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Ectopic pregnancy - signs, symptoms. How to identify an ectopic pregnancy in the early stages. How long does the tube burst during an ectopic pregnancy? Diagnostics of the ectopic pregnancy. Ectopic pregnancy: signs, symptoms, treatment

An ectopic pregnancy, the signs of which in the early stages are no different from carrying a child in the uterus, is a very dangerous condition that threatens a woman's life. Unfortunately, even doctors do not always manage to identify this pathology in the first weeks after conception, when even surgical intervention can be avoided (yes, now there are such techniques!) health. Every woman should know the signs of an ectopic pregnancy. So, what are these symptoms and distinctive features of the development of the fetus outside the uterus?

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

2. Toxicosis.

3. Soreness of the mammary glands.

4. Frequent urination.

5. Slightly elevated basal temperature.

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

1. If the chorionic gonadotropin (its concentration) is lower than it should be at this stage of pregnancy.

2. Pregnancy tests show negative or slightly positive results.

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

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

5. An increase in body temperature is recorded.

6. Low pressure.

7. Dizziness.

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

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

If an ultrasound scan reveals an ovum in the uterus, then the diagnosis of "ectopic pregnancy" is immediately removed - cases when uterine and ectopic pregnancies occur simultaneously are very, very rare. A woman is diagnosed with either a threatening miscarriage or a frozen pregnancy.

Why is an ectopic pregnancy scary? The fact that a woman can die from blood loss ... Not a single pathological pregnancy of this kind can end happily, no matter what type it is: with localization in the cervix, ovary, fallopian tube or peritoneum. It's just that its spontaneous interruption occurs a little differently and at different times. The most common ectopic tubal pregnancy. In very rare cases, the ovum freezes in its development, dies and no medical intervention is required. It is not uncommon for an overgrown ovum to rupture the tube, causing severe bleeding. So what are the signs of an ectopic ruptured tube?

1. Soreness of the uterus when examined by a doctor and palpation. Through the lateral fornix of the vagina, the doctor can feel the ovum in the area of ​​one of the appendages.

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

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

4. Bleeding from the genital tract.

These signs are already indications for surgery. The type of surgery is determined by the doctor on site. Depends on the localization of the ovum, the amount of blood loss, the patient's condition, etc.

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

First, go to the gynecologist and as soon as possible. The diagnosis may not be what you think it is. A negative test can be not only in case of an ectopic pregnancy, but also in the absence of pregnancy. Therefore, it is too early to worry. Low chorionic gonadotropin, or rather a slightly reduced one, may indicate a lack of progesterone due to some hormonal disorders, but this can also be solved with the help of modern medicines. In addition, hCG can be increased not only in expectant mothers, but also in certain diseases in persons of any gender and age.

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

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

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

Also, for short periods in the absence of contraindications, conservative, non-surgical treatment with Methotrexate is possible.

Often, an ectopic pregnancy occurs for no good reason at all, as it seems to a woman. But this is not the case. For example, inflammatory processes in the fallopian tubes can be almost asymptomatic, but lead to the formation of adhesions - the main cause of ectopic pregnancy. Therefore, take care of your health from a young age, properly protect yourself from unwanted pregnancy and do not forget to make preventive visits to the gynecologist at least once a year.

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

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

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

An ectopic pregnancy is pathological, due to the "irregularity" of the process, or rather the "non-penetration" of the fertilized egg (ovum) into the uterus. For some reason, the egg after fertilization is fixed outside the uterus, where it continues its short development.

Depending on the place where the ovum is attached, an ectopic pregnancy is:

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

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

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

The exact reasons why conception occurs this way cannot be given by any doctor, but they single out risk groups who may have an ectopic pregnancy:

  1. Violation of the properties of the most fertile egg;
  2. Unreliable contraception against the background of diseases of the female stripe system;
  3. Hormonal imbalance;
  4. Anatomical features of the fallopian tubes - excessively tortuous, long, "obstruction";
  5. Earlier surgical operations on the abdominal and pelvic organs;
  6. Often, signs of ectopic pregnancy after the production of modern reproductive technologies are in vitro fertilization;
  7. Tumor formations on the uterus and its appendages, abdominal organs, disrupting the patency of the fallopian tubes;
  8. Chronic inflammatory processes of the female reproductive system. They contribute to the disruption of the functionality and anatomy of the fallopian tubes, for example, a decrease in their contractility, which means their ability to push the egg that has found the sperm is reduced. Consequently, the implantation will be in some part of the tube or in the abdominal cavity, and an ectopic pregnancy occurs.

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

  1. Surgical interventions in the abdominal cavity.
  2. Contraception.
  3. Hormonal failure or hormonal deficiency.
  4. Inflammatory diseases and infections of the female genital organs.
  5. Violation of the transport function in the fallopian tubes.
  6. Tumors of the uterus and its appendages.
  7. Abnormalities in the development of the genital organs.

Symptoms for an ectopic pregnancy may be exactly the same as for a normal pregnancy.

Symptoms and first signs

A fertilized egg can stop anywhere along the path from the ovary to the uterus. This can be the abdomen, the ovarian area, or the fallopian tube. Such a pathology occurs due to an inflammatory or adhesive process in the reproductive organs and the abdominal cavity.

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

  1. There will be a delay in menstruation;
  2. The breasts will become tender, slightly painful, and enlarged;
  3. More frequent urination;
  4. The test will show a positive result in the form of two strips;
  5. Signs of toxicosis may appear;
  6. The mood will become changeable;
  7. The basal temperature will be elevated, which happens during a physiological pregnancy; if the rectal temperature is below 37 degrees, then it is likely that the embryo has died;
  8. The general body temperature can also rise to subfebrile values ​​- 37.2–37.5 degrees.

In addition to common signs in the early stages, ectopic pregnancy is characterized by specific symptoms:

  1. General weakness, malaise, chills are characteristic.
  2. Body temperature may rise. Basal temperature is higher than general values, mostly subfebrile.
  3. The appearance of bloody discharge from the genital tract like menstruation. They can be dark brown or brownish. It is important not to confuse them with menstruation if there was a long delay. It should be remembered that there may not be visible bleeding if blood accumulates in the abdominal cavity.
  4. Along with the discharge, severe pains appear in the abdominal region of a cutting nature. In this case, the localization of pain depends on in which part the embryo develops. The pain syndrome increases with movements, changes in body position.
  5. If there is a lot of blood loss, dizziness and fainting appear. This lowers blood pressure.

With such symptoms, you need to rush to the doctor, otherwise the exfoliated ovum will cause irreparable damage to the woman's health.

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

Symptoms depending on the type

For each type of pathological fixation of the ovum, there are characteristic symptoms

  1. Ovarian ectopic pregnancy does not show any pathological symptoms for a long time. This is because the follicle can stretch to fit the size of the embryo. But when the limit of elasticity is reached, there is a strong point pain in the lower abdomen, gradually it spreads to the lower back and the area of ​​the large intestine. The defecation becomes painful. The attack lasts from several minutes to hours and is accompanied by dizziness, lightheadedness.
  2. Tubal ectopic pregnancy is manifested by pain on the left or right side, depending on where the fertilized egg was implanted. If it is fixed in the wide ampulla part, then the symptom appears at 8 weeks, if in the narrow (in the isthmus) - then at 5-6. The pain intensifies during walking, turning the torso, and sudden movements.
  3. An ectopic pregnancy in the abdominal cavity in the early stages has symptoms that are no different from those of a normal pregnancy. But as the embryo grows, there are dysfunctions of the gastrointestinal tract (constipation, diarrhea, nausea, vomiting), signs of an "acute abdomen" (sharp pain, bloating, fainting).
  4. Cervical and cervico-isthmus ectopic pregnancy is pain-free. Spotting comes to the fore - from smearing to profuse, profuse, posing a threat to life. Due to the increase in the size of the cervix, urination disorders (for example, frequent urge) develop.

When does a pipe rupture occur?

It is difficult to pinpoint when the worst will happen. The term can be as long as 4 weeks, or it can be extended up to 16.

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

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

Uterine (fallopian) tube rupture

Rupture of the fallopian tube during ectopic pregnancy is the most severe complication that can be fatal for a woman. This condition always occurs suddenly and has pronounced symptoms:

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

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

Diagnostics

In all cases of delayed menstruation, pain and bloody discharge, an ectopic pregnancy should be suspected. With symptoms of shock, a positive pregnancy test, the absence of the ovum in the uterus and a large amount of fluid in the abdominal cavity by ultrasound, the diagnosis of an ectopic pregnancy is not difficult. In other cases, the concentration of hCG in the blood and transvaginal ultrasound are of decisive importance.

If the hCG level exceeds 1500 mIU / ml, and the ovum in the uterine cavity is not detected, this may indicate an ectopic pregnancy. If the hCG level is below 1500mIU / ml, then it is advisable to repeat the analysis after 48 hours. An increase of less than 1.6 times, the absence of growth or a drop in the level of hCG testify in favor of an ectopic pregnancy.

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

Surgery

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

  1. Laparoscopy is an operative, relatively sparing method of disposal, since it allows you not to make an incision in the abdominal cavity, preserves the fallopian tube, and penetrates into it by making a puncture. This is a reliable diagnostic method and the most reliable.
  2. Tubectomy is an operation to remove a tube with a pathology; in the case of an ectopic pregnancy, it is performed if it cannot be preserved. Tubectomy is used more often in case of repeated pregnancy outside the uterine cavity. In emergency cases, when it is necessary to save a woman, the removal of the ovary is also possible.
  3. Tubotomy (salpingotomy) is the second variant of the operation performed in case of impossibility of using milking. The surgeon is forced to cut the fallopian tube in the area of ​​attachment of the non-developing ovum, remove its fragments, and sew up the fallopian tube after the procedure. Part of the tube may need to be removed if the embryo is too large. Tubotomy makes it possible to preserve the genital organ, which is then able to perform its functions fully. In the future, a woman may become pregnant, although the percentage of this possibility is decreasing.
  4. Milking (extrusion) - this surgical procedure is advisable in case of an anomaly of the ovum - detachment, the egg itself from the fallopian tube is removed by extrusion, and the genital organ is preserved. True, the use of such a gentle method is not always possible, but in the case of the location of the zygote near the exit from the pipe. And the decisive factors are the facts of stopping the development of the zygote in the embryo and its detachment, as well as the location of the ovum in the tube of the uterus.

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

All patients who have undergone an ectopic pregnancy are advised to protect themselves from pregnancy for the next 6 months after surgery in order to avoid repeated relapses of ectopic pregnancy and to prepare the body for a normal pregnancy.

Rehabilitation after surgery

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

The rehabilitation period usually goes smoothly. After the operation, the patient must adhere to a special diet - fractional meals (cereals, cutlets, broths) are recommended. For a speedy recovery a week after the operation, a course of physiotherapy (magnetotherapy, electrophoresis, laser therapy) is indicated.

Physiotherapy methods in the rehabilitation period:

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

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

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

After the end of rehabilitation measures, before recommending the patient to plan the next pregnancy, it is advisable to perform diagnostic laparoscopy, which allows to assess the condition of the fallopian tube and other organs of the small pelvis. If no pathological changes are detected during control laparoscopy, then the patient is allowed to plan pregnancy in the next menstrual cycle.

Question answer

1) I had an ectopic pregnancy for 4-5 weeks in the ampullary tube. Conducted laparoscopy with squeezing the ovum and preserving the tube. The next day after the operation, the surgeon prescribed an injection of methotrexate (I understood that for reliability). They put in droppers for 3 days, probably with some kind of medicine. No adhesions were found. What is the likelihood of a recurrent ectopic? And what additional examinations would you recommend? And treatment still needs to be carried out to exclude a recurrent ectopic? The surgeon advises an X-ray with a contrast agent and maybe again laparoscopy to restore the function of the tubes, but I really don't want to go through 3 laparoscopy again (1 - removal of fibroids and adhesions on the tubes, then the birth of a child, and 2 - removal of the gallbladder). I really want a second child.

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

2) I am 26 years old. This year in April I had an ectopic pregnancy. The operation was performed by extruding the pipe, and the pipe was saved. Then the doctors said that no adhesions and bends were found in the tube. And strictly half a year to be protected. As for the second month, an irregular cycle. Month were supposed to be on November 11, but they are still not there, already a month's delay, I'm afraid that wb. Are there any chances of pregnancy? What should be done to avoid repeated wb ???? What should be done for a normal pregnancy? I have a daughter, she is 1.5 years old, I want more children.

  • Donate blood for hCG and then you will find out if there is a pregnancy or not. In addition, tracking hCG in dynamics, one can assume the presence of wb. Normally, hCG should double every 2 days. If the growth of hCG is poor, then one of the reasons for this is an ectopic pregnancy. Since there are no adhesions and bends, then something cannot be done to avoid a repetition of wb. Increases the risk of developing wb, taking hormonal contraceptives or the presence of a spiral before planning pregnancy, therefore, it is recommended, after canceling OC or removing the spiral, to refrain from unprotected PA for 3 menstrual cycles. Also, taking progesterone (Utrozhestan, etc.) when planning a pregnancy can increase the risk of WB.

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

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

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

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

Prevention

Ectopic pregnancy is impossible to predict - there are too many factors that can lead to such a development of events. But doctors have developed specific preventive measures:

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

An ectopic pregnancy is considered a rather complex and dangerous pathology. But if medical measures were carried out at an early stage of pathology or competent measures were taken when the fallopian tube ruptured, then the prognosis will be favorable. Modern advances in medicine make it possible not only to save a woman's life, but also provide her with the opportunity to have children in the future.

EXTRAUTERINE PREGNANCY: HOW TO RECOGNIZE THE FIRST SIGNS AND EARLY SYMPTOMS OF EXTRAUTERIC PREGNANCY

A pathological pregnancy, in which the ovum does not begin to develop in the uterus, is called ectopic, and is a relatively common occurrence. Initially, an ectopic pregnancy has signs of the usual: the standard timing of the development of the ovum , absence of signs of menstruation in the first three weeks of pregnancy.

The fallopian tubes - part of the female reproductive system - are responsible for lowering the ovum into the womb within 30 days after conception. But if they have inflammatory processes, they narrow, the walls of the uterus seem to be "glued" in certain places, and the tubes cannot contract and push the egg. When ectopic pregnancy will demonstrate the first signs, the situation can take a tragic turn.

It does not matter what will cause the egg to attach in the area of ​​\ u200b \ u200bthe tubes, cervix, this is a pathological condition which is fraught with tissue rupture at 4-6 weeks of gestation ... Enlargement of the egg, if the pregnancy is ectopic, the manifestation of signs will provide very quickly. In this case, qualified medical assistance is important. Otherwise, an abdominal hemorrhage can kill a woman in a matter of hours. All of this is preceded by signs with an ectopic pregnancy of a classic course with severe pain.

Sometimes a tubal abortion simply occurs with the outflow of an egg into the abdominal cavity. If you don't pay attention in time for such an ectopic pregnancy and its signs, you can easily get a purulent inflammation of the abdominal cavity - peritonitis.

It is imperative to know what the early signs of an ectopic pregnancy are. It:

severe pain, with a return to the rectum;
bleeding in case of rupture of the fallopian tube. In an ectopic pregnancy, the symptom of pain is often preceded by blood;
vomiting, nausea, severe dizziness.

EXTRAUTERINE PREGNANCY. TIME DURING WHICH TYPICAL SYMPTOMS OF EXTRAUTERIC PREGNANCY MANIFEST

Normal uterine pregnancy should proceed without pain and temperature. All signs of toxicosis and even a change in the psychological state are not pathologies. A woman should be alerted pain in different body positions , fever and general painful malaise.

Ectopic pregnancy in the early stages, first of all, is manifested by constant pain in the lower abdomen ... The more physically active a woman is, the more pronounced the pain.

With an ectopic pregnancy, the timing when its symptoms begin to appear are different. It depends on the position of the egg. If it is attached at the widest part of the pipe, then disturb this position will start around the 8th week ... If the isthmus became such a place, then already 5-6 the week of pregnancy is overshadowed by unpleasant symptoms ... Sometimes cervical pregnancy may not manifest itself at all, because ultrasound is very important in the early stages.

An ectopic pregnancy in the very first stages often manifests itself as malaise, an increase in the uterus to a size characteristic of 6 weeks from the beginning of conception. When the ovum is fixed in the tube, a miscarriage can occur at 11-12 weeks with bleeding. Ultrasound can "figure out" the situation within 10 days after conception. It can become an indication for surgery, laparoscopy.

An early ectopic pregnancy is an indication for immediate hospitalization. Next, as a rule, the fallopian tube is removed, where the ovum is attached. But it should be said that this is not an absolute contraindication to subsequent pregnancy.

The main thing for saving the health and life of a woman with an ectopic pregnancy at any time is her conscious attitude to her condition. You can not neglect examinations, do not write off too painful a condition for the "normal" course of pregnancy.

ECTOPIC PREGNANCY. SYMPTOMS

For a long time to identify an ectopic pregnancy by symptoms it was very difficult, the probability of error was high. Medicine has now become more accurate. A woman will have to undergo several examinations in order to exclude developmental pathologies, to avoid tragic consequences.

At the first bloody discharge, decreased pressure, pain, loss of consciousness, you need to consult a doctor again. This should be done even if previous tests have shown a course without pathologies.

For any "wrong" symptoms of a possible ectopic pregnancy, an important indicator is the level of human chorionic gonadotropin (hCG). By the way, it is on its identification that the positivity or negativity of even a household pregnancy test is based. This hormone is contained only in the tissues of the embryo, by which it can be said whether conception has occurred. Only with an ectopic pregnancy and the presence of symptoms does its level rise extremely slowly, and a standard pharmacy test will not record it at all.

Lean menses are an additional symptom. ... If a woman had a long delay, and then her periods of an unusual nature came, then this can be a dangerous signal. In particular, if the pregnancy test is positive, and the bleeding with pain does not stop, an urgent visit to the doctor is necessary.

Since now an ectopic pregnancy, even without symptoms, is determined earlier using very sensitive tests for progesterone and hCG levels, ultrasound and laparoscopy, most women successfully avoid tragic consequences.

The first "bell" for the doctor is a slow increase in human chorionic gonadotropin and progesterone during a fixed pregnancy ... Immediately, a referral for an ultrasound is issued, where they can more accurately tell about what is happening in the woman's body. The fertilized egg should be visualized when the hCG level is above 1800 IU / L, but it is better to perform laparoscopy.

FIRST EXTRAUTERIC PREGNANCY

The first ectopic pregnancy can occur for many reasons. For some, this will be the result of inattention to their own health, abortion, advanced inflammation and hypothermia.

Someone may face infantilism of the internal genital organs. In this case, the fallopian tubes are tortuous, uneven. Naturally, it is difficult for the ovum, which grows very quickly, to reach the bottom of the uterus within the time frame specified by nature.

But since the normal conditions for the development of the fetus in the tubes or neck, no, the egg disintegrates very quickly and enters the abdominal cavity. This state of affairs requires surgical intervention, as does the situation when the ovum continues to grow. In this case, the pain only intensifies, and dizziness may begin. You should definitely visit a doctor or even call an ambulance. A very important factor here is the sensitivity, attentiveness and adequacy of the gynecologist.

If a first ectopic pregnancy is suspected, the fallopian tubes should not be tightened until the fallopian tubes rupture. Otherwise, you can get extensive hemorrhage in the abdominal cavity with rupture of the tubes, peritonitis and urgent indications for the removal of the uterus.

A complex of examinations is often carried out just at lightning speed due to the very rapid development of the ovum at such times. To begin with, a woman's blood is taken for analysis to determine the level of hCG and progesterone. Further, an ultrasound examination is required. Although it is not the most perfect method, the percentage of accuracy is high.

If the percentage that a woman's condition is pathological is high, a small surgical operation called peritoneal endoscopy will definitely be performed. Removal of the fallopian tube or laparotomy occurs while maintaining a healthy tube. The accumulated blood is additionally removed. All these manipulations involve being in a hospital under supervision.

PREGNANCY AFTER EXTRAUTERIC PREGNANCY

Many women who have undergone laparoscopy with the removal of one fallopian tube are very worried about further pregnancies after undergoing an ectopic pregnancy. This excitement is understandable, because the desire to have children is natural.

However, the development of medicine today allows conception and gestation after an ectopic pregnancy. This is possible since only the damaged part of the organ is removed, while the second tube and uterus remain capable of performing their functions.

Pregnancy should be planned no earlier than six months after undergoing laparoscopy. Of course, it is best to endure a year. This will allow you to prepare not only physically, but also psychologically, to survive the pain of losing a child and to forget the feeling of a pathological state.

Full recovery of the body for a new pregnancy after an unsuccessful ectopic pregnancy necessary for the successful bearing of a child and a successful childbirth. Perhaps women will find useful information about how to get pregnant after unpleasant dramatic events.

The second tube and the other ovary usually remain healthy. This is similar to the condition when numerous cysts are removed from one ovary, and practically nothing remains of it. And pregnancy begins successfully and develops safely.

If a healthy fallopian tube retains the cilia and peristalsis necessary for the advancement of the ovum, then it will even be possible to conceive a child a second time naturally. Peristalsis is a wave-like muscle contraction (contraction of the gastrointestinal tract muscles is called the same), which allow the initially immobile ovum to reach the bottom of the uterus along the widest part of the tube. Developmental pathologies lead to ectopic pregnancy.

Even if the organs are diseased, there is always a chance of pregnancy. after a tragic ectopic pregnancy "created" by IVF.
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Unfortunately, the long-awaited two stripes on the test are not always a really joyful event. In gynecological practice, pathological implantation of an embryo is quite often diagnosed, which is located outside the uterine cavity, and is localized on other parts of the reproductive organs.

This condition is rather difficult to diagnose, since at the initial stage of development of the ovum, there are no characteristic clinical symptoms of improper attachment. That is why women quite often ask themselves what signs of an ectopic pregnancy at an early stage (2 weeks) can be.

Every girl who is preparing to become a mother in the near future should know certain signs of an ectopic pregnancy at an early stage (2 weeks). This information will help her avoid the development of serious complications in the functioning of the reproductive system.

There are many factors under the influence of which, after fertilization, the egg does not attach to the uterine wall, but, for example, goes into the abdominal cavity or remains on the cervix. This condition is often diagnosed in the presence of adhesions, an abnormal structure of the reproductive organs, an impaired balance of hormones, and after contact with sedentary sperm.

Depending on where exactly the embryo implantation took place, the symptoms of the pathology will differ. It is also worth noting that it is very difficult to diagnose IMD in the early stages, since a woman, as in a normal pregnancy, suffers from nausea and vomiting, her mammary glands swell, and an unstable psychoemotional state is noted.

If the ovum is attached in an area where there is enough space for its long-term development, then the pathology can be detected already in a neglected state, when the only solution to the problem is surgical intervention. Starting from about 2 weeks, an ectopic pregnancy will begin to manifest itself.

Visualization of an ectopic pregnancy. Source: formama.online

First of all, a woman will begin to notice that in the area of ​​the lower abdomen she has painful sensations that are aching or pulling in nature. Already this symptom should make her think about the probable problem. Often this condition occurs when the ovum is implanted in the fallopian tube.

However, if the embryo is located in a wide zone, then the first pronounced symptoms may appear no earlier than 7-8 weeks of development. For about 3 weeks, an ectopic pregnancy will manifest itself with the following conditions:

  1. In the lower abdomen, where the embryo is localized, pain of a cutting, pulling or aching character will appear;
  2. Discharge with obvious blood impurities may begin;
  3. The skin of the face and body will become pale;
  4. Blood pressure drops sharply;
  5. The woman feels general fatigue;
  6. The appearance of fainting conditions is possible;
  7. The body temperature is kept within 37-38 degrees.

If a girl has one symptom or a complex of them, it is recommended to immediately call an ambulance and go to the hospital, since this condition can be dangerous to the patient's health. Often, in advanced situations, peritonitis develops, severe bleeding opens and the fallopian tube ruptures.

The optimal outcome of the event is spontaneous rejection of the pathologically implanted fetus. However, such situations are extremely rare, and, often, a woman needs emergency surgery to remove an embryo attached to the cervix, peritoneum or tube.

Ultrasound

In gynecological practice, it is customary to determine the expected duration of pregnancy, starting from when the woman ended the last regular bleeding in the next cycle. Often this period differs from that which is determined by ultrasound screening.

Symptoms of an ectopic pregnancy at an early stage (2 weeks) are almost invisible on an ultrasound scan. The localization of the ovum in the uterine cavity can be determined starting from the 21st day of embryo development. That is why this technique is not suitable for early diagnosis of VMD. Accordingly, it is necessary to pay attention to the indirect signs of pathology.

HCG

After the fertilization of the egg by the sperm, the human chorionic gonadotropin hormone begins to be produced in the woman's body. If you regularly donate blood to determine its concentration, at an early stage you can understand whether a normal pregnancy or pathological is developing.

HCG indicators in normal and ectopic pregnancy.

The diagnosis of an ectopic pregnancy (hereinafter referred to as EB) 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 about them in detail in the article.

What does ectopic pregnancy mean? When the egg is fertilized in the fallopian tube, it moves into 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 an ectopic pregnancy is localization in the fallopian tube. Less commonly, it happens that a fertilized egg begins to develop in the peritoneal cavity, on the cervix or the ovary itself.

Early signs

How to identify abnormal 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.

Increased basal temperature

Many women are accustomed to monitoring their basal 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, BT 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.

Lack 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 the delay. These can be provoking factors such as nervous shock, hormonal imbalance, serious illness, including oncology. In addition, one cannot be one hundred percent sure that there is no pregnancy when menstruation occurs, since many girls have their periods after conception.

Morning sickness

You can recognize the onset of conception at an early stage by morning sickness. Many women know about this ailment when they become pregnant. Often this symptom also manifests itself in the daytime and evening. This is due to hormonal changes in the body, a drop in sugar and some other reasons. If you notice such signs, you should do a pregnancy test. The most accurate test is digital. If he shows two stripes, it is important to get a medical examination as soon as possible.

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

Breast changes

When pregnancy occurs, many girls already in the early stages note the following signs from the breast:

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

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

Increased vaginal discharge

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

Fast fatiguability

When pregnancy occurs, it does not matter if it is ectopic or proceeds normally, the woman's body suffers 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 fatigue. Girls note a constant desire to sleep, physical activity is significantly reduced. In addition, the hormone progesterone acts as a relaxing factor, 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 after 7-10 days after the onset of conception, a girl may encounter such a phenomenon as frequent urination. The fact is that when pregnancy occurs, human chorionic gonadotropin begins to be produced in the body. HCG is the so-called pregnancy hormone. As a result, the blood supply to the pelvic organs is increased. In this case, the urge to urinate is observed even with a slight filling of the bladder. This symptom intensifies at night.

Painful sensations 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. Cramping can also occur during normal pregnancies. In this case, painful sensations are considered quite normal, because the uterus is constantly contracting, and with the development of the fetus, its spasms are observed.

The alarm should be sounded if the pain is accompanied by bleeding. A sign such as the appearance of blood can indicate both an ectopic pregnancy and a threat of miscarriage. In such a situation, you need to contact the gynecology as soon as possible. If we consider the question of when 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 periods. These two conditions should not be confused. Every woman knows when she is having her period and what is the nature of the discharge at the same time.

Indigestion

Due to hormonal changes, the usual work of the intestinal tract is disrupted. The walls of the stomach and intestines relax under the influence of progesterone, and 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 an ectopic one.

Increased sensitivity to odors

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

Nasal congestion

With the onset of conception, immunity decreases. It is a normal physiological process that ensures that the fetus is accepted 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 acne 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. Acne may appear along with inflammation on the skin.

Changing 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 pregnancy. In this case, the mood can change several times a day. A woman can laugh and cry after five minutes. Such "swing" is observed due to changes in the hormonal balance of the body.

Positive pregnancy test

And, of course, the surest way to determine early pregnancy, which can be done at home, is a test. Will the test show the onset of an ectopic pregnancy or not? Today there are a lot of 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 rush to the doctor. From the first days of conception, the test may show a negative result.

The sooner an ectopic pregnancy is diagnosed, the more chances you have to maintain health and eliminate dangerous consequences.

Signs of a ruptured tube in an ectopic pregnancy

The rupture of the organ occurs when the patient is not admitted to the hospital on time. If the girl has not passed the necessary examination, including ultrasound, screening and other methods, an ectopic pregnancy can remain undiagnosed and lead to very negative consequences. One of these complications is rupture of the tube with subsequent internal bleeding. The fact is that only the uterus has a special structure. This organ is capable of stretching, which is a prerequisite 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 as the fetus develops.

Signs of a rupture:

  • acute pain on the right or left in the lower abdomen;
  • cold clammy perspiration;
  • a sharp drop in blood pressure;
  • nausea, repeated vomiting that does not lead to relief;
  • headache and dizziness;
  • rapid heartbeat;
  • weakness, fainting.

If you try to answer the question of how long the organ is bursting, then you will hardly be able to give an exact answer. This happens most often in the period from the second to the third month. But cases of rupture 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 development of the fetus, the presence of abnormalities in the formation of the embryo, and so on.

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

Why the egg is attached outside the uterus

Why does the syndrome - ectopic pregnancy occur? As we have already found out, in contrast to the intrauterine, when the ectopic 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 of the most varied nature. Let's consider the most common ones.

Physical disorders in the body

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

  • adhesive processes;
  • cysts;
  • scarring;
  • oncological diseases of the reproductive system;
  • transfer of an abortion;
  • various inflammatory processes;
  • genital infections.

In order 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 the help of drug treatment and minimally invasive surgical techniques.

Congenital diseases of the uterus and appendages

The etiology of ectopic pregnancy often hides the reasons, which consist in 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 patient's life.

Some types of contraception

No matter how it sounds, 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 lasts no more than five years. If it stays in the body longer, the spiral no longer fulfills 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 get pregnant, who cannot do it naturally for various reasons. It would seem that this procedure should completely eliminate 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 female organs, taking contraceptives and IVF, it is possible to distinguish such factors that provoke cases of ectopic attachment of a fertilized egg. Pathogenesis includes:

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

Bad habits are a common cause of ectopic pregnancy.

Experts pay attention to the fact that patients who have once encountered an ectopic pregnancy are much more susceptible to the likelihood of a recurrence of this pathological condition.

Types or classification of WB

Ectopic pregnancy in medical practice is classified by the place of localization, that is, the attachment of the ovum, and by 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 to the tube, where it grows and develops until it bursts or a spontaneous miscarriage occurs;
  • in the ovary (ovarian attachment). ICD-10 code - O00.2. Egg attachment in the ovary is rarely diagnosed (1-2% of cases). This condition is observed due to the ingress of a fertilized female cell into the ovary. The danger is that the organ will burst due to the growing embryo;
  • in the abdominal cavity (sebarami abdominal pregnancy or pregnancy manga). ICD-10 code - O00.0. Here the fertilized cell is attached to one of the organs of this cavity. Medicine has registered cases when, with such an attachment, the pregnancy proceeded normally, but in most cases there are still severe defects in the fetus;
  • in the area between the large ligaments of the genital organ. This is a disturbed uterine pregnancy. If not interrupted early, the fetus can 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 fetal attachment in the cervical region. Later, a woman may notice spotting and pain during intercourse;
  • in the rudimentary uterine horn. This type of pathological condition is accompanied by spontaneous abortion no later than 4 months after the attachment of the cell, 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 early signs in the interstitial type. Pregnancy can be completely normal for up to twenty weeks.

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

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 termination (interrupted). This is a condition in which the fallopian tube bursts or the embryo spontaneously rejects;
  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 multiple pregnancy, during which one of the fertilized eggs is fixed in the uterus, and at the same time another cell is attached outside of it.

Is it possible to conceive a child after an ectopic pregnancy

On numerous forums, one can find questions from women about whether it is possible to get pregnant normally and give birth to a healthy child after WB? We will try to answer this question.

When to plan for a second pregnancy

How long does it take to get pregnant after WB? Sufficient time should pass after the operation to remove the pathologically located egg. 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 must prescribe the patient a thorough medical examination, including ultrasound examination, 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 period of WB there was a rupture of the right or left tube, the chances of successfully conceiving a child are halved, but a woman can still become pregnant and give birth.

Possible difficulties

Often, when the fallopian tube ruptures, doctors decide to remove it completely. This is due to the fact that the risk of reattachment of the ovum in this area is quite high. Despite the surgery 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 rather difficult to find out that the ectopic attachment of the ovum has occurred in the early stages. This can only be checked in the hospital. As a rule, this condition is detected when the first signs appear, which coincide with the manifestations during a normal pregnancy. The patient notes the absence of menstruation, toxicosis, change in taste, exacerbation of odor, drowsiness, ultrasound can detect changes in the endometrium. Having noticed such signs, you should immediately visit the female gynecology. Unfortunately, not a single patient is safe from the ectopic attachment of a fertilized egg. If there is a suspicion of this dangerous condition, you can not hesitate, you need to 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 pipe rupture or a frozen pregnancy, an urgent surgical intervention is indicated for the woman. The most accurate and informative method that is used in early diagnosis in IB is ultrasound.

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 deny the diagnosis of an ectopic pregnancy. This method is called puncture of the Douglas space. This space is the 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 fluid, which is examined in laboratory studies. Deciphering the results allows you to get an accurate diagnosis.

Does the level of hCG increase with WB?

The 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 in any clinic. Sometimes women are interested in whether this indicator can fall with WB? In fact, the level of the hormone with an ectopic attachment may be slightly lower than during a normal pregnancy, but it does not begin to fall until after the twelfth week. How the level of hCG 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 with 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 an ectopic one.

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 for the diagnosis and treatment of WB.

What does an ectopic pregnancy look like in the photo

Some patients are interested in whether WB is visible in the early stages on an ultrasound scan? Yes, it is really possible to recognize the condition using ultrasound. In the pictures you can see the places of pathological attachment of the ovum in different areas.

As already mentioned, pipe fastening is the most commonly diagnosed.

Treatment methods

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

Drug treatment

WB treatment with 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 the medication Methotrexate. This remedy leads to the freezing of the embryo and its resorption. The main disadvantage of this treatment is the risk of developing 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 is a low-traumatic surgical technique used for the treatment and diagnosis of many diseases of 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 a short 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 top of the umbilical region.
  3. A Veress needle is inserted, the purpose of which is to introduce carbon dioxide into the abdominal cavity.
  4. A laparoscope (a device with a camera) is introduced.
  5. Instruments are inserted through additional incisions, with the help of 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 low tissue damage. The disadvantage is the high price.

Salpingotomy

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

During surgery, the doctor removes the ovum. 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 less traumatic, rarely causes complications, and helps to preserve the woman's reproductive organs. The disadvantages include the possibility of using it especially in the early stages and, if the embryo is located close to the exit of the pipe. In addition, the technique is used only with a small diameter of the fertilized egg.

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

With the tubal arrangement of an ectopic pregnancy, the surgeon through an incision in the abdominal cavity excises part of the tube along with the ovum. If the embryo is located in the abdominal cavity, the doctor removes it in the same open way. If the patient has a missed pregnancy, it must also be removed immediately.

Tubectomy

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

The rehabilitation period after such an operation is quite long. The patient must be in the hospital under close 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, in the early stages, the intervention lasts no more than 30 minutes. If the embryo reaches a rather large size, the tube ruptures, 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 rate 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 providing medical care to patients with tube rupture and bleeding is to perform urgent surgical intervention, remove ectopic pregnancy, and stop blood loss. Before the arrival of an ambulance, it is necessary to ensure that the patient is calm and in a horizontal position of the body.

The rupture of the tube can occur at an early stage or already with a rather 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 the answers to various questions, which we will talk about below.

Why does an ectopic pregnancy happen?

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 poorly expressed. They usually coincide with the signs of a normal pregnancy.

It is impossible to diagnose WB in the early stages without tests and examination by a gynecologist.

Is it possible to have sex with this diagnosis

You should consult your doctor with this question. 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 VD were noticed at an early stage and a diagnosis was made, it is possible to preserve the organ.

How long can you not have sex after surgery

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

Is there implantation bleeding 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 it possible for WB with bandaged pipes

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 quickly get pregnant after WB

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

Can such a pregnancy come out on its own

Cases of miscarriage in case of IB are indeed registered. In this case, as a rule, a woman experiences bleeding, which carries a threat to her life. If you suspect such a condition, you should urgently go to the hospital.

Than such a condition threatens

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

Can an ectopic pregnancy go to the uterine

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

Prevention of pathological attachment of the ovum 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 when signs such as increased vaginal discharge, change in their color, odor, appearance of pain during intercourse, itching in the vaginal area appear;
  • exclusion of bad habits (smoking, drinking alcoholic beverages);
  • regular preventive examination by a gynecologist.

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

Video

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