One of the most beautiful periods in a woman’s life is pregnancy. It is good if the embryo develops according to the timing in a place determined by physiology. But it also happens that the attachment of the fetal egg does not occur where it is provided. Then there is a suspicion that the patient had an ectopic pregnancy (tube, ovarian, abdominal, cervical). About one of these types and will tell you the article. You will learn what tube pregnancy is. Causes and symptoms, methods of diagnosis and treatment will be described later.
The mechanism of occurrence and classification of ectopic pregnancy
After the fusion of male and female gametes (sperm and egg), active division of the formed mass begins. Slowly but surely, the zygote advances into the uterine cavity. This is where the fetal egg should be fixed, according to the rules of physiology. But this does not always happen.
For certain reasons, a fertilized egg does not enter the uterus, but remains in the fallopian canal. In this case, tube pregnancy develops. If the zygote is pushed back, then the fetus can attach in the ovary or abdominal cavity. Less commonly, a fetal egg bypasses the genital organ and is fixed in the cervical canal (cervical pregnancy).
Tubal pregnancy: causes
In general, ectopic attachment of the ovum occurs in two percent of all cases. At the same time, tubal pregnancy occurs in 97% of them. In half the situations, the reasons for this outcome remain unknown. But gynecologists identify risk factors that can lead to the described pathology. Consider them.
- Operations performed on the abdominal organs. If previously a woman had surgical interventions, then this can cause the formation of adhesions. These films, in turn, interfere with the normal progress of the fertilized cell.
- Incorrectly selected contraception. If you use oral hormones in the wrong dose, then conception can take place, but the embryo will not develop properly. Also, tubal pregnancy happens when using intrauterine devices.
- Infectious diseases and pelvic inflammation. These pathologies (even in the anamnesis) lead to deformation of the reproductive organs, hormonal failure and the formation of adhesions. The fallopian tubes become thinner, the internal villi cease to function correctly.
- Neoplasms. If there is a fibroid in the uterus, polyps or ovarian cysts, the entire process of conception is disrupted. Therefore, a high probability of attachment of the fetal egg outside the cavity of the genital organ.
- Anomalies of the genitals. Often an ectopic (tube) pregnancy occurs with congenital or acquired pathologies of the pelvic organs (the presence of a septum, adhesions, bicornuate uterus, and so on).
Signs of pathology
What are the symptoms of tubal pregnancy? This question interests many women. Clinical manifestations are divided into primary and secondary. At first, the symptoms are no different from those that appear during normal pregnancy. But later signs that signal a pathological process join.
Up to a period of 5-7 weeks, a woman may feel nauseous, sometimes it is accompanied by vomiting. There is increased fatigue, drowsiness. There is a delay in menstruation, and a pregnancy test shows a positive result.
With the onset of 4-8 weeks, additional symptoms join. It is they who should alert the woman and become the reason for contacting the doctor. Among these manifestations:
- pain (pulling sensations in the lower part, giving to the back or leg; girdle backache);
- bleeding from the genital tract (more often the discharge is smearing, they are associated with a decrease in progesterone level).
Aborted tube pregnancy
Violation of the viability of the embryo can be considered an abortion. In this case, it can have two types:
- interrupted tubal pregnancy by type of tubal abortion;
- the cessation of embryo development by the type of rupture of the fallopian tube.
Both conditions are manifested by increased bleeding, pain in the lower abdomen. It is worth noting that rupture of the fallopian tube is characterized by acute pain in the abdominal cavity, decreased pressure and pulse, pallor of the skin, respiratory failure and fainting. This picture is life-threatening, therefore, requires immediate medical attention.
Methods for diagnosing an ectopic pregnancy
How is ectopic pregnancy determined by doctors, tube abortion? Specialists conduct a number of studies to make the correct diagnosis. Among them are the following:
- Gynecological examination. When treating a patient with the described gutters, the doctor first palpates on the chair. In this case, the size of the genital organ is noted, the ovaries are palpated. In some cases, the doctor may determine the presence of a neoplasm (ovum) between the uterus and ovaries. After such an examination, only a preliminary diagnosis is made, since it is not yet possible to say for sure whether it is a tube pregnancy or other pathology.
- The next step in the diagnosis will be ultrasound. After him, the picture clears up. During the procedure, the specialist measures the uterus and ovaries, compares the obtained data with the established day of the cycle. With an ectopic pregnancy, the reproductive organ does not match the gestational age. Also, the uterus does not detect a fetal egg. At a period of 7-10 weeks, the doctor can clearly see the location of the embryo.
Diagnosis of tube abortion is more complicated, it requires a thorough history taking, examination of the patient (objective and vaginal examination, bimanual examination, determination of chorionic gonadotropin in blood serum, ultrasound, laparoscopy). Difdiagnosis is often required.
Laboratory research
Confirm tubal pregnancy can also be done using laboratory diagnostics. For this, the patient must donate blood to determine the level of two substances: progesterone and chorionic gonadotropin. In normal pregnancy, these values are constantly increasing, corresponding to the term. If you get values that are less, there is a chance that the embryo has attached itself outside the uterine cavity.
To make a reliable diagnosis, you need to re-take the analysis after a few days. Positive dynamics or its absence will correctly interpret the situation.
Treatment: is a medical correction possible?
If tubal pregnancy is confirmed, treatment should begin immediately. It is worth saying right away that it is impossible to eliminate the pathology with pills and drugs. Even the means for medical or tablet abortion will not help here. Interruption and elimination of a pathologically located fetal egg is possible only surgically. Correction is always carried out under general anesthesia. Currently, doctors use two methods of treating tubal pregnancy: laparotomy and laparoscopy.
Laparotomy operation
Such an intervention is quite difficult for patients to tolerate. The recovery period lasts from two weeks to several months. During the manipulation, the abdominal cavity is cut in layers. After this, an ectopic pregnancy is corrected.
During laparotomy, a tubectomy is more often performed. In other words, the affected fallopian tube along with the embryo is completely excised. After this, the toilet of the peritoneum is carried out, and the wound is sutured in the reverse order.
Gentle method: laparoscopy
The most popular in recent years is laparoscopic surgery. It involves two to four punctures in the abdominal cavity. Laparoscopy allows you to not completely remove the fallopian tube, but only to excise its damaged area. This operation is called trubotomy.
This method is selected taking into account the age, condition and desires of the patient. Preservation of the fallopian tube allows you to further maintain the reproductive function. However, with repeated ectopic pregnancy, the complete removal of the fallopian canal is indicated.
Heterotopic pregnancy and its features
Rarely enough, but still there are cases when the tubal pregnancy is combined with normal. In this case, one fetal egg is located as described above, and the second - in the uterus.
The possibilities of modern medicine and the high qualification of surgeons make it possible to eliminate a pathologically attached embryo while maintaining the viability of a normal embryo. Note that the sooner a problem is discovered, the greater the chance of a positive outcome.
The consequences of a pregnancy developing in the fallopian tube
If tubal pregnancy is removed, then it is necessary to conduct drug therapy. It provides physiotherapy, acupuncture, the selection of the right contraceptives. Also, a woman needs antibacterial, anti-inflammatory and regenerative therapy.
The consequences of the pathology can be different: it all depends on the duration and method of completing a tubal pregnancy. The probability of a normal conception and subsequent birth is 50%. In 30% of cases infertility occurs (usually with a repetition of the pathology and complete removal of the fallopian tubes). The recurrence rate of an ectopic pregnancy is determined at 20%.
The consequences of the pathology include the adhesion process in the pelvis, pain, menstrual irregularities, hormonal failure, psychological abnormalities. With repeated conception, a woman should from the very first days of delay be under the close attention of specialists. This will help in time to detect and adjust or refute relapse.
To summarize
If you suspect a tubal pregnancy, you should contact your gynecologist as soon as possible. The doctor will be able to dispel or confirm your doubts and, if necessary, prescribe treatment. Remember that during the period of carrying a baby it is unacceptable to be nervous. Therefore, it is better to once again consult with a gynecologist.
If both fallopian tubes were removed during treatment (surgery), do not lose hope. Modern medicine allows you to conceive a child even in this case. To find out more information about this, you need to visit a gynecologist. All the best to you!