Ectopic pregnancy signs in the early stages. Early signs of an ectopic pregnancy

A positive result on the test strip indicator can sometimes turn into an unexpected problem: fertilized egg begins to grow and develop outside the uterus. The complexity of diagnosis lies in the lack of specific clinical data in the initial period. Signs of an ectopic pregnancy in the early period of 2 weeks are of a certain nature.

Dangerous signals must be known in order to avoid serious complications. The cause of the pathology may be due to the presence of chronic inflammatory processes, which resulted in adhesive formations affecting the permeability of the egg. The reasons include malformations of the reproductive organs, hormonal imbalance and too “slow” spermatozoa. The nature of the signs indicating pathology depends on the place of attachment of the egg. From the first week of pregnancy, it is very difficult to determine the anomaly. The manifestation of toxicosis is a normal picture in the symptoms of pregnancy.

The manifestation of symptoms depends on the place where the fertilized egg is attached. The more room for its growth, the longer the patient may not experience the characteristic symptoms of a pregnancy that develops under abnormal conditions.

From the second week of pregnancy, pain sensations of aching and pulling nature signal a problem. This may indicate that the egg is attached in the fallopian tube. According to statistics, this picture occurs most often. When the embryo is localized in a wide area of ​​the tube, obvious signs are palpable in the period of 7-8 weeks. And in the cervical region, symptoms may appear much later.

Signs of pregnancy in the early 2 weeks may be indistinguishable from physiological manifestations. In the second - third week, anxious moments are expressed in this way:

At the first signs indicating abnormal development, immediate medical attention is required. Pathology endangering women's health. If you do not see a doctor in time, there is a risk of developing peritonitis (inflammation of the peritoneum), rupture of the fallopian tubes and bleeding.

At terms of 2 weeks, a pathology is determined due to the implantation of an embryo in a narrow lumen of the tube or ovary. Sometimes there is a spontaneous separation of the fetal egg, which leads to tubal abortion. This situation is relatively favorable, because it does not entail pipe rupture.

The gestational age is set from the end of the last day of the menstrual cycle. It may not coincide with the value set on the basis of an ultrasound examination. At what time can you see pregnancy on an ultrasound, many women are interested. The fetus in the uterus can be seen from the 3rd week. This is the difficulty in determining the development of the embryo in the tube or ovary. Sometimes, before the onset of 5 weeks, it is not possible to determine the abnormal position of the fetal egg. That's why Ultrasound in the early stages does not give a 100% guarantee of diagnosis. An important aspect for accurate diagnosis is a set of special measures.

HCG during ectopic pregnancy weekly rate table

From the moment of fertilization, the female body begins to produce a hormone called gonadotropin (hCG). Laboratory studies allow you to monitor the growth of gonadotropin readings. During physiological pregnancy, the growth of hCG is expressed in 1 unit per day. Sometimes, when the embryo is located outside the uterus, the hormone continues to increase its performance until a critical moment.

Below are the physiological norms for the growth of hCG in pregnant women.

May vary, weekly rate is tracked in the table. Hormone value 0 to 5 is considered negative.

A deviation from normal values ​​by 20% requires a re-examination of the hormone level. A change expressed in 50% upwards or downwards is considered critical. This situation indicates a pathology.

The diagnostic complex includes ultrasound, monitoring of the hCG index, bimanual examination, monitoring of the level of progesterone growth in the blood serum. The level of progesterone in an ectopic location of the embryo much lower than in a normal pregnancy. A bimanual examination reveals the presence of an abundant secretion, cyanosis of the mucous membranes of the neck and its slight induration.

Painful sensations are localized in the area of ​​​​attachment of a fertilized egg. After 2 weeks, clinical manifestations are revealed that indicate the position of the egg in the fallopian tubes or ovary (isthmic, interstitial, ovarian). Later, at a period of 5 to 8 weeks, a pregnancy is diagnosed that develops in the abdominal cavity, in the widest part of the fallopian tube (fimbrial, ampullar). The biggest threat is cervical location of the egg. Such a pregnancy can be asymptomatic for a long time, which poses a threat to the woman.

Can establish the location of the fetal egg diagnostic ultrasound examination carried out over a period of 5 weeks. Earlier, in particular at a two-week period, there is no guarantee of an accurate result, which complicates the identification of the pathological process.

Signs of an ectopic pregnancy at an early stage of 2 weeks - pain is intense and prolonged. Such manifestations should not be ignored.

The presence of secretions is a dangerous symptom, when they appear, you need to consult a gynecologist

• in most cases, spotting is characteristic;
• when bleeding into the abdominal cavity, bloody discharge from the genitals appears.

These symptoms are always accompanied by aching pain.

Many women ask the question: if the pregnancy is ectopic, will the test show 2 strips? From the moment of fertilization of the egg, the female body begins to produce chorionic gonadotropin, which is responsible for the reaction on the test strip. That's why the test will be positive regardless of where the embryo was implanted.

When diagnosing the incorrect position of the fetal egg, its removal is required. In the future, after a course of treatment aimed at eliminating the causes of the pathology, the woman has a chance of getting pregnant and have a happy baby. An ectopic pregnancy is not a sentence, but an accidental coincidence. For the prevention of pathologies of the reproductive function, it is necessary to carefully monitor health, to prevent hypothermia.

We examined the signs of an ectopic pregnancy at an early 2-week period. The forum will help you learn more. Have you come across this? Leave your opinion or feedback for everyone on the forum.

An ectopic pregnancy develops in the fallopian tube, ovaries, abdominal cavity; most often, the fetal egg is implanted and continues to develop in various parts of the fallopian tube. The delay of a fertilized egg in the tube and its further development in it are due to inflammatory changes and impaired patency of the fallopian tube. How to determine an ectopic pregnancy, read further in the article.

Signs and symptoms of an ectopic pregnancy

Manifestations of the disease often develop in women who suffer for a long time and receive treatment for "chronic inflammation of the appendages", in women who have not become pregnant for a long time and consider themselves incapable of becoming pregnant.

Early manifestations of ectopic pregnancy

As a rule, the first symptoms of an ectopic pregnancy are detected at the 4-6th week. It is not uncommon for a fallopian tube to rupture after a gynecological examination or sexual intercourse. There are cases of rupture of the "pregnant" tube that occurred after curettage of the uterine cavity in connection with the alleged uterine pregnancy. If there were no pronounced symptoms, and the test showed two strips, the woman comes to the honey. an abortion resulting in a rupture of the tube. The development of the disease is usually accompanied by a delay in the next menstruation and an increase in the uterus. True, the uterus, which does not contain a fetal egg, usually lags noticeably behind the size of the gestational age, which could be assumed from the delay in menstruation.

Even with a rare long-term pathology, the enlargement of the uterus never exceeds the usual size for a 5-6-week pregnancy, and this is the most important diagnostic symptom by which an ectopic pregnancy can be determined.

Late symptoms of ectopic pregnancy

If a woman has signs of illness due to acute blood loss, with a disturbed tubal pregnancy, the following are quite characteristic:

sharp pallor,

dizziness,

general weakness,

tachycardia,

hypotension in severe cases with the development of collapse),

there is a sudden severe anemia without visible bleeding.

Sudden syncope is often the main reason for seeking medical help in patients with impaired tubal pregnancy.

Signs of bleeding during an ectopic pregnancy

However, in the clinical picture there is always a group of symptoms of an ectopic pregnancy due to the accumulation of blood in the abdominal cavity.

This is primarily the appearance of sudden pain in the abdomen. In every pregnant woman, sudden fainting and abdominal pain suggest an ectopic pregnancy and bleeding into the abdomen.

Initially, the pain, as a rule, is localized in the lower abdomen, and the accumulation of blood in the small pelvis and the pressure of the resulting hematoma on the rectum and bladder cause two extremely characteristic symptoms - the appearance of pain during urination, frequent urge to it and a feeling of pressure on the anus.

With the gradual "corrosion" that usually occurs with tubal termination of an ectopic pregnancy, these complaints often come to the fore. The accumulation of blood in the uterine space is manifested by a kind of testiness, softening of the posterior fornix, its swelling and severe pain.

However, with significant bleeding, the blood poured into the abdominal cavity is localized not only in the small pelvis. It often accumulates under the diaphragm, causing pain in the shoulder and shoulder blade (phrenicus symptom).

With a sudden fainting in a woman, the appearance of this symptom should always be regarded as a sign of bleeding into the abdominal cavity. Significant (1 l or more) hemorrhages in the abdominal cavity are manifested by symptoms of an ectopic pregnancy due to the accumulation of free fluid (dulling of percussion sound in the sloping sections of the abdomen, which changes with a change in body position). Unsharp bloating is characteristic, the loops of the intestines seem to float above the blood accumulated in it.

For disturbed tubal pregnancy, as well as for other bleeding into the abdominal cavity, the absence of protective muscle tension is characteristic. The abdomen always remains soft, although blood irritation of the parietal peritoneum is almost always manifested by a positive diffuse symptom of Shchetkin-Blumberg.

Symptoms of tubal ectopic pregnancy

The destruction of pregnancy, whether it proceeds at lightning speed, violently or gradually, is always accompanied by rejection of the decidua of the body of the uterus and the appearance of mild “smearing” bloody discharge from the genital canal, resembling coffee grounds. Many women take these discharges for the next menstruation, which came with a slight delay, and not for a symptom of an ectopic pregnancy, often a delay in menstruation can be detected only with a thorough and directed questioning about the nature and timing of the discharge. There are women in whom the termination of an ectopic pregnancy is noted earlier than the onset of the next menstruation.

The clinical picture of an interrupted pregnancy consists of symptoms of acute blood loss and symptoms caused by the accumulation of blood in the abdominal cavity. Depending on the rate and volume of internal bleeding, either violent and extremely severe abdominal catastrophes or relatively slow bleeding with gradual anemization of patients can be observed.

The symptoms of the disease largely depend on the location and nature of its destruction - rupture of the pregnant tube with rapid and profuse bleeding or the so-called tubal abortion (detachment of the fetal egg from the wall of the fallopian tube). In the latter case, pregnancy can be determined by a less acute, and sometimes even a protracted course, in which a gradual “correction” into the abdominal cavity for several days precedes severe, life-threatening intra-abdominal bleeding.

How to determine an ectopic pregnancy - diagnosis of the disease

The diagnosis is based on:

history data (delayed menstruation),

overall clinical picture

vaginal examination (pain on palpation of the posterior fornix of the vagina and the presence of a tumor-like formation in the area of ​​​​the appendages)

and additional research methods (including ultrasound, puncture of the posterior vaginal fornix, in doubtful cases, laparoscopy).

Terrible picture of sudden intra-abdominal bleeding in case of rupture of the pipe, as a rule, is quite bright and characteristic (severe abdominal pain, severe anemization, fainting, shock). It is more difficult to determine an ectopic pregnancy by diagnosing mild, but repeated hemorrhages during tubal abortion, manifested by mild syncope and accumulation of blood in the pelvis. In these cases, patients are often treated for "cystitis", sometimes they suggest a disturbed uterine pregnancy and undertake curettage of the uterine cavity. However, in contrast to uterine abortion, with a disturbed tubal pregnancy, there is always a clear discrepancy between severe anemia and slight bloody discharge from the uterus.

It is sometimes possible to determine the disease even with significant intra-abdominal hemorrhages, abdominal pain radiating to the shoulder, and the accompanying disorders of the digestive system (vomiting, pressure on the anus, frequent urge to defecate) are explained by diseases of the gastrointestinal tract and gallbladder, that is, they do not see symptoms of ectopic pregnancy in them. Patients are diagnosed with "food poisoning", "food poisoning", "acute cholecystitis", sometimes "acute dysentery". Useless and extremely dangerous measures are taken in these situations to “cleanse” the stomach and intestines, and the true nature of the disease is recognized with a significant delay, when extremely bleeding patients have to be operated on.

The same clinical picture is characterized by ruptures of the ovary (the so-called aporexia ovarii), accompanied by bleeding into the abdominal cavity. However, bleeding in this pathology rarely reaches such a volume as with a rupture of the pregnant tube. With ovarian ruptures, there is usually no delay in menstruation and bloody discharge from the uterus, so characteristic of a disturbed tubal pregnancy.

Treatment of an interrupted ectopic pregnancy

As a result of the destruction of the fallopian tube by chorionic villi, 3 outcomes of tubal pregnancy are possible:

• detachment of the ovum from the wall of the fallopian tube
• and spontaneous tubal abortion
• or rupture of the fallopian tube.

Aborted tubal ectopic pregnancy is the most common cause of intra-abdominal bleeding and requires urgent surgery.

Emergency care for ectopic pregnancy

Patients need immediate hospitalization and surgery. Even with a tubal abortion with a satisfactory condition of the patient, bleeding from the fallopian tube can always resume and take on life-threatening dimensions. This necessitates timely diagnosis and emergency hospitalization of such patients. They must be transported lying down.

As with all patients with acute massive blood loss, if necessary, intensive therapeutic measures are taken to compensate for blood loss and replenish the volume of circulating blood (intravenous infusion

• polyglucin,
• plasma,
• protein
• various types of blood substitutes).

These measures in a serious condition of a patient with an ectopic pregnancy should be carried out during transportation to the hospital. Heat, cold, enemas are contraindicated, as they can provoke re-bleeding. Analgesics in ectopic pregnancy with severe abdominal pain are also contraindicated, since they can “lubricate” the clinical picture of the disease and hide diagnostically important symptoms.

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.

During ovulation, a mature and fully formed egg leaves the ovary. It enters the tube, where the process of direct fertilization takes place. After the completion of conception, the zygote migrates into the uterine cavity. This phenomenon is facilitated by measured peristaltic contractions of the fallopian tubes and undulating swaying of the villi of the mucous membrane.

The path is long, the migration lasts about 3 days. This time is enough for the embryo to form special cells responsible for the release of a number of enzymes. With their help, the process of attachment to the mucous membranes of the formed zygote takes place.

If at one of the stages listed above, the zygote encounters mechanical or hormonal obstacles, the fertilization algorithm will be disrupted. The main reasons for the development of ectopic pregnancy in the early stages are discussed in the table below.

The development of an ectopic pregnancy may be due to local tuberculosis or external endometriosis. Moreover, long-term treatment of infertility with hormonal drugs can also cause such a specific problem.

Classification of ectopic conditions

Ectopic pregnancy, given its signs and symptoms, is divided into several categories. The classification is conditional, but rather complicated.

Types of pathological conditions according to the localization of the fetal egg:

• pipe;
• ovarian (intrafollicular and developing on the surface of the glandular organ);
• abdominal (primary and secondary);
• interligamentous;
• cervical;
• implantation in the rudimentary horn of the uterus;
• interstitial pregnancy.

According to the stages of the course and how exactly an ectopic pregnancy manifests itself:

• progressive pregnancy;
• interrupted pregnancy;
• interrupted pregnancy.

Signs of an ectopic pregnancy

An early period (5-6th week) does not allow a woman to independently determine whether an ectopic pregnancy has occurred.

Primary signs are typical for everyone:

• delayed pregnancy;
• breast enlargement, soreness;
• toxicosis of the first trimester (nausea, accompanied by vomiting).

Most often, an ectopic pregnancy is diagnosed when the symptoms already indicate the development of a tubal abortion or other termination scenarios. Progressive ectopic pregnancy, in which the fetus develops relatively normally in the initial stages, is established during an ultrasound examination.

At the same time, the task of the diagnostician was not always to search for “traces of pregnancy”. The abnormal location of the fetal egg is most often detected during diagnostic measures to identify completely different pathological conditions.

If the pregnancy did not take place in the uterus and unexpectedly terminated, the symptoms will be as follows.

1. - the first dangerous sign by which it is possible to recognize various forms of ectopic pregnancy. If the pain is dull and persistent, advanced tubal pregnancy may be suspected. The fetus is growing, and it will eventually become too crowded. Every day the risk of pipe rupture will increase. Constant cramping pain radiating to the lower back indicates that the gap did occur.
2. The first signs of a progressive ectopic pregnancy that has already been interrupted is often associated with specific pain or discomfort in the anus. Women experience unusual pressure, as at the beginning of labor or before the act of defecation;
3. Bloody issues appear at the moment when the roof from the pipe has found a way out. Small spotting of scarlet, brown, beige, which cannot be described as menstruation, is a formidable symptom. A woman should immediately consult a doctor;
4. Signs indicating rapid progression internal bleeding, - pallor of the skin, hypotension up to the development of collapse, severe weakness, severe dizziness. There is no time to determine the exact cause of this condition - you must immediately call an ambulance.

If, among other things, the patient has hyperthermia, prone to progression, there is every reason to believe that an inflammatory process has begun in the body. This is a particularly severe case requiring immediate treatment and long-term rehabilitation.

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 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.

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.

Treatment of patients

Treatment of an interrupted abnormal pregnancy is carried out exclusively by the method of salpingoectomy. The deformed tube is removed if the gestation period is relatively early. There are two reasons for this:

• stop massive bleeding that cannot be controlled otherwise;
• get rid of an organ that has completely lost its functional potential.

Distinguish between laparoscopic and laparotomic scheme of surgical intervention. The intervention itself is quite traumatic, it requires the appropriate qualifications of the doctor.

If the pipe has retained its integrity, the treatment of ectopic progressive pregnancy is carried out in other ways. A chemical substance is injected into the fruiting egg for the purpose of subsequent medical tissue sclerosis. Then, the walls of the tube are excised, followed by removal of the fetus.

The fabrics are neatly sewn up. Not a single specialist guarantees that the pipe will eventually retain at least a minimum patency. As for scars and fibrous bands, they are formed as a natural reaction of the body to surgical interventions.

Rehabilitation and subsequent preparation for pregnancy

All rehabilitation activities are presented below.

1. Immediately after the operation, intensive infusion therapy is prescribed in order to correct the water and electrolyte balance.
2. Antibiotic therapy to prevent a number of postoperative complications.
3. Stabilization of the hormonal background.
4. Contraception 6 to 12 months after surgery.
5. Prevention of adhesive processes using enzyme preparations.
6. Physiotherapy for general wellness.

Provided that the woman has at least one tube with optimal patency, the probability of becoming pregnant in the future is quite high. The optimal period for re-conception is 1 year after the operation. In general, the prognosis is favorable, but on the condition that the disease was detected fairly quickly and really professional help was provided.

Our life sometimes presents us with pleasant and not very surprises. It happens that a woman, trying to get pregnant, undergoes expensive treatment courses, does everything possible to make a miracle happen, and now, when the test shows the long-awaited 2 stripes, the obstetrician-gynecologist is dumbfounded by the diagnosis -.

The name "ectopic" speaks for itself. It occurs when the egg is fertilized outside the uterine cavity, but, say, in the fallopian tube, ovaries or abdominal cavity.

Why does an ectopic pregnancy happen?

One of the main reasons for this phenomenon, gynecologists call the inflammatory process in the genitals, which leads to blockage of the fallopian tube. Also, an ectopic pregnancy can occur due to hormonal failure, congenital underdevelopment of the fallopian tubes, past infections of the uterus or its appendages, bladder, inflammation of the mucous membrane of the uterine walls, abortions and other disorders. Another possible reason for the occurrence of this pathology is the “slowness” of spermatozoa, one of which does not have time to infiltrate the egg in time, which in turn prevents the fertilized egg from being in the uterus at the right time, and it is attached “where necessary”. In addition, a fertilized egg can get stuck in the tube if it is very tortuous or has adhesions, narrowing, or scars on the inner surface. An induced abortion can also cause an ectopic pregnancy.

Is it possible to independently suspect an ectopic pregnancy?

Diagnosis of this pathology in the early stages is complicated by the fact that a woman does not suspect a threat, because she has all the symptoms that a woman with a normal, uterine, pregnancy observes. Later, a pulling or spotting discharge may appear, pain is possible, as a rule, it is localized at the site of the introduction of the fetal egg. And since ectopic pregnancies are 98% tubal, the pain is felt in the area of ​​\u200b\u200bone of the tubes, closer to the ovaries. If the test showed two strips, there are signs of pregnancy, but at the same time, discharge has appeared and contact your doctor immediately. The earlier an ectopic pregnancy is diagnosed, the higher the chances of keeping the fallopian tube intact and giving birth to a healthy baby in the future. Note that in the early stages (4-6 weeks) it is possible to see the location of the embryo (or its absence in the uterus) only with the help of ultrasound diagnostics. If no pathology is detected in the first weeks of pregnancy and, accordingly, the necessary measures are not taken, the fetus begins to grow and develop. In this case, the pipe, not intended for bearing a child, cracks, accompanied by bleeding. At this moment, the woman feels severe pain, weakness. Hemorrhage may occur in the abdominal cavity. And this already poses a threat to the life of the woman herself. In this case, emergency surgery is necessary. With a large blood loss, fainting, pale skin, falling, frequent can be observed.

Modern medicine is familiar with cases of "double" pregnancy, when one is uterine, and the second is ectopic. In this case, surgery is also necessary.

Call an ambulance immediately or go to the hospital if you have the above symptoms with an established pregnancy!

Usually, immediately after the diagnosis is established, the question of surgery is decided. With an interrupted ectopic pregnancy, the operation should be performed 30-40 minutes after the diagnosis. From the same moment, blood transfusion and blood-substituting solutions begin.

How is an ectopic pregnancy removed?

An ectopic pregnancy is always a purge. In many cases, doctors have to remove the fallopian tube. Sometimes it is possible to perform a plastic surgery: remove the fetal egg with the restoration of the integrity of the fallopian tube as the most important organ of the reproductive system. Another method of research and treatment of ectopic pregnancy is the introduction of special drugs. But this method is only suitable for those women who do not plan to have more children.

After the operation, it is very important, in order to prevent infertility, to carry out rehabilitation measures aimed at preventing the development of adhesions and adhesions at the site of the operation and restoring the motor activity of the fallopian tubes.

What happens after an ectopic pregnancy?

Practice shows that many women, having heard this disappointing diagnosis addressed to them, after a certain time, nevertheless become happy mothers. As a rule, with favorable treatment, doctors allow pregnancy after 6-8 months. True, 5-10% of women after an ectopic pregnancy make another terrible diagnosis - infertility. To prevent this from happening, it is very important to determine an ectopic pregnancy as early as possible.

Prevention of this pathology is to prevent unwanted pregnancy through the use of various methods of contraception, as well as in the prevention of inflammatory diseases of the female genital organs.

Especially for- Elena Kichak

An ectopic pregnancy is a fairly serious disease that can lead to various problems with women's health. Currently, this phenomenon is treated with due attention, because it has become quite common. The frequency of its occurrence is 2% of the total number of all pregnancies.

To begin with, let's figure out what this phenomenon is, how can an ectopic pregnancy be determined and prevented?

The concept of ectopic pregnancy

An ectopic pregnancy is an abnormal course of pregnancy, in which it is possible to cause a serious threat not only to health, but also to the life of a woman. Normally, during pregnancy, a fertilized egg must develop in the uterus. To do this, it passes through the fallopian tube, descends into the uterine cavity and attaches to the place of the mucosa, which is most favorable for the development of the fetus. This process is referred to in medicine as “implantation”.

But sometimes this does not happen, and the egg begins its development in various places that are not adapted for this, in particular in the fallopian tubes (according to statistics, 99% of the total number of ectopic pregnancies develop here). But the development of the egg can also occur in other places - for example, in the ovaries and even the abdominal cavity.

Most often, an ectopic pregnancy is not viable., but there are cases when, even in such a situation, the fetus develops normally and a healthy child is born, without any pathologies.

Until today, it is impossible to name the exact reasons why an ectopic pregnancy occurs. However, there is a certain category of women who are at risk. The most likely occurrence of ectopic pregnancy in women after 35 years.

Attention to their own health should be shown to women who suffer from chronic inflammatory diseases caused by chlamydial infection, mycoplasma or ureoplasma. Also at risk are women who have ever undergone treatment associated with tubal and hormonal infertility.

On the alert should be women who have endometriosis, congenital anomalies of the uterus and fallopian tubes, as well as anyone who has ever encountered the problem of miscarriage. Another possible cause of this disease is the use of an intrauterine device as a contraceptive.

Classification of ectopic pregnancy

Depending on where exactly the fertilized egg was attached, an ectopic pregnancy can be:

• pipe;
• abdominal;
• pregnancy in the rudimentary horn of the uterus.

Each name for an ectopic pregnancy speaks for itself. But also in medicine, another type of ectopic pregnancy is distinguished, which is called heteroscopic pregnancy. In this case, there are two fetal eggs, one of which is fixed in the uterus, and the other in any of the above places.

If you have been diagnosed with an ectopic pregnancy, there can be a variety of reasons for this. This condition can be provoked by:

• inflammatory processes that occur in the female genital organs (namely the ovaries and fallopian tubes). This can happen, for example, after an abortion;
• congenital underdevelopment of the fallopian tubes;
• hormonal disorders;
• tumors of the internal genital organs (both malignant and benign).

Also, the cause of an ectopic pregnancy may be the use of assisted reproductive technologies, such as IVF (in vitro fertilization), ovulation stimulation.

Sometimes individual structural features of the woman's reproductive system can lead to an ectopic pregnancy (for example, the presence of long tortuous fallopian tubes with underdevelopment of the reproductive system).

How is an ectopic pregnancy

If a fertilized egg fails to enter the uterus in time, it can attach itself to another place where it is currently located. This is where the growth of the egg begins. But other places are not provided for the development of the fetus (they do not have the ability to stretch the way the uterus can do), and therefore the moment is inevitable when there is simply not enough free space for the normal development of the fetus.

If an ectopic pregnancy develops in the fallopian tube, then at some point it breaks (its walls are not as elastic as the uterus). Due to rupture of the fallopian tube, bleeding into the abdominal cavity occurs, which is accompanied by symptoms such as sharp pain, which to some extent resembles cramping pain, dizziness. Loss of consciousness is also possible. In this case, a sufficiently large vessel can be damaged, during which a large amount of blood can be lost, and this, as you know, is deadly for a woman.

How to recognize an ectopic pregnancy?

In order for this process not to cause an irreparable blow to women's health, it should be recognized as early as possible. You should definitely know what symptoms of an ectopic pregnancy may be in order to be able to see a doctor in time and determine an ectopic pregnancy in the early stages.

The worst thing about this situation is that identifying an ectopic pregnancy early can be problematic, as the symptoms that signal its onset can be the same as the usual symptoms of pregnancy.

Delayed menstruation is the most common symptom in this case. At the same time, a woman can observe spotting that appears from time to time during an ectopic pregnancy from the vagina. But very often this symptom signals not only the presence of an ectopic pregnancy, but also the termination of the usual one.

The first signs of an ectopic pregnancy can sometimes be somewhat different from the symptoms of a normal pregnancy. For example, sometimes menstruation with an ectopic pregnancy still occurs, but the discharge is very scarce, very different from the usual. Other symptoms can also be pain in the lower abdomen (most often in the area of ​​​​the fallopian tube - where the egg is fixed). Pain during an ectopic pregnancy is most often of a pulling nature.

Most often, unpleasant symptoms that only indicate how an ectopic pregnancy manifests itself occur at 5-8 weeks from the end of the last menstruation.

Tests to determine pregnancy

Women who suspect they are pregnant often use a variety of tests to determine them. Many women are concerned about whether the test shows an ectopic pregnancy. The answer is yes and no.

The thing is that these tests are designed to determine whether a woman is pregnant at the earliest possible date. But when the fetus develops outside the uterus, such tests may not show that the woman is pregnant at all. Therefore, if you have an ectopic pregnancy, a pregnancy test may show that you are not pregnant.

The most common pregnancy test determines the level of hCG (human chorionic gonadotropin), with which it is possible to detect pregnancy even in the early stages. The level of hCG during an ectopic pregnancy will be significantly lower than during a normal one. HCG indicators may not even reveal the presence of pregnancy at all.

The analysis of hCG in an ectopic pregnancy will be very different from the analysis of hCG in a normal pregnancy. HCG levels during ectopic pregnancy are 2/3 less than those when the fetus develops in the right place.

Therefore, if you have all the symptoms of pregnancy, and tests to determine it say otherwise, then it is possible that you are dealing with an ectopic pregnancy. In this case, it is still better to consult a doctor. After all, as you know, the sooner you have this problem, the less serious risk you are exposed to.

Diagnosis of an ectopic pregnancy

Modern medicine makes it possible that an ectopic pregnancy in the early stages can already be detected, and, therefore, to minimize the harm that can be caused to women's health. First, you should conduct tests for the presence of pregnancy in general. The best way to do this is with a blood test for human chorionic gonadotropin.

If you have symptoms of an ectopic pregnancy, you should immediately have a pelvic ultrasound with a transgival transducer. Sometimes an ectopic pregnancy is not detected on ultrasound, but if there is no fetal egg in the uterine cavity, the study must be repeated after a few days. It will not be superfluous to hospitalize a woman in a hospital, because at such a time the fetal egg must certainly be viewed by doctors.

If, while in the hospital, doctors are still unsure whether you have an ectopic pregnancy or not, they may resort to a procedure such as exploratory laparoscopy. This is a kind of operation during which, under anesthesia, an examination of the pelvic organs is performed. This is an excellent procedure for detecting an ectopic pregnancy. If the disappointing diagnosis of an ectopic pregnancy is confirmed, then this operation develops into a therapeutic manipulation.

Treatment of an ectopic pregnancy

Not so long ago, it was believed that the only way to get rid of an ectopic pregnancy was to remove the fallopian tube. Then a laparotomy was necessarily performed (an operation during which an opening of the abdominal cavity was performed). But at present, laparoscopic surgery is developing very quickly, and therefore now doctors can perform more gentle operations (now access to organs is carried out only through a few points located on the abdominal wall).

Now, by carrying out the laparoscopy procedure, you can remove the fallopian tube, or remove the fetal egg, but at the same time not damage the integrity of the fallopian tubes, which are one of the most important organs of the woman's reproductive system.

If an ectopic pregnancy was detected in the early stages, the operation may not be performed, because its treatment can be carried out with the help of chemotherapy. In this case, the development of the fetal egg stops, as well as its gradual resorption.

Postoperative period

Treatment after an ectopic pregnancy should take place in two directions - medical and physiological. With the help of drug treatment, it is possible to improve the condition of the fallopian tubes after surgery, to promote speedy healing. Also, many women are prescribed physiotherapy procedures (such as magnetotherapy). It is especially recommended to carry out these procedures if there was heavy bleeding into the abdominal cavity.

Consequences of an ectopic pregnancy

Due to the fact that only the uterus is intended for carrying the embryo, a rupture of the fallopian tubes may occur, which will inevitably be accompanied by bleeding into the abdominal cavity. Therefore, a woman in this condition must be hospitalized. An ectopic pregnancy can lead to various health problems., the inability to have children in the future and even death.

If you have discovered such a disappointing phenomenon as an ectopic pregnancy, the consequences of it can be the most terrible, and therefore you should be very careful about your health and not neglect visits to the doctor for a certain time.

Ectopic pregnancy

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 of the fetal egg is not so rare anymore: although there is little pleasant in this, due to 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 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 a normal pregnancy begins, 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 mother's 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.
• Some technologies of artificial insemination.
• 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: regular periods do not occur, the breasts fill up, the uterus enlarges and can sip, toxicosis 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 the 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 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?

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 period 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 will be an ultrasound of the pelvis 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 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!

Also Read: Symptoms of an Ectopic Pregnancy

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 (for different women, these figures may vary 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.

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 a normally 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 an ectopic hCG level, it 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 is not found in the cavity of the fallopian tube or uterus (when the period is still too short 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 a fallopian tube ruptures, a woman experiences severe acute pain, shock, fainting, and intra-abdominal bleeding are possible.

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.

More and more doctors are studying and putting into practice drug treatment of ectopic pregnancy with the help of hormones. However, even if you have one damaged fallopian tube removed, you have every chance of becoming pregnant and bearing a child if the other is preserved.

True, you first need to undergo a rehabilitation treatment course. And also a woman who has experienced an ectopic pregnancy should not become pregnant for at least another six months. Be extremely careful when choosing a contraceptive method. You must understand that there are still fairly high chances of such an abnormal pregnancy recurring. And in order to prevent this, it is imperative to find out the reason why the fetal egg in your case cannot reach the uterus. Well, of course, eliminate it.

Especially for beremennost.net — Elena Kichak