Can ectopic pregnancy occur when lifting heavy objects? Why does ectopic pregnancy occur?

Why is it important to know about ectopic pregnancy? I’ll retell the story of one young woman I heard in a antenatal clinic.

“It all started as usual: I had a delay and felt a little dizzy. I ran to the pharmacy for a pregnancy test, performed a simple procedure and saw two stripes. My joy knew no bounds: I am PREGNANT!!! In the evening my husband came, I told him this wonderful news, he was also incredibly, fabulously happy. I was just flying around for a week, we were already starting to think about a name, imagine what the children’s room would be like...

One morning I felt a nagging pain in my lower abdomen, side and lower back at the same time. I went to the gynecologist. The doctor briefly examined me, listened to me, chuckled and said that I was not pregnant, but just a cyst. “Reassuring” me with the words “tests sometimes lie,” the doctor prescribed treatment for the cyst. I was treated properly, but after a few days strange brown discharge, severe pain. My husband could not stand the sight of my suffering and called an ambulance. The doctors initially thought I had appendicitis. As it turned out, it was good that they suspected such a dangerous disease and very quickly took me to the hospital. In fact, my tube burst... It was an ectopic pregnancy. Thanks to the ambulance team and the surgeon who operated on me. Although I now only have one tube, I was allowed to get pregnant a year later, after a course of vitamins and other procedures aimed at restoring the body so that the next pregnancy would be normal.”

Ectopic pregnancy - Very serious problem, because it is often the cause of female infertility. However, if it is diagnosed in time, the prognosis is likely to be favorable - a woman who has had an ectopic pregnancy will be able to become pregnant normally in the future.

In order not to miss the opportunity for a favorable outcome, it is important to know what an ectopic pregnancy is, why it occurs and how it manifests itself. At the first symptoms, you should consult a doctor.

Answered our questions about ectopic pregnancy Lyudmila Pavlovna Shishova, gynecologist at the Diagnoz medical center.

— What is an ectopic pregnancy?

— To answer these questions, you must first recall how pregnancy begins in general. The fertilized egg descends through the fallopian tube into the uterine cavity and attaches to the most favorable area of ​​the mucous membrane. If this mechanism fails, then the fertilized egg attaches “in the wrong place.” Most often, attachment occurs in the fallopian tube, sometimes on the ovary or in the abdominal cavity. In this case, doctors talk about an ectopic pregnancy.

— Why is an ectopic pregnancy dangerous?

“This is a big threat to the mother’s life.” If the embryo is implanted outside the uterus, then there is a risk of rupture of the organ to which it is attached. The uterus is elastic because it is designed to accommodate a growing fetus, and the fallopian tubes are too narrow to stretch as much. If a rupture occurs, the woman will bleed heavily. In addition, if an ectopic pregnancy “goes too far,” then everything may end in an operation, after which it will be difficult to get pregnant.

— What are the symptoms of an ectopic pregnancy?

— First of all, these are all the symptoms of a normal pregnancy: delayed menstruation, nausea, enlarged mammary glands, enlarged uterus. Sometimes there is no delay, but periods are more scanty, there may be dizziness and even fainting, pain in the abdomen or pelvis. As a rule, an ectopic pregnancy does not manifest itself in any special way until spontaneous termination occurs. In this case, the woman experiences sharp stabbing pain, and uterine bleeding begins. If it comes to this, you need to urgently call an ambulance.

— At what time does this usually happen?

— It all depends on where exactly the fruit is attached. Roughly speaking, the sooner he no longer has enough space, the sooner the interruption will occur, usually from two to six weeks.

- Why does ectopic pregnancy occur?

- There are several reasons. The most common of them is poor patency of the fallopian tubes. It may be due to the fact that there are adhesions, narrowings or scars in the pipe; in addition, the pipe itself may be excessively tortuous and therefore impassable. Often such pregnancy occurs against the background of long-term inflammatory processes of the internal genital organs (including those caused by sexually transmitted infections). Infantilism - that is, insufficient development of the female genital organs - can also cause ectopic pregnancy. In addition, women who have had an abortion and those who take drugs to stimulate ovulation and increase fertility (“fertility”) are also at risk.

— How is an ectopic pregnancy diagnosed?

— Modern medicine makes it possible to make or refute this diagnosis quite early. First, you need to establish pregnancy using an hCG test or test strip. If there is a suspicion of an ectopic pregnancy, the woman is offered to go to the hospital.

-Why is it necessary to go to the hospital?

“Only in a specialized institution equipped with modern equipment can the necessary research be carried out, the diagnosis be finally clarified, and the location of the embryo be determined - in the uterus or outside it. Please note: the earlier an ectopic pregnancy is diagnosed, the less negative consequences it will have on a woman’s health. coronary angiography coronary angiography of cardiac vessels Diagnostics of coronary artery disease

— How does termination of an ectopic pregnancy occur?

— Which method of surgical intervention the doctor will choose depends on what stage the pregnancy is at. If the pathology is detected before spontaneous abortion, that is, the sac of the fertilized egg is still intact, a low-traumatic method is used - laparoscopy. The surgeon inserts the instrument through a small incision in the skin. With such an intervention, the surrounding organs and tissues are practically not injured, there is no severe bleeding, and the risk of formation of adhesions and scars is significantly less. If a pathological pregnancy is spontaneously terminated, then large blood loss occurs. In this case, the operation is more complex and requires a blood transfusion.

— The most important question that interests all women who have had an ectopic pregnancy: is it possible to get pregnant after this?

- In most cases - yes. But for this you need to undergo a special rehabilitation course, Special attention should be given to contraception. Often, after an ectopic pregnancy, a woman loses one fallopian tube. But sometimes, with the help of a laparoscope, it is possible to simply “suck out” the fertilized egg in approximately the same way as a mini-abortion. It is important that during such operations the pipe is preserved and continues to function. If an ectopic pregnancy is detected in time, it does not pose a serious threat to the life and health of a woman.

A normal pregnancy occurs without fever or any pain. Signs of toxicosis are not pathology.

A woman should be alert to pain in different body positions and general soreness. It is very important to do an ultrasound early stages, since some types of ectopic pathology pass without symptoms.

If the fertilized egg is attached to the tube, then the woman will begin to worry about her health at the 8th week of pregnancy. If the isthmus becomes such a place, then unpleasant symptoms will begin as early as 5 weeks.

Ectopic pregnancy: clinical picture

In the first trimester, the signs of pathology are almost identical to the symptoms of normal pregnancy, therefore, it is possible to determine that the fertilized egg is attached outside the uterus only using special methods, for example, ultrasound diagnostics.

It is for this reason that gynecologists strongly recommend that in the absence of menstruation on time, contact a supervising specialist. The only symptom that distinguishes an ectopic pregnancy from the normal process of embryo development in the first trimester is minor painful pulling sensations in the lower abdomen, which will intensify as the fetal embryo grows.

Important. Statistics show that almost half of women ignore recommendations about early production registered with antenatal clinic(10-12 weeks).

Such carelessness can end badly, since after the 8th week of an ectopic pregnancy, the risk of fallopian tube rupture is almost 70%. Expectant mothers should know that positive result when used at home, test strips will be detected even if the fertilized egg is stuck outside the uterus, since hCG level increases regardless of the location of the embryo.

Signs and symptoms

It is impossible to say exactly at what time the fallopian tube will rupture. Sometimes the tube bursts at 4-6 weeks, but in most cases it happens between 8 and 12 weeks of gestation. In terms of averages, the most common time frame for a fallopian tube rupture is between 4 and 12 weeks.

When exactly this happens depends on many factors:

• the woman's health status;
• the presence of pathologies in the formation of fetal tissues;
• individual growth and development rates of the fetus;
• fallopian tube size, etc.

This process is indirectly influenced by a woman’s lifestyle. If future mom eats a lot of vegetables and fruits, the fruit grows more intensively, and there is less space in the pipe.

Early rupture

It is very rare, but in the practice of obstetricians and gynecologists there are cases when a rupture occurs at very early stages (up to 4 weeks). This situation is possible if the fertilized egg is fixed in a place where the diameter of the organ itself does not exceed 2-3 mm (the isthmic part of the fallopian tube).

In this case, the pipe may burst even before the woman finds out about pregnancy.

Positive prognosis in in this case depends on how quickly a woman seeks the help of doctors, so if any signs of rupture of the fallopian tubes appear, you should immediately call “ ambulance"or go to the hospital if you can get there quickly.

Important! If a woman goes to the hospital on her own, it is better to take a lying position in the car - this will help reduce blood loss and relieve pain. painful sensations.

Late rupture

The maximum size of the fertilized egg that the fallopian tube can hold is 5 mm. The most favorable situation is when the fertilized egg is fixed in the lower part of the tube, which directly borders the uterus.

In this zone, the elasticity of the tissues is higher, so there is a possibility that the pathology will be diagnosed earlier than the size of the embryo reaches the values ​​at which rupture usually occurs (provided that the woman applies for registration in due time).

Fact! According to statistics, most cases of ruptured fallopian tubes occur between 8 and 12 weeks, so with a responsible approach to their own health, a woman has every chance to avoid serious complications and detect an ectopic pregnancy at an early stage.

An ectopic pregnancy is a dangerous pathology, therefore, if signs of pregnancy appear ( positive test, dizziness, nausea) women must immediately register with the antenatal clinic. Only timely identification of the problem will help to take timely measures and prevent serious consequences, the worst of which is death.

A ruptured tube during an ectopic pregnancy is a dangerous condition that can lead to death. Therefore, it is important to promptly diagnose the condition and remove the pathological embryo. Depending on where exactly in the pipe it is attached, the rupture period may vary. In wider areas of the pipe it is larger, in narrower areas it is smaller.

When an ectopic pregnancy is terminated due to a ruptured fallopian tube, a severe acute condition develops. It requires immediate surgical intervention and hospitalization of the patient. If this is not done, death may occur. Moreover, quite quickly. Therefore, it is important to know what signs and symptoms this condition has:

1. Sharp abdominal pain, mostly one-sided, radiating to the lower back and hips;
2. Cold sweat;
3. A sharp decrease in blood pressure;
4. Severe pulse lability;
5. Brief loss of consciousness.

If you observe such symptoms, regardless of the expected duration of the IMP, you should consult a doctor. This condition can develop rapidly, or a little more slowly. But it is always acute, so you can’t put off seeing a doctor.

VMB is dangerous in itself. Fallopian tube rupture is a serious condition. It is accompanied by severe pain shock, changes in pulse and blood pressure. Can lead to prolonged loss of consciousness and a critical decrease in blood pressure, shock.

In addition, the damage is accompanied by a significant release of free blood into the abdominal cavity. This can provoke hemorrhagic shock and severe anemia. May also lead to sepsis. And sometimes to peritonitis. Each of the conditions, and even more so in combination, can lead to the death of the patient.

You can read more about what complications an ectopic pregnancy leads to in the article “Consequences of an ectopic pregnancy.” However, with timely treatment, most of the negative consequences can be avoided. But if the fallopian tube ruptures, the consequences can be more severe.

Obstruction of the fallopian tubes can develop for the following reasons:

• STD ( sexually transmitted diseases);
• uterine polyps;
• mechanical damage to the uterine mucosa and fallopian tubes;
• inflammation of neighboring organs;
• squeezing the pipe from the outside;
• functional disorders;
• surgical tubal ligation;
• birth defects.

Sexually transmitted diseases

Sexually transmitted diseases are perhaps the most common cause of tubal obstruction. As a result of life activity

An inflammatory process develops in the genitourinary tract, which can lead to a variety of consequences. For example, during acute inflammation, the lumen of the fallopian tubes may close due to swelling of the mucous membrane. After the inflammatory process subsides, healed areas may remain in the uterine cavity (

intrauterine

), which also lead to tubal obstruction. In addition, many

primarily viral

) increase the risk of developing tumors in the uterus.

or polyps caused by infection may, during their growth, block the lumen of the fallopian tubes.

If any of these diseases is present, the patient's risk of developing fallopian tube obstruction increases greatly. Basically, this occurs when the infection is chronic, when we are not talking about acute inflammation, but about structural changes in tissues.

Thus, timely diagnosis and treatment of sexually transmitted diseases can prevent the development of tubal obstruction in the future.

Uterine polyps

Uterine polyps are benign neoplasms that develop from the inner lining of the organ wall. Their base (

attachment site

) is almost always located in the uterine body cavity or in the cervical canal. However, in rare cases, the presence of polyps can cause blockage of the fallopian tubes. This happens when the polyp reaches a sufficiently large size (

a few centimeters

) and is located in the upper part of the organ. Then the neoplasm tissues, growing, block the opening of the fallopian tube. In the vast majority of cases, this process is one-sided.

Mechanical damage to the uterine mucosa and fallopian tubes

Mechanical damage to the uterine mucosa and fallopian tubes is usually the result of medical or diagnostic procedures. For example, after an abortion using the method

curettage of the uterus

) adhesions may remain in the organ cavity. This phenomenon is called Asherman's syndrome and can cause tubal obstruction. Although adhesions are not located directly in the lumen of the tubes, strands of connective tissue can close the openings connecting the tubes to the uterine cavity.

In more rare cases, scars on the lining of the uterus form after hysteroscopy (

examination of the uterine cavity using a special camera

) or other diagnostic procedures.

Mechanical damage to the mucous membrane is often observed in patients who have resorted to intrauterine contraception. First of all, we are talking about spirals that are introduced into the organ cavity to prevent

Despite the fact that these devices are made from special safe materials, the risk of injury is still present. Damage often occurs when attempting to insert or remove coils on your own.

In response to mechanical damage, an inflammatory process develops. The uterine cavity is not normally sterile.

This means that it contains a fairly large number of opportunistic microbes. With a healthy mucous membrane, these microorganisms do not cause disease.

However, mechanical damage makes the uterine tissue vulnerable. After prolonged and widespread inflammatory processes, adhesions may remain in the organ cavity, which, as mentioned above, often contribute to tubal obstruction.

Inflammation of neighboring organs

In the vast majority of cases, tubal obstruction does not manifest itself with any specific symptoms. All serious complaints with which patients come to the gynecologist are usually caused not by the obstruction itself, but by the underlying disease that caused this syndrome.

In this regard, the manifestations and symptoms of the disease are divided depending on the causes and complications.

Clinical manifestations in patients with tubal obstruction may be as follows:

• symptoms of isolated tubal obstruction;
• symptoms of obstruction caused by acute inflammation;
• symptoms of obstruction caused by adhesions;
• symptoms of ectopic pregnancy.

Symptoms of isolated tubal obstruction

Direct tubal obstruction leads to only one important clinical manifestation - infertility. This is explained by the fact that the physiological mechanism of fertilization of the egg is disrupted. Infertility is diagnosed one year after married couple started regularly trying to have children (

refused contraceptive methods

). In the absence of acute processes in the pelvis, the patient may not have other manifestations of tubal obstruction.

Symptoms of obstruction caused by acute inflammation

In case of an acute inflammatory process, moderate or acute pain in the lower abdomen is added to infertility. As a rule, the pain intensifies with physical activity, sudden movements, during sexual intercourse. Specific sign is an increase

and mucous membranes (

less often mucopurulent or foamy

The pain is explained by mechanical compression of the inflamed area, which leads to irritation of pain receptors. Temperature and discharge are signs of active reproduction of pathogenic microbes.

Symptoms of obstruction caused by adhesions

During the adhesive process, unlike an infectious or inflammatory process, the temperature does not rise. The leading symptom is pain in the lower abdomen, which also intensifies with mechanical irritation. In this case, this is due to stretching of the adhesions.

Symptoms of ectopic pregnancy

Ectopic pregnancy is usually early stages manifested by nagging pain in the lower abdomen and amenorrhea. This is explained by the gradual growth of the embryo in the tube and the stretching of its walls. Patients often seek help only when the embryo reaches a significant size and no longer fits in the lumen of the tube.

Late symptoms of an ectopic pregnancy may include:

• sharp pain in the lower abdomen;
• massive bleeding;
• painful shock (sharp drop in blood pressure);
• fainting;
• urinary disorders;
• increase in temperature (due to rupture of the fallopian tube and the development of pelvioperitonitis).

Diagnosis of fallopian tube obstruction is of great importance, as it completely determines treatment tactics. The main goal of diagnostic procedures and examinations is not only to identify the very fact of obstruction, but also to accurately determine the reasons that led to it.

Currently, there are quite a large number of methods that make it possible to obtain accurate and unambiguous data on the pathology of a particular patient.

The main methods used in the diagnosis of fallopian tube obstruction are:

• Ultrasound of the pelvic organs;
• endoscopic methods;
• radiocontrast methods.

Ultrasound of the pelvic organs

ultrasonography

) of the pelvic cavity is performed using a special apparatus that sends sound waves into the thickness of the tissue. The method is based on obtaining an image by receiving reflections from internal organs waves

In this case, clear boundaries between anatomical formations are obtained due to the fact that each tissue has a certain density and is capable of reflecting only a certain number of waves.

During ultrasound, special attention is paid to structures located in close proximity to the fallopian tubes. A search is underway for adhesions or neoplasms. In case of massive tissue swelling or intense inflammatory process, the specialist will also note these changes.

The device makes it possible to establish the exact dimensions and location of various anatomical formations. Thus, the doctor will receive data to confirm or refute the diagnosis.

Ultrasound is painless and safe method. It is allowed at any stage of pregnancy and for almost any chronic disease. The examination usually lasts from 5 to 15 minutes and gives immediate results.

Endoscopic methods

Endoscopic examination methods involve insertion into the uterine cavity (

hysteroscopy

) or into the pelvic cavity (

) a special camera on a flexible wire. With its help, the doctor examines the condition of the internal organs. The advantage of the method is that it gives an unchanged picture - the doctor sees the tissue live on a special monitor. The downside is the invasiveness of the examination. Insertion of the camera may be painful and requires the use of topical

. Before the procedure, the patient may be prescribed sedatives (

Typically, the procedure lasts about half an hour if the camera is inserted through the body's natural orifices (

vagina, cervix

). If we are talking about introducing a camera into the pelvic cavity, then for this it is necessary to make several incisions on the anterior abdominal wall. Then the procedure may be delayed.

The following pathological processes can be detected using endoscopic examination:

• adhesions in the pelvic or uterine cavity;
• congenital defects in the development of fallopian tubes;
• twisted pipes;
• neoplasms of the pelvic organs;
• acute inflammatory processes;
• mechanical damage to the mucous membrane.

X-ray contrast methods

X-ray contrast methods are a set of methods based on obtaining images using x-rays. If tubal obstruction is suspected, an examination with contrast is recommended.

This is a special substance that appears different in color from other tissues on an x-ray. As a rule, radiocontrast agents have a uniform White color (.

more pronounced than bone tissue

), while the tissues and cavities of the body are represented by darker areas.

Treatment of fallopian tube obstruction should be focused on eliminating the cause that caused this problem. For this purpose, before starting a course of treatment, and especially before performing surgery, a thorough examination of the patient is carried out.

As already mentioned, symptoms of an ectopic pregnancy only appear in the middle of the first trimester. At an early stage, identifying the disease is difficult.

In the first weeks, pathology can only be seen in ultrasound photographs, so it is recommended to undergo an ultrasound immediately if the immunochromatographic test is positive. You should also go for an examination if you experience pain.

Immediately after abnormal fertilization, the same processes occur in the female body as after a normal pregnancy. However, over time, the disease makes itself felt.

The time at which painful symptoms appear during ectopic gestation depends on the location of implantation of the fertilized egg. However, no matter how long it appears, this is an alarming manifestation.

If pain appears during an ectopic pregnancy in the early stages, this may indicate attachment of the egg to the fallopian tube. Severe pain warns of rupture of the fallopian organ.

This condition has an abrupt onset. The patient feels sharp pain, increased heart rate, and a drop in blood pressure.

A pipe rupture is accompanied by profuse bleeding.

Discharge

It is impossible to say exactly how long it will take for a pipe to burst. This happens both in the fourth week (which is rare), and the fetus can grow up to the sixteenth week of pregnancy.

It all depends on where exactly the egg is located. Most often, a tube rupture occurs between 6-8 weeks of pregnancy. A pipe rupture does not occur asymptomatically - the pain is detected first in the lower abdomen, on one side, it intensifies and becomes acute.

When the fallopian tube ruptures, the following is noted:

• drop in blood pressure;
• pallor skin;
• painful sensations at this time can lead to loss of consciousness;
• Vaginal bleeding may not occur.

If a pipe ruptures, the woman must be urgently hospitalized for emergency care.

Treatment after a ruptured fallopian tube involves:

• restoration of reproductive function;
• preventing the formation of adhesions;
• normalization of hormonal balance;
• development of methods of reliable contraception.

After surgery, the patient remains in the inpatient department for several days.

At this time, intravenous administration of fresh frozen plasma and saline solutions is indicated. It is necessary to prevent infectious processes. For this, drugs such as Cefuroxime or Metronidazole are used. To reduce the risk of adhesions, enzymes are administered intramuscularly.

A week later, it is recommended to begin physiotherapeutic treatment using magnetic therapy, electrophoresis, and laser therapy. Discharge from the hospital after laparotomy occurs on days 7-10. The sutures can be removed on the 7-8th day after surgical treatment.

During rehabilitation, a woman should take reliable contraceptives.

The duration of the recovery period is determined by individual indicators.

Typically, the course of taking contraceptives lasts for six months.

At the end of this period, diagnostic laparoscopy is performed to assess the condition of the pelvic organs and the likelihood of conception.

If the results are considered positive, you can plan a pregnancy after the next cycle.

To avoid the risk of rupture of the fallopian tube, you should be attentive to your health and not neglect the treatment of infectious and inflammatory processes.

Simple prevention of gynecological diseases significantly reduces the likelihood of tubal pregnancy.

At the very beginning, an ectopic pregnancy is no different from a normal pregnancy. A woman may be concerned about the absence of menstruation, soreness and engorgement of the mammary glands, nausea, vomiting, dizziness, weakness, and drowsiness.

Only after some time do symptoms appear that are not typical for the course of the disease normal pregnancy. This occurs as a result of the growth of the embryo and the application of pressure on the walls of the pipe.

With an ectopic pregnancy of 3-4 weeks, the following symptoms appear:

• - the appearance of dark bloody discharge from the vagina in scanty quantities;
• - periodic nagging, sometimes paroxysmal pain in the groin area on one side;
• - pain during intercourse.

With timely diagnosis of ectopic pregnancy, it became possible to use surgical treatment methods with preservation of the uterine appendages through laparoscopy.

Fallopian tube rupture or ectopic pregnancy

In cases where an ectopic pregnancy has not been diagnosed, overstretching and rupture of the fallopian tube occurs at approximately 5-8 weeks. This acute, life-threatening condition is clinically manifested by:

• - acute pain in the lower abdomen, from the side of the damaged tube, radiating to the shoulder blade, back, shoulder;
• - development of a state of shock (sharp drop in blood pressure, loss of consciousness, increased heart rate, cold sweat);
• - severe internal bleeding into the abdominal cavity;
• - presence of bloody discharge from the genital tract.

When a fallopian tube ruptures, depending on the speed of treatment medical care A woman's life depends. In this case, along with anti-shock therapy, urgent surgery– laparotomy, during which the fertilized egg and damaged fallopian tube are removed and internal bleeding is stopped.

Consequences of ectopic pregnancy

When ectopic pregnancy is diagnosed in the early stages, in most cases the outcome is favorable. Even with the complete removal of one fallopian tube, a woman has every chance of developing a normal pregnancy.

The main condition is to plan pregnancy no earlier than six months after the ectopic pregnancy. In addition, you need to install exact reason development of ectopic pregnancy and eliminate this unfavorable factor in order to prevent relapses.

If it was not possible to detect an ectopic pregnancy in time, an unfavorable outcome is possible:

• - development of inflammatory processes in the pelvic organs;
• - development of adhesive disease;

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Ectopic pregnancy in the early stages is not accompanied by any pronounced symptoms.

As the organ stretches and the fetus grows, the following signs are observed:

• after a 10-15 day delay, a small amount of bleeding appears;
• With the development of an ectopic pregnancy, bleeding intensifies. The discharge becomes dark, almost black, and contains a small amount of clots.

• sharp unbearable pain in the left or right pelvic area. The pain can radiate to the anus, hypochondrium and upper abdomen;
• nausea, vomiting, dizziness;

As the embryo grows and develops, the cells of its mucous epithelium gradually corrode the walls of the tube. Under the influence of any traumatic moment (sudden movement, push, lifting of weight, difficult defecation), the pipe ruptures.

A rupture of the fallopian tube is accompanied by sharp and severe pain in the lower abdomen, lower back and anus. At this moment, blood from the damaged vessels pours into the peritoneal cavity.

When the tubes rupture during an ectopic pregnancy, a woman feels nausea, the urge to defecate, and severe dizziness. Cold sweat appears on the forehead, lips turn blue, skin turns pale, and pupils dilate. This condition requires immediate hospitalization and surgery.

Treatment methods of modern medicine make it possible to preserve the reproductive function of the female body if the patient seeks help in a timely manner.

If you are faced with your first ectopic pregnancy, then do not despair, because with proper and timely treatment, you will certainly be able to give birth to a baby in the future.

The rupture of the fallopian tubes depends on the age, shape and location of the embryo. If the pipe is smooth, without bends, with a wide part, then the fruit can remain there for up to two months. Moreover, you won’t even notice anything until it starts pressing on the walls. The tubes cannot stretch much, so rupture occurs at 6-8 weeks.

If the fetus stops in the middle, then a rupture cannot be avoided within a maximum of 5 weeks. that is the narrow part, it can only stretch up to 2 mm.

As soon as the embryo becomes larger, severe pain will begin from attempts to stretch the tube under itself. Bloody discharge will appear as a sign of injury to the pipe itself.

Usually a woman has only a few days to avoid a rupture.

But sometimes the fruit goes down and attaches to the very bottom of the pipe. that is a very unfortunate place, because the uterus begins there.

that place is well supplied with blood and due to the dense layer of muscles, the embryo can develop there perfectly for up to 15 weeks. The woman does not feel any pain or stinging.

And only when the fetus begins to gain weight more rapidly can it fall into the peritoneum. then indications for immediate surgery.

As a rule, the initial symptoms of this condition manifest themselves within 2 to 12 weeks. The exact period of onset of symptoms depends on the functioning of the woman’s body (for example, on the level of her pain threshold).

The organ where the ectopic pregnancy occurred is also of great importance. How long a pipe can burst depends directly on the nature and period of onset of symptoms.

Doctors warn that in addition to a positive test result, ectopic pregnancy may be indicated by:

• Drawing or sharp cutting pain in the lower abdomen, directed to the lower back and rectum.
• Nausea or vomiting.
• General weakness, dizziness.
• Painful sensations when visiting the toilet.
• Scarce bleeding from the vagina.
• Chills combined with increased body temperature.

Experts remind that in most cases, the negative consequences of ectopic pregnancy are the result of late consultation with a doctor. Even when they notice unpleasant symptoms, many ladies delay going to a medical facility, not realizing the seriousness of the situation.

The diagnosis of “ectopic pregnancy” sounds like a bolt from the blue and does not fit into the idyllic picture of future motherhood at all... However, according to statistics, in Russia one woman out of a hundred faces a similar problem. It's scary to think about, but nevertheless, it's worth learning more about ectopic pregnancy, then it will be easier to avoid it.

An ectopic pregnancy is a pathology of gestation when the embryo implants and develops not in a “specially designated place” - the uterus, but outside it. How dangerous is this? Judge for yourself, pathology is the main cause of death for women in the first trimester of pregnancy, because the risk of death in this case is 10 times higher than during childbirth, and 50 times higher than during an induced abortion.

The pipe is a bad place

Around the middle of the menstrual cycle, an egg is released from one ovary into the abdominal cavity. She carries half the genes of the future baby and some nutrients that will be enough for him for the first time. From the abdominal cavity, the “traveler” enters the fallopian tube, where sperm await her. During the “touching” meeting, fertilization occurs. After this, armed with a full set of genetic information, the egg rushes to the uterus - the ideal container for the fetus. In any other organs and conditions its further development is simply impossible.

Now imagine that a woman previously had inflammatory diseases of the appendages. She successfully cured them, and since then nothing has bothered her. But during the period of that first, aggressive inflammation, the inner lining of the fallopian tubes stuck together, resulting in the formation of adhesions. By themselves, they do not cause inconvenience, but they create obstacles to the movement of the fertilized egg. Because of them, it does not have time to reach the uterus and is attached wherever necessary: ​​in 95% of cases of ectopic pregnancy - to the mucous membrane of the tube, less often - to the ovary, cervix or any organ in the abdominal cavity.

Having settled in the “wrong place”, the fertilized egg begins to grow and stretch its container. After some time, usually at 7–8 weeks, the developing embryo runs out of nutrients, and the wall of the tube, which is no longer able to stretch, bursts or contracts, expelling the fertilized egg. Thus, the pregnancy is terminated. But losing a child is not the worst thing. The fact is that in the process of its development, the fertilized egg creates a placental platform for itself - the very place through which the embryo receives oxygen and nutrients. When the pregnancy is terminated, this area of ​​tissue begins to bleed. If it is also “joined” by a broken pipe, the woman can die in a matter of hours.

Reasons for concern

To avoid such a development of events, the expectant mother should immediately consult a doctor at the slightest suspicion of an ectopic pregnancy. The first alarming symptom is a fuzzy second line on a home rapid test. The contours may be blurred due to the fact that the level of a hormone called human chorionic gonadotropin is slightly lower during an ectopic pregnancy than during a normal pregnancy. However, this indicator does not provide an absolute guarantee that the egg is “stuck” in the tubes. There are more specific signs that 90% confirm the presence of pathology: short - no longer than two weeks - delay of menstruation and dark brown spotting, accompanied by attacks of cramping, but not passing very quickly. severe pain lower abdomen.

But, unfortunately, these symptoms do not always appear. There are times when a woman does not feel any discomfort and does not even realize that she is pregnant. Therefore, suddenly appearing signs of internal bleeding - nausea, acute pain in the lower abdomen, which often radiates to the shoulder, shoulder blade and neck, dilated pupils, shallow breathing and a barely noticeable pulse - can, unknowingly, be easily attributed to appendicitis or poisoning. Her suspicions are confirmed by the absence external signs: bleeding does not break out, but “goes” into the abdominal cavity. Therefore, instead of calling an ambulance, many pregnant women expect everything to go away on its own. And delay in this case is fraught with death.

Delete or leave?

The only treatment for a ruptured ectopic pregnancy is removal of the burst tube. This procedure is necessary for several reasons: firstly, it stops the bleeding, and secondly, the injured organ will never function again anyway. The operation can be done laparotomically (through an incision in the abdomen) or laparoscopically (through small punctures). The doctor decides which option to prefer, and often he does not choose the second, more gentle method. This method requires careful preparation, for which there is simply no time.

As for progressive ectopic pregnancy, when a woman consults a doctor at an early stage, in most cases the operation is performed laparoscopically. However, you can do without surgical intervention: restore the tube and remove the fertilized egg or inject chemicals into it so that it resolves on its own. But both options are not nearly as good as they seem. In the first case, the risk of a repeat ectopic pregnancy is too great; in the second, serious complications are possible. After surgery, the woman must undergo a course of anti-inflammatory therapy. Since the second tube remains intact, the young lady can plan her next pregnancy, but not earlier than after 6 months. You should take precautions for the next six months.

How to prevent trouble?

If you do not have congenital defects of the genital organs and you try your best to protect yourself from infections and inflammatory processes or treat them in a timely manner, you have every chance of avoiding an ectopic pregnancy. It is also important to eliminate in time hormonal disorders and plan for future pregnancies. If you are already expecting a baby, see a gynecologist right away to find out if the fetus is developing normally.

Women at risk

* ... have had inflammatory diseases of the uterine appendages (the most dangerous is chlamydial infection, which increases the risk of developing an ectopic pregnancy by 7 times);

* ...those who have already experienced an ectopic pregnancy (the risk of recurrent pathology increases by 7–13 times);

* ...protected by an intrauterine device and hormonal contraceptives;

* ...who have undergone operations on pipes;

* ... having tumors of the uterus and appendages and abnormal development of the genital organs;

* ...suffering from endometriosis;

* ...have had abortions;

* ...who used assisted reproduction methods (IVF);

* ...over 35 years old.

Website illustrations: © 2011 Thinkstock.

Ectopic pregnancy occurs when implantation of a fertilized egg occurs not in the uterine cavity, but in another place. Pregnancy begins from the moment the sperm and egg merge. Normally, a fertilized egg, or zygote, attaches to the lining of the uterus.

Most often, an ectopic, or ectopic, pregnancy develops in one of the fallopian tubes through which eggs enter the uterus (fallopian tubes). This type of pathology is also known as tubal pregnancy. However, in some cases, an ectopic pregnancy develops in the abdomen, ovary, or cervix.

• Ectopic pregnancy.
• Cannot be completed and must be aborted.
• Involuntary abuse.

Ectopic or ectopic pregnancy is a dangerous complication in which the embryo implants and begins to develop outside the uterine cavity. Depending on the site of implantation of the embryo, such a pathology can have consequences of varying severity. In any case, at the first signs, it is necessary to urgently consult a doctor in order to eliminate risks to the woman’s life and minimize delayed consequences, including tubal factor infertility. Let's figure out how an ectopic pregnancy manifests itself, what symptoms are considered alarming, and what to do with such a diagnosis.

Why does pain bother you when you have an ectopic?

Pregnancy begins with a fertilized egg. Typically, the fertilized egg attaches to the lining of the uterus. An ectopic pregnancy most often occurs in one of the tubes that carry eggs from the ovary to the uterus. This type of ectopic pregnancy is called a "tubal pregnancy." However, in some cases, ectopic pregnancy occurs in the abdomen, ovary, or cervix.

The fertilized egg cannot survive, and tissue expansion can destroy various maternal structures. If left untreated, life-threatening blood loss can occur. Prompt treatment of an ectopic pregnancy can help preserve your chances of having a healthy pregnancy in the future.

What happens during an ectopic pregnancy?

The first stages of ectopic and normal pregnancy are identical: after the dominant follicle matures, ovulation occurs. If unprotected sexual intercourse takes place on days favorable for conception, the oocyte unites with the sperm. This usually occurs in the fallopian tube, and normally the embryo divides and moves along the tube into the uterine cavity. With ectopic pregnancy, its advancement stops, and implantation begins directly in the fallopian tubes. The further development of this situation may be different:

First, an ectopic pregnancy may not cause signs or symptoms. In other cases, the first signs and symptoms of an ectopic pregnancy may be the same as with any pregnancy: absence of a menstrual period, breast tenderness and nausea.

If you take a pregnancy test, the result will be positive. Typically, the first warning sign of an ectopic pregnancy is mild vaginal bleeding with abdominal or pelvic pain. If blood comes out of the fallopian tubes, you may also feel pain in the shoulder or the need to evacuate the bowels, depending on where the blood is pooling or which nerves are irritated. If the fallopian tubes rupture, there will likely be heavy bleeding into the abdomen, followed by lightheadedness, fainting, and shock.

• in the case of a progressive ectopic pregnancy, the fertilized egg continues to grow and penetrate into the soft tissue of the fallopian tubes, and this within several weeks, in the absence of medical intervention, leads to rupture of their walls;
• with the so-called tubal abortion, the embryo stops developing, its outer membranes are completely or partially torn off from the wall of the fallopian tube;
• rupture of the fallopian tube and associated termination of pregnancy is accompanied by acute pain and bleeding. This condition occurs from the 6th to the 10th week and requires emergency hospitalization.

The causes of ectopic pregnancy are not fully understood

Seek emergency care if you experience any signs or symptoms of an ectopic pregnancy, including. Tuberculosis pregnancy occurs when a fertilized egg becomes trapped on its way to the uterus, often because the fallopian tubes are damaged by inflammation or malformation. Hormonal imbalances or abnormal development of the fertilized egg may also interfere.

Types of ectopic pregnancy

There are several factors associated with ectopic pregnancy, including: Inflammation of the fallopian tubes or infection in the uterus, fallopian tubes, or ovaries increases the risk of ectopic pregnancy. Fertility problems. Some studies show a link between fertility difficulties, fertility drug use and ectopic pregnancy. Structural problems. You are more likely to have an ectopic pregnancy if you have unusually shaped fallopian tubes or if they are damaged, perhaps due to surgery. Even surgery to reconstruct the fallopian tubes can increase the risk of ectopic pregnancy. Choosing a contraceptive method. You are unlikely to get pregnant while using an intrauterine device. However, if you become pregnant, the pregnancy will most likely be ectopic. The same is true for pregnancies after a tubal ligation, which is a permanent method of contraception that consists of "tying the tubes." Although pregnancy after a tubal ligation is unusual, if it does occur, it will most likely be ectopic. Smoking cigarettes before you become pregnant may increase your risk of having an ectopic pregnancy. And the more you smoke, the greater the risk.

• Early ectopic pregnancy.
• If you have had an ectopic pregnancy, you are more likely to have another.
• Inflammation or infection.
• These infections are often caused by gonorrhea or chlamydia.

Signs of an ectopic pregnancy of any severity are a reason to consult a doctor: the sooner a woman receives qualified help, the lower the risks to her health and life will be. Regardless of the degree of development and location of embryo implantation, such pathology requires surgical treatment. The consequences of ectopic pregnancy include:

• infertility due to tubal or ovarian factors;
• high probability of repeated ectopic implantation of the embryo;
• inflammation in the abdominal cavity and pelvis;
• adhesions and obstruction of pipes.

If a woman does not consult a doctor if the symptoms of an ectopic pregnancy intensify, internal bleeding is most likely due to damage or rupture of the fallopian tube, which is dangerous not only to her health, but also to her life.

Types of ectopic pregnancy

Ectopic pregnancy develops in 2-3% of women expecting a child, and in the vast majority of cases, incorrect implantation of the embryo occurs in the fallopian tube. However, the embryo can take hold in another place:

• in the ovary - the egg can connect with the sperm in the upper part of the tube and, when the structure changes, begin to move not to the uterus, but in the opposite direction, to the ovary;
• in the rudimentary uterine horn - this relatively rare pathology, which is difficult to diagnose, can occur with a bicornuate uterine structure, the situation becomes more complicated due to the fact that the clinical picture of such an ectopic pregnancy before the “dangerous” 12-16 weeks may be similar to a fibroid ovary or implantation in the fallopian tube;
• in the abdominal cavity - this pathological process is considered the most dangerous and can be fatal, but it accounts for no more than 0.3% of cases of ectopic pregnancy, when the embryo is implanted on the surface of the uterus, in the spleen, in the space of Douglas, in the intestinal loop and others pelvic areas.

Ectopic pregnancy develops in 2-3% of women

What symptoms a woman may notice during an ectopic pregnancy depend on the site of implantation of the embryo and the degree of its development. However, there are also common signs that cannot be ignored.

Signs of an ectopic pregnancy

All symptoms of ectopic pregnancy, including the first signs before the delay, are associated with physiological processes. When an embryo is implanted, the chorionic villi, which cover its outer shell, are embedded in the soft tissues, after which the “feeding” of the embryo begins through the vessels located in the tissues. The conditions necessary for the development of the fetus exist only inside the uterus, and normal growth of the embryo after a certain period becomes impossible, but due to an increase in its size, tension, pain and tissue damage occur at the site of implantation. The “classic” symptoms of an ectopic pregnancy include:

• delayed menstruation, as in normal pregnancy;
• characteristic signs of early toxicosis are nausea, vomiting, dizziness;
• spotting and increasing;
• painful sensations of different localization;
• weakness, apathy, drowsiness caused by hormonal changes;
• shock state - occurs with significant blood loss, accompanied by a frequent weak pulse, decreased blood pressure, pale skin, and loss of consciousness.

Don't ignore warning signs

How does your stomach hurt during an ectopic pregnancy?

Pain during ectopic pregnancy gradually increases. At first, a woman may notice tension and pulling sensations similar to those observed on the first day of menstruation. Unpleasant sensations are localized in the lower abdomen, but not in the center, but with some displacement. As the embryo grows, the pain becomes more pronounced and has a stable “aching” character. Further, the painful sensations become more intense and frequent, they “radiate” to the lower back, groin and upper thighs. Severe discomfort occurs when defecating and emptying the bladder, since the growing fertilized egg can put pressure on an area of ​​the intestine or bladder.

When a rupture begins, there is an acute dagger-like pain, which sometimes spreads to the entire body and puts the woman into a state of shock. Internal bleeding causes pain in the chest and shoulders as the blood irritates the tissues of the diaphragm and other organs. You should not allow a pipe to rupture - this is dangerous for reproductive function and life in general. If the pain intensifies, you should immediately consult a doctor or call an ambulance.

Pain during ectopic pregnancy increases every week

It is impossible to say exactly where it hurts during an ectopic pregnancy, since in each individual case this pathology develops differently. In general, painful sensations begin to appear in the lower abdomen, then spread to the pelvis, then begin to spread to the spine and legs, and in the later stages of ectopic pregnancy they cover the entire body.

What kind of discharge occurs during an ectopic pregnancy?

Discharge as an early symptom of ectopic pregnancy also appears due to implantation of the fertilized egg “in the wrong place.” Chorionic villi damage the vessels of tissues not intended to nourish the embryo, so a woman may notice spotting and bloody discharge. They are scanty, but constant, heavy bleeding, similar to menstrual bleeding, is extremely rare, since most often blood during ectopic pregnancy is released not into the uterine cavity, but into the abdominal cavity. Uterine bleeding may be caused by a drop in progesterone levels.

When the soft tissue of the fallopian tubes or ovary begins to rupture, or a tubal abortion occurs, the bleeding becomes more abundant and bright. Such conditions are rarely accompanied by bleeding alone; they are characterized by pain, weakness and other symptoms, each of which is a reason to seek medical help.

It is necessary to monitor changes in health

It is worth adding that even with a normal pregnancy, even scanty spotting is an alarming symptom. They can be caused by fading of fetal development or detachment of the membranes of the ovum, which leads to the formation of a hematoma or death of the embryo. That is why, if you experience discharge mixed with blood in any quantity and any color, you should consult a doctor as soon as possible.

What will a pregnancy test show?

The fallopian tube, ovaries or abdominal cavity are not intended to attach the fertilized egg, however, due to its small size and structural features, the embryo is able to attach to soft tissues, and after implantation - receive nutrition. Such conditions leave no chance for normal height the fetus, although in the first stages of its development all the same mechanisms are activated as in normal pregnancy. in particular, ingrowth of chorionic villi activates the production of progesterone, estrogens and human chorionic gonadotropin. It is hCG, or the “pregnancy hormone”, that all pharmacy tests react to. Even with an ectopic pregnancy, in the first weeks they will show a positive result, although the woman may notice that the second line is very weak, and the gestational age according to the electronic test is very different from the real ones.

HCG rises slowly during ectopic pregnancy

A more accurate picture can be drawn from a blood test for hCG, and its results need to be monitored over time. Normally, the concentration of human chorionic gonadotropin in the blood plasma doubles every 48 hours. With ectopic, the level of this hormone increases, but much more slowly. An important nuance is that only a specialist should interpret the results of hCG tests. Monitoring hCG alone is not enough, because a weak increase in indicators can be provoked by the threat of fading of fetal development or the onset of abruption. A final diagnosis of ectopic pregnancy can only be made after a high-quality ultrasound, which will show that the fertilized egg is not visualized in the uterine cavity.

Can there be toxicosis during an ectopic pregnancy?

The main problem of ectopic embryo implantation is the coincidence of its symptoms with those characteristic of a normal pregnancy. Simply put, the changes in the very first weeks will be the same, since the hormonal background will change in a certain way. Along with it, traditional harbingers of an “interesting situation” will appear - delay, changes in taste and olfactory habits, breast enlargement and sensitivity, etc. Toxicosis during ectopic pregnancy can be accompanied by nausea in the morning, sometimes turning into vomiting, dizziness, weakness and decreased performance. In a word, a woman will feel pregnant, and therefore only those who planned the pregnancy and took the required tests in a timely manner can suspect the presence of a problem before the 3-4th week of pregnancy. You need to be attentive to your well-being so as not to miss the alarming symptoms - painful sensations and characteristic spotting.

During a frozen pregnancy, nausea can be as severe as during a normal pregnancy.

Causes and risk factors

There are a large number of direct and indirect prerequisites that can trigger the development of ectopic pregnancy. At the same time, there are frequent cases of incorrect embryo implantation in the absence of clinically confirmed reasons. The most common and studied factors that increase the risk of such pathology include:

• anatomical - changes affecting the patency of the fallopian tubes;
• hormonal - processes that have an indirect effect on the causes of ectopic pregnancy;
• doubtful - little-studied or controversial factors.

Anatomical causes of ectopic pregnancy

In 55% of cases of ectopic implantation of the fertilized egg, the problem lies in inflammatory processes in the fallopian tubes - past or current. They can develop for various reasons, for example, due to early onset of sexual activity, hypothermia, a large number and frequent change of sexual partners, which increase the risk of transmitting infections. The leader among these factors is salpingitis - chronic inflammation of the fallopian tubes, which causes functional and anatomical damage, disrupts steroid synthesis in the ovaries and the production of amino acids necessary for the development of the egg.

3-4% of cases of ectopic pregnancy developed due to improper placement and use of intrauterine contraceptives such as IUDs. Such statistics are especially relevant for funds of previous generations that have a T-shaped configuration. Their use increases the risk of ectopic pregnancy by more than 20 times.

Ectopic pregnancy most often develops due to inflammation in the fallopian tubes

Anatomical reasons can also be caused by mechanical “interventions” in the pelvis. These include injuries and operations, removal of fibroids, cesarean section, consequences of a previous ectopic pregnancy, pelvioperitonitis and peritonitis. Because of them, scars appear, which can serve as a barrier to a dense egg. This same group of risk factors includes previous laparoscopic operations, for example, for reconstruction of the fallopian tubes in case of obstruction or damage, as well as surgical interventions to treat other abdominal organs. The risk of ectopic pregnancy is increased by the consequences of abortions and diagnostic procedures - uterine curettage, cervical probing, etc.

Another group of prerequisites due to which signs of ectopic pregnancy develop are fibroids, as well as other benign or malignant neoplasms that change the shape of the uterine body.

Hormonal factors

Among the most common hormonal causes of ectopic pregnancy are sexual infantilism and other disorders that arose due to abnormalities in the functioning of the adrenal cortex and hypothalamic centers. Due to hormonal medications used in the treatment of some forms of endocrine infertility, the risk of pathological implantation of the fertilized egg increases 3 times. The same situation applies to drugs that are prescribed in the stabilizing and stimulating phase of in vitro fertilization. According to statistics, every 20th patient who chooses IVF develops an ectopic pregnancy.

Hormones regulate pregnancy

Less common are problems with the production of prostaglandins - physiologically active substances that are responsible for the advancement of the egg in the fallopian tubes. It also happens that the problem lies in the egg itself. Its membranes produce substances that dissolve the endometrial mucosa for faster implantation. If this process is too active, the fertilized egg may become entrenched in the tube without ever reaching the site of physiologically correct implantation.

Controversial factors

There are some prerequisites that have not yet been scientifically confirmed, but are considered among the probable factors of ectopic pregnancy. These include:

• deviations of some sperm parameters, in particular - anomalies of prostaglandins in the partner’s seminal fluid;
• congenital anatomical features of the structure of the uterus, for example, bicornuity, due to which the fertilized egg can penetrate into the area of ​​a rudimentary horn that does not have an outlet into the vagina;
• diagnosed endometriosis.

Ectopic pregnancy is caused by many factors

Diagnosis and treatment

Timely identification and confirmation of symptoms of ectopic pregnancy will allow you to prescribe the correct treatment as quickly as possible and minimize the delayed consequences of this pathology. For diagnosis you need:

• consultation with a gynecologist with a survey and examination in a chair - this will help identify changes in the size of the uterus, the structure of the appendages and the sensitivity of certain areas characteristic of ectopic pregnancy. If the pregnancy is terminated, and most often this happens in the 6th week, then the diagnosis is based on a medical examination and on existing signs of complications;
• laboratory testing - this primarily includes an analysis of the level of hCG in the blood plasma, which, when repeated at intervals of 2-3 days, makes it possible to detect ectopic pregnancy even at an early stage. A progesterone test may also be prescribed; in the case of abnormal implantation of the fertilized egg, it will show a hormone level below 26 mg/ml. Less commonly, and solely according to indications, for the diagnosis of ectopic pregnancy, a general blood test (a strong increase in leukocytes is possible) and histology of a fragment of the endometrium (decidual tissue may be detected in scrapings) are prescribed;
• Ultrasound allows you to confirm the results of examination and tests, but such a study will be effective for a period of about 6 weeks, i.e. it is extremely difficult to carry it out before the delay. During ectopic pregnancy, the fertilized egg is not visualized in the uterine cavity.

Only ultrasound can confirm the diagnosis

There are other specific examination methods, for example, differential diagnosis for various diseases and pathologies, diagnostic laparoscopy, culdocentesis with puncture of the rectal uterine cavity. Only a doctor can choose a set of measures that will confirm or refute the symptoms of ectopic pregnancy.

Ectopic pregnancy is treated in two ways - surgery and medication. Surgery is needed in all cases without exception when bleeding is observed. The patient may be prescribed laparoscopy (microsurgical intervention) or laparotomy, which involves excision of the abdominal wall. Chemotherapy in Russia is used in a few clinics. This treatment gives good results in early pregnancy and is carried out using methotrexate. Its main advantage is the ability to avoid surgical intervention and maintain patency of the tubes.

When can you plan to become pregnant again?

On average, after an ectopic pregnancy, the body recovers within six months or more. When planning a child, a woman should undergo a comprehensive examination in advance to exclude post-operative inflammation, make sure there are no infertility factors, or, if present, choose the correct assisted reproductive technology.

An ectopic pregnancy is an abnormal condition that poses a serious threat to a woman’s life. The normal location of a fertilized egg is the uterus. If fixation occurs in any other place, this is a pathology and requires immediate intervention from doctors. The first signs of an ectopic pregnancy, if known about them, should alert a 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 occurs. After conception occurs, the zygote migrates into the uterine cavity. This phenomenon is facilitated by measured peristaltic contractions of the fallopian tubes and wave-like swaying of the villi of the mucous membrane.

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

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 can be caused by local tuberculosis or external endometriosis. Moreover, long-term treatment of infertility with hormonal drugs can also cause this specific problem.

Classification of ectopic conditions

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

Types of pathological conditions according to the location of the ovum:

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

The early period (5-6th week) does not allow a woman to independently determine whether the pregnancy is ectopic.

Primary signs are typical for everyone:

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

Most often, the diagnosis of ectopic pregnancy is made when the symptoms already indicate the development of a tubal abortion or other termination scenarios. A 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 diagnostician’s task was not always to search for “traces of pregnancy.” The abnormal location of the ovum is most often discovered during diagnostic measures to identify completely different pathological conditions.

If the pregnancy did not occur in the uterus and was unexpectedly interrupted, the symptoms will be as follows.

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

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

What will the test show?

When considering the question of what symptoms an ectopic pregnancy gives, what signs in the early stages are characteristic of this condition, it is worth separately considering 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 discharge. As a rule, they are scanty and of a specific color. “Pseudo-mentruation” occurs 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. Wary, patients often purchase a pregnancy test.

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

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

Sad consequences

The consequences of an ectopic pregnancy include:

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

Treatment of patients

Treatment of interrupted abnormal pregnancy is carried out exclusively by salpingectomy. 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 in any other way;
• get rid of an organ that has completely lost its functional potential.

There are laparoscopic and laparotomic surgical procedures. The intervention itself is quite traumatic and requires appropriate qualifications of a doctor.

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

The fabrics are carefully sewn up. No specialist can guarantee that the pipe will ultimately retain at least minimal permeability. As for scars and fibrous bands, they form as a natural reaction of the body to surgical interventions.

Rehabilitation and subsequent preparation for pregnancy

All rehabilitation measures 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 hormonal levels.
4. Contraception from 6 to 12 months after surgery.
5. Prevention of adhesions using enzyme preparations.
6. Physiotherapeutic procedures for general health.

Provided that a woman has at least one tube left with optimal patency, the likelihood of becoming pregnant in the future is quite high. The optimal period for reconception is 1 year after surgery. In general, the prognosis is favorable, but provided that the disease is identified fairly quickly and truly professional assistance is provided.