Ectopic pregnancy in the early stages

Contents

Symptoms of ectopic pregnancy
Causes of an ectopic pregnancy
Methods for diagnosing ectopic pregnancy
- Tests
- РњРµРґРёС † РёРЅСЃРєРёРµ РїСЂРѕС † РµРґСѓСЂС ‹
Treatment of an ectopic pregnancy
Prevention of ectopic pregnancy
Pregnancy after an ectopic pregnancy
Popular questions and answers
- What complications can occur?

Delayed menstruation, toxicosis, pain in the lower abdomen – an ectopic pregnancy is cleverly disguised as a normal one, but the consequences are not at all funny. Therefore, it is important to register with a gynecologist as soon as possible.

Ectopic pregnancy is an extremely serious pathology. It threatens a woman not only with the possibility of infertility, but even with a fatal outcome. We will figure out with gynecologist Alexandra Saifullina whether it is possible to avoid this complication and what to do about it.

Symptoms of ectopic pregnancy

An ectopic pregnancy is a pregnancy in which a fertilized egg is not attached to the uterine cavity, as it should be, but somewhere nearby. It is most commonly found in the fallopian tube, sometimes in the cervix, on the ovary, or in the abdomen (1).

As long as the egg is small, the symptoms of an ectopic pregnancy are no different from those of a normal, healthy pregnancy. It:

delayed menstruation;
bloody issues;
toxicosis (nausea, weakness, dizziness);
enlargement and soreness of the mammary glands.

But with an increase in the duration of pregnancy, the woman’s body begins to feel “something is wrong” and begins to give certain signals, the main of which is pain.

– As the embryo grows, at 3-4 weeks, dull aching or pulling pains may appear in the lower abdomen, in the area where the tissues are stretched. More often on the right or left lower abdomen, where the fallopian tubes are located, so sometimes the symptoms are confused with appendicitis, explains gynecologist Alexandra Saifullina. – At 4-6 weeks, if you do not notice in time that the embryo does not develop in the uterus, the pregnancy may be interrupted – the fallopian tube will rupture. Which is accompanied by severe bleeding and a sharp pain of a paroxysmal nature, which radiates to the rectum or legs.

Added to this is difficulty urinating, diarrhea. It is important to diagnose an ectopic pregnancy in time. This condition is dangerous for a woman’s life.

Causes of an ectopic pregnancy

The specific causes of ectopic pregnancy are still unknown. However, there are some factors that contribute to this pathology:

inflammatory diseases of the internal organs of the reproductive system;
too long and tortuous fallopian tubes;
the formation of adhesions, leading to fusion of the fallopian tube with neighboring organs;
sexually transmitted diseases;
violation of the hormonal function of the ovaries;
a history of abortion;
installed intrauterine device;
pregnancy with IVF;
endometriosis on the fallopian tubes;
surgical interventions in the area of internal genital organs.

If you are in a “risk group”, it is recommended to plan a pregnancy together with a gynecologist. However, unfortunately, even this does not give a 100% guarantee.

Methods for diagnosing ectopic pregnancy

It is impossible to confirm an ectopic pregnancy at home!

There are laboratory tests and medical procedures that can be diagnosed by a doctor (2). Such preventive procedures are recommended for all women who have encountered a delay and whose pregnancy test gave a positive result.

– Along with tests and ultrasound diagnostics, a vaginal examination is performed in a gynecological chair. With such an examination, a specialist can detect a painful formation and confirm the presence of an ectopic pregnancy, says gynecologist Alexandra Saifullina.

Tests

The first thing to do with delay, pain and spotting from the vagina is a pregnancy test. If he showed a negative result, do not rush to relax. In the early stages, tests can be wrong. So it’s worth either repeating the test a little later, or choosing a more revealing method of testing – a blood and urine test for hCG. For analysis, blood is taken from a vein.

HCG, or human chorionic gonadotropin, is a hormone produced by a fertilized egg. It consists of alpha and beta units, but in the case of pregnancy diagnosis, only the latter are indicative. They are detected in the blood plasma approximately 6-8 days after fertilization.

A gynecologist may suspect an ectopic pregnancy based on the level of these beta units. In a normal pregnancy, their number increases by about half every 48 hours, and this is rarely observed with an ectopic pregnancy.

However, this is not yet an indicator, because hCG may not increase even during uterine pregnancy, which, for some reason, froze. This requires additional procedures.

РњРµРґРёС † РёРЅСЃРєРёРµ РїСЂРѕС † РµРґСѓСЂС ‹

Expectant mothers, regardless of whether they have symptoms of an ectopic pregnancy or not, are definitely recommended to undergo an ultrasound scan. In the early stages, ultrasound diagnostics is designed to exclude an ectopic pregnancy. Together with the analysis for hCG, these are the main ways to diagnose such a pathology.

Typically, pregnant women are advised to undergo a transvaginal ultrasound, in which a transducer is inserted directly into the vagina. So the specialist will be able to more accurately determine whether there is a problem. And to understand where it is – in the fallopian tube, in the cervix or elsewhere.

In cases where it is impossible to conduct an ultrasound scan, and there are suspicions of an ectopic pregnancy, an emergency procedure is performed – culdocentesis. With her, the doctor pierces the back wall of the vagina and takes fluid from there for analysis. If dark blood with clots appears in the syringe, this may be a sign of an interrupted ectopic pregnancy.

Treatment of an ectopic pregnancy

All women with suspected ectopic pregnancy are referred to the hospital. This is necessary, since an egg growing in the wrong place can cause a lot of harm, in the worst cases, rupture the fallopian tube, provoke bleeding, hemorrhagic shock and death.

The main treatment for ectopic pregnancy is surgery (3). Alas, medicines cannot get rid of a growing egg. Depending on the specific situation and localization of pregnancy, the operation can be laparoscopic, that is, the surgeon will make small incisions, the intervention will be minimal, or laparotomy, when you have to make an incision on the anterior abdominal wall.

– First, as a rule, they carry out diagnostic, and later therapeutic laparoscopy, – explains gynecologist Alexandra Saifullina. – In simple terms, the egg is removed through three punctures in the abdomen. At the same time, everything that the doctor does inside the body is visible on the screen.

Sometimes the fetus can be removed without causing any harm to the woman’s reproductive system. But there are situations when, in order to remove an egg, you have to sacrifice an ovary or fallopian tube. In such situations, a woman may forever lose the opportunity to become a mother. To reduce the likelihood of such an outcome, it is necessary to diagnose an ectopic pregnancy as early as possible.

“Women who have had an ectopic pregnancy need rehabilitation, which includes treatment for anemia, physical therapy, restoration of menstruation and preparation for the next pregnancy,” adds gynecologist Alexandra Saifullina.

Prevention of ectopic pregnancy

There are several recommendations for the prevention of ectopic pregnancy:

timely treat diseases of the reproductive system, such as vulvovaginitis, endometritis and others, as well as sexually transmitted infections (gonorrhea, chlamydia);
avoid casual sex and use condoms;
observe the rules of personal hygiene;
try as little as possible to have abortions, diagnostic curettage, hysteroscopy;
regularly visit a gynecologist – at least twice a year. This becomes especially true with age, because the risk of ectopic pregnancy also increases with it.

Pregnancy after an ectopic pregnancy

After an ectopic pregnancy, the possibility of a normal birth and childbearing is reduced by about 2 times. But of course there are chances. For this, it is necessary to treat subsequent planning with maximum responsibility.

After an ectopic pregnancy, it is mandatory to be tested for infections, as well as to be examined for the presence of chronic inflammation and adhesions. Now the latter are quite successfully removed with a laser or, in advanced cases, promptly.
Make an ultrasound and check the patency of the fallopian tubes, changes in them, the presence of benign tumors, cysts and fibroids.
Conduct an endocrinological examination. Because one of the causes of ectopic pregnancy is hormonal imbalance.
Get rid of the intrauterine device (if any) and use other methods of contraception that the gynecologist will prescribe. These are usually condoms or, less commonly, oral contraceptives.

For at least a year after an ectopic pregnancy, it is not recommended to become pregnant again. This time should be dedicated to your health, both physical and psychological. It is important to be observed by a gynecologist when planning and subsequent conception of a child. In this case, it is necessary to completely eliminate all possible risks.