Fitness and healthy lifestyle 

Questions about ectopic pregnancy. Is there a chance to give birth during an ectopic pregnancy, is trophoblast migration into the uterus possible?

Ectopic pregnancy occurs in 5-7% of cases, and it is determined in the early stages of pregnancy. It is characterized by the fact that the fetal egg is attached not to the wall of the uterus, but to the fallopian tube. With further growth of the fetus, the fallopian tube expands and there is a high probability of its rupture, which will be accompanied by profuse bleeding.

Some women who experience this problem are wondering if an ectopic pregnancy can be saved. However, in most cases this is not possible.

The preservation of an ectopic pregnancy depends directly on what kind of pregnancy it is typical for a woman:

  • Trubnaya
  • Abdominal
  • Ovarian
  • Cervical

With regard to tubal pregnancy, special attention is paid to the fact that in an ectopic pregnancy, the tube can be saved. This is what will allow a woman to have a higher chance of becoming pregnant in the future.

Abdominal pregnancy is a fairly rare form of ectopic pregnancy. In this case, the fetal egg can attach to:

  • Spleen
  • Liver
  • Mesentery of the intestine

Abdominal pregnancy can be primary when the egg immediately enters the cavity, and maybe even if the fallopian tube has ruptured and the fetal egg already enters the abdominal cavity. Only complications with the fallopian tubes, where the egg could not be fixed, can lead to this type of pregnancy. It is characterized by severe nausea, bloating and frequent diarrhea. When asked whether an ectopic pregnancy is preserved in this case, doctors answer that such a process is impossible and even dangerous for a woman.

Removal of the fetal egg occurs using laparoscopy. They are quite rare and difficult to perform.

Ovarian pregnancy is also quite rare. It is characterized by the fact that the fertilization of the egg occurs even before it leaves the ovary. This can happen due to genetic disorders of a woman or colds during fertilization.

Cervical pregnancy is characterized by the attachment of the ovum to the cervix. In this case, the pregnant woman is necessarily hospitalized and an operation is performed to remove the egg. If the gynecologist fails to remove the embryo due to various complications, then supravaginal amputation of the uterus may be used.

If the fetal egg attaches to the fallopian tube, then an ectopic pregnancy is diagnosed. In this case, it is possible to save the pipe if the fruit is removed from it in time. Approximately 98% of cases of ectopic pregnancy indicate that the fetal egg is attached to exactly one of the fallopian tubes.

May occur if a woman has used hormonal contraception in the past. It can also be due to a hormonal imbalance in the body or in the case of a uterine tumor. If you do not turn to specialists in time, then an outcome in the form of a rupture of the fallopian tube is possible.

Regarding the question of whether the tube is preserved during ectopic pregnancy, it should be noted that in most cases it is possible to preserve it in the early stages. Even in cases where its removal is required, this does not at all indicate that a woman will not be able to become pregnant in the future. As a rule, the second fallopian tube does not have any abnormalities in operation.

If the fetus is attached to the wall of the tube and begins to develop there, then its removal is mandatory in the diagnosis of an ectopic pregnancy. Preservation of the tube is possible only if it has not ruptured due to the intensive growth of the fetus.

In order to prevent spontaneous tubal abortion with hemorrhage into the abdominal cavity, doctors are increasingly using a method such as laparoscopy for ectopic pregnancy with tube preservation. The procedure itself is quite painful, therefore it is performed under general anesthesia.

Can an ectopic pregnancy be saved?

If there is an ectopic pregnancy, can the baby be saved? Most women ask just such a question, but doctors insist that this is impossible. In addition, if the fetal egg is not removed in time, then there is a high probability of blood poisoning and other complications. Therefore, intensive care may be required.

It is not possible to save an ectopic pregnancy, even if precautions are taken and ongoing therapy is carried out. The transplantation of the fetal egg is also impossible, since there is not only a risk of violation of the structure of the embryo, but also a high probability that it will not attach to the uterine cavity.

Methods for the treatment of ectopic pregnancy are effectively used, which are designed to preserve the reproductive organs as much as possible and not harm them in such quantities. Thanks to modern methods of removing a fertilized egg, it is possible to maintain a woman's uterus and its appendages in a favorable condition for a successful pregnancy in the future.

To prevent ectopic pregnancy in the future, women are advised to completely get rid of any infectious diseases. If possible, you should consult with a specialist regarding the possibility of complications in chronic diseases, if any.

In most cases, gynecologists do not prescribe intensive therapy to prevent ectopic pregnancy. However, they pay attention that in the event of such a manifestation, one should not delay its treatment and removal of the fetus, since this can provoke infertility in the future.

After an abortion of an ectopic pregnancy, you should take a course of anti-inflammatory drugs that will improve the functioning of the body. They will also help protect a woman from the development of other infections in the body.

A rather rare, but dangerous pathology that all expectant mothers fear is an ectopic (ectopic) pregnancy.

It affects an average of 1-2 pregnant women out of 100, and with IVF the probability increases to 11%. Ectopic pregnancy in some cases can be avoided, or its consequences can be reduced to nothing. To do this, you must definitely visit a gynecologist at the slightest sign of pregnancy for an early diagnosis.

How does an ectopic pregnancy develop?

The name of the problem speaks for itself: the term “ectopic pregnancy” means the attachment of a fertilized egg not to the uterus, but to a place not intended for the development of the embryo. A fertilized egg can "settle" both in the ovary itself and in the abdominal cavity (liver, omentum or intestines), rudimentary horn, or cervix. But these are the rarest cases. Usually, the fallopian tube becomes the localization of the egg during an ectopic pregnancy.

An unpredictable and very dangerous type of ectopic pregnancy is heteroscopic. This is a condition where two eggs are implanted in a woman: one in the uterus, and the second in one of the above places. Such a pathology is difficult to identify, because the embryo is in the uterus, and at first the deviations are not noticeable, and the second fetal egg grows, leading to rupture and serious consequences.

Can the child be kept?

In none of the listed cases, a successful pregnancy is possible, normal gestation with childbirth in the final will not work. Starting from the sixth, maximum - at the tenth week of an ectopic pregnancy, a tube rupture occurs. This condition usually leads to heavy profuse bleeding, rapidly developing hemorrhagic shock. If you do not seek medical help in time, the process will end fatally for the woman.

Regardless of the form of ectopic pregnancy, its causes are the same.

What contributes to an ectopic pregnancy

Normally, a fertilized egg should move as soon as possible through the fallopian tube into the uterine cavity and be implanted in its wall. But if the fallopian tube is partially or completely blocked, the release of the egg is impossible. Damage to the tube can be very close to the ovary, so the zygote remains in it and cell division begins.

The chances of an ectopic pregnancy are increased if a woman:

endometriosis;

Venereal diseases;

Scar tissue on the fallopian tubes from surgery;

Inflammation;

Viral or bacterial infection;

Tumor;

Congenital defect or acquired deformities;

Mature age.

An ectopic pregnancy is also considered if the zygote is implanted in the uterus, but the woman has an intrauterine device. Such a pregnancy is immediately interrupted by doctors, leaving the child in this case will not work.

If a woman has already had an ectopic pregnancy, but becomes pregnant again, then the risk of another ectopic pregnancy is much higher.

Methods for diagnosing ectopic pregnancy

The severe state of ectopic pregnancy is further complicated by the difficulty of diagnosis. At the appointment, the doctor checks the size of the uterus, examines the abdominal cavity, finds sources of pain and excludes neoplasms.

The problem is that only half of the women have all the characteristic symptoms:

delay in menstruation;

Vaginal bleeding.

The remaining cases are accompanied by one or two symptoms, which does not allow doctors to immediately suspect pregnancy. Pain and symptoms may be similar to tumors of the reproductive organs, salpingitis, or appendicitis. And when examined, gynecologists sometimes take fragments of the endometrium for a miscarriage that has begun. What do gynecologists do to diagnose an ectopic pregnancy?

HCG level during ectopic pregnancy: is there a norm?

If an ectopic pregnancy is suspected, first of all, a urine or blood test is performed to determine pregnancy. In the results of the analysis, when pregnancy occurs, hCG, which is produced by the placenta, will be detected. Human chorionic gonadotropin appears in the blood and urine somewhere in 10-14 days after conception, which makes it possible to detect pregnancy at the earliest possible time, before the delay.

At first, it is impossible to determine whether the pregnancy is normal, or the zygote has attached itself in the “wrong” place. But for several weeks at the start of a normal pregnancy, hCG levels double every two to three days. It is considered normal to increase the concentration of hCG in the blood by 66% every other day, until it reaches 10,000-20,000 mIU / ml. A pregnant woman takes tests several times, and if the dynamics are lower than expected, doctors suspect an ectopic pregnancy.

It has not yet been possible to derive a single hCG value, one hundred percent confirming an ectopic pregnancy.- indicators vary from 10-25 mIU / ml to 70,000 mIU / ml. However, doctors are suspicious of a reduced level of the hCG hormone in the blood to 1500 mIU / ml in the early stages. There may be several reasons, including intrauterine death of the fetus, missed pregnancy, and a number of other pathological conditions.

The concentration of the hormone can fluctuate up or down in both healthy and ectopic pregnancy. Therefore, additional diagnostic methods are used to clarify the diagnosis.

Ultrasound is mandatory for suspected ectopic pregnancy

On extracorporeal ultrasound from the fifth week of pregnancy, you can see the developing embryo in the uterus, or outside it.

On ultrasound during ectopic pregnancy, the following features are visible:

The presence of a seal in the fallopian tube (appendages),

The uterus is much smaller than it should be at the expected date,

The embryo in the uterine cavity is not visible;

Fluid in the retrouterine space.

It is the ultrasound examination, which confirmed the absence of an embryo in the uterus, in combination with a low level of the hCG hormone in the blood, that makes it possible to detect an ectopic pregnancy.

When is laparoscopy needed?

Usually, the results of the two studies described above are sufficient for diagnosis, but in some cases, laparoscopy is also used. This is an intrauterine and intratubal examination, which is performed under general anesthesia.

A very small video camera is inserted through a minimal puncture in the abdominal wall - a hole with a diameter of 1 to 3 mm. If a woman finds a fetal egg outside the uterine cavity, laparoscopic equipment allows you to remove it. If necessary, the fallopian tube is also removed.

Only complete exclusion of uterine pregnancy allows laparoscopy.

Is it possible to detect an ectopic pregnancy with a test

The basis of all home pregnancy tests is a substance that reacts when interacting with the urine of a pregnant woman, which contains the hormone hCG. The higher its concentration, the brighter the reagent becomes. That is, if a woman has signs of pregnancy, and the test shows a weak line, you need to repeat it every other day. The next test should show a more intense color. If the strip is barely visible, then you need to urgently go to the doctor - the likelihood of an ectopic pregnancy is increased.

Recently, tests for the detection of pathological pregnancy based on immunochromatographic analysis have entered the market. The test was made for the ratio of hCG isoforms: intact and modified. An ectopic pregnancy is determined using innovative home tests with a 90% probability, but so far you can not find them everywhere and they are not cheap. In addition, an independent analysis can be carried out only from 5-8 weeks of pregnancy, so it is better to consult a doctor early and not experiment.

Modern diagnostic methods make it possible to determine an ectopic pregnancy and get rid of it quickly enough - already 3-5 months after treatment, a woman can again try to conceive a child.

Ways to treat an ectopic pregnancy

Now doctors have several options for getting rid of a woman's ovum outside the uterus. Treatment usually depends on which part of the fetal egg is located and its size. The approach to treatment should be comprehensive, its goal is to restore reproductive function.

Medical treatment

In the early stages, interruption is carried out by a number of medications that can stop growth and expel the fetal egg. The initial concentration of hCG in the blood for prescribing medications should not exceed 3000 mIU / ml, otherwise surgery is used.

Usually, for medical abortion, pregnant women are prescribed Methotrexate, which prevents cell division. Mifepristone, potassium chloride, prostaglandins, and hypertonic glucose solution are used much less frequently. After questionable results of therapy, at the discretion of the doctor, the drugs are prescribed again, monitoring the level of hCG.

After injection or oral administration of drugs, symptoms of toxicosis, pain in the place where the fetal egg is located are possible. If the hCG level does not decrease a week after the medical abortion, a surgical operation is performed to remove the fetal egg.

If medical termination of an ectopic pregnancy is successful, then a second pregnancy cannot be allowed in the next three months. Use the most reliable contraceptives.

Surgery

Unfortunately, there are very frequent cases of late diagnosis of ectopic pregnancy, when medicines can no longer help. If it came to ruptures, bleeding and severe pain, shock, then an emergency laparotomy is used - surgical excision of the anterior wall of the abdominal cavity with removal of the fallopian tube or ovary. In other cases, laparoscopy is sufficient.

Laparoscopic method allows you to remove the fetal egg with minimal damage to soft tissues and skin, acting exclusively on the affected area. Microscopic instruments and a video camera, inserted through a tiny incision in the abdominal wall during laparoscopy, provide high-precision surgery. Damaged organs after removal of the fetal egg, the doctor quickly removes or restores.

Complications after laparoscopy are very rare. After laparoscopy, a woman can try to get pregnant again in a month, and the chances of a successful pregnancy are up to 60%.

If the level of hCG after the operation has not decreased enough, gynecologists prescribe methotrexate. There should be no hCG in the blood of a non-pregnant woman (one month after the operation).

Prevention of ectopic pregnancy

In half of the cases of ectopic pregnancy, doctors cannot determine its cause. But there are still a number of measures, following which, you can reduce the risk of pathology.

You can not neglect a visit to the gynecologist, at least once a year. Timely diagnosis and treatment of gynecological diseases prevents damage to the fallopian tubes, the egg easily passes into the uterus.

Prevention and treatment of STDs (gonorrhea, chlamydia, and the like) is mandatory when planning a pregnancy.

The absence of infections and the integrity of the fallopian tubes is the key to a healthy pregnancy and unborn child.

Not all girls have a normal pregnancy. There are cases when an ectopic pregnancy is found in a future mother. The pathological condition is characterized by the fact that the egg is fixed not in the uterine cavity, but in another place. It is fixed in one of the ovaries, fallopian tube or abdominal cavity.

With the development of the embryo outside the uterus, the risk of opening internal bleeding increases, which is a mortal threat to a woman. That is why it is extremely important to identify the abnormal development of the fetus in time and correct the situation.

What is dangerous ectopic pregnancy

An ectopic pregnancy (EP) is an abnormal development of the fetus, when a number of dangerous complications can occur in the body of a girl.

The most frequent include:

  • profuse internal bleeding;
  • hemorrhagic shock;
  • adhesion in the pelvis;
  • secondary infertility;
  • bowel dysfunction;
  • the formation of inflammatory processes;
  • recurrence of ectopic pregnancy;
  • death of the patient.

Due to possible serious complications, it is impossible to delay treatment in the presence of WB. At the first sign of pathology, you should immediately contact a gynecologist and undergo a medical examination.

Why does such a disease appear

Fixation of the fetal egg outside the uterus occurs due to dysfunction of the peristalsis of the oviducts. And also an important role is played by the deformation of the egg itself.

Doctors identify the following factors due to which the disease occurs:

  1. inflammatory processes. Inflammation of the uterus and appendages provokes abnormal neuroendocrine processes. There is poor obstruction of the fallopian tubes and malfunction of the ovaries. Infectious diseases of the genital organs in 70% are the main cause of abnormal development of the placenta.
  2. Intrauterine contraceptives. Spirals, suppositories and other means of protection that are inserted into the vagina can cause inflammatory changes and provoke the development of pathology.
  3. abortion. Termination of pregnancy at an early age, frequent abortions provoke diseases of the genital organs, adhesions and impaired judgment in the ampullary tubes. With abortions, there is an increased risk that the next fertilization will occur outside the uterus.

Other reasons for the appearance of a pathological condition include:

  • malignant tumors;
  • hormonal disbalance;
  • surgical intervention;
  • abnormal development of the embryo;
  • sexual infantilism;
  • endometriosis;
  • constant tension, stress, overwork, anxiety;
  • the age of the expectant mother (after 30 years, the risk of complications during the gestation period increases);
  • congenital malformations of the uterus;
  • genital tuberculosis.

Medical fact: in a smoking woman, the development of an embryo outside the uterus is observed 5-6 times more often than in non-smokers. This is due to the fact that nicotine negatively affects the peristalsis of the oviducts, and the tone of the walls of the uterus. This leads to a weakened immune system and poor health.

What are the consequences of an ectopic pregnancy?

If we talk about what threatens the abnormal location of the fetus, then it must be said that the consequences of an ectopic missed pregnancy are not always deplorable. In some cases, with proper conservative treatment, there is a chance that the girl will remain healthy and be able to become pregnant again. The result of pathological development is different depending on the situation.

If not interrupted in time

The consequences of an ectopic tubal pregnancy are unpredictable. Sometimes death is possible. If the abnormal development of the fetus was determined in the early stages of gestation, there is a chance to do without serious consequences.

If an ectopic pregnancy was detected at a later date, then the likelihood of complications increases. Because of this, the girl may open internal bleeding. She may die from hemorrhagic shock if medical assistance is not provided in time. In addition, after such complications, there is a high risk that the girl will no longer be able to have children.

If one fallopian tube was removed during the operation

Quite often, the pathological development of the fetus eventually leads to infertility. After all, if one oviduct was removed, the chance of getting pregnant is very small. The rupture of the oviduct occurs due to the strong pressure of the placenta on the walls of the canal. This provokes internal bleeding and severe inflammation. This condition is a threat to life. According to the type of breakup, it will be known whether a woman can still have children. If two canals burst, a blood transfusion is given to the pregnant woman and emergency assistance is provided. In this situation, infertility is often diagnosed.

But such cases are not observed in all women. Sometimes a girl is able to get pregnant even with one fallopian tube. If the body is healthy and the sexual organ is functioning effectively, then it will not be difficult to fertilize the egg. It is much more difficult for women who are over 30 years old to get pregnant. The ovaries at this age work poorly, and ovulation is less frequent. In this situation, IVF is done. Thus, most women will be able to become mothers even with one oviduct. With IUI (intrauterine insemination) ) The expectant mother is implanted with already fertilized eggs.

If the fallopian tube was preserved

If the problem was identified in time, and there is a chance to quickly fix it, then the fallopian tube can be saved. Whether the organ remains unharmed depends on the professionalism of the doctors and the quality of the operation. With the preservation of the tubes, problems with fertilization most often do not appear.

Surgical intervention by doctors, deliberate removal of the fallopian tubes and ligation of the canals is carried out only if the woman herself desires it. This is most often observed after the age of 35, or when a woman already has 1-2 children. This procedure will be called sterilization.

Laparoscopic surgery can save the fallopian tubes. During surgery, the fetus and placenta are removed with medical instruments inserted through an opening in the abdominal wall. Such an operation is quite expensive, so it is not done in all clinics.

Medical termination of pregnancy has the most minimal negative consequences. A drug for the treatment of oncological diseases Methotrexate (or analogues) will come to the rescue. The drug is very toxic and harmful to humans, so the attending physician must make sure that the pregnant woman needs to interrupt the development of the fetus. The active components of the drug stop the development of the egg, which means that it dies. A tubal miscarriage occurs.

After 1-2 months, when the girl has two cycles of menstruation, the remains of the embryo will come out. This method of treating a pathological condition is possible only at the initial stages of embryo development. If the problem was established at 27-30 weeks, then one cannot do without surgical intervention and artificial termination of pregnancy.

Unfortunately, many of us have to hear from the doctor: "Do you have an ectopic pregnancy?" It becomes scary from these words, panic, how you want to save the long-awaited pregnancy. The question immediately arises: “What is an ectopic pregnancy? Is it possible to give birth during an ectopic pregnancy?

Let's start in order. An ectopic pregnancy is a pregnancy that inherently develops in the fallopian tube, but, unlike a normal pregnancy, does not reach the uterus itself.

Only an ultrasound doctor can determine such a pregnancy; it is impossible to determine this at home using a pregnancy test.

As a rule, if your doctor makes such a diagnosis, then the pregnancy is terminated, the sooner the better. The fact is that this is dangerous both for the mother herself, since such a pregnancy leads to uterine bleeding, and for the child, as a rule, such a pregnancy does not develop normally, which, as a result, leads to the death of the child.

As a rule, the risk that you have an ectopic pregnancy applies to women who have different partners, who have undergone surgery on the intestines or pelvic organs, in smokers, in those who have put a coil and pregnancy has occurred, in women who have sexually transmitted diseases.

How does a doctor determine what an ectopic pregnancy is? As a rule, this is by ultrasound, since it is it that determines where the fetal egg is attached, and by blood. HCG during such a pregnancy is lower than it should be during a normal pregnancy at the current time.

What to do? How to be now? First of all, it is strictly strictly under the supervision of the attending physician. Further, the pregnancy is terminated depending on the term: with the help of a medicine without surgery, or an operation is performed, the essence of which is to remove the fetal egg, sometimes they can even remove the fallopian tube, but some, so to speak, manage to do laparoscopy when the tube is not yet torn.

Dear mothers, do not be discouraged, after all these unpleasant procedures, you can still get pregnant, since the second fallopian tube is preserved. It will be possible to get pregnant only six months later, after treatment, which must be completed if you really want to have children.

We wish you all good health and have a "football team"!

- this is a pathological condition, a complication, when a fertilized egg (fetal egg) does not enter the uterine cavity as it should, but attaches and develops outside it. An ectopic pregnancy is not viable because it does not have conditions for development, and is dangerous for a woman by rupture of the organ in the cavity of which it was formed, internal bleeding and germination of the chorionic villi (formation of the placenta) into the internal organs.

An ectopic pregnancy has the same signs and symptoms as a normal pregnancy. It is possible to determine where the fetal egg develops - in the uterus or outside it - only through ultrasound.

Types of ectopic pregnancy

88-90% of all cases of ectopic pregnancy occur in a tubal pregnancy - the embryo is fixed in the fallopian tube and begins to grow there. This provokes a rupture of the tube for a period of 7-9 weeks or earlier, internal bleeding and has serious consequences for a woman, up to death from blood loss. Previously, after the diagnosis of a tubal pregnancy, the embryo was removed along with the tube. Modern methods allow you to remove the fetal egg even without an incision - by puncturing the pipe.

Abdominal ectopic pregnancy occurs when the fetal egg is strengthened on the surface or in the cavity of the internal organ. If the fetal egg is fixed on an area rich in blood vessels, then it begins to develop and grow. The growth of the egg leads to displacement and disruption of the functioning of the internal organs. If the egg is inside any organ, then it is destroyed sooner or later, which leads to a critical condition. If the embryo is fixed on a low-vascular area, it quickly dies. With early death of the embryo, resorption is possible - resorption of the dead fetal egg. This is the most favorable and less traumatic outcome of an ectopic pregnancy.

In an ovarian pregnancy, the embryo is fixed in the ovary. Over time, this leads to rupture of the ovary and irreversible impairment of its functionality. If the embryo is found earlier, then the organ can be saved.

Cervical pregnancy is the rarest type of ectopic pregnancy. In this case, the fetal egg develops either directly in the cervix, or in the isthmus - the place where the cervix passes into the body of the uterus. Previously, cervical pregnancy led to the removal of the uterus. Now the embryo is removed from the cervix by vacuum, and its bed is destroyed by a laser.

Chances of maintaining an ectopic pregnancy

Gynecologists unequivocally insist on the removal of the embryo when an ectopic pregnancy is detected.

While there are several scientifically proven stories of healthy full-term babies being delivered by surgery, doctors rightly consider ectopic pregnancy deadly and do not accept arguments for preserving the embryo.

Even if the pregnancy is abdominal, the fetal egg is located on the surface of the internal organ, its growth does not threaten to rupture, it is necessary to remove the embryo. In the world, several operations were carried out to transfer a live, normally developing embryo with an overgrown chorion into the uterine cavity, but this experience did not become a world practice. Therefore, in obstetrics and gynecology, the only way out of the situation with an ectopic pregnancy is to terminate it with subsequent