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Incredible! A healthy baby was born in Russia after the mother's ectopic pregnancy. Russian woman gave birth to a healthy baby with an ectopic pregnancy

For the most part, an ectopic pregnancy is not viable, however, there are exceptional cases when the fetus develops normally even in this situation and a healthy, full-fledged child is born, without any pathologies.

Nevertheless, even today it is impossible to name the exact reasons why an ectopic pregnancy is manifested. It is only clear that certain categories of women are in the so-called risk group. Ectopic pregnancy is most likely in women over 35. Women who suffer from chronic inflammatory diseases, including those caused by chlamydial infection, ureoplasma or mycoplasma, should pay attention to their health. Women who have undergone previous treatment associated with hormonal and tubal infertility are also at risk.

You should be on the lookout for women who have congenital anomalies of the uterus and its tubes, endometriosis, as well as anyone who has ever had problems with miscarriage. Undoubtedly, women who have already faced an ectopic pregnancy have a great chance of encountering it again if they do not receive the necessary treatment and do not control, do not plan its occurrence. Among other things, the use of an intrauterine device as a contraceptive is considered a possible reason for its appearance.

What is an ectopic pregnancy?

Where exactly the attachment of the fertilized egg took place determines the type of ectopic:

  • 1.tubal pregnancy;
  • 2. ovarian pregnancy;
  • 3. abdominal pregnancy;
  • 4. pregnancy in the rudimentary uterine horn.

In addition, in medicine, another type of ectopic pregnancy is distinguished, called heteroscopic pregnancy. We are talking about two fetal eggs at once, one of which is attached in the uterus, the other outside the uterus.

Causes of an ectopic pregnancy

The reasons for the diagnosis of an ectopic pregnancy can be very diverse. This pathological condition can be provoked by:

  • 1.inflammatory diseases and processes in the female genital organs (ovaries, fallopian tubes). This often happens after an abortion;
  • 2. hormonal disorders;
  • 3. congenital underdevelopment of the uterine, falopian tubes;
  • 4. tumors of the genital internal organs (both benign and malignant).

Among the possible reasons for the onset of an ectopic pregnancy is also the use of all kinds of assisted reproductive technologies, in particular, stimulation of ovulation, IVF (in vitro fertilization).

Individual features of the structure of the organs of the reproductive system (the presence of convoluted long fallopian tubes in case of underdevelopment of the reproductive system of a woman) can lead to an ectopic.

How does an ectopic pregnancy manifest?

As already mentioned, a fertilized egg that has not reached the uterus in a timely manner can gain a foothold in another place, where it is currently located. There she continues to grow. But other places for the development of the fetus are not provided (they do not have the ability to neither stretch nor nourish the fetus, unlike the uterus), and therefore the moment when there is simply not enough free space for the development of the fetus becomes inevitable.

An ectopic pregnancy that develops in the fallopian tube simply ruptures at some point. As a result of the rupture of the fallopian tube, bleeding begins into the peritoneal cavity. What symptoms of ectopic pregnancy indicate tubal rupture? Typical symptoms are: sharp pain, acute, to some extent cramping, dizziness, painful shock and loss of consciousness are possible. The consequence of such a development of events may be damage to a sufficiently large vessel, and further large blood loss, severe internal bleeding, which is deadly for a pregnant woman, as well as for any person.

How to recognize an ectopic pregnancy, how to identify an ectopic pregnancy at home?

To prevent this process from causing an irreparable blow to women's health, it is important to recognize an ectopic pregnancy as soon as possible. It is important for every woman to know what symptoms of an ectopic pregnancy are manifested in order to be able to timely identify an ectopic pregnancy at home and consult a doctor for help in the early stages.

The worst part of this is that early recognition of an ectopic pregnancy and its symptoms is often problematic. The fact is that these symptoms are identical to those of a normal, normal pregnancy.

Menstruation during an ectopic pregnancy is "delayed" - this is the most common symptom. Meanwhile, often with an ectopic pregnancy, menstruation occurs, although their character is somewhat different: from time to time there are bloody discharge from the vagina, but even they are often just smearing. Moreover, these symptoms are not always caused by "improper implantation", they are characteristic of both the normal course and the termination of a normal pregnancy.

Sometimes the first symptoms of an ectopic pregnancy may be somewhat different. As already mentioned, menstruation with an ectopic pregnancy can still occur, however, menstrual flow is very scarce, or strikingly different from ordinary ones, which a woman is able to notice herself at home. Other symptoms that make it possible to recognize an ectopic pregnancy are the appearance of pain syndrome: pain in the lower abdomen (most often in the area of ​​the fallopian tube, that is, directly in the place where the egg is fixed). Pain with an ectopic, most often pulling in nature.

The unpleasant symptoms that manifest an ectopic pregnancy occur within 5 to 8 weeks from the end of the last menstruation.

What are the symptoms of an ectopic pregnancy?

So, to summarize: the symptoms accompanying normal and ectopic pregnancy are:

  • 1. soreness and swelling of the mammary glands of a woman;
  • 2. toxicosis of pregnant women (nausea, vomiting, feeling unwell);
  • 3. menstruation is defective or there is a delay in menstruation.

Specific symptoms of an ectopic pregnancy can help determine that a fertilized egg has attached and develops in the wrong place, namely:

  • 1. Pain. It is localized in the lower abdomen, lower back, and has a pulling, growing character, can give into the anus, rectum, or be felt as a point where the ovum is attached.
  • 2. Bloody discharge. Their appearance is possible from the first days of pregnancy, they have a brown color and scanty volume.
  • 3. Dizziness, weakness, changes in blood pressure.

Diagnostics of the ectopic pregnancy

early terms, and, therefore, to minimize the harm that can be caused to women's health. First of all, a woman needs to carry out appropriate tests and tests for the very presence of pregnancy. This is best done by performing a blood test for chorionic gonadotropin, or hCG for short. has differences.

If a woman has symptoms of ectopic development of the ovum, then an ultrasound examination (ultrasound) of the pelvis should be performed immediately, using a transgival transducer. Despite the possibilities of modern equipment, an ectopic pregnancy is not always determined by ultrasound, but if there is no fetal egg in the uterus, it is necessary to repeat the study after a few days. In this case, the woman is recommended to be hospitalized in a hospital, since the ovum at this time must certainly be seen.

If the further development of events does not clarify the situation about the location of the ovum and its assessment, then doctors may resort to diagnostic laparoscopy. This procedure is a kind of operation in which the organs of the small pelvis are examined under anesthesia with a special device - a laparoscope. A procedure that allows both to identify an ectopic pregnancy and to treat it if it is detected. If the disappointing diagnosis is confirmed, then this operation will continue with medical manipulation.

  • Does the basal temperature rise during an ectopic pregnancy?

The change in basal temperature occurs with the same tendency as with the correct course of pregnancy. Simply put, the basal temperature rises in this situation to an average of 37.3 C - keep in mind that this indicator is individual for each woman. Determining the increase in temperature caused by the production of progesterone will not be a problem in the very first days from conception, if a woman regularly keeps a temperature chart, measuring it for at least 5 menstrual cycles.

  • How does an ectopic pregnancy appear on an ultrasound scan?

With the help of a transvaginal sensor for a period from 4.5-5 weeks, and on an abdominal ultrasound - 6-7 weeks, a specialist can determine an ectopic pregnancy by its characteristic signs, namely:

  • 1.the size of the uterus is smaller, corresponding to the normal pregnancy period;
  • 2. the presence of fluid in the posterior space;
  • 3. The ovum, in the presence of signs of pregnancy, is not visible in the uterine cavity, but a seal is visible in a certain place of the fallopian tube or in another place where it is attached.

  • Does a puncture show a pathological condition?

Taking a puncture from a woman through the posterior vaginal fornix is ​​another way to diagnose an ectopic pregnancy. Doctors insert a needle through the posterior fornix of the vagina to take a fluid sample from the uterine cavity. If blood is found in it, the diagnosis of an ectopic pregnancy is confirmed. However, this method is not considered 100% reliable, but it is quite painful, and in some cases even dangerous.

  • Does the test show an ectopic pregnancy?

Many women are interested in a logical question: does the test determine an ectopic pregnancy? The answer is not straightforward: yes and no. Since during an ectopic pregnancy, the test shows a positive result, due to the fact that the membrane of the ovum during its development produces human chorionic gonadotropin - hCG, which identifies the pregnancy test in the urine. But the level of hCG in the pathological development of events grows more slowly than in the case of the normal course of the process. Determining this at home using a test is not easy.

Ectopic pregnancy and pregnancy test

Any pregnancy test is designed to determine the very presence of pregnancy in its early stages. The hCG hormone is localized in the placenta, which begins to form, and not in the uterus. That is, if there is a pregnancy (no matter what, normal or pathological), the test should show it. But it is impossible to determine what it is with the help of an ordinary home test. But, one can suspect the wrong course of the processes.

When the fetus develops outside the uterus, a pregnancy test may not show the woman is pregnant at all. That is, with an ectopic pregnancy, the test shows its absence. Thus, if a woman observes all the symptoms of an "interesting situation" (breast swelling, toxicosis, delayed menstruation, etc.), and the test shows that there is no pregnancy, immediately contact the antenatal clinic to identify the causes and reliably diagnose the condition.

As a rule, a pregnancy test determines it by the level of hCG (chorionic gonadotropin), which allows you to detect its onset even at the earliest stages. With an ectopic pregnancy, the level of hCG is much lower than with a normal pregnancy. At the same time, hCG indicators are 2/3 less than those indicators that are inherent in the development of the fetus in the right place. Therefore, with an ectopic pregnancy, the test sometimes shows a negative test result. In addition, an ectopic pregnancy is determined by the test as normal, but the second strip is faintly colored. Sometimes both strips of test may not be very bright, but this is more often determined by women who have sufficient experience to notice such differences.

As already mentioned, the level of hCG in the pathological development of events grows more slowly than in the case of the normal course of the process. That is, in order to determine an ectopic pregnancy with a test at home, you need to carry out several tests at intervals of several hours. If, after repeated tests, pregnancy is detected, but the color of the test strips becomes paler, or does not become brighter than in previous times, you have cause for concern. In this case, we recommend that you consult with a gynecologist as soon as possible. After all, the earlier you identify a possible problem, the less risk you run.

If there is a suspicion of pregnancy - normal or pathological, it does not matter - you need to consult a doctor. Of course, today there are many different tests, including very high sensitivity, showing high accuracy of the results, but, unfortunately, not a single pregnancy test gives a 100% guarantee of the correctness of the result. Determine reliably whether a woman is pregnant or not, can only be a gynecologist after an appropriate examination or several at once. This is especially true for the diagnosis of ectopic fetal development.

In no case should you try self-medication interruption. Firstly, drugs are prescribed strictly individually, taking into account the constitution, age and general hormonal background, and secondly, all this should be under the supervision of staff almost hourly or even every minute. And even such precautions may not give 100% of the result.
If a woman is not operated on with this detected problem, then she may die. If this condition is detected already at the stage of bleeding accompanied by acute pain syndrome, then even at the present level of development of surgery, there is a risk of loss of fertility. And if this condition is neglected and the bleeding that has begun is intra-abdominal, followed by peritonitis, then there is a risk of not only health problems, but also the death of the patient.

With a small age of ectopic pregnancy, this condition is removed very simply - with the help of a special drug that blocks the development of the embryo, which simply kills it.

This is not about whether a woman is acting ethically. In any case, in any case, an ectopic pregnancy cannot develop. The embryo will die, but the question is whether he will "pull" the woman with him.

At a later date - an unambiguous surgical intervention. Nowadays, laparoscopy is very common - a type of almost bloodless operation in which an unwanted element is removed using several incisions up to one and a half centimeters long. This is the most modern, "point" method of removing an unwanted element in the abdominal cavity. Its main feature is that the recovery period until the moment a person can get on his feet lasts from several hours to half a day. Not more. Of course, unless there are complications or special recommendations on this matter.
But if the timing is late, and the tube is completely ruptured, then the abdominal cavity opens completely, and the entire tube is removed.

That is why, ideally, early diagnosis is carried out so carefully in order to prevent an acute condition and minimize risks.

Until the 19th century, or rather - before the invention of antibiotics, this condition was incredibly dangerous - depending on the region and the development of medicine, about 70% of women with this diagnosis died in it. Now everything is different, but nevertheless it is worth listening to advice on how to prevent the occurrence of this condition.

The first and foremost rule for any person is family planning. That is, any pregnancy should ideally be planned. Before her onset, a full hormonal screening of both the expectant mother and the future father is carried out. Diagnostics of all possible genital infections that may be present in the body even in the latent stage are carried out, then vitamin therapy is performed, if no problem was found.

Of course, even before trying to get pregnant and before all the tests, both partners simply have to get rid of all bad habits, first reduce, and then completely give up any smoking, remove all non-organic foods from their diet, and so on.
Such as it seems to some, sacrifices are needed only for a limited and certain amount of time, later, if, of course, you want, you can switch to your usual mode of life. But now wise restrictions are a guarantee of the health of not only the expectant mother, but also the future person, for whom two adults take responsibility. Ultimately: the health of future children is the well-being of the family.

Due to the fact that tubal uterine pregnancy is the most frequent, special place should be given to it. Symptoms of an ectopic pregnancy passing in the oviducts - the so-called fallopian tubes - until about 5-8 weeks do not differ from the symptoms of a normal state. The only difference is a more pronounced symptom of pain, but even this is infrequent. Because of this state of affairs, this type of pathology most often leads to fatal consequences.

So, a tubal ectopic pregnancy begins in the same way as a normal one - with the fertilization of an egg with a sperm. Due to the fact that the sperm is incomparably smaller than the egg and is mobile by itself, it is not difficult for it to pass the fallopian tube, even if there are adhesions or constrictions in it.

After fertilization, the future embryo passes through the oviduct, and then enters the uterus, where it must attach in order to subsequently turn into a baby and after a period of 36 to 41 weeks will be born. But there are times when, for a number of reasons, the egg either does not reach the uterus at all, or is attached almost at the exit of the tube, but not yet in the uterus. If the latter is the case, then it takes about eight weeks until the woman discovers the problem itself, when, of course, it will not be detected using ultrasound or hormonal tests. In this case, it is necessary to remove the entire tube together with the unsuccessfully attached embryo.

In very rare cases, spontaneous abortion of the embryo occurs, that is, a miscarriage. Then, after the release of the biomaterial, the woman must undergo a series of examinations, in particular for the presence or absence of remnants of embryonic tissue in the tube.

In especially difficult cases, such a pregnancy can proceed in the same way as a normal one, for up to three months. But this is an extreme threshold period at which there is already a real threat not only to health, but, in general, to the patient's life. If such a pregnancy does not freeze spontaneously, then the oviduct will surely rupture, which can cause peritonitis or acute inflammation of the peritoneum. Then a simple removal and cleaning will not be enough. To save lives, an abdominal operation is already needed here, which will help remove the consequences of internal bleeding, and then, long-term hormonal therapy.

In almost 80% of cases, the symptoms of an ectopic pregnancy make themselves felt very gradually. Over the course of days, or even weeks, a woman gets worse every day. Constant pulling aching pain is replaced by bouts of apathy and chronic fatigue. Going to the toilet is accompanied at first by mild and then more severe pain. Moreover, this pain differs from the usual almost every "monthly" pain. If this type is localized, as it were, in the middle of the abdomen and has a spasmodic character, then the pain in the tubes is always localized on the side where the fetal body was introduced. Moreover, it is not spasmodic, but more acute.

A woman who has already carried a child will immediately determine that something is wrong here. The very first pregnancy and not yet familiar sensations can get confused with normal ones, but in the subconscious, at the level of some elusive instincts, a woman begins to worry.

If, at the initial stages, the violation was not noticed, then at one fine moment an acute condition develops, accompanied by a change in the indicators of the whole organism.
It all starts with an attack of general weakness. It feels like every bone, every cell of the skin, every muscle is filled with liquid lead. Appears,. It can go as far as vomiting, but not always. As a rule, a woman practically cannot eat in the last hours before an acute attack. It darkens in the eyes, makes a noise in the ears - a consequence of changes in blood pressure. All these general symptoms are accompanied by acute pain, which is localized in a strictly defined place, but at the same time radiate "rays" throughout the body.

Contrary to popular belief, an acute condition of an ectopic pregnancy does not always accompany heavy or low bleeding. In any case, it is present, but it does not always come out in the form of the usual menstruation. If the rupture of the tube has already occurred, then internal bleeding begins. And if the ovary ruptured, then there is only internal bleeding, which is much more dangerous than external.

Often, at the same time, a woman feels such a strong piercing pain that a painful shock sets in - also a very difficult condition.

Therefore, if a woman has already reached such a date that all the above symptoms begin to appear in her, then her well-being and even life no longer depend on herself. I need urgent hospitalization.

There are cases that, due to the painful shock, the lady herself is not even able to call an ambulance - there is only hope for her relatives.

In case of an acute pain attack or bleeding at home, before the arrival of an ambulance woman, you need to help. The first and most important thing is to apply cold to the abdomen at the level of the uterus, if the pain is localized throughout the abdomen, or to the place of special sensitivity. This can be any contents of the freezer, previously wrapped in a thin calico cloth. Do not apply ice or any frozen food directly to bare skin - this can damage it.

If you wait for an ambulance for a long time, more than 15 minutes, then you should give the woman an anesthetic antispasmodic drug. In the absence of antispasmodics of the "" type, analgin or any other drug that relieves pain may be suitable.

If active external bleeding is present, ideally give the woman plenty of sweet, cold liquids to drink. The best option is pomegranate juice with honey. Thus, the dehydration effect will not occur too quickly.

The cold in the abdomen should be kept as much as possible, and the position should be strictly horizontal or with a slight rise. In no case should you try to get to the hospital on your own, you don't even need to move. The more the muscles tighten, the more active the bleeding will be.

If you suspect internal bleeding, you can drink only a few sips of liquid, and any liquid you drink should be cold. But at the same time, it is better to keep the legs warm - this way, you can achieve an outflow of blood from the abdominal cavity and reduce blood loss.

Does the test show an ectopic pregnancy? A regular test strip that is dipped in urine to determine if a pregnancy is present cannot show an ectopic test. Symptoms and the presence of hormones, namely the presence, and not their percentage, can be exactly the same in normal and ectopic pregnancy.

The first thing a woman who suspects of an interesting condition should do is to take a pregnancy test at home. Now it is very simple - such tests are sold in every pharmacy. The only thing to do to get a positive or negative response is to submerge the test strip in a container of urine. Some tests are even easier to use - you need to substitute a special test stick under the stream of urine. If there is any pregnancy, then such a test will immediately determine it.

Both in the blood and in the urine already on the seventh day after conception, hCG or human chorionic gonadotropin is already present, secreted by the tissues of the embryo that come into contact with the inner epithelium of the uterus.

Most test manufacturers advise using them in the morning, because morning urine contains the highest percentage of hormones and other elements. That is why all doctors insist that they are taken in the morning.

What is all this information for? The key is that during an ectopic pregnancy and during an ordinary one, exactly the same is present in the urine and blood, the only difference is the difference in saturation. In an ectopic case, the amount of hCG or human chorionic gonadotropin is lower than in the normal case, so the second strip of the test, which, in fact, shows the presence of pregnancy, will be much paler. Moreover, if you do several tests, then one can be positive, and the next one - negative.

ATTENTION!!! If the test showed a second strip, no matter how pale it was, then this! The second strip reacts to a single substance - hCG or human chorionic gonadotropin, which, in turn, is released only if new life is present in the woman's body.

At home, in the early stages, even before the onset of an acute surgical condition, it is almost impossible to determine an ectopic pregnancy, there are only a number of factors that can alert a woman. The first is not a completely clear second line in the test, although this may simply be a consequence of an early date. In theory, the next day the second strip should be clearer, the next day - even clearer. If this does not happen, there is a good reason to sound the alarm. HCG or human chorionic gonadotropin grows one and a half times every day.

Other signs of an ectopic pregnancy are more than usual, fatigue, depression, lethargy. Drawing pains and incessant restlessness.

Are there any cases where tests go wrong?

There are cases when pregnancy tests are wrong, but the error is most often given by the absence of both the first and second strips, or by darkening, coloring the entire screen. The appearance of a more or less clear second strip in 99% of cases indicates the presence of pregnancy. This is a signal to contact the appropriate medical institution for additional tests.

After an ectopic pregnancy, the optimal recovery period is two years. In some cases, the successful conception and bearing of a child may occur within six months, but there is a unanimous opinion: it is better not to do this. There are many reasons for the postponement: recovery of the body after an injury, physical, psychological recovery of a woman, diagnostics, including hormonal dynamics, tests for sexually transmitted diseases, inflammation. All this is necessary in order to exclude all possible risks of a similar situation in the future. After an ectopic pregnancy was transferred once, the risk of re-formation of such a pathology is much higher than the previously indicated general - one and a half to two percent risk.

Again, the answer to this question depends primarily on the timing in which the problem was discovered. If we are talking about recovery after simple drug treatment, then there is only one algorithm. And if the problem was solved by an extensive abdominal surgical operation - another.

With a mild form of disorders, without removing the fallopian tubes, the restoration is simple. The first thing a woman should do is to undergo a complete hormonal examination, examination for venereal and immunological diseases. Even if the tests already listed were passed, it is better to pass the second test.

Hormonal diagnostics is carried out in chronology - here it is mandatory - the delivery of tests in several stages.

The next step, even if there is no direct appointment of a treating specialist for him, is to consult a good psychologist. It is especially necessary if pregnancy for a woman was simply very desirable, and such an outcome caused not only physical disturbances, but also psychological and emotional ones. Such a loss is very difficult to bear, even if outwardly there are no changes, or just imperceptibly, no hysterics or a decline in well-being.

Consulting a psychologist is necessary not only to calm the woman down, but also to help the body to normalize hormonal levels. Humoral regulation depends on both the state of health and the state of the nervous system. There is a sensitive area that may not even be noticed while awake. The only signal of an existing disorder is heavy dreams, nightmares, trouble falling asleep, or chronic fatigue syndrome, the cause of which will be attributed only to a previous physical injury.

Hormonal recovery is impossible without the restoration of the nervous system. Therefore, in addition to the attention of a psychologist, a woman needs the attention of loved ones - ideally, attention, care and understanding of her husband. And yet, no matter how it sounds, a rich sex life, but with a proven constant partner and, of course, only after complete physical recovery and with the permission of doctors.

The fact is that an active sex life with a beloved, caring and understanding person is the key to a stable emotional state of a woman. In addition, this practice will help prevent the subconscious fear of intercourse that may arise after the experienced drama.

With an ectopic pregnancy, fetal survival is practically zero, and carrying a healthy baby is zero in one hundred percent of cases. In medicine, there are several cases that describe carrying a baby outside the uterus. Most often it is the ovarian form of pregnancy. At least the last two cases, officially documented and proven, are in time an undetermined ovarian form of ectopic pregnancy.
Why is this possible? The fact is that ovarian tissue is very unique. It is capable of deforming, stretching to incredible sizes. It is with this that cyst formation is associated. By the way, very often the ovarian form of an ectopic pregnancy is confused with a cyst or tumor, and the understanding that this pathology is just this occurs already on the surgical table, after dissecting the abdominal cavity and removing the alleged tumor.

In any case, if this type of pregnancy is detected, either surgery or medical termination of pregnancy is indicated. No ethical or religious norms should stop a woman from taking this step. Rather, on the contrary, such a pathology, noticed and successfully eliminated in time, provides an opportunity to become pregnant and give birth to a woman in the future, and a protracted problem - in 99.9% will cause the death of not only the fetus, but also the critical state of the woman.

You shouldn't even risk carrying an ovarian pregnancy, let alone other types. The ovaries are paired organs, so the removal of one reduces the chances of conception by exactly 50%, but does not reduce them, but you already know about this. And with proper use after surgery, hormonal oral contraceptives, which block the function and maturation of eggs, then after a year or a year and a half, in the absence of other pathologies, a successful pregnancy and bearing a healthy child are possible.

After an ectopic pregnancy, the chances of bearing and giving birth to a healthy baby are almost the same as before, except for those cases when there was a removal of parts of the reproductive organs. But even with such options, the chances remain. Only in 5%, with quality care, a woman loses the chance of getting pregnant, and even then this applies only to those moments when the situation was inadvertently prolonged.

About the chances:

  • With medical stopping of an ectopic pregnancy, at very early stages, in the case when the internal organs are not disturbed, and, of course, after a complete additional immunological and hormonal examination, the chances of getting pregnant remain practically at the same level as before.
  • After laparoscopy with preservation of the reproductive organs, the chances are reduced by 5-10 percent, but after competent restorative therapy, they can return to a normal state.
  • When you remove one paired organ, such as one tube or one ovary, the chances are reduced by 50%, but with the right hormone therapy using medications, everything is quite possible.
  • When two pipes are removed, the chances are reduced, but it is a mistake to believe that they disappear altogether. In vitro fertilization is the way out of this situation. Undoubtedly, this is an expensive procedure that can give only 30% positive results, but it can be done many times. It is repeated until the result is positive.

In in vitro fertilization, a woman's egg is taken from a blocked ovary, in a special test tube, it is fertilized with the partner's sperm and the result is placed in the uterus. IVF is a relatively new method, but it is gaining momentum.

  • With the removal of the uterus, pregnancy is not possible. Here, the only way out for the family will be either surrogacy, in which the child is carried by a woman donor or adoption. But if you determine an ectopic pregnancy at a very early stage and take all appropriate measures, then the problem will not reach such a situation.

  • Ectopic pregnancy occurs on average in 2% of cases.
  • There are a number of factors that can increase and decrease your chances of getting this condition.
  • 85% of ectopic pregnancies are tubal pregnancies.
  • The survival of the fetus in this type of pathology is practically equal to zero percent.
  • Treatment of an ectopic pregnancy is possible only in a hospital.

Collapse

An ectopic or ectopic pregnancy is called when the trophoblast is localized not in the uterus, but in the abdominal cavity, oviduct or ovary. This pathology is very dangerous for the patient, as it can provoke her death. Most doctors, when asked whether it is possible to give birth with an ectopic pregnancy, will answer negatively. Although in history there have been cases of the birth of children from pregnancy located outside the uterine cavity. For example, in 1999, Jane Ingram gave birth to triplets: two girls and a boy, who then joined the woman's uterus from the outside, where he grew, developed and was born at term. But such cases are rare.

It happens that there is a heterotopic pregnancy, when one fetus is localized in the uterine cavity, and the second outside it.

Etiology and clinical picture of heterotopic pregnancy

Heterotopic pregnancy is rare. It is diagnosed in about one woman in 30 thousand. Often, uterine pregnancy and ectopic pregnancy simultaneously develop after artificial conception in a laboratory, when several zygotes are introduced into the uterus at the same time. Until they are implanted, one of them can migrate into the oviduct or cervical canal and settle in them. It can also develop after the induction of ovulation or after taking medications that affect the function of the reproductive system. In addition, it can be genetically determined.

Heterotopic pregnancy

There have been cases when oocytes implanted in the uterus and beyond were fertilized in different menstrual cycles. For example, the age of a zygote that has attached outside the uterine cavity is 5-6 weeks, and a normal pregnancy is only 14 days. This is possible if the woman has a short, regular monthly cycle.

Heterotopic, like an ectopic pregnancy at a short time, is no different from a healthy one and can be accompanied by such signs as:

  • absence of menstruation, positive pregnancy test;
  • nausea and vomiting;
  • change in taste preferences, intolerance to certain foods, odors;
  • swelling and soreness of the mammary glands;
  • frequent urge to urinate;
  • emotional lability.

As the trophoblast grows outside the uterus, the following clinical manifestations of abnormal pregnancy may occur:

  • pulling pains in the lower abdomen, which can radiate to the lower back or sacrum;
  • in parallel, bleeding from the vagina may appear, often bleeding is observed after intimacy;
  • asthenia, nausea, vomiting, vertigo develops.

If such symptoms appear, you should not postpone a visit to the doctor, since delay can cause a woman's death.

But if a heterotopic pregnancy is observed, this does not mean that two fetuses will die, a normal trophoblast can be saved.

In case of early detection of an abnormal pregnancy, it can be terminated. It will not be possible to avoid this, since the location of the blastocyst outside the cavity of the genital organ is dangerous for a woman's health.

At a short time, a laparoscopic operation can be performed, which will allow you to get rid of an abnormal pregnancy without harming the second embryo.

Of course, the possibility of preserving the uterine trophoblast must be decided on an individual basis. At the same time, experts take into account the gestational age, the risk of injury to a healthy pregnancy during surgery, the danger of anesthesia for the fetus localized in the uterus, and other important factors.

Can an ectopic pregnancy end in miscarriage?

Can there be a miscarriage during an ectopic pregnancy? Yes, it can result in a miscarriage or rupture of the oviduct.

Moreover, they need to be differentiated from uterine miscarriage, adnexitis, inflammation of the appendix, neoplasms and ovarian torsion. Distinguishing these pathologies, especially at an early stage, is difficult.

Typically, a tubal miscarriage, when the embryo is pushed through the ampulla of the oviduct into the peritoneal cavity, occurs between 4 and 6 weeks, and a uterine miscarriage usually develops later.

With an ectopic miscarriage, pain in the lower abdomen appears unexpectedly, they are localized on one side, in the place where the pathological process is observed. They can be of a different nature, be:

  • aching;
  • dagger;
  • cramping.

If internal hemorrhages have opened, then they can radiate into the rectum, the posterior fornix of the uterus.

In addition to pain, there may be:

  • vertigo;
  • loss of consciousness;
  • nausea, vomiting;
  • hypotension;
  • pallor of the skin;
  • rapid, weak pulse.

Bleeding with tubal miscarriage is not abundant, smearing, almost brown in color, contains pieces of tissue or mucous membrane of the uterus. They may be similar to your period, but not as abundant.

If a woman develops a uterine miscarriage, then cramping pains, build up gradually, are localized in the lower abdomen or in the lower back. They are accompanied by intense scarlet bleeding, in which clots can be found.

Is it possible to keep an abnormal pregnancy?

Usually laparoscopic surgery is performed. During it, 3 punctures are made on the anterior wall of the abdomen and the embryo is removed from the fallopian tube using vacuum aspiration. After such treatment, a woman can return to normal life after 10 days. And experts recommend planning conception again in 6-12 months. Although the timing in each case must be negotiated with the doctor individually. If the woman is doing well, she may be allowed to start planning for conception in the first cycle after laparoscopy.

Can an ectopic pregnancy go into a uterine pregnancy? No. Therefore, if such an anomaly is found, surgical treatment should not be postponed. Delay in this case is very dangerous, it can be fatal. Therefore, if a woman suspects that she is developing an abnormal pregnancy, she should consult a doctor or do an ultrasound scan. It is recommended to consult a doctor 5-6 days after a delay in menstruation, already at this time it is possible to identify the development of pathology, and you should not refuse hospitalization.

Currently, thanks to assisted reproductive methods, many women who have undergone an ectopic pregnancy and surgery to remove the fallopian tubes and ovaries become pregnant and give birth to healthy children. Therefore, do not despair, but it is better to properly prepare for carrying a child: give up bad habits, undergo a rehabilitation course after surgical treatment, after consulting a specialist, drink vitamin and mineral complexes for pregnant women, relax, and eat balanced.

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This happened in the perinatal center of the city of Dzerzhinsk. A healthy baby was born, despite the fact that the fetus was developing in the abdominal cavity. Mother, a resident of Balakhna Oksana Kuzhevatova was hospitalized with suspected appendicitis.

Upon admission, the patient complained of severe abdominal pain, - says the surgeon Valery Bazanov. - The examination showed that Oksana needs an urgent operation. And already during the operation, doctors found the fetus in the abdominal cavity. The chief obstetrician of the city was urgently summoned, and two hours later the operation was completed.

What was our surprise when, during the operation, we saw pregnancy not in the uterus, but in the abdominal cavity, and the child was alive at the same time, says Olga Aleksandrova, the chief obstetrician-gynecologist of Dzerzhinsk.

This is a very rare case. Despite the ultrasound, the doctors simply did not see the living fetus, so the diagnosis was made only during the operation. According to Olga Aleksandrova, if doctors found out about the diagnosis before childbirth, then this would definitely entail a forced termination of pregnancy. What does forced termination of pregnancy mean? There is no such concept in Russian legislation, but, nevertheless, these words were spoken. This suggests that forced termination of pregnancy is still practiced.

Baby Arseny, who was born in such a miraculous way, is healthy and weighs 2750 kg and is 51 cm tall.

At first, the baby was very weak and could not breathe on its own. Only after a few hours we were able to transfer him from artificial respiration, - says Marina Pichugina, head of the intensive care unit of the Dzerzhinsk perinatal center. - Now Arseniy is already gaining weight, eats well, is active and is catching up with his peers.

Naturally, conception occurs in the abdominal cavity, from where the already conceived child moves towards the uterus and attaches to the wall. Under certain circumstances, the embryo can attach in the abdominal cavity and begin to develop. This occurs with inflammation, partial obstruction of the tubes, as a complication after abortion and taking hormonal contraceptives. Almost always, such a child is doomed to death, and a serious threat to the mother's life is also created. Nevertheless, it is possible that in the future, doctors will be able to develop technologies that will allow children to be born with an ectopic pregnancy. Unfortunately, now no one wants to take even attempts to save such children.

If such a technique is developed, then it will consist in allowing the embryo to survive under the supervision of doctors until such time when it is viable outside the mother's womb. Next, a caesarean section is performed, and the child is assisted as a premature baby. At the moment, an ectopic pregnancy is considered the case when the child's life cannot be saved and it is only about saving the mother. Moreover, according to the Social Concept of the Russian Orthodox Church, when a child dies in such circumstances, a mother is not excommunicated from the Church, as for an abortion on a whim.

This case is notable for the fact that the child survived only due to the fact that the doctors made the wrong diagnosis. It is possible that more children could be saved if medicine were more focused on saving the life of an unborn child, and not on abortion, especially since technologies are developing and not standing still.


A unique case occurred in the Nizhny Novgorod region: in Dzerzhinsk, a woman gave birth to a healthy child with an ectopic pregnancy. Over the past ten years, only two such episodes have been recorded in the world.

For Oksana Kuzhevatova, a 37-year-old resident of Balakhna, this pregnancy was the first and planned, and proceeded easily. The expectant mother was observed in the antenatal clinic, did an ultrasound. All studies have shown that the baby is healthy. But the doctors did not notice that the fetus develops outside the uterus.
On November 1, at the 37th week of pregnancy, Oksana had a severe stomach ache, and with suspicion of appendicitis, she was taken to the Emergency Hospital in the city of Dzerzhinsk. According to the hospital surgeon Valery Bazanov, upon admission, the woman complained of severe abdominal pain.

“The surgeons decided on an emergency operation, but they were in for a big surprise - the fetus was not in the uterus, but in the abdominal cavity.

Together with the chief obstetrician-gynecologist of Dzerzhinsk, Elena Alexandrova, a complex two-hour operation was carried out, during which on November 2 at 3.30 a full-term, and most importantly, a living boy weighing 2,750 grams and a height of 51 centimeters was removed from Oksana's abdominal cavity.

- At first, the baby was very weak and could not breathe on its own. Only after a few hours we were able to transfer him from artificial respiration. Now he is already gaining weight, eats well, is active and is catching up with his peers,- said Marina Pichugina, head of the resuscitation department of the Dzerzhinsky perinatal center, where the mother and baby were transferred.

After the operation, the mother and baby, who was named Arseniy, were observed by specialists of the perinatal center. Their condition was stable, on the tenth day the mother and child were discharged home.


"- I want to say many thanks to all the doctors of the emergency hospital and Elena Evgenievna, because now nothing threatens either my life or the life of my child! Apparently, this Earth needs my baby for some reason," says Oksana Kuzhevatova.

According to Elena Alexandrova, it is not surprising that the ultrasound did not reveal the correct location of the fetus. This was influenced by many factors: from the transverse position of the child to the thickness of the placenta. In this case, it is extremely difficult to make the correct diagnosis.

If doctors see that the fetus is in the abdominal cavity, they urgently send the woman to terminate the pregnancy, because this poses a serious danger to her life:

"The risk of complications, up to the threat of death of a woman, is 90 times higher than in a normal pregnancy!

That is why in the literature there are statistics only on cases of premature ectopic pregnancy, and the birth of a healthy child is considered an incredible event.

- How it happened is hard to say. The egg was attached to the right appendages, and the placenta began to develop there. At the same time, the uterus was absolutely unchanged. The vascular bundle went from the corner of the uterus to the placenta, - said Alexandrova.

Most likely, the fertilized egg was originally in the tube, which for some reason ruptured. She went into the abdominal cavity and attached to the right ovary, on which the placenta developed. Histologists can still say for sure: the ovum consisted of two chambers, one of them ruptured, and the amniotic fluid leaked into the abdominal cavity of the pregnant woman. That is why her stomach ached.

“In general, the incidence of pregnancy in the abdominal cavity is about one in a thousand.

However, most often, an ectopic pregnancy (when the embryo remains in the abdominal cavity or in the fallopian tube) is terminated early. The fact that the baby was able to be born is a real miracle!