A woman who dreams of a baby will be glad to know about her pregnancy. But, unfortunately, the fetus can gain a foothold not only in the uterus. There are many pathologies that threaten the life and health of the expectant mother. Sometimes after an ultrasound, she hears her diagnosis and cannot understand what ectopic pregnancy means? This is a pathology in which the ovum is attached, for example, to the omentum or to the liver.
General information
Ectopic pregnancy is a pathology in which an embryo is implanted outside the uterus, for example, into the fallopian tubes or into the abdominal cavity. A fertilized egg, developing, can break the organ in which it is located. Therefore, ectopic pregnancy is a threat to the life and health of a woman. Only the uterine cavity by nature is intended for the development of the fetus, everything else is dangerous. Ectopic pregnancy ranks 6th in the world for maternal mortality.
After a disease, a woman can remain infertile. Up to 2.4% of pregnancies are ectopic. Until the 20th century, in the presence of this pathology, women always died. Currently, doctors have learned to cope with the disease with minimal complications for the mother.
Ectopic pregnancy is a pathology that can only be detected in a clinic. Home tests, very popular with women, will show 2 strips. This is because pregnancy, even an ectopic, is present. Typically, with this pathology, the second strip is somewhat paler than the first, even if the delay period is already long. Sometimes it is bright at first, and on the next test, which will be done in a couple of weeks, is almost invisible. In this case, the pallor of the second strip is associated with a decrease in the level of hCG. Sometimes a woman feels that she is in position, and tests show one strip. It is likely that this is an ectopic pregnancy. A woman is recommended to visit a doctor as soon as possible.
Classification
There are several types of ectopic pregnancies, they differ in localization. According to scientists from the United States, the number of pathologies for implantation of the ovum has recently increased by 5%. Often an ectopic pregnancy occurs repeatedly, with a high probability this leads to infertility. In 99% of cases, a fetal egg is implanted in the fallopian tubes.
Classification of ectopic pregnancies by type of localization:
- in the abdominal cavity;
- in the rudimentary horn of the uterus;
- in the ovary;
- in the fallopian tube;
- on the cervix.
Science knows cases when a woman had both a normal pregnancy and an ectopic pregnancy. This pathology is most often found in women aged 35 years. Multiple ectopic pregnancy has been described in the medical literature. Science knows several cases when a fetal egg was attached to a liver or omentum, and a woman safely bore a baby. Patients undergoing hormonal treatment for IVF are at risk. Doctors associate a higher number of ectopic pregnancies in these women with hormonal disorders.
Risk group
All sexually active women are at risk, since any of them may have an ectopic ectopic pregnancy. But there are factors that increase the chance of pathology. At risk:
- Women after 40 years. In women after this age, ectopic pregnancy and other pathologists are much more common. While waiting for a child, a woman over 40 should listen to the attending doctor. If the doctor prescribes an extraordinary examination, then this is necessary for the mother and fetus.
- Women with anomalies in the structure of the fallopian tubes and their diseases. Normally, they are located on either side of the uterus. The organs are hollow; their patency should not be impaired. Through the fallopian tube, the egg enters the uterine cavity. With an abnormal structure of the pelvic organs, this may not happen. Then it is very likely that an ectopic ectopic pregnancy occurs.
- Women with neoplasms in the pelvis. Any tumor, whether benign or cancerous, can squeeze the fallopian tubes. Because of this, the likelihood of pathology increases.
- Smoking women are at risk, since the harmful substances contained in cigarettes adversely affect the entire body of the expectant mother.
Another factor is in vitro fertilization. This is due to hormonal treatment and implantation of several embryos. Often in this case, 2 pregnancies occur immediately: one is normal, and the second is an ectopic.
Symptoms
In the early stages, an ectopic pregnancy may, in symptoms, be similar to normal. The woman has toxicosis, menstruation does not occur, but at the same time, tests show either a negative or a weak positive result. In the gynecology department, ectopic pregnancy can be distinguished from normal. This is done by analysis for chorionic gonadotropin. An ectopic pregnancy in this case can be diagnosed at a very early stage.
The doctor during the examination of a woman on a chair already at 3 weeks of gestation will notice a mismatch in the size of the uterus. Ultrasound will also show that there is no normal pregnancy. The further the pathological condition enters, the more suspicions will begin to appear in the woman. With an ectopic pregnancy, vaginal discharge with bloody impurities is present.
A woman may experience pain in the area of the organ to which the fertilized egg has attached. In some cases, the expectant mother will suffer from fainting and bouts of lightheadedness. If a woman is used to measuring basal temperature in the morning, she will soon notice that she has risen. If the embryo was implanted in the fallopian tube, then over time it will tear it. In this case, the woman will have an attack of unbearable pain and bleeding will open.
Causes
Ectopic pregnancy - what is it and why does it occur? There are several reasons that can contribute to the fact that the fetal egg does not fix in the uterus. Factors that increase the risk of developing pathology:
- numerous abortions;
- obstruction of the fallopian tubes;
- first pregnancy ending in abortion;
- chronic inflammatory processes in the pelvis;
- an intrauterine device installed in a woman;
- abnormalities in the development of reproductive organs;
- too young or old woman.
Gynecological surgery can also cause the development of ectopic pregnancy and other complications. Sometimes women do contraceptive fallopian tubes for contraception purposes. Occasionally, this leads to the onset of ectopic pregnancy. The likelihood of pathology increases after suffering diseases that are sexually transmitted. Chlamydia is especially dangerous.
The tendency to ectopic pregnancy can be transmitted from mother to daughter. Therefore, if there were women in the family who were prone to this pathology, you need to think about the hereditary factor. The likelihood of an ectopic pregnancy increases in women who have an erratic sex life. The cause of the pathology may be endometriosis.
Diagnostics
In the early stages, ectopic pregnancy is rarely detected. This happens because initially it does not have pronounced symptoms. Diagnosis of ectopic pregnancy is complicated by the fact that by signs it is very similar to normal. For example, a woman has a lack of menstruation, softening of the uterus, the formation of the corpus luteum. A future mother may experience toxicosis or strange taste preferences.
In order to increase the chances of a favorable outcome, a diagnosis is required as early as possible. A woman needs to be operated on urgently, because an ectopic pregnancy threatens her life. Diagnose pathology using ultrasound. During the procedure, the doctor will notice that there is no fetal egg in the uterus.
Another effective method for detecting ectopic pregnancy is HCG analysis. According to the result of the study, the doctor will immediately understand everything. If the level of chorionic gonadotropin is low, then, most likely, pregnancy develops outside the uterus. If both studies are not clear, then the doctor may recommend laparoscopy. This method allows you to diagnose through small incisions in the abdominal cavity. The operation is completely safe and has almost no contraindications.
Treatment
If an ectopic pregnancy is diagnosed early, doctors can remove the embryo before it breaks the organ to which it is attached. This allows you to save the life of the patient, and most often - and reproductive function. After the operation, the woman will be able to become pregnant and bear a healthy child after some time. But you need to plan the baby only after consultation with a gynecologist, this will avoid such problems in the future.
Ectopic pregnancy is treated surgically. The most preferred method is laparoscopy. This method is the least traumatic, it rarely leads to complications. A pregnant woman is injected into anesthesia, and an instrument penetrates her into the abdominal cavity through small holes. The progress of the operation is constantly monitored using an ultrasound machine. The doctor discovers a fetal egg and removes it; in some cases, the fallopian tube is removed at the same time. When conducting laparoscopy, blood loss is minimal, and the likelihood of complications is minimized. Patients usually recover quickly after surgery.
If it is impossible to do a gentle operation for any reason, then a laparotomy is performed. With this type of intervention, the abdominal wall is completely cut, which gives good access to internal organs. This operation is more dangerous than laparoscopy. Usually it is used in cases where there is a threat to the life of the pregnant woman and you need to act quickly.
Rehabilitation
After surgery, a woman will need time to recover. Rehabilitation after an ectopic pregnancy includes seam care, diet, and psychological support. If the intervention was laparoscopic, then recovery will be faster. Sutures are removed after 10-14 days. Until this moment, the patient should keep them dry and clean.
During rehabilitation after an ectopic pregnancy, a woman should monitor her diet. This is especially important in the early days. The patient should consume foods that will be well absorbed, for example, cereals, yoghurts, light broths. Gradually, a woman can expand her menu, focusing on well-being.
In the first 2-3 weeks, the patient should abandon physical activity, including sexual contacts. Gynecologists recommend planning the next pregnancy in 1-2 years, by this time the woman will have time to undergo the necessary treatment and recover after the operation. The minimum term is 6 months. If, after the operation, a natural pregnancy is impossible, then the woman can undergo the in vitro fertilization procedure. The patient is recommended to visit a psychologist for some time, the doctor will help her again to look positively at the world.
Effects
Ectopic pregnancy often gives complications, and sometimes undermines a woman’s health. In the early stages of gestation, uterine bleeding is possible. If it is not possible to timely identify that the pregnancy was an ectopic pregnancy, then a fallopian tube rupture is likely. If the pathology was noticed in the early stages, then during the operation in some cases not only the embryo is removed. If the embryo is attached to the ovary, then it can be removed, or a resection can be performed. If an ectopic pregnancy developed in the fallopian tube, then in some cases it is removed along with the fetus.
In some cases, the fertilized egg exfoliates itself, at which time the woman experiences terrible pain. Doctors call this situation a spontaneous tube abortion. In this case, there is a threat to the woman’s life, she urgently needs to go to the hospital. Another complication after an ectopic pregnancy is infertility. If both fallopian tubes have been removed, then natural conception is no longer possible. Women who have had an ectopic pregnancy have an increased chance that the next one will also be an ectopic. If the future mother’s fallopian tube bursts without carrying the load, then she may die.
Prevention
Clinical recommendations for an ectopic pregnancy should be discussed with the attending gynecologist. All cases are individual, but there are situations that should be avoided. In order to prevent the development of repeated ectopic pregnancy, it is necessary:
- Avoid abortion, they cause irreparable damage to women's health. In addition, termination of pregnancy is the main factor provoking the occurrence of ectopic pregnancy.
- Use contraceptive methods recommended by a gynecologist.
- Choose the least traumatic methods of abortion, if it is undesirable. For example, with the help of drugs.
- Avoid inflammation of the pelvic organs, especially associated with sexually transmitted diseases.
- Observe a gynecologist and follow all his instructions. This will help the woman in the future to give birth to a healthy baby.
Before planning to carry a child, a woman who has a history of ectopic pregnancy should be tested. Consultation of at least 2 doctors is required - a gynecologist and an endocrinologist. If both fallopian tubes are removed, then the woman needs to start preparing for in vitro fertilization.
Gynecologist's recommendations
Some women after surgery are afraid that in the future they will not be able to bear the baby. Most often, these fears are groundless. If the patient listens to the recommendations during an ectopic pregnancy, then, most likely, after a while she will give birth to a healthy baby.
For at least 6 months, the patient should be protected. Most often, the doctor prescribes either vaginal suppositories or oral contraceptives. Six months later, a woman should be tested for hormones and discuss them with a gynecologist and endocrinologist. If no problems were identified using the study, then you can go to the next step. Both a woman and her partner should be tested for sexually transmitted diseases. After this, you need to go through a study of the pelvic organs.
Sometimes a doctor may prescribe other tests, such as an x-ray of the fallopian tubes. Repeated ultrasound or any tests may also be required. If all the results are good, then the woman is allowed to become pregnant.