The main signs and symptoms of how to determine an ectopic pregnancy in the early stages. Causes of ectopic pregnancy. Among the main features it should be noted

An ectopic pregnancy is not common, but it cannot be called a rarity either. According to statistics - 2 out of 100 pregnant women have this dangerous pathology.

Its causes have not been thoroughly studied, so any woman who does not avoid sexual activity can face it.

An ectopic pregnancy, even in the mildest cases, does not go unnoticed for a woman - it is always accompanied by inflammation, bleeding, anemia and scars in the appendages.

About 30% of women remain infertile, about 20% are at risk of repeating this unpleasant experience. However, almost half have every chance of a subsequent normal pregnancy with the birth of a healthy child.

These chances increase if, without wasting time in the early stages, as soon as the first suspicions and signs of ectopic fixation of the egg appear, take the most active measures to avoid rupture and removal of damaged organs.

There is not enough space for the growth of a rapidly developing embryo outside the uterus, tissues of other organs are not adapted for fetal implantation and do not have the necessary elasticity.

As a result, the embryo itself either exfoliates from the wall of the appendage or breaks it. Both cases cause internal bleeding and threaten the death of the woman.

Important to remember! It is impossible to do without surgical medical intervention in case of spontaneous abortion or rupture, and with an increase in the period, the risk increases.

It is very important to have an idea of ​​​​how an ectopic pregnancy manifests itself in the early stages. Recognizing the first signs of this dangerous pathology, you can solve the problem with minimal consequences.

Symptoms of an ectopic pregnancy before a delay

Before a delay in menstruation, not every woman succeeds in suspecting serious changes in the normal course of the cycle, including dysfunction or pregnancy (both normal and ectopic).

At this stage, many do not think about a possible problem.

Especially since the very first evidence of conception is very similar to PMS:

• decreased tone and drowsiness;
• appetite changes;
• dizziness, absent-mindedness and mood variability;
• the chest fills up, becomes sensitive.

ectopic early pregnancy manifests itself in the same way as a normal one, and its first signs may not be pronounced.

Symptoms of an ectopic pregnancy in the first week, as it manifests itself in the early stages

The egg begins to move towards the uterus during fertilization. Within 5-6 days, the embryo (still in the form of a single cell - a zygote) exists in a state not associated with the mother's body.

By the end of the first week, he is already completely ready for implantation - for subsequent development, he needs nutrition and oxygen. If it was not possible to reach the uterus by this time, the process of fixing begins where it is at that moment.

It happens (but less often) that a fetal egg that has already entered the uterus is pushed out of it and attached to the surrounding tissues of the peritoneum or in the ovary.

To fix the shell of the fetal egg begins to form outgrowths-villi - chorion(from which the germinal part of the placenta subsequently develops).

These villi actively penetrate into the tissues of the uterus (and in case of ectopic pregnancy - into the walls of the organ to which the embryo tries to attach), destroying them and the walls of blood vessels. This process takes about 2 days.

Note! The very first sign of conception is a slight discharge of blood about a week before the expected period. They are called implantation bleeding.

At this stage, it is still impossible to distinguish an ectopic pregnancy from a normal one.

Unpleasant sensations (if any) are often explained by the body's reaction to restructuring, and not by the presence of any pathology.

Symptoms of an ectopic pregnancy at 6-8 weeks

How an ectopic pregnancy manifests itself in the early stages (its first signs) depends entirely on which of the organs the fetal egg is implanted.

There are such types of this pathology:

Type of ectopic pregnancy	How it manifests itself in the early stages	First signs
Trubnaya	Usually the embryo stops in the widest part of the fallopian tube. Then the first symptoms become noticeable by the 8th week and later. But in 1/3 of such pathologies, it is located closer to the uterus, where the walls of the tube are narrow and inelastic. Then sharp, painful sensations appear as early as 5 weeks. With this position of the embryo, the risk of rupture of the tube is very high.	Stitching pains from the affected oviduct; Blood discharge (usually weak, spotting); Convulsive pains under the peritoneum; Incessant, drawing pain; Lethargy, dizziness, low blood pressure are signs of internal bleeding.
Abdominal	Appears closer to 5 weeks.	Discharge, weakness, pallor - indicate bleeding; Pain can be both on the side and in the middle of the abdomen.
Cervical	Usually it does not arouse suspicion for a long time, because in this organ there is enough space for the growth of the embryo at first.	Very rarely causes pain or discomfort unusual for pregnancy; Has a tendency to prolonged and profuse vaginal bleeding, because there are many blood vessels in the attachment zone; Blood loss can be significant and can cause shock and life-threatening.
Ovarian	The walls of the ovary are well stretched, so the embryo can develop with little or no deviations up to 18–20 weeks (begins to move). A woman at this time does not notice any discomfort. After that, an inevitable rupture of the organ occurs.	Usual toxicosis and spotting; Tolerable point pain at the implantation site; Later - severe attacks of pain radiating to the lower back and anus, accompanied by dizziness and nausea; Pain during bowel movements.

Be careful! It happens that an ectopic pregnancy is asymptomatic and does not cause any unusual sensations until an emergency. This leads to its delay and threatens with irreversible consequences.

Symptoms of an ectopic pregnancy for more than 8 weeks

By the way the first signs of pregnancy appear in the early stages, it is difficult even for qualified specialists to distinguish a normal process from an ectopic pathology.

8 weeks is considered a critical period - at 8-10 weeks of tubal pregnancy, a rupture of the oviduct is likely. Therefore, doctors try to remove the fetal egg before the 7-week period.

It is already possible to assume ectopic implantation at week 8 with a high degree of certainty:

However, all of these factors cannot give complete confidence in the presence (or absence) of this pathology:

• Low hCG it can be a symptom of problems with a normal pregnancy - this is how the first signs of a threatened miscarriage, delayed fetal development, pregnancy fading appear;
• Dimensions of organs and seals in them, with a manual examination, they can also indicate both an ectopic pregnancy and other causes, especially against the background of already existing diseases;
• With ultrasound in the early stages of fluid accumulation, blood clots or folds of the epithelium are easily mistaken for a gestational sac.

That's why if necessary, confirm suspicions, diagnostic laparoscopy is prescribed– internal examination of the abdominal cavity using a telescopic tube connected to a video camera.

Holes for insertion of instruments have a minimum size, and the method is considered one of the most forgiving.

If pathology is present, such equipment allows you to continue the procedure, such as surgery to remove the fetal egg and cauterize the damaged vessels.

Timely laparoscopy allows you to save the appendages in which implantation has occurred, and reduce the risk of infertility.

Symptoms of an ectopic pregnancy due to rupture of the tubes

Without medical intervention, tubal pregnancy leads to two results:

• tubal abortion- the dead embryo exfoliated (sometimes partially) from the wall of the oviduct enters the abdominal cavity. Based on such a natural solution to the problem, doctors sometimes choose a temporary tactic of monitoring the course of pregnancy without intervention;
• pipe rupture- if a spontaneous abortion has not occurred before the 10th week or measures to remove the embryo have not been taken.

Tubal abortion is accompanied by:

Pipe rupture symptoms:

• Unilateral, "dagger" pain in the lower abdomen with nausea and intense sweating;
• Internal bleeding, causing a sharp decrease in pressure, fainting, shock, threatening the life of a woman;
• Since the blood flowing into the abdominal cavity painfully affects the nerve endings, and there are fewer such endings in the pelvis, pain relief comes in a sitting position. However, when you try to sit down, the loss of blood results in severe dizziness (sometimes with loss of consciousness). This characteristic symptom is called the Roly-Vstanka symptom.

Methods for determining an ectopic pregnancy

The most reliable ways to identify how an ectopic pregnancy manifests itself, to detect the first signs of this pathology in the early stages:

• monitoring changes in hCG levels;
• Ultrasound studies compared with the results of laboratory tests.

Low hCG level, as an indicator of HMP

HCG (chorionic gonadotropin) is a hormone produced by the chorion (embryo membrane) from 6 days after fertilization.

By 7-11 weeks, the production of hCG increases several thousand times, and after that it decreases.

This period is the most productive for identifying various pathologies in the early stages, because with an abnormally developing pregnancy, the level of hCG lags behind the indicators inherent in a healthy process.

To determine the increase in hCG, a series of analyzes is performed with a small difference in time, the results of which are compared with normative tables.

During a pregnancy that proceeds without problems, the level of chorionic gonadotropin increases by at least 1.6 times in 48 hours.

If the test results showed a slower growth rate, this is a reason to suspect an ectopic pregnancy, a pathology of fetal development, or a threat of miscarriage.

When the hormone level is above 1800 mU / ml, a fetal egg is already clearly visible with transvaginal ultrasound. If, with such indicators, it is not detected in the uterine cavity, the doctor suggests ectopic implantation of the embryo.

How to identify HMP with a pregnancy test

On the 10-11th day after the conception of hCG in the urine of a woman, it is already enough for an express test to react to it.

And although it is impossible to distinguish an ordinary pregnancy from an ectopic one, some features of the result should be taken into account in order to conduct more reliable analyzes later.

With an ectopic pregnancy, the concentration of hCG in the urine of a woman is lower than expected in time, and the test can show:

• Absence of pregnancy. If it is later confirmed, the woman should inform the doctor about this, strictly observe the regimen of tests and studies, carefully consider any unusual sensations, even if they are not directly related to pregnancy;
• The test confirms pregnancy, but only one strip is clearly colored. This should also alert, because it indicates a low level of hCG. Therefore, either it is too early to conduct the test (or it was not sensitive enough), or not everything is in order with the embryo.

Two or three repeat tests can be done 48 hours apart. If they show the same result or do not confirm pregnancy at all, there is reason for concern.

Interesting fact! An ectopic pregnancy (or other pregnancy-related problem) is just one possible reason for this result. The most harmless of them is an erroneous calculation of the gestational age.

If the express test showed the content of the hormone (at least the minimum), but the pregnancy was not confirmed, you should check for the presence of neoplasms.

When to see a doctor

Ectopic implantation of the embryo should be suspected if at 4–5 weeks (from the end of the last menstruation) the following are observed:

• pulling pains in the lower abdomen, sometimes chronic or associated with stress, walking, changing position;
• discharge of blood (usually small, spotting), which is often mistaken for menstruation;
• signs of bleeding - low blood pressure, anemia, dizziness, cyanosis of the lips, nails and eye sockets;
• slow growth of hCG indicators;
• the size of the uterus does not reach the prescribed time;
• increased level of leukocytes;
• elevated temperature (indicates tissue injury and the onset of inflammation).

Although The cause of ectopic pregnancy is not fully understood. s, they are mainly associated with violations of the patency of the pipes and their insufficient activity.

The egg does not have the ability to move independently, and the role of the vehicle when delivering it to the uterus is played by the cilia of the epithelium and the muscle contractions of the walls of the oviduct.

In this process, the balance of estrogen and progesterone, the absence of bends, adhesions and scars, as well as the mobility of the cilia, play an important role.

That's why The most at risk group are women who:

Unfortunately, it is very difficult to determine the presence of this pathology in time, even with all the considerable arsenal of modern medicine.

Judging by the reviews of women who have personally encountered this problem, an erroneous diagnosis is not uncommon. They advise, in case of any doubts, not to waste time, and check with several specialists in different clinics who have the necessary equipment and a reliable reputation.

This video will acquaint you with how an ectopic pregnancy manifests itself in the early stages:

In this video, you will be shown and told about the main and main signs of an ectopic pregnancy:

Any expectant mother is afraid to hear the diagnosis of "ectopic pregnancy" from the doctor. It is necessary to understand what it is and how it can be dangerous. An ectopic pregnancy is a pathology in the process of development of which the egg is attached not to the uterus, where it should be, but in another place:

• in the walls of the fallopian tubes;
• in the ovaries;
• in the peritoneum.

Features of the course of pathology

In an ectopic pregnancy, the embryo enters the fallopian tubes. Most often this is due to a violation of the normal functioning of this body. During the passage of the embryo towards the uterus, it is delayed and implanted in the wall of the fallopian tube. If the pregnancy breaks the pipe, then you have to urgently resort to surgical intervention.

An ectopic pregnancy essentially differs from the standard one in that in such a situation, the mother cannot bear the fetus and give birth to a child. In any case, you will need the help of qualified obstetricians who will determine the timing of the operation. The consequences of an ectopic pregnancy can be the most negative, especially if the disease was not diagnosed in a timely manner. According to statistics, about two percent of all pregnancies are ectopic.

The danger of pathology

If a fertilized egg develops in the mucous membrane of the fallopian tube, then the diameter of the latter will begin to increase over time. This is a completely natural process under such circumstances. The appendages are not designed for such a load, therefore, after a short period, the walls of the pipes will stretch so much that the pathology will become noticeable to a pregnant woman.

If you do not intervene in this process in a timely manner and do not take the necessary measures, stretching can lead to a rupture of the shell. As a result, unwanted substances such as blood and mucus will enter the abdominal cavity. This is where the fertilized egg comes out. The problem is that the abdominal cavity needs to be as sterile as possible, otherwise the risk of infection greatly increases. Such cases often end with the development of peritonitis and excruciating pain.

An ectopic pregnancy is accompanied by massive bleeding, which is caused by damage to blood vessels. This condition is considered critical, since the treatment of a pregnant woman requires immediate hospitalization. A similar danger exists not only for tubal, but also for other pathological course of pregnancy.

Now experts identify several key reasons that can serve as an impetus for the development of an ectopic pregnancy. Often the basis for the disease are any problems with the normal functioning of the fallopian tubes. It's connected with:

• infectious diseases - chlamydia, gonorrhea, etc.;
• inflammatory diseases - adnexitis;
• surgical interventions - for example, after surgery, the risk of ectopic pregnancy increases;
• procedures to restore normal tubal patency;
• medical treatment for infertility;

There are situations when even experts cannot explain why the pregnancy turned out to be ectopic. However, it should be borne in mind that if a woman has already encountered such a problem once, then she is at an increased risk.

In this case, it is necessary to be extremely scrupulous about pregnancy: regularly visit an ultrasound scan, during which the presence of a fetal egg in the uterus will be confirmed. It is important to remember that in the early stages of gestation, the egg is extremely small in size, so it is quite difficult to notice it during one examination.

Precautionary measures

In order to prevent an ectopic pregnancy, you must be very careful about your health. This is primarily due to gynecological diseases that are sexually transmitted. Usually they are accompanied by vaginal discharge, but some of them are extremely insidious and do not have pronounced signs.

Women are accustomed to identifying the problem by pain in the abdomen, bleeding, problems with menstruation, but sometimes the disease that can lead to an ectopic pregnancy is asymptomatic. That is why it is so important to visit the gynecologist twice a year for a preventive examination.

When can a pathology be diagnosed?

In most cases, the disease becomes apparent after an artificial or natural termination of pregnancy, which most often takes the form of a rupture of the fallopian tube or tubal abortion. The probability of this exists at different times, but the period from 4 to 6 weeks of gestation becomes especially dangerous.

The next time you can detect pathology around the third or fourth week. Alarm signals should be the presence of hCG and the absence of any signs of uterine pregnancy during ultrasound examination.

In a situation where the fetus is localized in the rudimentary horn of the uterus, it is possible to determine the pathology only at the tenth to sixteenth week.

Contacting a specialist

Timely intervention by medical professionals is key in an ectopic pregnancy, but for a successful outcome, a woman should see a doctor even before complications appear. Currently, two methods of treatment are used, which are widely practiced in medicine: surgical and medical.

Not so long ago, doctors removed the affected organ along with the uterus, which completely deprived the woman of the opportunity to become a mother in the future. Modern technologies allow operations to be carried out in such a way that the integrity of the structure is in the first place.

In medical practice, there are drugs that allow you to treat an ectopic pregnancy without surgery. Specialists use medications that stop the development of the fetus. In other words, they are used in cases where the fetal egg continues to grow.

The disadvantage of the conservative method of treatment is that it is fraught with a large number of side effects: from kidney damage to baldness. The desired result can be achieved only in some cases. That is why the operation to this day continues to be the safest method to terminate a tubal pregnancy.

The success of therapy directly depends on the stage at which the pathology of the location of the fetal egg was detected. That is why it is so important that every woman knows how an ectopic pregnancy manifests itself in the initial stages of development.

Clinical manifestations of ectopic pregnancy

Specialists cannot identify obvious symptoms that would categorically indicate the development of a tubal pregnancy. Diagnosis is hampered by the fact that the symptoms of this pathology are often present in the early stages of a standard pregnancy. This is due to the inability to see the fetal egg during an ultrasound examination.

Laparoscopic surgery is required to accurately determine the diagnosis. However, for its implementation, a set of signs indicating the development of an ectopic pregnancy is necessary.

Laparoscopic surgery, due to its characteristics, is not only a diagnostic, but also a therapeutic procedure, but you should not bring it to the point where it becomes necessary. In the event of a sharp decrease in blood pressure, pain in the abdomen, severe weakness and loss of consciousness, you should immediately call a doctor for hospitalization.

Pregnancy test and pathology

To determine the development of the pathology is obtained by a conventional pregnancy test, but this method should not be fully trusted. It reacts to a special hormone called human chorionic gonadotropin. In the case of pathology, its concentration is significantly lower than in traditional pregnancy.

Women who are faced with pathology can identify alarming signals by the nature of menstruation. During menstruation, a bloody substance is released from the genital tract, which, by and large, is not even menstruation. In some cases, the secretions contain fragments of the decidua, which was rejected by the body.

Among the main signs it should be noted:

• scanty menstruation;
• a strong delay in menstruation;
• painful pulling pains in the abdomen (this is a consequence of an increase in the diameter of the pipe);
• profuse bleeding;
• early toxicosis;
• enlarged and painful breasts;
• pain radiating to the rectum and lower back.

Experts are convinced that with due attention, it is possible to determine an ectopic pregnancy even before the delay of menstruation. This is facilitated by competent history taking and timely examination.

At the first suspicion of a pathology, which can be determined by the signs listed above, you should immediately contact a gynecologist. The doctor should conduct an examination, during which the degree of softening of the cervix and its bluish color is revealed.

In the process of palpation, a specialist can determine how much the delay in menstruation corresponds to the size of the uterus. If a pathology is noticed, then he prescribes a mandatory additional examination:

• Ultrasound of internal organs;
• hCG analysis;
• analysis of progesterone concentration.

It is also extremely important to know the signs of internal bleeding in order to have time to call doctors in a timely manner. Symptoms include:

• severe pain in the lower abdomen;
• a sharp deterioration in the state, apathy;
• pale skin;
• increased sweating;
• dizziness;
• bloody issues.

Internal bleeding most often indicates that the internal organs of a woman are significantly damaged.

Types of pain in the lower abdomen and possible pathologies

Possible diagnosis	Gestational age	The nature of the pain	Other symptoms		Degree of danger
	5-7 weeks	Sudden sharp pain in the lower abdomen	Dizziness, bleeding	Early ultrasound
Threat of abortion	Any gestational age	Aching unrelenting pain in the lower abdomen, radiating to the lower back	Bloody issues		Elevated, immediate medical attention needed
Premature placental abruption	Any gestational age	Severe sharp pain in the lower abdomen, bleeding in the uterus	Any symptoms consistent with significant blood loss	Emergency doctor or hospital	High, urgent medical attention required

Rehabilitation

After an ectopic pregnancy, doctors turn to a set of measures that allow the body to return to normal. First of all, it is necessary to take care of the prevention of the adhesive process and the normalization of the hormonal background.

Video - The first signs of an ectopic pregnancy in the early stages

The diagnosis of an ectopic pregnancy (hereinafter referred to as WB) sounds very unpleasant. In modern medical practice, such cases are recorded quite often. The condition is not only accompanied by pain and many other unpleasant symptoms, but also poses a serious threat to the patient's life. In order to prevent dangerous consequences, every woman should know the signs of an ectopic pregnancy in the early stages. You can read more about them in the article.

What does the term ectopic pregnancy mean? When the egg is fertilized in the fallopian tube, it moves to the uterus, where it is fixed and has all the necessary conditions for the normal development of the fetus. In the case of an ectopic pregnancy, the egg does not enter the uterus, but is attached elsewhere. The most common variant of ectopic pregnancy is localization in the fallopian tube. It rarely happens that a fertilized egg begins to develop in the peritoneal cavity, on the cervix or the ovary itself.

early signs

How to determine a pathological pregnancy? In the early stages, it is quite difficult to recognize an ectopic pregnancy. The fact is that the body of each girl is individual and the signs of such a pregnancy can manifest themselves in different ways. So, what manifestations can indicate the fixation of a fertilized egg outside the uterus? Let's figure it out.

Increase in basal body temperature

Many representatives of the fair half are accustomed to monitoring their basal body temperature (BT). By measuring the temperature in the anus, you can determine the onset of ovulation or early pregnancy. Due to the increased amount of progesterone, BBT will remain high throughout the cycle. If conception did not occur, BT decreases. It is worth noting that this indicator can be used to determine the onset of pregnancy in general, but not specifically ectopic conception.

Absence of menstruation

The absence of menstruation is the surest way to determine the onset of conception at an early stage. Despite this, we must not forget that other reasons can lead to a delay. These can be such provoking factors as a nervous shock, hormonal failure, serious illnesses, including oncology. In addition, one cannot be one hundred percent sure that there is no pregnancy during the onset of menstruation, since many girls have menstruation after conception.

morning sickness

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

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

Changes in the mammary glands

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

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

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

Increased vaginal discharge

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

Fast fatiguability

When pregnancy occurs, it doesn’t matter if it is ectopic or proceeds normally, the woman’s body already undergoes various changes in the early stages. At the same time, metabolic processes are enhanced to maintain the normal development of the fetus. This often leads to rapid fatigue. Girls note a constant desire to sleep, motor activity is significantly reduced. In addition, the role of a relaxing factor is the hormone progesterone, which has a sedative effect. All this leads to disability, a constant desire to lie down and sleep.

Frequent urination

Another common sign of early pregnancy is increased urination. Already 7-10 days after the onset of conception, a girl may experience such a phenomenon as frequent urination. The fact is that when pregnancy occurs in the body, human chorionic gonadotropin begins to be produced. HCG is the so-called pregnancy hormone. As a result, the blood supply to the pelvic organs increases. At the same time, the urge to urinate is observed even with a slight filling of the bladder. This symptom intensifies at night.

Pain in the lower abdomen

Will the stomach hurt during a pathological pregnancy? Spasms are often observed with the onset of an ectopic location of the fetus already at an early stage. This is due to the fact that the fetus grows and develops. Cramps can also be observed during normal pregnancy. In this case, pain is considered quite normal, because the uterus is constantly contracting, and with the development of the fetus, its spasms are observed.

Sound the alarm should be in the event that the pain is accompanied by bleeding. Such a sign as the appearance of blood can indicate both an ectopic pregnancy and a threatened miscarriage. In such a situation, you need to contact the gynecologist as soon as possible. If we consider the question of when the pain begins during an ectopic pregnancy, it should be noted that most often a woman experiences discomfort when the embryo reaches about 5 cm in diameter, that is, at 12-16 weeks.

Many girls experience cramps during their period. Do not confuse these two states. Every woman knows when she has her period and what is the nature of the discharge.

Indigestion

In connection with hormonal changes, the usual work of the intestinal tract is disrupted. The walls of the stomach and intestines under the influence of progesterone relax, peristalsis decreases. This can lead to excessive gas production, constipation or, conversely, diarrhea and other symptoms. Such manifestations often indicate the onset of pregnancy, including ectopic.

Increased sensitivity to odors

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

Nasal congestion

When conception occurs, immunity decreases. This is a normal physiological process that ensures the acceptance of the fetus by the body. Along with this, many girls are faced with colds and nasal congestion. In addition, swelling of the nasal passages is also associated with changes in hormonal levels.

The appearance of acne

Another early sign of pregnancy is the formation of acne and pimples on the body. Of course, this is not a mandatory sign of conception, but many girls who have not previously suffered from acne may experience this phenomenon. Along with inflammation, acne can appear on the skin.

Change in taste preferences

Due to hormonal changes, some ladies may experience different tastes in their mouths. Often girls talk about the appearance of a metallic taste. In addition, stories about the desire to eat completely incompatible foods during pregnancy are far from myths.

Emotional outbursts

Violation of the emotional background is a common early sign of pregnancy, including ectopic. In this case, the mood can change several times a day. A woman can laugh, and after five minutes cry. Such "swings" are observed due to changes in the hormonal balance of the body.

Positive pregnancy test

And, of course, the surest way to determine pregnancy at an early stage, which can be done at home, is a test. The test will show the onset of an ectopic pregnancy or not? To date, there are many such tests. Many of them accurately determine the increase in hCG from the first weeks of conception. If you see 2 clear stripes or one fuzzy, and the second clear line, you should hurry to the doctor. From the first days of conception, the test may show a negative result.

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

Signs of a ruptured tube during an ectopic pregnancy

Rupture of the organ occurs when the patient is not admitted to the hospital in time. If the girl has not undergone the necessary examination, including ultrasound, screening and other methods, an ectopic pregnancy may remain undiagnosed and lead to very negative consequences. One of these complications is a rupture of the tube with subsequent internal bleeding. The fact is that only the uterus has a special structure. This organ is able to stretch, which is a necessary condition for carrying a pregnancy. In contrast, the fallopian tubes are made up of muscle fibers and dense tissue. They cannot stretch, so a rupture occurs during the development of the fetus.

Signs of a break:

• acute pain in the right or left lower abdomen;
• performance of cold sticky sweat;
• a sharp drop in blood pressure;
• nausea, repeated vomiting, not leading to relief;
• headache and dizziness;
• rapid heartbeat;
• weakness, fainting.

If you try to answer the question of how long the organ bursts, then it is unlikely that you will be able to give an exact answer. Most often this happens in the period from the second to the third month. But cases of ruptures are often recorded in the period from the fourth to the sixth week of an ectopic pregnancy. This is due to some factors. For example, it depends on the size of the organ, the rate of fetal development, the presence of deviations in the formation of the embryo, and so on.

If you find such signs, you should call an ambulance as soon as possible. In a clinic with timely treatment, it is usually possible to save the health and life of the patient.

Why does the egg attach itself outside the uterus?

Why does an ectopic pregnancy syndrome occur? As we have already found out, unlike intrauterine, with ectopic, the fetus is attached in most cases in the fallopian tube and only in 5% of cases in the abdominal cavity or ovary. In this case, the fertilization of the egg by the sperm occurs in an absolutely natural way.

The reasons for this violation are very diverse. Let's consider the most common of them.

Physical disorders in the body

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

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

To prevent the formation of adhesions and scars, you should visit a female gynecology every six months. In the early stages, such diseases are successfully treated with medical treatment and minimally invasive surgical techniques.

Congenital diseases of the uterus and appendages

The etiology of ectopic pregnancy often hides the reasons, which are the presence of congenital diseases of the female reproductive system. Often, the patient learns about congenital pathologies after an ectopic pregnancy has been diagnosed. If it was possible to identify this dangerous condition in a timely manner, treatment in the early stages, as a rule, is carried out without negative consequences for the life of the patient.

Some types of contraception

No matter how it sounds, but some contraceptives can actually cause an ectopic pregnancy. The fact is that they protect the uterus from the attachment of a fertilized egg, but do not act in the same way on other parts of the reproductive system.

If a woman uses a spiral, it is important to remember that this type of protection is valid for no more than five years. If it is in the body longer, the spiral no longer performs its functions fully. In this case, the fetus can attach to the cervix.

Artificial insemination

Artificial insemination is a method that allows a woman to become pregnant who cannot do this naturally for various reasons. It would seem that this procedure should completely exclude any risks. Despite this, according to medical statistics, cases of ectopic pregnancy during IVF are observed quite often. The doctor is obliged to warn the couple who decided to conceive a child in this way about such risks.

Other reasons

In addition to congenital and acquired diseases of the female organs, the use of contraceptives and IVF, there are such factors that provoke cases of ectopic attachment of a fertilized egg. The pathogenesis includes:

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

Bad habits are a common cause of ectopic pregnancy.

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

Types or classification of WB

An ectopic pregnancy in medical practice is classified according to the place of localization, that is, the attachment of the fetal egg, and according to the stages of the course. By location, the following types are distinguished:

• in the fallopian tubes. ICD-10 code - O00.1. This type is considered the most common, occurs in more than 90% of all women. In this case, the embryo is attached in the tube, where it grows and develops until it bursts or spontaneous miscarriage occurs;
• in the ovary (ovarian attachment). ICD-10 code - O00.2. Attachment of the egg in the ovary is diagnosed extremely rarely (1-2% of cases). This condition is observed due to the entry of a fertilized female cell into the ovary. The danger is that the organ bursts due to the growing embryo;
• in the abdominal cavity (sebarami abdominal pregnancy or Manga pregnancy). The ICD-10 code is O00.0. Here, the fertilized cell is attached to one of the organs of this cavity. Medicine has recorded cases when, with such an attachment, the pregnancy proceeded normally, but in most cases severe defects in the fetus are still observed;
• in the area between the large ligaments of the reproductive organ. This is a disturbed uterine pregnancy. If not interrupted early, the fetus may develop quite normally up to twenty weeks;
• in the area of ​​the cervix (cervical attachment). In the early stages, there are no clinical signs of conception and attachment of the fetus in the cervix. Later, a woman may notice spotting and pain during intercourse;
• in the vestigial uterine horn. This type of pathological condition is accompanied by spontaneous abortion no later than 4 months after cell attachment, profuse bleeding. The danger lies in a significant loss of blood, a woman can die in a few hours;
• interstitial appearance or attachment in the interstitium of the fallopian tubes. As with other types of pathological egg attachment, there are no signs in the early stages with the interstitial type. Pregnancy can proceed absolutely normally up to twenty weeks.

With any type of WB, the chances of enduring and giving birth to a healthy child are reduced to almost zero. The maximum period of an ectopic pregnancy is considered to be a period of up to 20 weeks, with the exception of the attachment of the fetus in the abdominal cavity. Only with the abdominal location there is a slight probability of normal development of the fetus.

Such branches of medicine as obstetrics and gynecology are engaged in ectopic pregnancy. For the convenience of making a diagnosis, doctors divide WB into several stages of development.

The dynamics of development can be as follows:

1. Progressive pregnancy (early stage).
2. Pregnancy at risk of interruption (intermittent). This is a condition in which the fallopian tube bursts or spontaneous rejection of the embryo occurs;
3. Completely terminated ectopic pregnancy.

In addition, there is a condition in which there is a pathological attachment of two fertilized eggs at once in different parts or a multiple pregnancy, during which one of the fertilized eggs is fixed in the uterus, and at the same time another cell is attached outside it.

Is it possible to conceive a child after an ectopic pregnancy

In numerous forums, you can find questions from women about whether it is possible to get pregnant normally and give birth to a healthy child after WB? Let's try to answer this question.

When should you plan for another pregnancy?

How long can you get pregnant after WB? After the operation to remove the pathologically located egg, enough time should pass. This is necessary in order for the postoperative sutures to heal normally. In addition, it is necessary to carry out therapy aimed at preventing the formation of tissue scarring. After 6 months, the specialist should prescribe the patient a thorough medical examination, including ultrasound, histology analysis, and so on. If the wounds have healed normally and there are no other contraindications, the woman is allowed to conceive a child.

If during the WB period a rupture of the right or left tube occurs, the chances of successfully conceiving a child are halved, but a woman can still become pregnant and give birth.

Possible difficulties

Often, when a fallopian tube ruptures, doctors decide to completely remove it. This is due to the fact that the risk of repeated pathological attachment of the fetal egg in this area is quite large. Despite the operation and the absence of one of the tubes, the patient may well become a mother. To do this, you need to undergo competent rehabilitation, listen and follow all the recommendations of doctors. Even if the expected conception does not occur immediately, do not despair. The methods of modern medicine can solve many problems with the conception and bearing of a child.

It is quite difficult to find out that an ectopic attachment of the fetal egg has occurred in the early stages. This can only be checked in a hospital. As a rule, this condition is detected when the first signs appear, which coincide with the manifestations during normal pregnancy. The patient notes the absence of menstruation, toxicosis, change in taste, exacerbation of smell, drowsiness, ultrasound can detect a change in the endometrium. Noticing such signs, you should immediately visit the female gynecology. Unfortunately, not a single patient is immune from ectopic attachment of a fertilized egg. If there is a suspicion of this dangerous condition, you should not hesitate, you should make an appointment with a doctor as soon as possible.

Differential Diagnosis

To distinguish WB from other pathologies, a protocol is drawn up, its differential diagnosis is carried out with appendicitis, ovarian apoplexy and other diseases. If doctors detect a tube rupture or missed pregnancy, the woman is shown urgent surgical intervention. Ultrasound is the most accurate and informative method that is used in making an early diagnosis with WB.

With the help of ultrasound, you can detect a right-sided or left-sided pregnancy, as well as see the development period.

Puncture

With the help of a puncture, the doctor can confirm or refute the diagnosis of an ectopic pregnancy. This method is called Douglas space puncture. This space is a section of the abdominal zone between the anterior surface of the rectum and the uterus. By piercing the posterior fornix of the vagina, the doctor receives a fluid that is examined in laboratory tests. Deciphering the results allows you to get an accurate diagnosis.

Does the level of hCG increase with WB

Attachment of the egg outside the uterus also entails the production of hCG. This is an absolutely normal process that is observed in every woman during the period of bearing a baby. Such an analysis can be taken at any clinic. Sometimes women are interested in whether this indicator can fall with WB? In fact, the level of the hormone during an ectopic insertion may be slightly lower than during a normal pregnancy, but it begins to fall only after the twelfth week. How the hCG level changes with WB can be seen in the table.

week of pregnancy	Human chorionic gonadotropin level
1 to 2	5,7-750
3 to 4	150-7 200
4 to 5	1000-31 900
6 to 7	3 500-160 000
7 to 8	64 000-155 000
8 to 9	460 000-211 000
10 to 11	130 500-63 000
11 to 12	13 500-63 000
13 to 14	12 000-71 000
15 to 25	8 000-60 000
26 to 37	5 000-55 000

The table shows that at week 12, the hCG level reaches its maximum value, after which it begins to fall.

Corpus luteum in WB

After ovulation, a temporary gland is formed in the ovary, the role of which is the production of progesterone. If fertilization does not occur 2 weeks after the release of the egg, the corpus luteum dies. If conception occurs, this gland does not die, but continues to produce progesterone. If there is no menstruation 2 weeks after ovulation, and pregnancy is not visible on ultrasound, conception can be determined by the presence of this corpus luteum. That is, the presence of this gland 14 days after ovulation means the onset of pregnancy, including ectopic.

Use of laparoscopy

To identify and eliminate the pathological condition in the early stages allows such a modern technique as laparoscopy. This minimally invasive technique is used not only for diagnosis, but also for the removal of the embryo. Laparoscopic technique is an effective, but at the same time safe method of diagnosing and treating VP.

What does an ectopic pregnancy look like in a photo

Some patients are interested in whether the WB is visible in the early stages on ultrasound? Yes, you can really recognize the condition with the help of ultrasound. In the pictures you can see the places of pathological attachment of the fetal egg in various areas.

As already mentioned, pipe fastening is most often diagnosed.

Treatment Methods

What to do if you suspect an ectopic pregnancy? The question of how this condition is removed is relevant for many women. First of all, you should consult a gynecologist. The doctor will direct you to the necessary tests, select the best method of treatment. Without proper medical care, there is a serious threat to a woman's life and health.

Medical treatment

Treatment of VB with the help of conservative therapy is carried out only at an early stage in rather rare cases. In this case, micropreparations and macropreparations are used. This type of therapy often involves the use of methotrexate. This means leads to the fading of the embryo and its resorption. The main disadvantage of this treatment is the risk of systemic side effects. Therefore, it is recommended to treat WB with this medication only if necessary. In addition, the drug Duphaston is used. It is a hormonal agent that increases the level of progesterone in the blood.

Laparoscopy

Laparoscopy refers to low-traumatic surgical techniques used for the treatment and diagnosis of many diseases of the human internal organs. The operation is performed under general anesthesia, so there is no discomfort during the procedure. In addition, laparoscopy is performed with minimal damage to the patient's tissues, as a result of which rehabilitation takes an insignificant period of time.

How is the operation going? The technique is carried out in several stages:

1. The operated area is treated with an antiseptic.
2. A small incision is made on the left or above the umbilical region.
3. A Veress needle is inserted to inject carbon dioxide into the abdominal cavity.
4. A laparoscope (a device with a camera) is inserted.
5. Through additional incisions, instruments are inserted with which the surgeon removes the embryo.

During the operation, the doctor decides whether to remove or preserve the fallopian tube. If it is subject to irreversible changes, it is removed along with the attached egg. The advantage of the technique is good efficiency and little tissue damage. The disadvantage is the high price.

Salpingotomy

This technique is used mainly in the early stages, it allows you to get rid of the fetal egg. If the patient has already had a rupture of the tube, the technique is not applied. In addition, the method is ineffective when the fetus is larger than 5 cm, if the hCG level exceeds 15,000 IU/ml, as well as in unstable hemodynamics.

During surgery, the doctor removes the fetal egg. If the specialist sees that the embryo has reached a large size, he removes part of the fallopian tube, trying to preserve the organ as much as possible. In difficult situations, it is necessary to completely remove the pipe. In the future, a woman can become pregnant again, but, unfortunately, cases of ectopic pregnancy in a single tube are often recorded.

milking

Milking is one of the methods of removing the ovum from the fallopian tube. If we describe the essence of this method of treatment, then we can say that its main advantage is that the elimination of the embryo is carried out not by cutting the pipe, but by extrusion. Such an operation is considered low-traumatic, rarely causes complications, and helps to preserve the reproductive organs of a woman. The disadvantages include the possibility of using it purely in the early stages and if the embryo is located close to the outlet of the pipe. In addition, the technique is applied only with a small diameter of a fertilized egg.

In the early stages of WB, this technique is rarely used, only in situations where other types of therapy have been ineffective. The main indication for carrying out is profuse bleeding, which can lead to death. Laparotomy is a complex and dangerous operation that requires a long recovery.

With a tubal location of an ectopic pregnancy, the surgeon excised a part of the tube along with the fetal egg through an incision in the abdominal cavity. If the embryo is located in the abdominal cavity, the doctor removes it in the same open way. If the patient has a frozen pregnancy, she is also subject to immediate removal.

tubectomy

Another way to remove the ectopic attachment of the embryo is tubectomy. This is an open surgical method, which is used both in the early stages and when the embryo reaches a fairly large size. The operation is performed by cutting the lower wall of the peritoneum. In this case, the uterus and appendages are released into the wound. The doctor cuts out part of the tube or the entire organ. Bleeding is stopped with clamps and tissue suturing.

The recovery period after such an operation is quite long. The patient must be in the hospital under careful nursing care.

How long does the operation take

The duration of the operation depends on the period of fetal development and the presence of complications. Usually at an early stage, the intervention lasts no more than 30 minutes. If the embryo reaches a fairly large size, a pipe rupture occurs, the condition is accompanied by bleeding and other complications, the duration of the operation can take a rather long period of time. In addition, the speed of further recovery will also depend on the presence of complications. You can usually eat and get up after the intervention the next day.

Algorithm for providing emergency first aid to a patient

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

A rupture of the tube can occur at an early stage or already with a fairly long development of the fetus. Self-medication in this situation is prohibited, as it often leads to the death of the patient. If you suspect an ectopic pregnancy, you should call an ambulance as soon as possible, take the patient to the hospital. After the arrival of a team of doctors, even an ordinary paramedic can easily make a preliminary diagnosis.

Answers to common questions

On the forums you can find numerous conversations and reviews about ectopic pregnancy. Women are interested in answers to various questions, which we will discuss below.

Why does an ectopic pregnancy occur?

The reasons for this condition have already been discussed in the article. The most common among them are congenital and acquired diseases of the female organs, smoking, taking contraceptives.

Is it possible to recognize the condition in the early stages without tests

In the early stages, the signs of WB are weakly expressed. As a rule, they coincide with the signs of a normal pregnancy.

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

Is it possible to have sex with such a diagnosis

This question should be addressed to a doctor. To give an answer, a specialist must examine the patient, take into account the peculiarities of the course of pregnancy in a particular patient.

Is the fallopian tube always removed?

Organ removal is not performed in all cases. As a rule, if the signs of WB were noticed at an early stage and a diagnosis was made, it is possible to save the organ.

How long can you not have sex after surgery

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

Does implantation bleeding occur with WB?

The course of an ectopic pregnancy is often accompanied by the release of blood, even in the early stages. Bleeding is one of the most common signs of this condition.

Is WB possible with ligated tubes

The onset of an ectopic pregnancy after organ ligation is a fairly common occurrence. This happens due to damage to the surface of the organ, the appearance of flaws on it.

Is it possible to get pregnant quickly after WB

After removal of the WB, the next conception should be carefully planned. It is really possible to get pregnant, but if the body has not recovered sufficiently, and the scars have not healed, the likelihood of a second ectopic pregnancy is quite high.

Can this pregnancy come out on its own?

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

What threatens such a state

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

Can an ectopic pregnancy turn into a uterus?

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

Prevention of pathological attachment of the fetal egg is the maximum elimination of factors that can provoke an ectopic pregnancy.

Prevention includes the following activities:

• prevention and timely treatment of genital infections in the early stages;
• timely access to a doctor if signs such as increased vaginal discharge, a change in their color, smell, the appearance of pain during intercourse, itching in the vaginal area appear;
• exclusion of bad habits (smoking, drinking alcohol);
• regular preventive examination by a gynecologist.

Compliance with these simple measures will help prevent the onset of an ectopic pregnancy and keep the female organs in a healthy state.

Video

This video will help you become more familiar with an ectopic pregnancy, early signs of this condition, and methods of treatment.

What is an ectopic (ectopic) pregnancy? This is the name of a pathological condition in which a fertilized egg is attached not in the uterus (the only possible place for the successful development of the fetus), but outside its cavity. This condition is dangerous for a woman. With an incorrect diagnosis or untimely access to a doctor, you can die. It is important to know the signs of an ectopic pregnancy.

According to statistics, the incidence of pathology is about 1.5%. The mortality rate caused by its complications is on the order of 1-5%. The most common cause is a ruptured tube and a life-threatening level of blood loss.

Meanwhile, ectopic pregnancy is successfully treated thanks to early diagnosis and minimally invasive therapy. The earlier a problem is identified, the better the prognosis.

Conditions for the origin of ectopic pregnancy

This is a dangerous case

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

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

The cell, thanks to the ciliated epithelium lining the inner surface of the fallopian tubes, moves deep into the organ. It travels through the fallopian tube to the uterus, where it is implanted. This is how an intrauterine pregnancy occurs. See photos of the conception process.

During the period of promotion, the cell goes through several stages of division. It is being prepared for implantation into the epithelium. This happens after 5 - 7 days from fertilization, the cell is implanted in the uterine cavity. Once attached, it multiplies to form the placenta and embryo.

An ectopic pregnancy occurs due to a failure in the process of advancement of a fertilized egg or the impossibility of its introduction into the endometrium. It happens because of a violation.

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

Since the fetal egg is attached ectopically, the normal course of pregnancy and the formation of the embryo is impossible. The placenta, which develops in the lumen of the fallopian tubes or on other organs, destroys the vessels. This is a condition that leads to the development of hematosalpinx - the accumulation of fluid (blood) in the tube and intra-abdominal bleeding.

In many cases, this leads to the termination of an ectopic pregnancy, that is, the cell can come out on its own. But there is a high probability that the growing fetus will provoke a pipe rupture or damage to internal organs.

Who is at risk

An ectopic pregnancy can be caused by a number of reasons. The study by its specialists made it possible to identify risk factors:

• previous ectopic pregnancies;
• IVF (in vitro fertilization);
• age over 35;
• infertility or its treatment earlier;
• many sexual partners;
• smoking;
• hormonal contraceptives;
• stimulation of ovulation;
• stress, neuroses;
• congenital pathologies of the genital organs, which are inherited;
• transferred operations in the small pelvis;
• infections and inflammation;
• sedentary lifestyle.

Types of ectopic pregnancy

What is dangerous ectopic pregnancy

One of the main dangers is damage to the internal genital organs and the development of bleeding, which can lead to death. That is why it is important not to confuse and recognize the symptoms of an ectopic pregnancy in time, and go to the hospital.

Other complications:

• inflammation of the pelvic organs, abdominal cavity;
• the development of adhesions, leading to infertility, as the pipes become impassable;
• increased risk of conception outside the uterus later.

According to medical statistics, the removal of one fallopian tube increases the likelihood of an ectopic pregnancy by 5 percent. If doctors managed to keep it, the risk rises to 20%.

Nausea is one of the symptoms

Signs of an ectopic pregnancy

For a period of 2 weeks, the condition may be asymptomatic. You can suspect something is wrong by the following complaints:

• cessation of menstruation;
• swelling, soreness of the breast;
• toxicosis (nausea, vomiting);
• aggravation of smell, change in taste.

A number of symptoms that appear during an ectopic pregnancy are similar to those in the early stages of a healthy conception, but only at first.

The woman may experience pain. This pathology is characterized by a small amount of spotting, this is the difference between spontaneous abortion.

Symptoms of an ectopic or ectopic pregnancy at 5 to 6 weeks depend on how quickly events develop. With tubal abortion occur.

1. Periodic, cramping, brief pains in the lower abdomen. Sharp pains that last for a long time mean hemorrhage in the abdominal cavity.
2. Discharges of blood. Occurs with rejection of the endometrium and damage to blood vessels.
3. Signs of internal bleeding: dizziness, weakness, fainting, nausea, drop in blood pressure, enlargement or bloating.

An ectopic pregnancy can cause the tube to rupture under the influence of the growing fetus. This condition is accompanied by an obvious clinical picture that occurs suddenly:

4. Pain. How does it hurt? It starts on the side of the damaged tube, spreads to the groin and rectum.
5. Loss of consciousness, weakness, fever. Occur due to hypoxia of the brain due to a sharp drop in blood pressure.
6. Frequent urge to defecate, diarrhea. Due to irritation of the peritoneum.
7. Nausea, vomiting.
8. Symptoms of hemorrhagic shock. Occurs with profuse blood loss. Manifested by pallor of the skin, apathy, lethargy, shortness of breath, cold sweat, increased heart rate.

Ectopic pregnancy according to signs and symptoms is divided into whole groups.

Frequency of occurrence

Types of ectopic pregnancy

They are divided into two types:

• ectopic progressive;
• broken.

The first is very scary, as it is difficult to detect in the early stages, because it proceeds without symptoms. The size of the uterus is normal for this period of pregnancy, there is no bleeding.

Violated or interrupted ectopic pregnancy is accompanied by clear signs:

• paroxysmal pain in the abdomen;
• the uterus is enlarged;
• bleeding;
• painful and soft formation to the touch (located on the left or right side).

If you had such manifestations, you felt bad, began to smear, consult a doctor. Most likely, there was a breakdown or it is an old or non-developing ectopic pregnancy. This condition needs to be treated.

There are the following options for attaching the fetal egg, pregnancy classification:

• pipe - 98-99%;
• abdominal - 0.3% of cases;
• ovarian - 0.2%;
• cervical - 0.01%.

tubal pregnancy

The most common variety is the attachment of an egg in the fallopian tube, most often the right one. The cell is located in the region of the ampulla. In this case, an ectopic pregnancy may go unnoticed until 8-12 weeks and end with a tubal abortion.

If the egg is attached in narrower parts, after 6 weeks there is a violation of nearby vessels and tissues, a rupture of the tube and intra-abdominal bleeding are possible.

Ovarian pregnancy

It can be primary when the egg is retained in the ovary and fertilized there. Or secondary - re-implantation of the egg after a tubal abortion.

The tissues of the ovary are covered with vessels, which quickly collapse, causing internal bleeding.

In the abdominal cavity

Abdominal pregnancy

It occurs due to the attachment of the fetal egg after a tubal abortion, there may be a third pregnancy. So there are three ectopic. Implantation occurs on the peritoneum or intestines. This rare pathology is fraught with infection and bleeding.

Theoretically, it is possible to give birth with an abdominal ectopic pregnancy. In medical practice, cases are described when a woman who was given such a diagnosis carried and gave birth to a child. But most of the fruits die.

cervical pregnancy

A rare case, but the most dangerous for a woman's life due to the large number of blood vessels in this area.

The limited space of the cervical canal prevents the development of an ectopic pregnancy. If the fetal egg does not move into the cavity of the reproductive organ, the destruction of blood vessels and massive bleeding from the birth canal quickly occur.

Pathologies contribute to malformations of the uterus, operations, benign tumors and numerous miscarriages.

Causes of an ectopic pregnancy

Hormonal imbalance is one of the reasons

There is no single, strictly defined reason for pathology. It usually manifests itself under the influence of a number of factors, many of which are still unclear.

The most common cause is a failure in the process of transporting a fertilized cell due to the strong activity of the blastocyst or impaired progression through the fallopian tubes. As a result, the process of implantation begins when the fertilized egg has not yet reached the uterus.

What disrupts the progression of the cell through the tube?

1. Inflammatory processes in the appendages: acute and chronic salpingitis, infectious agents that cause functional changes in the tubes, chlamydia and other STDs.
2. Operations. Even minimally invasive interventions are associated with the risk of changes in the structure and functioning of organs. Connective tissue is formed at the site of the incision and suture. This affects the ability of the tube to contract, its mobility is impaired, and adhesions prevent the cell from passing to the uterus. An ectopic pregnancy occurs.
3. Hormonal imbalance. In the presence of any endocrine diseases, ovulation, fertilization processes and cell movement through the tubes are disrupted.
4. Endometriosis. A pathology in which the mucous layer of the endometrium extends outside the uterine cavity. This leads to structural changes in the reproductive organs, increasing the risk of developing an ectopic or post-uterine pregnancy.
5. Congenital and acquired anomalies of the genital organs: genital infantilism (fallopian tubes are longer than usual), stenosis, diverticulitis.
6. Neoplasms in the small pelvis. They affect the functioning of internal organs, change the size and diameter of the pipes, disrupt the function of the epithelium. Promote ectopic attachment of the embryo.
7. The action of toxic substances contained in salts of heavy metals, tobacco smoke, industrial dust, toxic fumes.
8. ECO. One of the ways to combat infertility is when conception occurs outside the woman's body, and then the embryos are placed in the uterus. The risk is associated with the fact that with indications for IVF, there are pathologies of the fallopian tubes and other parts of the reproductive system.

Diagnosis and definition of ectopic pregnancy

Need expert diagnosis

You can find out the pathology in the early stages by conducting a clinical and instrumental examination. The most difficult to detect is a progressive ectopic pregnancy outside the reproductive organ, since there are no signs of it.

Modern research methods make it possible to detect conception as early as 3 weeks, to prevent complications such as rupture of the fallopian tube and abortion.

1. Ultrasound - reliably diagnoses an ectopic pregnancy and determines the place of attachment of the egg.
2. Checking the level of hCG. Its concentration increases with the onset of pregnancy. If it is ectopic, the increase is much slower.
3. Study of progesterone levels. A concentration below 25 ng / ml is a sign of an ectopic pregnancy, and a decrease to 5 ng / ml indicates a non-viable fetus.
4. Culdocentesis (puncture of the posterior fornix of the vagina). It is carried out at the clinic of an acute abdomen with suspicion of a retrouterine pregnancy.
5. Cleansing the uterus (diagnostic curettage). It is prescribed for an established ectopic pregnancy.
6. Laparoscopy. Allows you to closely examine the internal organs. If an ectopic pregnancy is detected, it is immediately terminated.

Manifestation of ectopic pregnancy

Tell me about your feelings

How does an ectopic tubal pregnancy begin? What are its initial signs, can it be confused with full-term? The first symptoms of ectopic development, which should alert a woman, are felt 2-3 weeks after a missed period. This:

• cramping pain in the corner of the abdomen, radiating to the rectum;
• scanty, dark discharge from the genitals.

If these symptoms appear, you should call an ambulance, as this can begin internal bleeding. Trying to treat an ectopic pregnancy at home is a mistake. Lethal outcome is not excluded.

It is easy to understand whether a woman has conceived or not, even if an ectopic pregnancy does not make itself felt. It is enough to do the test on the days of the delay. If it is positive, the maximum period when you need to go to the doctor is 1-2 weeks. When the test is negative, you should wait a couple of days and take another one.

The nature of the pain

The first way pathology manifests itself is pain syndrome. But how to distinguish the pain of an ectopic pregnancy from other diseases, such as peritonitis?

Pain is often a symptom

A woman is worried about pain in the lower abdomen on the right or left, in the uterus. With massive bleeding, pain radiates to the region of the rectum, lower back. Unpleasant sensations during ectopic development of the fetus are expressed paroxysmal, each time the state of health worsens.

At what time does the pain appear? It depends on the place of implantation of the fetal egg. Since ectopic tubal pregnancy is the most common, it has been studied extensively. When a fertilized egg is located in a narrow part of the tube, pain occurs almost immediately after conception.

At what time does the fallopian tube burst

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

How long can this happen? Most women think that in the first days, weeks, even months after conception, this cannot happen, so they are in no hurry to see a doctor. But the risk for an ectopic location of the embryo exists in the very early stages.

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

Fallopian tube rupture

Early rupture is possible with a small diameter of the tube at the implantation site. So, in its isthmic part, stretching is possible by a maximum of 2 mm. Then the rupture of the tube occurs at 4-6 weeks. A tubal abortion can happen even earlier. This interrupts the ectopic conception itself.

The lowest risk for a woman in a situation where the attachment of the embryo occurred in the lower (interstitial) part of the fallopian tubes. This area directly borders the uterus, so it is the most elastic.

How long will it take to break in this case? Sometimes the pipe does not burst even when stretched up to 5 mm. On average, the time when it ceases to withstand the growth of the embryo is 8 to 12 weeks.

Timely treatment of ectopic pregnancy

Today there is no way to save a fetus that develops outside the uterus. There is evidence when, with ectopic pathology, it was possible to bear and give birth to a child. But this is possible only under extreme circumstances, it is associated with a very high risk to the life of the mother. With ectopic development, the probability of pathologies in the fetus is high.

Rare cases have been recorded when a woman had a double pregnancy at the same time: intrauterine and extrauterine. What is done with a pregnancy that is pathological? The ectopic embryo is disposed of as soon as it is discovered.

Previously, the treatment was surgical. Modern medicine offers non-surgical methods. The basis of drug therapy is the use of Methotrexate, a drug that can delay cell division. The drug is widely used in oncological practice and in organ transplants to suppress the immune system.

Methotrexate promotes rejection of the anomaly

In ectopic pregnancy, Methotrexate acts on fetal tissues and embryonic organs, stopping their development. The result is subsequent rejection.

Drug treatment reduces the risk of bleeding, minimizes organ trauma, and shortens the rehabilitation period. But there are also disadvantages: dizziness, nausea, vomiting, stomach diseases, rupture of the fallopian tube by a progressive ectopic pregnancy.

The use of Methotrexate is possible with the size of the fetal egg no more than 4 cm, good tests, no bleeding. Be sure to exclude the presence of other pathologies. In other cases, surgical treatment is indicated.

The choice of the operation method depends on the age of the patient, the location and size of the embryo, and the state of health. With massive blood loss, which becomes dangerous, the doctor will perform an emergency laparotomy - an intervention with a wide incision. It allows the surgeon to quickly eliminate blood loss and stabilize the condition.

In all other cases, preference is given to laparoscopic methods.

1. Salpingotomy. Preserves the fallopian tube and its reproductive capacity. The operation is feasible only with small egg sizes. Associated with an increased risk of recurrent ectopic pregnancy in the future.
2. Salpingectomy. Removal of the organ along with the implant. It is carried out with repeated ectopic conception, the size of the egg is over 5 cm. In some cases, the tube is not completely removed, partially preserving its function.

In the postoperative period, it is important to ensure that there is no bleeding in the uterus. Reception of antibiotics and anesthetics, NSAIDs is shown. A woman is discharged 1-2 days after laparoscopic intervention, 10-14 days after laparotomy.

Normal hCG level

To make sure that the ectopic fetal egg has been completely removed, for some time the woman monitors the level of hCG in the blood. From the cells of the chorion, a tumor can develop - chorionepithelioma.

How long should you use protection after surgery? Within 6 months in order to stabilize the reproductive function.

What does an ectopic pregnancy look like on ultrasound?

Ultrasound examination diagnoses pathology in the early stages. Her signs:

• enlargement of the uterus;
• compaction of the mucous layer of the uterus with an undetected fetal egg;
• heterogeneous formation in the area of ​​the uterine appendages;
• an egg with an embryo outside the uterus.

See the signs of pathology on the ultrasound video, the diagnosis is an example.

Transvaginal ultrasound has diagnostic value, which reveals ectopic pathology as early as 3 weeks after the delay in menstruation. With the help of the examination, it is possible to determine the rupture of the fallopian tube, bleeding in the abdominal cavity.

Consequences of late removal

If a woman after an ectopic tubal pregnancy decided to have a baby again, this should be approached thoughtfully and carefully. It is important to be observed by a gynecologist both during the planning period and from the first days of pregnancy, to make sure that everything is in order.

According to statistics, the chance of getting a normal uterine conception after an ectopic is 50%, tubal pregnancy twice - 20%, infertility - 30%. The numbers are serious, so you can’t let your health take its course, but plan everything.

Go for an ultrasound

Prevention

To reduce the risk of recurrent ectopic tubal pregnancy, the following measures are recommended:

• treat infections and inflammations of the uterus and other organs in time;
• periodically do an ultrasound and determine the level of hCG in the blood;
• when changing a partner, take tests for STDs;
• enrich the diet with vitamins and minerals;
• correct hormonal imbalances.

To prevent an ectopic or ectopic pregnancy, avoid:

• indiscriminate sexual relations;
• stress
• sedentary lifestyle;
• genital infections;
• smoking and alcohol abuse;
• multiple abortions and uterine cleansing;
• use of progestin contraceptives.

Recent advances in this area

In recent years, conservative treatment of ectopic pregnancy in girls and adolescents has become very popular. For this purpose, drugs are used that stop the development of the embryo. These include Methotrexate, Mifepristone, etc. However, it has been established that they have a lot of side effects: hair loss, kidney and liver damage. In this regard, they can only be used by healthy women.

Abroad, drug tactics, although considered promising, have not received wide distribution. Today, the main method of treatment is laparoscopy.

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An ectopic pregnancy is an abnormal, abnormal condition for the female body - this pregnancy carries a serious danger, even death. With the correct development of pregnancy, the fetus is in the uterus, this is the location intended for it by nature. If the fetal egg is fixed in some other organ, then this is always a pathology that requires immediate surgical intervention. That is why if you notice signs of an ectopic pregnancy in the early stages, then you definitely need to make an appointment with a gynecologist. After all, the more the fetus develops in this state, the worse it will affect your health.

Types of ectopic pregnancy

Ectopic pregnancies are named according to where the fetus is located. Types of these pregnancies:

• ovarian (the fertilized egg is not in the uterus, but remains in the space of the follicle);
• tubal (due to poor patency of the fallopian tubes, the embryo remains in one of the tubes);
• abdominal (the embryo is located in the peritoneal cavity);
• cervical (fetus in the cervical canal of the uterus);
• interligamentous (the embryo is attached to the serous membranes of the abdominal cavity);
• implantation in the rudimentary horn of the uterus (one of the most dangerous types of ectopic pregnancy, there is a serious risk of uterine rupture);
• interstitial pregnancy (fetus in the interstitium of the fallopian tubes, a very rare type of ectopic pregnancy).

An ectopic pregnancy, like any pathology, has its own stages of development. Which the farther, the more dangerous it is for the woman's body - so if you notice at least some symptoms of an ectopic pregnancy in the early stages, then urgently go to an appointment with a specialist. This is a deadly anomaly for a woman's body, so caution should not be neglected.

Stages of an ectopic pregnancy

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

An ectopic pregnancy, which at the beginning proceeds in the same way as a standard pregnancy - as the fetus grows, it can cause serious damage to the female body: the embryo, as it grows, compresses the tissues surrounding it, which entails the possibility of rupture of these tissues and threatens with internal bleeding. After such a pregnancy is spontaneously terminated, the fetus carries with it infection and intoxication for the rest of the body. This condition often develops into peritonitis. That is why it is so important not too late to detect signs of an ectopic pregnancy in the early stages - this can save your life in the truest sense of the word.

It is very important to detect an ectopic pregnancy in time. The signs of this condition are quite difficult to determine. Therefore, at the slightest suspicion, contact a gynecologist who can literally save your life.

Signs of an ectopic pregnancy

Trying to independently answer the question: “Ectopic pregnancy at what time does it appear?”, A woman is trying to find the distinctive features of this condition. However, this is quite difficult to do.

And yet, there are some symptoms of an ectopic pregnancy that may prompt you to urgently see a gynecologist for up to 5-6 weeks:

• delayed pregnancy;
• painful enlargement of the mammary glands;
• toxicosis of the first trimester (severe nausea, accompanied by vomiting).

How to determine an ectopic pregnancy?

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

Signs of an ectopic pregnancy in the early stages:

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

Ectopic pregnancy on ultrasound

It is not worth trying to determine the symptoms of an ectopic pregnancy at an early stage on your own, because they are all very relative. For a more accurate diagnosis of an ectopic pregnancy, the doctor will prescribe an ultrasound of the female genital organs. So the doctor will be able to see the exact location of the embryo in your body, understand its size - and choose the best option to get rid of the problem.

Causes of an ectopic pregnancy

The very fact of an ectopic pregnancy is a rather infrequent occurrence. Such a pregnancy accounts for only 2% of all pregnancies that occur. Be sure to keep in mind that for the occurrence of such a pathology as an ectopic pregnancy, there are quite serious prerequisites.

The embryo is attached to a place not intended for it in the female body only if there are some physiological obstacles on the way to the uterus.

The variations of these obstacles are quite extensive:

• inflammation of the female organs that you have encountered before (their consequence is adhesions that disrupt their patency);
• inflammatory processes in the fallopian tubes and appendages, which is why their inner side is covered with mucous secretions, from which the villi are destroyed and begin to lose sensitivity (as a result, the processes that normally promote the zygote to the uterus stop, which prevents the fetal egg from entering the uterus);
• tumors of a different nature (they can block the path of the embryo to the uterus, pushing it to the abdominal cavity);
• any hormonal abnormalities (polycystic ovary syndrome, hormonal disorders of the cycle and the work of the thyroid gland can contribute to the cessation of the movement of the oviducts, as a result of which the fetal egg will not be able to reach the uterus);
• non-standard arrangement of organs (deviations from the norm, which are immediately noticeable on ultrasound and place this woman in a high-risk group for the occurrence of an ectopic pregnancy in her, signs in the early stages of which are a reason to urgently come for an examination to a specialist);
• transferred sexual diseases (they disrupt the normal functioning of the body and often have their own unpleasant consequences, such as the appearance of adhesions in the fallopian tubes);
• operations relating to the female genital organs (including abortions in the past).

Does the test show an ectopic pregnancy?

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

HCG during an ectopic pregnancy: how the restructuring occurs

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

During the occurrence of an ectopic pregnancy, the same thing happens. The only clear difference is the fluctuating level of hCG (when the embryo dies, hCG drops sharply). In view of this, menstruation stops with an ectopic pregnancy - just like it happens with a standard pregnancy. Sometimes there may be small spotting, but they will not coincide with the days of the expected menstruation, but appear randomly. This is one of the clear signs of an ectopic pregnancy in the early stages - therefore, you should at least be alerted.

Will the test show the presence of an ectopic pregnancy? It depends on many factors. In most cases, hCG rises to a very high level by 5-6 weeks - for this reason, the classic two strips will be reflected on the test. Exactly the same as he shows in a standard pregnancy. However, if the ectopic pregnancy froze or terminated, the test may also show a negative result. If you have done tests to detect pregnancy at different periods - and received different results each time, this is an occasion to urgently go to the gynecologist and do an ultrasound of the female organs. A negative test after several positive tests that have been done before can mean the death of the fetus. This is also evidenced by fever, weakness, pallor unusual for you. With an ectopic pregnancy, such a spontaneous termination of the embryo's vital activity often occurs, and if you do not notice this, then you have a serious risk of infection of the body with embryo decomposition products.

Do menstruation occur during an ectopic pregnancy?

Menstruation stops in the same way as it happens with a standard pregnancy. Sometimes there may be small spotting, but they will not coincide with the days of the expected menstruation, but appear randomly. This is one of the clear signs of an ectopic pregnancy in the early stages, and this should at least alert.

Ectopic pregnancy: consequences

With an ectopic pregnancy, spontaneous termination of the vital activity of the embryo occurs. If you do not notice this, you have a serious risk of infection of the body with the decomposition products of the embryo.

Basal temperature during ectopic pregnancy

In the first phase of egg development, there are no differences between ectopic and normal pregnancy: basal temperature indicators vary from 36.2 to 36.5 ° C. The indicators during the periods of ovulation and conception also do not differ: first there is a decrease, and then an increase to 37-37.5 ° C.

Differences can be observed a little later. With normal implantation of the fetal egg in the uterus, which occurs 7-10 days after the release of the cell, a decrease in temperature should occur. In the values ​​of basal temperature during ectopic pregnancy, this does not happen. However, this is a weak argument for comparison, since everything depends on the individual characteristics of the woman.

However, you should be aware that a decrease in temperature indicates a decrease in the level of progesterone in the blood and may be a sign of a frozen fetus for a period of 1 month or 5 weeks. In case of detachment of the fetus or rupture of its attachment, in addition to severe pain in the lower abdomen and dark discharge, an increase in temperature readings above 37.5 ° C, and sometimes up to 38 ° C, is recorded. This is due to the inflammatory process due to the outflow of blood.

Surgical elimination of ectopic pregnancy

To remove from a woman a fetus that is incorrectly located inside her abdominal cavity or in one of the tubes - alas, is possible only by surgery. The way to quickly eliminate this pathology depends entirely on how long you discovered that you had an ectopic pregnancy, which is why try to pay attention to all the signs of an ectopic pregnancy in the early stages that you notice in yourself.

Ectopic pregnancy: operation and its options

Most often, a woman is concerned about the question: “If I have an ectopic pregnancy, how long does the operation last?”. The duration of the operation depends on the duration of diagnostic manipulations and the condition of the patient, but on average it ranges from 15 to 60 minutes.

• The most successful option is if an ectopic pregnancy is detected at an early stage, when the fallopian tubes have not yet been torn, deformed, and serious harm has not yet been done to the body. With this option, a laparoscopic operation is prescribed, in which the incision is made no more than 1.5 cm (the embryo is removed during it, the oviduct is then sutured).
• A less successful option, but not yet the most alarming, is if the fetus has already caused impressive deformations to the body, then the embryo is removed along with the fallopian tube, or even along with the ovary (however, the woman has the opportunity to become pregnant and carry the baby normally).
• The most unfavorable option is if the fallopian tube has already ruptured - after all, severe internal bleeding can lead to death. There is also a significant risk of peritonitis, which may result in sepsis. That is why it is so important to notice the symptoms of an ectopic pregnancy at an early stage in time!

After the operation, the woman must be prescribed recovery procedures:

• a course of antibiotics (to avoid the possibility of developing a postoperative infection);
• a course of droppers, where she will be injected intravenously with isotonic solutions to restore the water and mineral balance in the body;
• a course of enzyme preparations (in order to avoid the possible formation of adhesions in the tube that was operated on).

Normal pregnancy after ectopic pregnancy

Due to the fact that the ovaries and oviducts are located in the female body in two, a woman has the opportunity to become pregnant even after the removal of one of the fallopian tubes. However, any surgical intervention (even an operation that does not leave noticeable marks on the body) is a serious stress for the female body. For a normal recovery, he will need from six months to a year - and during this period, categorically repeat the attempt to get pregnant. The body needs time to restore the level of the epithelium and adjust the hormonal background disturbed by the operation.

• it is mandatory to conduct a course of physiotherapy, which helps to prevent the formation of adhesions and helps to strengthen women's health;
• six months after the operation, it is recommended to go to a sanatorium or a recreation center (fresh air and vivid emotions will create a favorable background for a future pregnancy);
• it is necessary to strictly protect yourself for at least a year after the elimination of an ectopic pregnancy.

The next conception should occur at least a year later, after which you should immediately go to the doctor's office, have an ultrasound scan and carefully monitor the further course of pregnancy until delivery. And pay attention to the possible symptoms of an ectopic pregnancy in the early stages! Remember that it is at an early stage that this pathology is the easiest to eliminate, and you can avoid serious harm to the body.