Any future mommy afraid to hear from the doctor a diagnosis of “ectopic pregnancy.” You need to figure out what it is and how it can be dangerous. An ectopic pregnancy is a pathology during the development of which the egg attaches not to the uterus, where it is supposed to, but in another place:
- in the walls of the fallopian tubes;
- in the ovaries;
- in the peritoneum.
Features of the pathology
In an ectopic pregnancy, the embryo enters the fallopian tubes. Most often this is due to a disruption in the normal functioning of this organ. As the embryo travels towards the uterus, it is retained and implanted in the wall of the fallopian tube. If pregnancy ruptures the tube, then it is necessary to urgently resort to surgical intervention. 
Ectopic pregnancy essentially differs from the standard one in that in such a situation the mother cannot bear the fetus and give birth to a child. In any case, the help of qualified obstetricians will be required, who will determine the timing of the operation. The consequences of an ectopic pregnancy can be very negative, especially if the disease was not diagnosed in a timely manner. According to statistics, about two percent of all pregnancies are ectopic.
Danger of pathology
If a fertilized egg develops in the mucous membrane of the fallopian tube, the diameter of the latter will begin to increase over time. This is a completely natural process under such circumstances. The appendages are not designed for such a load, so after a short period the walls of the pipes will stretch so much that the pathology will become noticeable to a pregnant woman. 
If you do not intervene in this process in a timely manner and do not accept necessary measures, stretching can lead to rupture of the shell. As a result, unwanted substances such as blood and mucus will enter the abdominal cavity. That's where it goes ovum. The problem is that the abdominal cavity needs to be as sterile as possible, otherwise the risk of infection greatly increases. Such cases often end in the development of peritonitis and excruciating pain.
An ectopic pregnancy is accompanied by massive bleeding, which is caused by damage to blood vessels. This condition is considered critical, since treatment of a pregnant woman requires immediate hospitalization. A similar danger exists not only for tubal, but also for other pathological pregnancy.
Now experts identify several key reasons, which can serve as an impetus for the development of ectopic pregnancy. Often the cause of the disease is some problem with the normal functioning of the fallopian tubes. It's connected with:
- infectious diseases - chlamydia, gonorrhea, etc.;
- inflammatory diseases – adnexitis;
- surgical interventions - for example, after surgery the risk of ectopic pregnancy increases;
- procedures to restore normal tube patency;
- medical treatment of infertility;
There are situations when even experts cannot explain why the pregnancy turned out to be ectopic. However, it is worth considering that if a woman has already encountered such a problem once, then she is at increased risk.
In this case, it is necessary to treat pregnancy extremely scrupulously: regularly attend an ultrasound scan, during which the presence of a fertilized egg in the uterus will be confirmed. It is important to remember that on early stages During pregnancy, the egg is extremely small in size, so it is quite difficult to notice it during one examination. 
Precautionary measures
In order to prevent ectopic pregnancy, you need to be very careful about your health. First of all, this is due to gynecological diseases which are sexually transmitted. They are usually accompanied by vaginal discharge, but some of them are extremely insidious and do not have pronounced symptoms. 
Women are accustomed to identifying the problem by abdominal pain, bleeding, and problems with menstruation, but sometimes the disease that can lead to an ectopic pregnancy is asymptomatic. This is why it is so important to visit a gynecologist twice a year for a preventive examination.
When can pathology be diagnosed?
In most cases, the disease becomes obvious after an artificial or natural termination of pregnancy, which most often takes the form of a ruptured fallopian tube or tubal abortion. There is a possibility of this different dates, however, the period from 4 to 6 weeks of gestation becomes especially dangerous. 
The next time pathology can be detected approximately in the third or fourth week. Alarm signals should be the presence of hCG and the absence of any signs of intrauterine pregnancy during ultrasound examination.
In a situation where the fetus is localized in the rudimentary horn of the uterus, pathology can only be determined in the tenth to sixteenth week. 
Contact a specialist
Timely intervention medical workers plays a key role in ectopic pregnancy, however, for a successful outcome, a woman should consult a doctor before complications arise. Currently, there are two treatment methods that are widely practiced in medicine: surgical and drug.
Not so long ago, doctors removed the affected organ along with the uterus, which completely deprived the woman of the opportunity to become a mother in the future. Modern technologies allow operations to be carried out in such a way that the integrity of the structure comes first.
In medical practice, there are drugs that allow you to treat ectopic pregnancy without surgical intervention. Experts use medications that stop the development of the fetus. In other words, they are used in cases where the fertilized egg continues to grow.
The disadvantage of the conservative method of treatment is that it is fraught with a large number of side effects: from kidney damage to baldness. Desired result can be achieved only in some cases. That is why the operation continues to be the most safe method terminate a tubal pregnancy.
The success of therapy directly depends on the stage at which the pathology of the location of the ovum was identified. That is why it is so important that every woman knows how an ectopic pregnancy manifests itself. initial terms development. 
Clinical manifestations of ectopic pregnancy
Experts cannot identify obvious symptoms, which would categorically indicate the development of tubal pregnancy. Diagnosis is complicated by the fact that the symptoms of this pathology are often present in the early stages of standard pregnancy. This is due to the inability to see the fertilized egg when passing ultrasound examination.
For precise definition diagnosis requires laparoscopic surgery. However, to carry it out, a set of signs is required that indicate the development of an ectopic pregnancy. 
Laparoscopic surgery, due to its characteristics, is not only a diagnostic, but also a therapeutic procedure, but it should not be carried to the point where it becomes necessary. In case of a sharp decrease in blood pressure, pain in the abdomen, severe weakness and loss of consciousness, you should immediately call a doctor for hospitalization.
Pregnancy test and pathology
The development of pathology can be determined using a regular pregnancy test, but this method should not be completely trusted. It responds to a special hormone called human chorionic gonadotropin. In the case of pathology, its concentration is significantly lower than in traditional pregnancy.
Women who are faced with pathology can identify alarms according to the nature of menstruation. During menstruation, a bloody substance is released from the genital tract, which, by and large, is not even menstruation. In some cases, the discharge contains fragments of the decidua, which was rejected by the body. 
Among the main features it should be noted:
- scanty menstruation;
- severe delay of menstruation;
- painful nagging pain in the abdominal area (this is a consequence of an increase in the diameter of the pipe);
- abundant bloody issues;
- early toxicosis;
- enlarged and painful breasts;
- pain radiating to the rectum and lower back.
Experts are convinced that with due attention, it is possible to determine an ectopic pregnancy even before a missed period. This is facilitated by competent history taking and timely examination.
At the first suspicion of pathology, which can be determined by the signs listed above, you should immediately contact a gynecologist. The doctor must conduct examinations, during which the degree of softening of the cervix and its bluish color are revealed.
During palpation, a specialist can determine how much the delay in menstruation corresponds to the size of the uterus. If pathology is noticed, he prescribes a mandatory additional examination:
- Ultrasound of internal organs;
- hCG analysis;
- analysis of progesterone concentration.
It is also extremely important to know the signs of internal bleeding in order to call doctors in a timely manner. Symptoms include:
- severe pain in the lower abdomen;
- sharp deterioration in condition, apathy;
- pale skin;
- increased sweating;
- dizziness;
- bloody issues.
Internal bleeding most often indicates that internal organs the women are significantly damaged.
Types of pain in the lower abdomen and possible pathologies
| Possible diagnosis | Gestational age | Nature of pain | Other symptoms | Danger level | |
|---|---|---|---|---|---|
| 5-7 weeks | Sudden sharp pain lower abdomen | Dizziness, bleeding | Ultrasound in the early stages | ||
| Threat of miscarriage | Any stage of pregnancy | Aching, persistent pain in the lower abdomen, radiating to the lower back | Bloody issues | Elevated, requires immediate medical attention | |
| Premature placental abruption | Any stage of pregnancy | Severe sharp pain in the lower abdomen, bleeding in the uterus | Any symptoms consistent with significant blood loss | By an emergency room doctor or in a hospital | High, emergency medical attention required |
Rehabilitation
After an ectopic pregnancy, doctors turn to a set of measures that allow the body to return to normal. First of all, it is necessary to take care of preventing adhesions and normalizing hormonal levels.
Video - The first signs of an ectopic pregnancy in the early stages
Every woman should know about dangerous pathology, which, according to statistics, affects 10-15% of women – ectopic pregnancy. In order to avoid complications, it is necessary to have some knowledge about its occurrence and course. First of all, you need to understand that the occurrence of an ectopic pregnancy is quite unpredictable.
This pathology has been described in medical textbooks since the 11th century. Until recently running forms led exclusively to death. Today, with the help of modern surgery, this problem can be solved much easier. Functional medical technology allows operations to be performed and reduces the risks of operations to almost zero. However, gynecologists around the world note an increase in average cases that are quite difficult to diagnose.
What is an ectopic pregnancy and how does it occur?
During a normal pregnancy, the fertilized egg, leaving the fallopian tubes, attaches to the uterus, where it continues to develop until birth. In a pathological pregnancy, the fertilized egg does not enter the uterus. This common pathology never ceases to amaze doctors. Wherever they have to remove an incorrectly attached fertilized egg. This could be the fallopian tubes, ovaries, or abdominal cavity. The most common is ectopic tubal pregnancy.
The retention of the egg in the tubes indicates their insufficient patency. Already a month after the fertilized egg attaches to the wall of the pipe, having increased in size, it can lead to rupture of the pipe. In this case, there is a very high probability of bleeding with blood entering the abdominal cavity. From this moment on, the woman's life is under threat. This is why it is so important when planning a pregnancy to undergo a full examination and eliminate possible violations.
Causes of ectopic pregnancy
Why does this phenomenon occur? How does an egg go off course and end up in a place not intended for development? It's all about the fallopian tubes, the patency of which is impaired as a result of some factors. This is almost always preceded by abortion or difficult childbirth, past or current inflammatory diseases of the genitals, and infections. The mucous membrane of the uterus in a swollen state sticks together in some places, the tubes lose the ability to contract.
An ectopic pregnancy can also occur in case of insufficient development (infantilism). The infantile tubes are long, narrow and tortuous, with narrowed openings. They are not able to contract and push the fertilized egg forward to the uterus. At a certain stage, the fertilized egg begins to develop villi in order to attach for development and receive a constant blood supply. If at a certain time the egg has not arrived in the uterus, it is attached to the place where it is. The thin and delicate walls of the tubes do not stretch like uterine tissue, so they soon rupture. This happens around 4-6 weeks. As a result of the rupture, blood rushes into the abdominal cavity, causing nausea and severe pain in the lower abdomen, reminiscent of contractions. Loss of consciousness often occurs. Broken large vessels can be fatal.
Sometimes the scenario occurs in the other direction, and the fertilized egg bursts and flows into the abdominal cavity. And along with it, a certain amount of blood, nausea and spotting may also occur. Tubal abortion occurs accompanied by severe pain, which subsides after some time. A woman can relax, thinking that everything is over. However, it is too early to rejoice. In any case, it is necessary to urgently contact specialists to exclude possible development peritonitis – purulent inflammation abdominal cavity.
Does the test indicate an ectopic pregnancy?
The test shows an ectopic pregnancy just like a normal pregnancy! The difference can only be detected by ultrasound examination. There will not be a simply fertilized egg in the uterus, and if specialists do not detect it on an ultrasound, they will conduct additional checks and be able to diagnose the pathology at the earliest stages. Already in the second week of pregnancy, the deviation can be diagnosed by inserting an ultrasound sensor into the vaginal cavity. Next, diagnostic laparoscopy is prescribed, which gives the most accurate results. Another way is a hormonal blood test. After a significant increase, the level of human chorionic hormone (hCG) may decrease at this time.
What are the signs (symptoms) of an ectopic pregnancy?
Among the first signs is bloody vaginal discharge (which may be minor). Then painful sensations in the lower abdomen, increasing as the pathology develops to very strong, sometimes cramping.
Is it possible to detect an ectopic pregnancy yourself?
It is difficult to make an accurate diagnosis for yourself, but you can suspect something is wrong based on the above signs. If to usual symptoms pregnancy (delayed menstruation, irritability, toxicosis, violation taste preferences etc.) even slight aching pain in the lower abdomen and at least slight spotting are added - immediately RUN for a gynecological examination to rule out pathology.
At the slightest suspicion of an ectopic pregnancy, specialists suggest observation in a hospital. This should not be abandoned, because necessary examinations To determine the site of embryo implantation, it is easier to carry out in a hospital setting. On early stages detection, doctors will be able to interrupt it in gentle ways.
Treatment of ectopic pregnancy
There are several treatment methods used at different stages. At the slightest suspicion of an ectopic pregnancy, specialists suggest observation in a hospital. This should not be abandoned, since the necessary examinations to determine the site of implantation of the embryo are easier to carry out in a hospital setting. In the early stages of detection, doctors will be able to interrupt it in gentle ways.
A low-traumatic method (laparoscopy) is offered in the case when the fertilized egg still retains its container. Inserted through a small incision in the skin the right tool. The laparoscope device has an optical system, so all manipulations and the surgical field are displayed on the device’s monitor. This is a fairly safe operation. The surrounding tissues and organs are not affected, there is no risk of adhesions and scars, and there are practically no deaths. The device “sucks out” the fertilized egg, acting like a mini-abortion. A great consolation for a woman is that such an operation prevents injury to the tube, and after a course of treatment, after a while the woman can become pregnant again.
Should I keep or remove the pipe?
You can save the pipe if the rupture has not yet occurred or is minor. Salpingotomy is a closed surgical operation. After it, recovery occurs much faster, less blood leaks, and the patient spends much less time in the hospital, and the procedure itself is less painful. Removing the tube during examination is called a salpingectomy. This procedure greatly reduces the risk of repeated pregnancy loss.
Some women (4 - 8%) still have pregnancy tissue in their tubes, so your doctor may suggest an injection. medicine, stopping tissue growth. This is methotrexate, a drug sometimes used as an alternative to surgery. It is used in the very early stages of pregnancy, while pregnancy hormones have still increased slightly. This drug causes pregnancy tissue to be absorbed into the body. Several injections are required, followed by bleeding for several weeks. At early diagnosis illness and surgery in the early stages, this procedure may not be necessary. The best solution According to the prescription of treatment, the doctor accepts it.
Is pregnancy possible after an ectopic pregnancy and what are its features?
After liberation from an ectopic pregnancy, monitoring and “expectant management” are carried out. If only one of the tubes is damaged or removed, the chances of another pregnancy are quite high. However, the unresolved cause of the disease can reduce them. It could be an infection or inflammation. They definitely need to be cured. With one working tube you can get pregnant and carry a child to term perfectly. Within about 18 months, 6 out of 10 women become pregnant again.
How long do you need to wait?
Gynecologists recommend waiting at least three months before trying again. After major surgery, you should wait six months for all scars to heal. After using methotrexate, you must wait three cycles to ensure that the drug is completely eliminated from the body.
What are the chances of recurrence of an ectopic pregnancy?
The chances of recurrence of an ectopic pregnancy are almost the same as with the first violation: 10-15%. The prognosis is rather vague, since everything depends on the woman’s specific body and circumstances. It is almost impossible to insure against this. However, it's worth Special attention Focus on treating infections, such as chlamydia, to prevent further damage to the fallopian tubes. When found new pregnancy It is better to consult a doctor as soon as possible so that he can refer you for an ultrasound examination. Make sure that this time the embryo develops correctly.
An ectopic pregnancy, the symptoms of which in the early stages are no different from carrying a child in the uterus, is very dangerous condition threatening the life of a woman. Unfortunately, even doctors are not always able to identify this pathology in the first weeks after conception, when even surgical intervention can be avoided (yes, there are such techniques now!) or, if an operation is performed, it is organ-preserving and without great risk to health. Every woman should know the signs of an ectopic pregnancy. So what are these symptoms and distinctive features fetal development outside the uterus?
In the first weeks of fetal development, a woman feels everything the same as those women who bear children in the uterus. That is, the signs of an ectopic pregnancy in the first days after the start of a missed period are not much different from a uterine pregnancy.
2. Toxicosis.
3. Soreness of the mammary glands.
4. Frequent urination.
5. Slightly increased basal temperature.
Now, what should be of concern? As a rule, these signs of ectopic pregnancy at 4, 5 weeks from conception appear in the first month of a missed period.
1. If human chorionic gonadotropin (its concentration) is lower than it should be at this period pregnancy.
2. Pregnancy tests show negative or weakly positive results.
3. If there is bloody discharge from the genital tract.
4. If pain is felt in the area of the uterus and ovaries.
5. An increase in body temperature is recorded.
6. Low blood pressure.
7. Dizziness.
The last 3 of the signs we have listed often appear when the fertilized egg is located in the uterus.
For doctors, signs of early ectopic pregnancy play a role, such as: reduced level human chorionic gonadotropin, painful sensations, the absence of a fertilized egg in the uterine cavity according to ultrasound results, whereas at this stage it should already be there. In addition, during a gynecological examination, the doctor notices that the size of the uterus is somewhat smaller than it should be at this stage of pregnancy. Of course, this may also indicate a frozen pregnancy. Therefore, a control examination is carried out a week later and if the uterus remains small in size, the woman is sent to donate blood for hCG and for an ultrasound examination. This can only be delayed for 7-10 days if there are no other ailments, otherwise the diagnosis is carried out immediately, and in a hospital setting. Another relative sign of pregnancy outside the uterus is an increase in the level of white blood cells (determined by laboratory tests).
If an ultrasound detects a fertilized egg in the uterus, then the diagnosis of “ectopic pregnancy” is immediately removed - cases when uterine and ectopic pregnancies occur simultaneously are very, very rare. The woman is diagnosed with either a threatened miscarriage or a frozen pregnancy.
Why is an ectopic pregnancy dangerous? The fact that a woman can die from loss of blood... None of this kind pathological pregnancy cannot end happily, no matter what type it is: localized in the cervix, ovary, fallopian tube or peritoneum. It’s just that its spontaneous interruption occurs a little differently and at different times. The most common is tubal ectopic pregnancy. Very in rare cases the fertilized egg freezes in its development, dies and no medical intervention is required. There are often cases when the grown fertilized egg ruptures the tube, causing severe bleeding. So, what are the signs of an ectopic tube that ends in rupture?
1. Pain in the uterus during examination by a doctor and palpation. Through the lateral vaginal fornix, the doctor can feel the fertilized egg in the area of one of the appendages.
2. Acute pain in the abdominal cavity, more often from the side of the tube where the fertilized egg developed. The pain radiates to the rectum.
3. Sweating, paleness skin, low blood pressure, darkening of the eyes or loss of consciousness.
4. Bleeding from the genital tract.
These signs are already indications for surgical intervention. The type of surgery is determined by the doctor on site. Depends on the location of the ovum, the amount of blood loss, the patient’s condition, etc.
What to do if you are afraid that you have an ectopic pregnancy - signs - negative test, low hCG, etc. What to do in this case?
First of all, go to the gynecologist as soon as possible. The diagnosis may not be what you think. Negative test can happen not only with an ectopic pregnancy, but also with... no pregnancy. Therefore, it is too early to worry. Low human chorionic gonadotropin, or rather slightly reduced, may indicate a lack of progesterone due to certain hormonal disorders, but this can also be solved with the help of modern medicines. In addition, hCG can be increased not only in expectant mothers, but also in certain diseases in people of any gender and age.
The diagnosis of “ectopic pregnancy” can be confirmed 100% only with surgical intervention. If the tube does not rupture, and doctors simply suspect an ectopic pregnancy, then the approximate course of action is as follows. Women who want to keep the child, if everything is in order, immediately undergo laparoscopy. Using special instruments, surgeons examine organs through small punctures in the abdominal wall. If a fertilized egg is found, it is removed. Removal of the fallopian tube is not always carried out - the task of doctors is to preserve the woman’s fertility and minimize the risks of a recurrence of the situation. However, sometimes the tube is so affected by adhesions that it is better to remove it than to save it... If a woman, even if intrauterine pregnancy is confirmed, does not plan to save it, then curettage of the uterine cavity is first performed. And if the resulting histological material contains chorionic villi, then we can state with a high degree of confidence that the pregnancy was uterine. And then the woman is observed a little more and discharged, since there is no longer a need for laparoscopy.
If there is VB, then the choice of the type of surgical intervention depends, to a greater extent, on the localization of the fertilized egg (even the segment of the fallopian tube in which it develops plays a role). In very rare cases, extirpation (removal) of the uterus may be required. In other cases, only laparotomy is possible - a classic operation through an incision, usually if the diameter of the fallopian tube already exceeds 5 cm.
In addition, in some cases it is possible to perform an artificial tubal abortion (the doctor squeezes the fertilized egg through the abdominal opening of the tube). This is possible in very short periods of time.
Also, for short periods of time, in the absence of contraindications, conservative, non-surgical treatment with the drug Methotrexate is possible.
Often, an ectopic pregnancy occurs without any good reason, as it seems to the woman. But that's not true. For example, inflammatory processes in the fallopian tubes can be practically asymptomatic, but lead to the formation of adhesions - the main cause of ectopic pregnancy. Therefore, take care of your health from a young age, properly protect yourself from unwanted pregnancy and do not forget to make preventive visits to the gynecologist at least once a year.
A pregnancy is called ectopic when a fertilized egg implants in the fallopian tube, ovary, abdomen, or cervix. In this case, it is impossible to carry and give birth to a child; in addition, the pathology poses a danger to the health and life of the woman herself. Therefore, it is important to detect symptoms of ectopic pregnancy, diagnose and treat them as early as possible.
The severity of symptoms may vary. Sometimes women already identify the manifestations of pathology in their early stages. But there are situations when ectopic implantation of the fertilized egg becomes known after a sharp deterioration in health and an ambulance is called.
But there are several signs that may indicate ectopic implantation of the embryo:
- Often the test works later than in a normal pregnancy. This is due to the fact that the concentration of hCG increases slowly. If the embryo is located ectopically, the timing of diagnosis is shifted by 2-3 days compared to normal.
- After the first day of delay, the second test strip appears. This is also explained by the slow rise in hCG levels in the urine.
If a specialist suspects the development of an ectopic pregnancy, the following studies are prescribed:
- Laboratory blood test for hCG . Human chorionic gonadotropin increases more dynamically in the blood than in the urine. Therefore, pregnancy can be confirmed in this way at an earlier date: 5-6 days after fertilization. To find out whether it is ectopic, it is necessary to compare data from several studies. During a normal pregnancy, the hCG level doubles every 2 days, with pathological changes minor.
- Transvaginal ultrasound . Using ultrasound, the position of the embryo can sometimes be determined from the 3rd week of pregnancy, but most often it is detected only by 4-5. If the doctor suspects an ectopic pregnancy, but the fertilized egg is not visible (its size is extremely small), then a repeat examination is prescribed or the woman is hospitalized so that she is under constant medical supervision. Transvaginal ultrasound is the most reliable method for diagnosing ectopic pregnancy, but in 10% of cases it also gives an error: the fertilized egg is considered as a blood or fluid clot. Therefore, the examination is always carried out in combination with a blood test for hCG.
- . The procedure is carried out as a diagnostic procedure only according to indications: when there is a serious suspicion of an ectopic pregnancy (symptoms, hCG dynamics), but it cannot be confirmed using ultrasound. Laparoscopic surgery is performed under anesthesia, using special tools Small punctures are made, where a tube with a camera and light is inserted, and the doctor examines the organs through the image on the monitor. If an ectopic pregnancy is detected, then immediate therapeutic measures(removal of fertilized egg, etc.).
Symptoms
Since ectopic pregnancy occurs in different ways, specific symptoms may appear gradually, delayed or completely absent until an emergency condition develops (with bleeding, rupture of the fallopian tube, etc.). Therefore, you should not hope only for a deterioration in your health; it is necessary to carry out diagnostic procedures: determination of hCG, ultrasound.
The first symptoms of an ectopic pregnancy coincide with those of a normal pregnancy: general weakness, drowsiness appears, and the mammary glands swell. Pathological implantation does not manifest itself in any way at first. A woman may also experience: nausea, vomiting, dizziness.
At this stage, an ectopic pregnancy can sometimes be determined by testing the level of hCG in the urine. As noted above, in this case, its results may be delayed for several days, since the hormone is produced more slowly than usual. Therefore, if a woman notices signs of pregnancy, but the test shows negative result, probably, the fertilized egg has settled outside the uterus.
An ectopic pregnancy in the early stages has the same symptoms as a normal one, but their nature is somewhat different:
- . Symptoms of an ectopic pregnancy before a missed period are spotting or slight bleeding. When the embryo is implanted into the wall of the uterus, they are short-lived, lasting several hours. But if it is established outside of it, this symptom will be more intense and lasting.
- . Often such sensations occur in the lower abdomen. During normal pregnancy, they are tugging and develop due to increased tone uterus With ectopic, they accompany the process of implantation and development of the embryo and can be localized in different areas - where the fertilized egg is attached. Later pain spreads to the entire abdomen. Its intensity constantly increases - from barely noticeable at first, to sharp, cramping after a few days.
- General malaise . Normal pregnancy in the early stages may be accompanied by decreased performance, increased sleepiness, fatigue. With an ectopic, all these symptoms are more pronounced, in addition, dizziness and fainting develop.
- Toxicosis . Nausea and vomiting often accompany normal pregnancy. In a pathological condition, these manifestations are more pronounced and intensify every day.
For more later symptoms of ectopic pregnancy increase faster, and in a critical situation - rapidly. A woman's arterial pressure, frequent dizziness, body temperature rises. Sometimes there are signs of anemia due to decreased hemoglobin levels.
If the fallopian tube ruptures and internal bleeding develops, this is very noticeable. severe pain, shock, loss of consciousness. Urgent medical attention is required.
For each type of pathological fixation of the ovum, there are characteristic symptoms:
- Pipe ectopic pregnancy is manifested by pain on the left or right side, depending on where the implantation of the fertilized egg occurred. If it is fixed in the wide ampulla part, then the symptom appears at 8 weeks, if in the narrow part (in the isthmus) - then at 5-6. The pain intensifies while walking, turning the body, or sudden movements.
- Ovarian ectopic pregnancy for a long time does not manifest itself with any pathological symptoms. This is explained by the fact that the follicle can stretch to fit the size of the embryo. But when the limit of elasticity is reached, severe point pain appears in the lower abdomen, gradually spreading to the lower back and large intestine area. Defecation becomes painful. The attack lasts from several minutes to hours and is accompanied by dizziness and faintness.
- Cervical and cervical-isthmus ectopic pregnancy occurs without pain. Bloody discharge comes to the fore - from spotting to copious, profuse, posing a threat to life. Due to the increase in the size of the cervix, urination disorders develop (for example, frequent urge).
- Ectopic pregnancy in the abdominal cavity in the early stages it has symptoms that are no different from those during normal pregnancy. But as the embryo grows, dysfunction appears gastrointestinal tract(constipation, diarrhea, nausea, vomiting), signs of an “acute abdomen” (severe pain, bloating, fainting).
What is an ectopic pregnancy and what symptoms are typical for it? With this pathology, the fertilized egg is implanted outside the uterus: most often in the fallopian tube, less often in the ovary, abdominal cavity, and cervical region.
An ectopic pregnancy can be detected from 4-6 weeks using a blood test for hCG and ultrasound. Symptoms in the early stages are almost the same as during normal pregnancy, but gradually they become more pronounced and specific (localization and intensity of pain, bleeding, disturbances in the functioning of other organs).
Useful video about the symptoms of ectopic pregnancy
You wouldn't wish this on any woman. This news will certainly come as a shock. Such diagnoses are always perceived emotionally. But we hasten to console you as much as possible: an ectopic pregnancy is not a death sentence.
In fact, ectopic implantation of the ovum is not such a rarity: although there is little pleasant in this, but due to the frequency of occurrence, doctors have already learned to quickly identify an ectopic pregnancy and take the necessary measures to prevent risks and minimize the consequences. However, future forecasts for a woman will depend on a number of factors.
It is of great importance at what stage an ectopic pregnancy makes itself known, and how exactly. Unfortunately, in 5-10% of all cases, a woman really cannot have any more children. But timely actions help to avoid many troubles, including preserving the functionality of the female reproductive system. So, the main thing is not to waste time.
Why is the egg not in the uterus?
When a sperm fertilizes an egg, the latter begins to move along the fallopian tube and at the end of the path is attached to the wall of the uterus for further development and growth - implantation occurs. This is how it begins normal pregnancy, during which the egg improves, constantly divides, a fetus is formed, from which it grows by the end of the period full-fledged child, ready for life outside the womb. For this complex process to take place, a certain “home” for the egg and space for its growth are necessary. The uterine cavity is an ideal option.
However, it happens that the egg does not reach its destination and settles earlier. In 70% of cases, it is attached to the fallopian tube, but other options are possible: to the ovaries, to the cervix, to any of the abdominal organs.
Causes of ectopic pregnancy
There are several reasons why the egg cannot reach the uterus:
- Disturbances in the condition of the walls and functioning of the fallopian tubes (when they contract poorly and are not able to move the egg further). This often happens due to previous diseases of the pelvic organs, as well as chronic inflammatory diseases of the genital organs, in particular STDs.
- Anatomical features of the fallopian tube (for example, infantilism): a tube that is too narrow, tortuous, scarred or scarred makes it difficult and slows down the passage of the egg.
- Previously undergone tubal surgery.
- Previous abortions, especially if the woman’s first pregnancy was artificially terminated.
- Slowness of sperm: the egg is “waiting” for fertilization, which is why it does not have time to reach the right place, that is, to the uterus - hunger forces it to settle earlier.
- Hormonal disorders in the body of a pregnant woman.
- Tumors on the uterus and appendages.
- Changes in the properties of the fertilized egg.
- A woman wearing a contraceptive intrauterine device.
- Some technologies.
- A woman’s constant nervous overstimulation, in particular, the fear of getting pregnant and unreliable methods of contraception, do not allow her to relax, which is why the fallopian tubes spasm.
Of course, ideally you should try to eliminate everything possible reasons development of ectopic pregnancy even at the stage of its planning.
Symptoms of ectopic pregnancy
How do you know that the pregnancy that has occurred is ectopic? In fact, it is not easy to “see” it. The symptoms of this pregnancy are exactly the same as a normal physiological one: the next period does not occur, the breasts become fuller, the uterus enlarges and can stretch, a change in appetite and taste preferences is possible, and so on. But some things may still raise some suspicions.
With an ectopic pregnancy, dark spotting and spotting may be observed from the first days. It happens that the next menstruation occurs in due date or with a slight delay, only the discharge is weaker than usual. Wherein nagging pain in the lower abdomen it radiates into the anus, and if the fallopian tube ruptures, it becomes unbearably strong, acute, even to the point of loss of consciousness, and bleeding begins. With internal bleeding, weakness and pain are accompanied by vomiting and low blood pressure. In such cases, the woman must be urgently taken to the hospital for immediate surgery.
An ectopic pregnancy is most easily confused with a threatened miscarriage. But this is precisely how it makes itself felt: it begins to be interrupted, which usually happens at 4-6 weeks. To prevent the worst from happening, it is necessary to make a diagnosis in time. Therefore, as soon as you find out that you are pregnant, immediately undergo an examination by a gynecologist and. This will allow you to sleep peacefully, because in such cases the location of the fertilized egg immediately becomes known (in most cases).
How to determine an ectopic pregnancy?
The success of resolving the situation with an ectopic pregnancy will depend on at what stage of its development the diagnosis was made. Pregnant women are registered in the second or third month, and this is already too late... Therefore, as soon as you have the slightest suspicion that something is wrong, you need to immediately verify the existence of a problem or rule it out. This happens through examination.
First, you need to make sure that pregnancy has actually occurred. The easiest and fastest way is to do a home pregnancy test. However, you should not rely only on the test in any case: a gynecologist will be able to confirm guesses about the conception that has taken place during an in-person examination. However, this is not always the case: if the period is not long enough or the egg is still too small, then the only way To reliably find out whether pregnancy has occurred or not, there will be an ultrasound of the pelvis with the introduction of a transvaginal sensor and.
If it’s too late to guess - there are all the signs of a pipe rupture or abdominal bleeding - call an ambulance immediately: this condition is life-threatening! And under no circumstances do you take any action on your own: don’t take painkillers, don’t use ice packs, don’t give enemas!
Basal temperature during ectopic pregnancy
Women who keep a basal temperature chart may suspect pregnancy at the earliest stages. After conception, the expectant mother’s body begins to intensively produce progesterone, which is necessary to ensure the vital activity of the egg and create favorable conditions for its further development. It is the increase in the level of this hormone that causes growth basal temperature. You can focus on indicators only if measurements are made from month to month according to all the rules, at least for 4-6 cycles in a row.
With the onset of pregnancy, the basal temperature rises to an average of 37.2-37.3 ° C (in different women these indicators may differ slightly) and is maintained at this level. This occurs regardless of whether the pregnancy develops intrauterine or outside the uterus. Basal temperature during ectopic pregnancy is no different, since progesterone is produced in any case.
A decrease in basal temperature (below 37°C) occurs only when the fetus freezes, which often happens during an ectopic pregnancy. But this is not necessary: often the BT indicators remain at the same levels in this case.
Does the test indicate an ectopic pregnancy?
It is impossible to give an exact unambiguous answer to this question. Firstly, not every test and does not always show a normal pregnancy. Secondly, in the case of attachment of the fertilized egg outside the uterus, there may indeed be nuances.
So, almost all pregnancy tests show the fact of fertilization. It does not matter where exactly the egg has stopped: the level of the hormone human chorionic gonadotropin (hCG) will certainly increase (since the developing placenta begins to produce it), which is what the test systems actually react to.
In principle, there are expensive cassettes that in most cases are able to detect not only pregnancy in the earliest stages, but also its ectopic development (read about this in the article Ectopic pregnancy and pregnancy test). But if we talk about ordinary home tests, they can only establish the fact of pregnancy, and even then with reservations.
The test for an ectopic pregnancy may “work” later than for a physiological one. That is, at a time when it’s normal developing pregnancy can already be diagnosed using a home test, a pathological pregnancy is sometimes still “hidden”. An ectopic pregnancy can often be detected using a delayed test, that is, 1-2 weeks later than the usual situation. Or the second test strip appears very weakly. What is this connected with?
HCG level during ectopic pregnancy
It's all about hCG. Wherever the fertilized egg attaches itself, its membrane (chorion) still begins to produce this hormone. This is why a pregnancy test will show a positive result even with an ectopic pregnancy. But doctors say that in the latter case, the level of hCG is lower than during intrauterine pregnancy and does not grow as dynamically. Therefore, at a time when a home test already shows a normal pregnancy, with an ectopic pregnancy the hCG level may still be insufficient for detection.
In the blood, the concentration of the hormone human chorionic gonadotropin increases earlier and faster than in the urine. Therefore, a blood test for hCG will be more informative. If a woman has unkind suspicions and the gynecologist, after examination and consultation, does not exclude the possibility of an ectopic pregnancy, then it is better to take this test and undergo an ultrasound.
By itself, a blood test for hCG cannot be a reason for making a final diagnosis, but together with an ultrasound it can clarify the picture. HCG during an ectopic pregnancy, although it increases, is not so rapid and dynamic. Regular monitoring of the level of hCG in the blood (with a break every 2-3 days) allows us to draw preliminary conclusions: during normal pregnancy it will double, during pathological pregnancy it will increase only slightly.
Does an ultrasound show an ectopic pregnancy?
Transvaginal ultrasound allows you to see the location of the fertilized egg already in the second week of pregnancy, although reliable data can certainly be obtained from approximately the fourth week. If the embryo is not detected in the cavity of the fallopian tube or uterus (when it is still too short period of time and the fertilized egg is not visible due to its extremely small size), but there is a suspicion of an ectopic pregnancy, the procedure is repeated after a while or the woman is immediately hospitalized and a medical examination is carried out. According to indications, it is even possible to perform laparoscopy: the pelvic organs are examined under anesthesia during an operation, which, if an ectopic pregnancy is confirmed, immediately turns into a medical procedure.
Ultrasound with intravaginal insertion of a sensor is considered the most reliable method for diagnosing ectopic pregnancy. However, it does not provide a 100% guarantee that the diagnosis will be made correctly. In 10% of all cases when an ultrasound is performed during an ectopic pregnancy, it is not installed because an accumulation of fluid or a blood clot located in the uterine cavity is mistaken for the fertilized egg. Therefore, even such highly accurate diagnostics are recommended to be combined with other methods for greater reliability, in particular with a blood test for hCG.
Ectopic pregnancy: forecasts
None of the organs female body not intended for bearing a child other than the uterus. Therefore, the embryo attached “in the wrong place” must be removed. If this is not done in advance, for example, a rupture of the fallopian tube may occur (if the egg is implanted here) or it may enter the abdominal cavity when bleeding opens. Both situations are extremely dangerous for a woman and require immediate surgical intervention. When a fallopian tube ruptures, a woman experiences severe acute pain, shock, fainting, and intra-abdominal bleeding are possible.
It is very important to detect an ectopic pregnancy in time in order to successfully solve the problem. Previously in such cases fallopian tube removed, which meant the inability to get pregnant and give birth in the future. Today it is last resort. In most cases, for an ectopic pregnancy, an operation is performed during which the fertilized egg is removed and the fallopian tube is sutured to preserve reproductive capabilities.