right side, depending on where the fertilized egg was implanted. If it is fixed in the wide ampoule part, then the symptom appears at 8 weeks, if in the narrow (in the isthmus) - then at 5-6. The pain intensifies during walking, turning the torso, sudden movements.
An ectopic pregnancy in the abdominal cavity in the early stages has symptoms that are no different from those in a normal one. But as the embryo grows, dysfunctions appear gastrointestinal tract(constipation, diarrhea, nausea, vomiting), signs of an "acute abdomen" (sharp pain, bloating, fainting).
Cervical and cervical-isthmus ectopic pregnancy proceeds without pain. Spotting comes to the fore - from spotting to copious, profuse, life-threatening. Due to the increase in the size of the cervix, urination disorders develop (for example, frequent urination).

When does a pipe burst occur?

It's hard to pinpoint exactly when the worst will happen. The term can be as 4 weeks, and you can reach up to 16.

The earliest rupture of the tube during an ectopic pregnancy occurs at 4-6 weeks if the fetal egg stops in the middle of the fallopian tube. This is the narrowest part of the pipe and it can only stretch up to 2 mm. At 4 weeks, the embryo is approximately 1 mm in diameter. At break there will be strong pain and internal bleeding in the abdomen.
The lower part of the tube is able to "hide" an ectopic pregnancy even up to 3 months. This part has a more elastic muscle layer. A woman may not feel any signs until the embryo has grown to 5 mm.
The ampullar part, which is located near the ovary, is able to withstand the egg for up to 4-8 weeks. But in this scenario, the pipe breaks in rare cases. Most often, the egg will increase to 2 mm and fall into the space of the abdominal cavity. The pipe ruptures only if this gap is deformed.

Up to 3-4 weeks, a tubal ectopic pregnancy may not reveal itself at all as a pathology.

Rupture of the fallopian tube

Fallopian tube rupture during ectopic pregnancy severe complication, which can be fatal for a woman. This state always occurs suddenly and has pronounced symptoms:

strong, sharp, "dagger" pain in the lower abdomen;
a sharp drop in blood pressure;
critical increase in heart rate;
the appearance on the forehead and palms of cold sticky sweat;
significant deterioration in general well-being, up to loss of consciousness.

Any examination of a woman in this condition is not required - hemorrhagic shock, loss of consciousness and deafening pain in a previously diagnosed pregnancy serve as the basis for emergency surgical care.

Diagnostics

In all cases of delayed menstruation, pain and spotting, an ectopic pregnancy should be suspected. For symptoms of shock positive test on pregnancy, the absence of a fetal egg in the uterus and in large numbers fluid in the abdominal cavity by ultrasound, the diagnosis of ectopic pregnancy is not difficult. In other cases, the concentration of hCG in the blood and transvaginal ultrasound are of decisive importance.

If the hCG level exceeds 1500 mIU / ml, and the fetal egg in the uterine cavity is not detected, this may indicate an ectopic pregnancy. If the hCG level is below 1500mIU / ml, then it is advisable to repeat the analysis after 48 hours. Growth less than 1.6 times, no growth or decline hCG levels support an ectopic pregnancy.

Detection of a fetal egg outside the uterus by ultrasound is quite rare, in most cases they are guided by such signs as the absence of a fetal egg in the uterus, the presence of free fluid behind the uterus and a heterogeneous volumetric formation in the area of \u200b\u200bthe appendages on one side.

Surgery

Surgical treatment of pathology - tubal ectopic pregnancy is performed by several methods known in medicine. To interrupt and get rid of pathology, it is used:

Laparoscopy is an operative, relatively sparing method of deliverance, since it allows you not to make an incision in the abdominal cavity, saves fallopian tube, it is penetrated by making a puncture. This reliable method diagnostics and the most reliable.
Tubectomy is an operation to remove a tube with pathology, in the case of an ectopic pregnancy, it is performed if its safety is impossible. Tubectomy is used more often in case of repeated pregnancy outside the uterine cavity. In emergency cases, when it is necessary to save a woman, it is also possible to remove the ovary.
Tubotomy (salpingotomy) is the second variant of the operation performed in case of impossibility of using milking. The surgeon is forced to cut the fallopian tube in the area of attachment of a non-developing fetal egg, remove its fragments, and sew up the fallopian tube after the procedure. You may have to remove part of the tube if the embryo is too large. Tubotomy makes it possible to preserve the reproductive organ, which is then able to fully perform its functions. In the future, a woman may become pregnant, although the percentage of this possibility is decreasing.
Milking (extrusion) - this surgical procedure is appropriate in case of an anomaly of the ovum - detachment, the egg itself is removed from the fallopian tube by extrusion, and the reproductive organ is preserved. True, the use of such a sparing method is not always possible, but in the case of the location of the zygote near the exit from the tube. And the determining factors are the facts of stopping the development of the zygote into the embryo and its detachment, as well as the location of the fetal egg in the uterine tube.

Most often, this is done by laparoscopy. Until the fallopian tube bursts, it is preserved, although there is a high probability of developing a second parallel ectopic pregnancy in it. The best solution is to remove the fallopian tube before it ruptures. The removal of the tube is surgically performed during a laparoscopy procedure.

All patients who have had an ectopic pregnancy are advised to use contraception for the next 6 months after surgery in order to avoid recurrence of ectopic pregnancy and to prepare the body for a normal pregnancy.

Rehabilitation after surgery

IN postoperative period requires dynamic monitoring of the patient's condition in a hospital setting. Be sure to carry out infusion therapy in the form of droppers to restore water and electrolyte balance after heavy blood loss (crystalloid solutions, reopoliglyukin, fresh frozen plasma). Antibiotics (Cefuroxime, Metronidazole) are used to prevent infectious complications. Rehabilitation measures after an ectopic pregnancy should be aimed at restoring reproductive function after surgery. These include: prevention of adhesions; contraception; normalization hormonal changes in organism.

The recovery period usually goes smoothly. After the operation, the patient must adhere to special diet- recommended fractional nutrition(cereals, meatballs, broths). For get well soon a week after the operation, a course of physiotherapy (magnetotherapy, electrophoresis, laser therapy) is indicated.

Physiotherapeutic methods in the rehabilitation period:

supratonal frequency currents (ultratonotherapy),
low intensity laser therapy,
electrical stimulation of the fallopian tubes;
alternating pulsed magnetic field of low frequency,
low frequency ultrasound
UHF therapy,
zinc electrophoresis, lidase,
pulsed ultrasound.

For the duration of the course of anti-inflammatory therapy and for another 1 month after the end, contraception is recommended, and the question of its duration is decided individually, depending on the age of the patient and the characteristics of her reproductive function. Of course, one should take into account the desire of a woman to maintain reproductive function. The duration of hormonal contraception is also purely individual, but usually it should not be less than 6 months after surgery.

After laparoscopy, they are discharged approximately 4-5 days after the operation, and after laparotomy after 7-10 days. Postoperative sutures are removed 7-8 days after surgery.

After graduation rehabilitation activities before advising the patient to plan next pregnancy, it is advisable to perform diagnostic laparoscopy, which allows to assess the condition of the fallopian tube and other organs of the small pelvis. If control laparoscopy does not reveal pathological changes, then the patient is allowed to plan pregnancy in the next menstrual cycle.

Question answer

1) I had an ectopic pregnancy for a period of 4-5 weeks in the ampullary section of the tube. Laparoscopy was performed with extrusion of the fetal egg and preservation of the tube. The next day after the operation, the surgeon prescribed an injection of methotrexate (as I understood it for reliability). They put on a dropper for 3 days, probably with some kind of medicine. Spikes were not found. What is the likelihood of a second ectopic? And what you will advise additional inspections? And the treatment still needs to be carried out to exclude a repeated ectopic? The surgeon advises an x-ray with a contrast agent and maybe again a laparoscopy to restore the function of the tubes, but I really don’t want to go through the 3rd laparoscopy again (1 - removal of fibroids and adhesions on the tubes, then the birth of a child, and 2 - removal of the gallbladder). I really want a second child.

Unfortunately, the risk of a recurrence of the situation is possible? and with each ectopic pregnancy it greatly increases, especially in women after 35 years. At the planning stage of pregnancy from possible surveys- this is only a diagnosis of the patency of both fallopian tubes (what the doctor suggested to you). But planning a conception immediately after such a procedure is not recommended (the influence of X-ray + contrast), but after an X-ray with contrast, the likelihood of a normal pregnancy increases, since the contrast, passing through the pipes, improves their patency. But for starters, you can do echohysterosalpingography (ultrasound). It is not as reliable as an x-ray, but it should show obvious problems with the patency of the pipes, if any.

2) I am 26 years old. This year in April I had an ectopic pregnancy. They did the operation by extruding the pipe, and saved the pipe. Then the doctors said that adhesions and bends in the tube were not found. And strictly half a year to be protected. Like it's already the second month irregular cycle. Month should have been on November 11, but they are still not there, already a month delay, I'm afraid that wb. Are there any chances of pregnancy? What should be done to avoid recurrence? What should be done for a normal pregnancy? I have a daughter, she is 1.5 years old, I want more children.

Donate blood for hCG and then you will find out if there is a pregnancy or not. In addition, by monitoring hCG in dynamics, we can assume the presence of VB. IN normal hCG should increase by 2 times every 2 days. If rise in hCG will be bad, then one of the reasons for this is an ectopic pregnancy. Since there are no adhesions and a bend, then it is impossible to do something to avoid a repetition of the VB. Increases the risk of developing VB hormonal contraceptives or the presence of a spiral before planning pregnancy, therefore it is recommended that after the abolition of OK or removal of the spiral, refrain from unprotected PA for 3 menstrual cycles. Also, taking progesterone (Utrozhestan, etc.) when planning a pregnancy may increase the risk of AP.

3) The delay is five days and the test response is positive, while the fetal egg cannot be visualized in the uterus. What to do?

This does not mean that it is safe to talk about an ectopic pregnancy. To exclude such a pathology, you should undergo an ultrasound scan in 1-2 weeks, as well as perform a blood test for the presence of hCG. At very early stages, pregnancy in the uterus may not be visualized.

4) How soon after an ectopic pregnancy can a new pregnancy be planned?

To exclude possible complications, the desired pregnancy can be planned no earlier than after 6 months.

Prevention

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:

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

An ectopic pregnancy is considered quite difficult and dangerous pathology. But if medical measures were carried out on early stage pathology or if the fallopian tube is ruptured, competent measures have been taken, 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.

An ectopic pregnancy, the signs of which in the early stages are no different from carrying a child in the uterus, is very dangerous state threatening a woman's life. Unfortunately, even doctors are not always able to detect this pathology in the first weeks after conception, when even surgical intervention(Yes, now there are such methods!) or, if an operation is performed, then an organ-preserving one without big risk for good health. Every woman should know the signs of an ectopic pregnancy. So what are these symptoms? distinctive features fetal development outside the uterus?

In the first weeks of fetal development, a woman feels everything the same as those ladies who bear children in the uterus. That is, the signs of an ectopic pregnancy in the first days after the onset of a delay in menstruation are not much different from the uterine one.

2. Toxicosis.

3. Soreness of the mammary glands.

4. Frequent urination.

5. Slightly elevated basal body temperature.

And now, what should alert. As a rule, these signs of ectopic pregnancy at 4, 5 weeks from conception appear in the first month of delayed menstruation.

1. If chorionic gonadotropin (its concentration) is lower than it should be on this period pregnancy.

2. Pregnancy tests show negative or weakly positive results.

3. If there is bloody discharge from the genital tract.

4. If pain is felt in the uterus and ovaries.

5. An increase in body temperature is recorded.

6. Low pressure.

7. Dizziness.

The last 3 of the signs we have listed are often manifested in the uterine localization of the fetal egg.

For doctors, such signs of an ectopic pregnancy in the early stages play a role, such as: reduced level chorionic gonadotropin, pain, the absence, according to the results of ultrasound, of the fetal egg in the uterine cavity, whereas at this time it should already be there. In addition, the physician gynecological examination notices that the size of the uterus is somewhat smaller than it should be at this stage of pregnancy. Of course, this may also indicate a missed pregnancy. Therefore, a control examination is carried out in a week, and if the uterus remains small, the woman is sent for blood donation for hCG and for an ultrasound examination. So pulling 7-10 days is possible only if there are no other ailments, otherwise the diagnosis is carried out immediately, and in stationary conditions. Another relative sign of pregnancy outside the uterus is an increase in the level of white blood cells (determined by laboratory tests).

If on ultrasound a fetal egg is found in the uterus, then the diagnosis of "ectopic pregnancy" is immediately removed - cases when uterine and ectopic pregnancies occur simultaneously are very, very rare. A woman is diagnosed with either a threatened miscarriage or a miscarriage.

What is the danger of an ectopic pregnancy? The fact that a woman can die from blood loss ... None of this kind abnormal pregnancy cannot end happily, no matter what kind it may be: with localization in the cervix, ovary, fallopian tube or peritoneum. It’s just that its spontaneous interruption occurs a little differently and at different times. The most common tubal ectopic pregnancy. In very rare cases, the fetal egg freezes in its development, dies and no medical intervention is required. There are frequent cases when a grown fetal egg breaks the tube, which causes heavy bleeding. So, what are the signs of an ectopic tube that ended in a rupture of the tube?

1. Soreness of the uterus when examined by a doctor and palpation. Through the lateral fornix of the vagina, the doctor can feel the fetal egg in the region of one of the appendages.

2. Acute pain in the abdominal cavity, more often from the side of the tube where the fetal egg developed. The pain radiates to the rectum.

3. Perspiration, pallor of the skin, lowering blood pressure, darkening of the eyes or loss of consciousness.

4. Bleeding from the genital tract.

These signs are already indications for surgical intervention. The type of operation is determined by the doctor on site. Depends on the location of the fetal egg, the volume of blood loss, the condition of the patient, etc.

What to do if you are afraid that you have an ectopic pregnancy - signs - the test is negative, low hCG, etc. What to do in this case?

First, go to the gynecologist and quickly. The diagnosis may not be what you think. Negative test it can be not only with an ectopic pregnancy, but also with ... the absence of pregnancy. Therefore, it is too early to worry. Low chorionic gonadotropin, more precisely, somewhat reduced may indicate a lack of progesterone due to some hormonal disorders, but this can be solved with the help of modern medicines. In addition, HCG can be increased not only in expectant mothers, but also in certain diseases in people of any gender and age.

100% confirmation of the diagnosis of " ectopic pregnancy"It is possible only with surgical intervention. If there is no rupture of the tube, and doctors simply suspect an ectopic pregnancy, then the approximate course of action is as follows. For women who want to keep the child, if everything is in order, laparoscopy is performed immediately. With the help of special instruments through small punctures in the abdominal wall, surgeons examine the organs. If there is a fetal egg, then it is removed. Removal of the fallopian tube is not always carried out - the task of doctors is to preserve the woman's fertility and minimize the risks of a recurrence of the situation. However, sometimes the tube is so affected by adhesions that it is better to remove it than to save it ... If a woman, even if a uterine pregnancy is confirmed, does not plan to save it, then curettage of the uterine cavity is first performed. And if there are chorionic villi in the obtained histological material, then it can be stated with a high degree of certainty that the pregnancy was uterine. And then the woman is observed a little more and discharged, since there is no longer a need for laparoscopy.

If there is WB, then the choice of the type of surgical intervention depends, to a greater extent, on the localization of the ovum (even the segment of the fallopian tube in which it develops plays a role). In very rare cases, extirpation (removal) of the uterus may be required. In other cases, only laparotomy is possible - a classic operation through an incision, usually if the diameter of the fallopian tube is already more than 5 cm.

In addition, in some cases it is possible to carry out an artificial tubal abortion(the doctor squeezes the fetal egg through the abdominal opening of the tube). This is possible for very short periods of time.

Also on small terms in the absence of contraindications, conservative, non-surgical treatment with Methotrexate is possible.

Often an ectopic pregnancy occurs without any good reason at all, as it seems to a woman. But it's not. For example, inflammatory processes in the fallopian tubes can proceed almost asymptomatically, but lead to the formation of adhesions - the main cause of ectopic pregnancy. Therefore, take care of your health from a young age, properly protect yourself from unwanted pregnancy and do not forget to make preventive visits to the gynecologist at least once a year.

You don't wish this on any woman. This news is sure to shock. Such diagnoses are always perceived on emotions. But we hasten to console you as much as possible: an ectopic pregnancy is not yet a sentence.

In fact ectopic attachment a fetal egg is not so rare anymore: even if there is little pleasant in this, but due to the frequency of occurrence, doctors have already learned how to quickly determine an ectopic pregnancy and take necessary measures to prevent risks and minimize the consequences. However, forecasts for the future for a woman will depend on a number of factors.

Of great importance is how long an ectopic pregnancy makes itself felt, and how exactly. Unfortunately, in 5-10% of all cases, a woman really can no longer have children. But timely actions taken help to avoid many troubles, including maintaining the functionality of the female reproductive system. So, the main thing is not to waste time.

Why is the egg not in the uterus?

When the sperm fertilizes the egg, the latter begins to move along the fallopian tube and at the end of the path is attached to the wall of the uterus for further development and growth - implantation occurs. This is how it starts normal pregnancy, during which the egg cell improves, constantly divides, a fetus is formed, from which, by the end of the term, a full-fledged child grows, ready for life outside the womb. For this most complex process to take place, a certain “dwelling” for the egg and space for its growth is necessary. The uterine cavity is ideal.

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 options are possible: to the ovaries, to the cervix, to any of the abdominal organs.

Causes of an ectopic pregnancy

There are several reasons why an egg cannot reach the uterus:

Violations in the condition of the walls and the functioning of the fallopian tubes (when they contract poorly and are not able to move the egg further). This often happens due to previous diseases of the pelvic organs, as well as chronic inflammatory diseases of the genital organs, in particular STDs.
Anatomical features of the fallopian tube (for example, infantilism): too narrow, tortuous, scarred or scarred tube makes it difficult and slows down the progress of the egg.
Previous surgical operations on the fallopian tubes.
Previous abortions, especially if the woman's first pregnancy was terminated artificially.
Slowness of spermatozoa: the egg is “waiting” for fertilization, which is why it does not have time to get to the right place, that is, to the uterus - hunger forces it to settle earlier.
Hormonal disorders in the body of a pregnant woman.
Tumors on the uterus and appendages.
Changes in the properties of the fetal egg.
A woman wearing a contraceptive intrauterine device.
Some technologies.
The constant nervous overexcitation of a woman, in particular, the fear of becoming pregnant and unreliable methods of protection do not allow her to relax, which causes the fallopian tubes to spasm.

Of course, ideally, it is necessary to try to exclude all possible causes of an ectopic pregnancy at the planning stage.

Symptoms of an ectopic pregnancy

How do you know that the onset of pregnancy is an ectopic? In fact, it is not easy to "see" it. The symptoms of this pregnancy are exactly the same as normal physiological ones: the next menstruation does not occur, the chest fills up, the uterus enlarges and can sip, it is possible, a change in appetite and taste preferences and so on. But some things can still cause some suspicion.

With an ectopic pregnancy, from the first days, spotting of a dark color can be observed. It happens that the next menstruation occurs on time or with a slight delay, only the discharge is weaker than usual. At the same time, the pulling pain in the lower abdomen radiates to anus, and if the fallopian tube ruptures, it becomes unbearably strong, sharp, up to 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 urgently taken to the hospital for urgent surgery.

An ectopic pregnancy is most easily confused with a threatened miscarriage. But this is exactly what she makes herself felt: she begins to interrupt, which usually happens at 4-6 weeks. To prevent the worst from happening, it is necessary to make a diagnosis in time. And therefore, as soon as you find out that you are pregnant, immediately go through an examination by a gynecologist and. 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?

The success of resolving the situation with an ectopic pregnancy will depend on at what stage of its development the diagnosis was made. Pregnant women are registered in the second or third month, and this is already too late ... Therefore, as soon as you have the slightest suspicion that something is wrong, you need to immediately verify the existence of a problem or exclude it. This happens through examination.

First you need to make sure that the pregnancy really has come. The easiest and fastest way is to do a home pregnancy test. However, relying only on the test is not worth it in any case: the gynecologist will be able to confirm the guesses about the conception that has taken place during an in-person examination. However, this is not always the case: if the term is not long enough or the egg is still too small, then the only way to reliably find out whether pregnancy has occurred or not, there will be an ultrasound of the pelvis with the introduction of a transvaginal sensor and.

If it's too late to guess - there are all signs of a tubal rupture or abdominal bleeding - immediately call an ambulance: this condition is life-threatening! And in no case do not take any action on your own: do not drink painkillers, do not put ice heating pads, do not put enemas!

Basal temperature during ectopic pregnancy

Women leading a chart of basal temperatures may suspect pregnancy at the earliest possible date. After conception, progesterone begins to be intensively produced in the body of the expectant mother, 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 is the cause of the increase in basal temperature. You can focus on indicators only when measurements are made from month to month according to all the rules, at least for 4-6 cycles in a row.

With the onset of pregnancy, the basal temperature rises to an average of 37.2-37.3 ° C (in different women these indicators may differ slightly) and is kept at this level. This occurs regardless of whether the pregnancy develops in the uterus or outside the uterus. The basal temperature during an ectopic pregnancy is no different, since progesterone is produced anyway.

A decrease in basal temperature (below 37 ° C) occurs only when the fetus freezes, which often happens during ectopic pregnancy. But this is not necessary either: often the BT indicators remain at the same levels in this case as well.

Does the test show an ectopic pregnancy?

It is impossible to give an exact unambiguous answer to this question. Firstly, not every test and not always shows a normal pregnancy. Secondly, in the case of attachment of the fetal egg outside the uterus, there may indeed be nuances.

So, almost all pregnancy tests show the fact of fertilization. It doesn’t matter where exactly the egg stopped: the level of the human chorionic gonadotropin hormone (hCG) will definitely increase (since the forming placenta begins to produce it), which, in fact, the test systems react to.

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

The test for an ectopic pregnancy may “work” later than for a physiological one. That is, at a time when normal developing pregnancy can already be diagnosed with a home test, a pathological pregnancy is sometimes still “hidden”. An ectopic pregnancy can often be detected with a delayed test, that is, 1-2 weeks later than usual. Or the second test strip appears very weakly. What is it connected with?

HCG levels during ectopic pregnancy

It's all about HCG. Wherever the fetal egg is fixed, its shell (chorion) still begins to produce this hormone. That is 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 during uterine pregnancy, and does not grow as dynamically. Therefore, at a time when a home test already shows a normal pregnancy, with ectopic level HCG may still be insufficient to determine.

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

By itself, a blood test for hCG cannot be a reason for making a final diagnosis, but together with an ultrasound scan it can clarify the picture. Although hCG during an ectopic pregnancy rises, it is not so fast and dynamic. Regular monitoring of the level of hCG in the blood (with a break every 2-3 days) allows us to draw preliminary conclusions: during normal pregnancy, it will double, with pathological - only slightly.

Does an ultrasound show an ectopic pregnancy?

Transvaginal ultrasound allows you to see the location of the fetal egg already in the second week of pregnancy, although reliable data can be obtained from about the fourth week. If the embryo in the cavity of the fallopian tube or uterus is not detected (when it is still too short term and the fetal egg is not visible due to its 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 a medical examination is performed. According to indications, even laparoscopy is possible: the pelvic organs are examined under anesthesia during the operation, which, upon confirmation of an ectopic pregnancy, immediately turns into a medical procedure.

Ultrasound with intravaginal insertion 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 made correctly. In 10% of all cases when ultrasound is performed during an ectopic pregnancy, it is not installed due to the fact that an accumulation of fluid or a blood clot located in the uterine cavity is taken for a fetal egg. Therefore, even such a highly accurate diagnosis is recommended to be combined with other methods for greater reliability, in particular with a blood test for hCG.

Ectopic pregnancy: forecasts

None of the organs of the female body is intended for bearing a child, except for the uterus. Therefore, the attached “in the wrong place” embryo must be removed. If this is not done in advance, for example, a rupture of the fallopian tube may occur (if the egg is fixed here) or it may enter the abdominal cavity when bleeding opens. Both situations are extremely dangerous for a woman and require immediate surgical intervention. When the fallopian tube ruptures, a woman experiences the strongest sharp pain, possible shock, fainting, intra-abdominal bleeding.

It is very important to detect an ectopic pregnancy in time in order to successfully solve the problem. Previously, in such cases, the fallopian tube was removed, which meant the inability to become pregnant and give birth in the future. Today it is a last resort. In most cases, an ectopic pregnancy is an operation during which the ovum is removed and the fallopian tube is sewn up to preserve reproductive capabilities.