What causes ectopic pregnancy signs. What are the signs of an ectopic pregnancy

Ectopic pregnancy is considered by doctors to be the most insidious and unpredictable gynecological disease. Ectopic pregnancy is not so rare, in about 0.8 - 2.4% of all pregnancies. In 99 - 98% it is a tubal pregnancy. After a disease, especially a tubal pregnancy, a woman's chances of remaining childless increase. What are the symptoms of an ectopic pregnancy, the causes of its occurrence, treatment, complications - this is our article.

Ectopic pregnancy: how is it classified?

An ectopic (ectopic) pregnancy is a pathology characterized by the fact that the embryo is localized and grows outside the uterine cavity. Depending on where the implanted egg was “deployed”, tubal, ovarian, abdominal and pregnancy are isolated in the rudimentary horn of the uterus.

Pregnancy in the ovary can be of 2 types:

• one progresses on the ovarian capsule, that is, outside,
• the second directly in the follicle.

Abdominal pregnancy happens:

• primary (conception and implantation of the egg to the internal organs of the abdominal cavity occurred initially)
• secondary (after the fetal egg is “thrown out” of the fallopian tube, it is attached in the abdominal cavity).

Example from practice: A young nulliparous woman was delivered to the gynecology department by ambulance. There are all symptoms of bleeding into the abdominal cavity. During the puncture of the abdominal cavity, dark blood enters the syringe through the Douglas space of the vagina. Diagnosis before surgery: ovarian apoplexy (no delay in menstruation and the test is negative). During the operation, an ovary with a rupture and blood in the abdomen are visualized. Ovarian apoplexy remained as a clinical diagnosis until the histological results were known. It turned out that there was an ovarian pregnancy.

How early can an ectopic pregnancy be diagnosed?

The disease is easiest to determine after the pregnancy is terminated (either a ruptured tube or a completed tubal abortion). This can happen at different times, but, as a rule, in 4 to 6 weeks. In case of further growth of pregnancy, it is possible to suspect its ectopic localization with a probable period of 21-28 days, the presence of hCG in the body and the absence of ultrasound signs of uterine pregnancy. Pregnancy, which "chosen" a place for itself in the rudimentary horn of the uterus, can be interrupted later, at 10-16 weeks.

Early symptoms of an ectopic pregnancy

When do early symptoms of an ectopic pregnancy appear? If a woman has a regular menstrual cycle, this pathology can be suspected if there is a delay in menstruation. However, an ectopic pregnancy that continues to grow and develop is practically no different from a pregnancy that is in the uterus in the early stages. The patient usually notes the following first symptoms of an ectopic pregnancy:

Firstly, this is an unusual regular menstruation - its delay or. Secondly, mild or moderate pains of a pulling nature due to stretching of the wall of the fallopian tube due to the growth of the fetal egg. The test for ectopic pregnancy is most often positive.

• delay in menstruation is noted by women in 75-92% of cases
• pain in the lower abdomen - 72-85% both weak and intense
• bloody discharge - 60-70%
• signs of early toxicosis (nausea) - 48-54%
• enlarged and painful mammary glands - 41%
• pain radiating to the rectum, lower back - 35%
• positive (not all) pregnancy test

The erroneous opinion of many is that if there is no delay in menstruation, then the diagnosis of ectopic pregnancy can be excluded. Very often, smearing vaginal discharge during ectopic pregnancy is perceived by some women as normal menstruation. According to some authors, it is possible to identify WB in 20% of cases before the delay in menstruation. Therefore, a thorough history taking and a complete examination are very important for the timely establishment of this diagnosis.

During examination by a gynecologist, he reveals cyanosis and softening of the cervix, an enlarged, soft uterus (the first signs of pregnancy). On palpation of the area of ​​the appendages, it is possible to determine on one side an enlarged and painful tube and / or ovary (tumor-like formations in the area of ​​the appendages - in 58% of cases, pain when trying to deflect the uterus - 30%). Their contours are not clearly palpable. On palpation of the tumor-like formation in the appendages, the doctor compares the size of the uterus and the delay in menstruation (obvious discrepancy) and prescribes an additional study:

• Ultrasound of the internal organs of the genital area
• Analysis for the content of hCG and
• The progesterone level in an ectopic pregnancy is lower than in a normal pregnancy and there is no increase in hCG after 48 hours if the pregnancy is ectopic

For an interrupted ectopic pregnancy by a tubal abortion, a typical triad of symptoms, signs is characteristic:

• pain in the lower abdomen
• bloody discharge from the genital tract
• as well as delayed menstruation

Pain in the lower abdomen is due to an attempt or pushing the fetal egg out of the fallopian tube. Hemorrhage inside the tube causes its overstretching and antiperistalsis. In addition, the blood that enters the abdominal cavity acts on the peritoneum as an irritant, which aggravates the pain syndrome.

A sudden, dagger-like pain in the iliac regions against the background of full health helps to suspect a tubal abortion. Pain, as a rule, occurs after 4 weeks of delayed menstruation, radiates to the anus, hypochondrium, collarbone and leg. Such attacks can be repeated repeatedly, and their duration is from several minutes to several hours.

If the internal hemorrhage is minor or moderate, an ectopic pregnancy may remain unrecognized for a long time, without any special signs. Some patients, in addition to the listed symptoms, note the appearance of pain during defecation. The pain attack is accompanied by weakness, dizziness, nausea. A slight increase in temperature is due to the absorption of the outflowing blood in the abdomen.

If intra-abdominal bleeding continues, the woman's condition worsens, and the pain intensifies. Bloody discharge from the genital tract is nothing more than a rejection of the mucous membrane in the uterus, transformed for future egg implantation (decidual layer), and they appear a couple of hours after the attack, and are associated with a sharp drop in progesterone levels. A characteristic feature of such secretions is their persistent repetition; neither hemostatic drugs nor curettage of the uterine cavity help.

When a fallopian tube rupture occurs, its symptoms

The timing of damage to the fallopian tube is directly related to in which part of the tube the embryo has settled. If it is located in the isthmic region, the rupture of the fetus occurs at 4-6 weeks, with the “occupation” of the interstitial region by the fetal egg, the terms are lengthened, up to 10-12 weeks. If the embryo has chosen a place for further development of the ampullar part of the tube, which is located next to the ovary, the rupture occurs after 4 to 8 weeks.

Fallopian tube rupture is a dangerous way to end an ectopic pregnancy. It occurs suddenly and is accompanied by the following symptoms:

• with severe pain
• drop in blood pressure
• increased heart rate
• general deterioration
• cold sweat and
• pain radiates to the anus, leg, lower back

All of these signs of ectopic pregnancy are due to both a severe pain attack and massive bleeding into the abdominal cavity.

During an objective examination, pale and cold limbs, increased heart rate, rapid and weak breathing are determined. The abdomen is soft, painless, may be slightly swollen.

Massive hemorrhage contributes to the appearance of signs of irritation of the peritoneum, as well as muting of the percussion tone (blood in the abdomen).

A gynecological examination reveals cervical cyanosis, an enlarged, soft and less than the expected gestational age of the uterus, pastosity or a tumor-like mass in the groin on the right or left. An impressive accumulation of blood in the abdomen and in the small pelvis leads to the fact that the posterior fornix is ​​smoothed or protruded, and its palpation is painful. Bloody discharge from the uterus is absent, they appear after the operation.

Puncture of the abdominal cavity through the posterior vaginal fornix yields dark, non-clotting blood. This procedure is painful and is rarely used for pipe rupture (pronounced clinical picture: sharp pain, pain and hemorrhagic shock).

Example from practice: A primigravida young woman was sent from the antenatal clinic to the gynecology department to maintain her pregnancy. But as soon as she arrived, the pregnancy was disrupted by the type of pipe rupture. At the reception in the area of ​​the appendages, the alarming formation was not palpated, and the diagnosis sounded like a pregnancy of 5-6 weeks, the threat of interruption. Fortunately, the woman went to the doctor. There was no time to conduct a gynecological examination, the pressure was 60/40, the pulse was 120, severe pallor, significant dagger pain, and as a result, loss of consciousness. They quickly opened the operating room and took the patient. There was about 1.5 liters of blood in the stomach, and the pregnancy in the burst tube was about 8 weeks.

Why does an ectopic pregnancy occur?

Attachment of the fetal egg outside the uterine cavity is due to a violation of the peristalsis of the fallopian tubes or a change in the properties of the fetal egg. Risk factors:

• inflammatory processes in the pelvis

Inflammatory processes of the appendages and uterus lead to neuroendocrine disorders, obstruction of the fallopian tubes, and ovarian dysfunction. Among the main risk factors, chlamydial infection (salpingitis) stands out, which in 60% of cases leads to ectopic pregnancy (see).

• intrauterine device

Intrauterine contraceptives in 4% of cases lead to ectopic pregnancy, with prolonged use (5 years), the risk increases by 5 times. Most experts believe that this is due to the inflammatory changes that accompany the presence of a foreign body in a woman's uterus.

• abortions

), especially numerous, contribute to the growth of inflammatory processes of the internal genital organs, adhesions, disruption of peristalsis and narrowing of the tubes, 45% of women after artificial termination of pregnancy in the future have a high risk of developing an ectopic.

In a smoking woman, the risk of developing an ectopic is 2-3 times higher than in a non-smoker, since nicotine affects the peristalsis of the tubes, the contractile activity of the uterus, and leads to various immune disorders.

• malignant neoplasms of the uterus and appendages
• hormonal disorders (including stimulation of ovulation, after IVF, taking a mini-drink, impaired production of prostaglandins)
• fallopian tube surgery, tubal ligation
• abnormal development of a fertilized egg
• sexual infantilism (pipes are long, twisted)
• endometriosis (causes inflammation and adhesions)
• stress, fatigue
• age (over 35 years old)
• congenital malformations of the uterus and tubes
• genital tuberculosis

What is the danger of an ectopic pregnancy?

An ectopic pregnancy is terrible for its complications:

• severe bleeding - hemorrhagic shock - death of a woman
• inflammation and intestinal obstruction after surgery
• recurrence of ectopic pregnancy, especially after tubotomy (in 4-13% of cases)

Example from practice: A woman was admitted to the emergency room with the classic symptoms of an ectopic pregnancy. During the operation, the tube was removed from one side, and when the patient was discharged, recommendations were given: to be examined for infections, to be treated if necessary, and to abstain from pregnancy for at least 6 months (pregnancy was desired). Not even six months have passed, the same patient comes with a tubal pregnancy on the other side. The result of non-compliance with the recommendations is absolute infertility (both tubes are removed). The only good news is that the patient has 1 child.

Ways to save appendages and should they be saved?

An ectopic pregnancy is an emergency and requires immediate surgery. Salpingectomy (removal of the tube) is the most common, because in most cases the fallopian tube is severely damaged (regardless of the gestational age) and a future pregnancy has a serious risk of being ectopic again.

In some cases, the doctor decides on a salpingotomy (pipe incision, removal of the fetal egg, suturing the incision in the tube). A tube-preserving operation is performed when the size of the fetal egg is not more than 5 cm, the patient is in a satisfactory condition, and the woman’s desire to maintain childbearing function (recurrence of an ectopic). It is possible to carry out fimbrial evacuation (if the ovum is in the ampulla). The embryo is simply squeezed out or sucked out of the tube.

Segmental resection of the tube is also used (removal of the damaged section of the tube, followed by suturing of the tube ends). In the early stages of tubal pregnancy, drug treatment is allowed. Methotrexate is injected into the tube cavity through the lateral fornix of the vagina under ultrasound control, which causes the dissolution of the embryo.

Will the patency of the tube remain after the operation? It depends on many factors:

• Firstly, early activation of the patient (prevention of adhesions) and physiotherapy
• Secondly - adequate rehabilitation therapy
• Thirdly, the presence / absence of postoperative infectious processes

FAQ:

• How to protect yourself after an ectopic pregnancy?

The use of pure progestin (mini-pill) drugs and the introduction of an IUD is not recommended. It is advisable to take oral combined contraceptives.

• Can a pregnancy test show where it is located?

No, the test shows that there is a pregnancy.

• The delay is 5 days, the test is positive, and the fetal egg is not visualized in the uterus. What to do?

It is not necessary that an ectopic pregnancy has occurred. It is necessary to repeat the ultrasound in 1 - 2 weeks and conduct a blood test for hCG (in the early stages, pregnancy in the uterus may not be visible).

• I had acute adnexitis, so I have a high risk of developing an ectopic pregnancy?

The risk, of course, is higher than in healthy women, but it is necessary to be examined for sexual infections, hormones, and to be treated.

• When can I plan a pregnancy after an ectopic?

An ectopic or ectopic pregnancy is approximately 2% of all pregnancies. And although the probability is small, any woman can face this problem, because the exact reasons for this development of events are not known until the end. What are the signs of an ectopic pregnancy, and at what time can it be recognized? Says obstetrician-gynecologist Victoria Gukovskaya.

In an ectopic pregnancy, the zygote—the cell that results from the fertilization of an egg by a sperm—does not reach the uterine cavity, as happens during a normal pregnancy, but remains in the fallopian tube. More rarely, it is pushed out of the tube in the opposite direction and attached in the ovary or on the surrounding peritoneum. This is fraught with complications and threatens the life of a woman.

How to recognize an ectopic pregnancy?

"Among the symptoms of an ectopic pregnancy are the following: pain in the lower abdomen - from pulling to acute, weakness, dizziness, fainting. Another clear sign of a possible ectopic pregnancy is bloody discharge from the genital tract: from smearing dark brown to scarlet," Victoria Gukovskaya says.

With these symptoms, you should see a doctor as soon as possible. The gynecologist will perform an ultrasound to determine if there is a fertilized egg outside the uterus. With abdominal ultrasound, a fetal egg in the uterus can be detected at term, and with vaginal ultrasound - at term.

In addition, the gynecologist will prescribe a blood test for hCG (chorionic gonadotropin, a hormone secreted by the placenta during pregnancy). As a rule, during an ectopic pregnancy, the levels of this hormone are lower and they grow more slowly than during a uterine pregnancy of the same period.

Treatment and prevention of ectopic pregnancy

Today, doctors can only offer surgical treatment, the issue of the possibility of preserving the tube is decided individually. "As a surgical intervention, laparoscopy is used - this is an endoscopic operation that is performed without an incision in the anterior abdominal wall using special optical equipment. It allows you to remove the fetal egg from the tube with the least damage and most sparingly, cauterize the damaged vessels and save the tube," the doctor explains. .

Gynecologists believe that the main thing to be wary of after a successful operation is inflammatory diseases - it is because of them that the risk of a second ectopic pregnancy increases.

Discussion

Hello everyone, the other day I found out that I had an ectopic pregnancy. And it was like this, I went to the doctor with abdominal pain and menstruation, which didn’t go away, so the doctor said that I had to go to the hospital. I became ill and was put back in the hospital, I already said a neuterine pregnancy and they did an operation and removed the tube, this is how it happens that doctors can not always recognize the disease

I had an ectopic pregnancy, after I have been taking all the treatment for 22 days after the operation, it should have gotten better, but like after the operation I had a problem with difficulty breathing and now I can’t turn over, the right side hurts where they removed my tube and on the right side it hurts up to the neck it tightens and I find it difficult to breathe and everything seems to be blocked, I also told the doctor in the clinic that it hurts, but nothing was added to the treatment, and I can’t breathe normally; I don’t know what to do, they called an ambulance, they can only anesthetize and that’s it, but it’s treated only in a clinic, such a difficult situation

Girls, I have been drinking jess from polykestosis for the second month already, I don’t see a pack of improvements. But I'm already two weeks late this month? What could it be???

Why only operation is allowed??? For a long time, both here and abroad, drugs have been used, if they don’t help, then yes, they cut. and me in the USA 2 weeks ago and a friend in Ukraine (3 years ago) were given Methotrexate injections, it seems. It dissolves the placenta and various formations. Check hCG levels every 48 hours. Ugh ugh everything worked out with injections. And so they found an ectopic in the right tube for 7 weeks. There was a brown daub and weakness of the body. On ultrasound and after tests, they confirmed, prescribed treatment

I had an ectopic pregnancy ... After it, the doctor prescribed Wobenzym for me so that there were no adhesions in the tubes and the egg cell was attached where necessary. Then she gave birth normally, the baby is already 5 months old)

Dear, I am writing and holding in my arms my golden sleeping daughter, 3 months old. A year ago, I had an ectopic pregnancy. Apparently, stress at work set in, before that she was healthy as a horse, not a single female sore. At that time I was 31 years old. 5 tests showed a positive result. I flew to the doctor, she said that I was not pregnant and sent me home. And this is in Germany with its vaunted medicine. If I were a fool, I would have believed and waited for the tube to burst. Week went to another doctor every 2 days to take a blood test. Blood began to flow and I decided to act, because everything was clear and incomprehensible - why else pull? I went to the third doctor, she also did not see anything in the uterus, and the tube too, but it was already the 8th week after the last menstruation. She sent me to the hospital, where I was examined by the 4th doctor and professor, who only suggested that the fetus was in the right tube. And immediately on the same day an operation was prescribed, because delay, as they say, is like death. Thank God, they left the tube, it was not damaged, but the chances of getting pregnant decreased to 80%. After 2 months they were allowed to get pregnant. Result - pregnancy in 3 months.
I hope I gave someone hope. The main thing - do not waste time and look for good doctors.

The article is good. Thank you.
I was very upset by the comments where women write about abortions. But abortion is a sin. No one gives a person the right to interrupt the life of another person.

Hello ... 7 years ago, something happened to me that today made me worry again ... my stomach hurt .. before the delay there were still 5 days, I went to the doctor, had an examination, saw signs of inflammation and possibly a cyst .. did the ultrasound confirmed all this, but not a cyst, but a corpus luteum ... I took pregnancy tests (2 different ones), both negative, they took me to the hospital to treat inflammation, prescribed an antibiotic and began to treat ... the pain intensified, I had been lying by that time for a week, 10 doctors stood in a row and everyone looked and shrugged, who said that someone was pregnant, that it was an ectopic pregnancy, and who was inclined that it was a cyst and inflammation ... the ultrasound still showed a corpus luteum ... then they said to donate blood for pregnancy, the analysis showed that there is a pregnancy, but the indicators are very small .. and again the discussion is ectopic or not, some say quickly for preservation, others quickly for laparoscopy ... in the evening they say "do not eat anything tomorrow morning we will do the operation and that's it, don't worry and one they give birth with a tube (I'm 19 years old, I burst into tears from this news), but something pulled me that evening without telling the doctors to call my husband and go back for an ultrasound scan ... the ultrasound showed 2 weeks of normal pregnancy, the fertilized egg attached and it can be it was noticed .. that's it, and I thought: what would have happened if I hadn’t gone for an ultrasound on the eve of the operation: I would have had a tube removed, and then, suddenly my stomach would begin to grow? or what would happen to my baby who is now 7 years ?? and all these antibiotics that were injected for 2 weeks ... (well, then they didn’t say that a freak could be born from this treatment of inflammation ....) as a result, all 9 months were preserved, and premature birth. and now, after 7 years .. my stomach got sick, there was still a week before the delay, I went to the doctor .. she looked and said that inflammation and cysts were possible, she did an ultrasound, it confirmed it (more precisely, not cysts, but a corpus luteum), I again soon they told me to go to the hospital for treatment .. and then I felt zhedava ... already when I got out and got into the car ... go to the hospital tomorrow, I will tell this case to the doctor ... so as not to guess on chamomile and not drag out time like that how at the moment I would not want a child, to immediately go and donate blood before treatment ... I don’t understand why doctors keep disease cards if every time they start treating by the selection method, if you can initially go by excluding what has already happened ...

Thank you for the article. I was always afraid of her, but now it is clear that there is nothing to be afraid of.

hello. My first pregnancy and abortion was at 17. at the age of 20, I gave birth by caesarean section of a child at the appointed time. half a year already as I do not take birth control pills and do not use special protection with my spouse. the last menstruation was on February 2-6, in March the planned menstruation did not come and I did a positive test. not yet registered. I went to the doctor after on March 21 I had blood discharge, blood clots (maybe menstruation). They did an ultrasound, looked at the pregnancy chair and did not find it. I have done 6 tests and they are all positive. the chest does not hurt, "monthly go." Tomorrow I'm going to donate blood to determine pregnancy. but tormented by fears and conjectures. what it could be and how it could be dangerous. Thanks

Is it possible to get pregnant like this ("cross")??? -?????? 2009 Laparoscopy. Adhesiolysis. CCC. Resection of the left ovary. fine.
After undergoing treatment, passing all the tests with her husband, no serious abnormalities were found. But the following happens: 2012 Operation-Laparotomy, Tubectomy on the right, Wedge resection of the right ovary. (Diagnosis: tubal pregnancy on the right, Internal bleeding at 8 weeks of pregnancy. Postoperative period without complications.
then, half a year later, I underwent Metrosalpingography (the left fallopian tube is of normal shape and is completely passable without deformities, the right one is halfway missing and sutured) The right ovary is 37 * 31 * 36 V-21 cm cubic, almost at the time of ovulation, it is completely working. The tests for all infections are negative. The spermogram is normal. The uterus is not deformed, the contours are even.
Question:
(During an operation on an ectopic, it turned out that in 2009 I had an ovary removed and they didn’t say anything, and they didn’t write in the conclusion except “Resection of the left ovary”.)
It turns out that the left tube is perfectly passable, the working right ovary, the spermogram is normal, ovulation occurs.
Is it possible to get pregnant like this ("cross")??? -?????? A very long-awaited baby.
Thank you in advance for the answer, I'm very worried, I really want to get pregnant

An ectopic pregnancy is an abnormal condition that poses a serious threat to a woman's life. The place of localization of a fertilized egg is normally the uterus. If fixation occurs in any other place, this is a pathology and requires immediate intervention by doctors. The first signs of an ectopic pregnancy, if you know about them, should alert the woman and encourage her to make an appointment with a specialist.

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

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

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

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

Classification of ectopic conditions

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

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

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

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

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

Signs of an ectopic pregnancy

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

Primary signs are typical for everyone:

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

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

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

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

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

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

What will the test show?

Considering the question of what symptoms an ectopic pregnancy gives, what signs in the early stages are characteristic of this condition, it is worth considering separately the nuances associated with the use of the test. This type of fertilization causes a delay in menstruation. In the first expected cycle, there may still be allocations. As a rule, they are scarce, of a specific color. "Pseudo-mentruation" comes at the wrong time and lasts only a couple of days.

This alarms the woman, since a normal cycle, in any case, cannot look like this. Alert, patients often purchase a pregnancy test.

The test will be positive. However, with ectopic localization of the fetal egg, the second strip is usually fuzzy, blurry. Experts attribute this to the fact that the level is lower if the zygote is attached to the tissues of the tube.

However, there are tests that help recognize an abnormal pregnancy, as well as assess the risk of a ruptured tube. However, in order to acquire and conduct such a specific test, a woman needs to be on the alert, distinguishing between normal and abnormal pregnancy.

Sad consequences

The consequences of an ectopic pregnancy include:

• rupture of the tube with subsequent migration of the fetal egg into the peritoneal cavity;
• termination of an abnormal pregnancy in any other way;
• massive bleeding due to detachment of the fetus from the walls of the appendage;
• bleeding due to actual damage to the tube, which can be fatal for a woman;
• the development of peritonitis, if the blood enters the abdominal cavity with the subsequent development of inflammatory processes.

Treatment of patients

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

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

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

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

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

Rehabilitation and subsequent preparation for pregnancy

All rehabilitation activities are presented below.

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

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

In the conditions of modern medicine, it is possible to save a child only with abdominal ectopic pregnancy, other types, such as tubal, cervical and ovarian ectopic conception, do not provide such an opportunity. This pathology is very dangerous for a woman. Doctors forbid even trying to give birth.

Can a fetus migrate into the uterus?

Ectopic pregnancy

No, this will not happen. Obstetricians will not be able to transfer the fetus to the uterus and save it during ectopic development. Laparoscopic surgery is prescribed, preferably in the early stages.

Treatment of an ectopic pregnancy, saving the fetus, can result in the death of a woman in labor. This is extremely dangerous. If there is an assumption that the embryo is not developing there, you should urgently contact the obstetrician and do an ultrasound.

You need to make an appointment for an ectopic pregnancy within a week after the delay. At this time, doctors will be able to find out that the fetal egg is not in the uterine cavity, so it is impossible to save an ectopic pregnancy. It is possible that the gynecologist will insist on hospitalization of the patient.

During laparoscopic surgery, the surgeon makes three tiny punctures in the abdomen and vacuum aspiration removes the ectopic fetus. After a week and a half from the procedure, a woman can return to normal life. But you need to introduce physical activity after an ectopic pregnancy gradually.

Planning for a child should be at least six months later. Each doctor stipulates the terms, based on the health of the patient. If the operation with an ectopic location of the fetus was successful, conception is possible during the first cycle.

Etiology of tubal pregnancy problem

This situation is rarely seen. Several types of ectopic pregnancy are diagnosed:

• egg;
• abdominal;
• pipe.

The last option is the most common. It is important to urgently do the operation, it will not work to save the child. Otherwise, you will have to save not only the fetus, but also the woman.

Cases are often diagnosed when uterine and tubal pregnancies are detected at the same time. This happens if the conception was carried out artificially, and the doctors introduced several zygotes into the uterine cavity at once. They may migrate to the tube or ovary and stay there. One child can be saved.

The fetus sometimes passes from the uterus to another cavity after artificial stimulation of ovulation or treatment with medications to improve the functioning of the reproductive system. Sometimes an ectopic pregnancy can be in a woman who has given birth if it is transmitted genetically. You can't save a child like that.

Tube obstruction

Tubal pregnancy is diagnosed by ultrasound. But as the child develops, accompanying symptoms appear:

• nausea, vomiting;
• constant fatigue;
• bleeding, including after intercourse;
• pain in the lower back, sacrum and abdomen.

It is impossible to give birth during an ectopic pregnancy, since the fetal egg bursts and you can bring the expectant mother to enormous risks. Therefore, if symptoms appear, you need to make an appointment with a specialist. After the examination, it will become clear whether it is a pathology or not, whether it is possible to save the fetus.

If one fetus is in the uterus, there is a chance that this child can be born healthy. But it is possible to save it only with the termination of an ectopic pregnancy. The earlier a problem is identified, the greater the likelihood of a positive outcome.

Conditions for ending a pregnancy with a miscarriage

Do not despair

Abnormal bearing of a child has adverse consequences for a woman. The result of an ectopic pregnancy is:

• pipe rupture;
• miscarriage.

With an ectopic pregnancy, they do not give birth, it is impossible to save the child. In the first case, the fallopian tubes do not withstand the division and growth of the egg. In the second, the fetus migrates into the abdominal cavity. In both cases, internal bleeding begins, threatening death.

A miscarriage manifests itself as an unexpected severe pain. With an ectopic pregnancy, it is felt from the side where the baby is located. The pain is cramping, aching, dagger. With an ectopic miscarriage, smearing brown discharge appears. It is important not to confuse them with menstrual blood. They are not that strong.

Preservation of the fetus is impossible. Therefore, after the onset of symptoms of a miscarriage, you should immediately contact a gynecologist. There is a risk that you will not be able to get pregnant again, as well as save the next child.

Unique cases of the birth of children after an ectopic pregnancy

Everything is real

There are few such stories. Carrying out a child to a woman with an ectopic pregnancy is obtained in rare cases, where the chances are extremely low. But sometimes a miracle does happen.

In 1999, in London, they managed to save and save the boy, who, unlike two twin sisters, grew up inside the fallopian tube. Gynecologists only found out at 5 months that the woman was pregnant with triplets. Her tube broke, but the fetus continued to develop successfully in the abdominal cavity, and the doctors brought the child into the world.

It is impossible to save and give birth to a child during an ectopic pregnancy, however, the boy from Australia grew inside the maternal ovary for the entire period. It was the first such case. During an operation in 2008, doctors had to remove the woman's right ovary.

An amazing story happened in the Midwest of the United States. A 36-year-old American woman was able to carry, keep a child and give birth with an ectopic pregnancy. The girl grew in the mother's ovary. The case was recorded in 2013.

Jane Jones is the heroine

Jane Jones also became famous thanks to the birth of a child after an ectopic pregnancy. At 6 weeks, the woman learned that her son was developing in the fatty layer covering the intestines. Laparoscopy was performed with the participation of about 40 doctors, and then the baby lived for another 2.5 months in a special incubator. The child was saved.

In Tanzania, it was only towards the end of pregnancy that the development of the fetus of a 22-year-old pregnant woman took place in the abdominal cavity. It is impossible to give birth, so obstetricians performed an operation and removed a tiny girl weighing less than 2 kg. The patient lost a lot of blood, but survived. The child was saved.

Chances of giving birth with a second ectopic pregnancy

Sometimes the anomalous situation is repeated several times. It is impossible to save a child and give birth. But even two ectopic pregnancies are not a sentence, there is a chance to give birth to a healthy baby.

After the extraction of the embryo, you need to make an appointment with an endocrinologist. It is possible that the woman experienced a pregnancy outside the uterus due to hormonal problems, it was not possible to save the child for the same reason. The doctor will tell you what it is and what to do now.

positive test

To increase the chances of re-conception after an ectopic, you will have to take tests. Including gonorrhea, chlamydia, inflammation, sexual infections. You may need to undergo treatment before trying to get pregnant again.

There are cases when women give birth in a year. But gynecologists recommend taking care of yourself for at least 3 months after an ectopic pregnancy. It is necessary to reduce physical activity and rest more, this will save the child.

During recovery and planning for conception, it is necessary to undergo an examination by a gynecologist every 2 to 3 months in order to monitor the state of health. In a year, you will be able to pass all the tests and fully check your body. This measure is necessary to exclude complications that interfere with the normal course of pregnancy and childbirth.

In the first week, not every woman will be able to distinguish. Considering the danger of such a situation, it is necessary to distinguish between warning signs and understand what to do with them.

An ectopic pregnancy is a pathology of fetal development that entails catastrophic complications. She's been seeing it a lot lately. What is pathology? Ectopic pregnancy expressed in the wrong position of the fertilized cell.

In the case of pathology, the egg does not penetrate the uterus, but remains in the tube and other places. However, the cell does not die immediately, it begins to develop. What she's going to die, that's a fact but how soon this will happen is unknown.

If the egg develops rapidly and the woman does not pay attention, serious health problems may arise, including a threat to life.

There are two types of ectopic pregnancy: progressive and interrupted. Let's take a closer look at each of them.

There can be several reasons for the occurrence of pathology. Experts note a sharp increase in the number of cases of ectopic pregnancy. What explains this trend? The thing is that the number of girls who have pathological abnormalities and various gynecological diseases from birth. Sometimes these diseases are not properly treated and the result is complications and pathologies even after many years. There are other common symptoms as well. Here is some of them:

• Diseases of the appendages, accompanied by severe inflammation.
• Reducing the level of the ability of pipes to contract.
• Failures in the reproductive function of the body.
• Made abortions.
• Previous ectopic pregnancy.

Treatment can be medical, and sometimes you have to resort to surgical methods. Let's consider each of them:

What else is the danger? In addition to worsening the patient's condition and loss of blood, pathology can cause infertility. For example, if two tubes had to be removed during a tubectomy, then the chances of becoming a mother in the future disappear. In especially severe situations, the appearance of pathology can lead to death. Of course, this happens when a woman does not seek help for a long time. It is not worth delaying contacting the clinic and starting treatment.

When do the first signs of an ectopic pregnancy appear?

The first signs of an ectopic pregnancy in the first week are difficult to identify. Unfortunately, the first 1-1.5 months there may be no signs of the development of pathology. As already mentioned, in the case of a progressive form of ectopic pregnancy, it is impossible to determine it. The main factor that affects the definition of symptoms is the position of the egg.

For example, if she remained in the pipe itself, then signs of her stay there will appear faster. After all, the pipe is narrow enough and fully grow in such an environment, the cell cannot. If she breaks the pipe, then heavy bleeding occurs, which will serve as the first alarm signal.

Signs of pathology can be:

However, for more severe symptoms it doesn't take much time. A week later, other symptoms may begin to develop:

• Severe abdominal pain (often on the left side).
• Vaginal discharge.
• Nausea, vomiting.
• With severe bleeding, fainting is possible.

Every girl knows that a test can determine the exact result even before doctors diagnose.

What does the improvised tool show in case of pathology? Most often he indicates pregnancy. Sometimes one strip may appear, however, this may simply be the result of the fact that very little time has passed.

No worse than a pregnancy test can be detected by ultrasound. However, during such a diagnosis, specialists immediately detect pathology which cannot be done with a single test. It follows from this that you should not delay contacting specialists with “two stripes”.

Some believe that menstruation with pathology is normal, however, they confuse normal menstruation with forced bleeding. It is impossible to predict what kind of discharges will be, but their nature will be necessary different from regular periods. Color, abundance, even smell can change.

Sometimes menstruation during an ectopic pregnancy is maroon-colored clots formed by mucus. It is this phenomenon that prompts many women to seek help from doctors and intervene in time. It should be noted that approximately in 15% of cases, there is no blood loss in pathology.

You can determine the pathology on ultrasound after a couple of days. The doctor will notice a slight induration and other abnormalities. However, for the reliability of the result prescribe an intravaginal ultrasound, the result of which unambiguously confirms the diagnosis.