Will the doctor notice an ectopic pregnancy during the examination? Types of ectopic pregnancy

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 bear 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 are already early stages determine the manifestations of pathology. 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:

1. 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. In normal pregnancy hCG level doubles every 2 days, with pathological changes insignificant.
2. 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.
3. . 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; small punctures are made using special instruments, where a tube with a camera and light is inserted, and the doctor examines the organs through an image on a monitor. If an ectopic pregnancy is detected, then therapeutic measures are immediately taken (removal of the fertilized egg, etc.).

Symptoms

Since ectopic pregnancy occurs in different ways, specific symptoms may appear gradually, late 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 in parallel: 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 gives a negative result, it is likely that 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 of the 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 the 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 drowsiness, and 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.

At later stages, the symptoms of ectopic pregnancy increase faster, and in a critical situation - rapidly. A woman’s blood pressure drops sharply, she experiences frequent dizziness, and her 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 manifested by very severe pain, shock, and loss of consciousness. Urgent medical attention is required.

For each type of pathological implantation of the fertilized egg, there are characteristic symptoms:

• Pipe An 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, and sudden movements.
• Ovarian An ectopic pregnancy does not show any pathological symptoms for a long time. 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, dysfunctions of the gastrointestinal tract appear (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

Normally, during conception, sperm enters the vagina, then through the cervix into the uterus. Then fertilization occurs in the fallopian tubes - the sperm fuses with the egg. A zygote is formed - a one-cell embryo, that is, the first stage of human development. The fertilized egg descends through the tubes into the uterus and begins to develop there.

But if for some reason the zygote does not enter the uterus, but gets stuck at some stage of the journey, the fetus begins to grow in the wrong place and an ectopic pregnancy is diagnosed. In 98% of cases, an ectopic pregnancy develops in the tubes, but in rare cases the fertilized egg may be located in the ovaries or abdominal cavity.

An ectopic pregnancy is quite dangerous. After all, the embryo develops at a rapid speed and can simply rupture the tube with its growth, which leads to severe internal bleeding. This can lead to irreversible consequences. Therefore, it is very important to determine the presence of an ectopic pregnancy in the early stages. A woman’s future reproduction and even her life depend on this. But first, let's try to figure out what can lead to such a pathology.

Causes of ectopic pregnancy

1. Chronic inflammatory or infectious gynecological problems. Infectious diseases of the reproductive system often lead to disruption of the fallopian tubes - they do not contract enough to push a fertilized egg into the uterus. Because of this, the egg simply cannot pass to its destination and becomes fixed where it is stuck. If a woman has suffered from inflammation of the uterus and appendages, adhesions, scars and narrowings may form in the tubes, which prevent the normal passage of the egg.
2. Surgery is another factor that can cause an ectopic pregnancy. This is because after surgery, the abdominal organs may be changed, which may interfere with the normal course of a healthy pregnancy.
3. Congenital tubal pathologies. Some women have congenital tubal pathology; the tubes may be very long, narrow, tortuous, or completely obstructed. This makes it difficult for the egg to pass through the tubes.
4. Tumors. Regardless of whether the tumor is benign or malignant, it can prevent the passage of the egg through the tube simply by pinching it.
5. Hormonal imbalances. Frequent and uncontrolled use hormonal contraceptives(especially concerns intrauterine devices) leads to disruption of a woman’s normal hormonal levels. As a result, the mobility of the tubes decreases, the tube cannot push the egg into the uterus.
6. Weak sperm. Sometimes it happens that the sperm that fertilized the egg is quite weak, and the zygote is simply unable to move through the tubes.

Very often, an ectopic pregnancy develops after an invasion of the body in the past - after an induced abortion.

Symptoms of an ectopic pregnancy generally differ little from the first signs of a healthy pregnancy. The woman also begins to experience toxicosis, her menstruation is delayed, the test shows two lines. A woman feels a frequent urge to urinate, her chest becomes congested and her basal temperature rises. But how to distinguish a healthy pregnancy from an ectopic one based on the first signs? Here are a few symptoms that are characteristic of an ectopic pregnancy.

1. Scarce bleeding of a smearing nature. They are often brownish in color. After a tube rupture, internal and uterine bleeding may occur.
2. Pain. This is the main sign of problems in the body. The pain can be cutting and stabbing, aching and sharp. Often the pain is localized on one side of the lower abdomen, namely in the tube where the egg is located. With abdominal bleeding, pain may radiate to the anus. Pain may also occur when urinating or having bowel movements. The pain increases or decreases with movement or changing body position.
3. Due to large blood loss, the woman experiences anaphylactic shock. She feels apathy, drowsiness, and may lose consciousness. In addition to this, her skin turns pale, her blood pressure drops, her pulse slows, and her head constantly feels dizzy.
4. The abnormal course of pregnancy can be indirectly determined by a pregnancy test. Everyone knows that the test reacts to the level of human chorionic gonadotropin. The level of the hCG hormone normally increases very quickly as pregnancy progresses. And if in the early stages the second strip on the test was weak and transparent (low hCG level), then the very next day the second strip will be much clearer. And with an ectopic pregnancy, the hCG level remains low over time, so the pregnancy test shows a clear and fuzzy line even the next day.
5. There are special tests that not only react to the level of the hCG hormone, but also, based on other hormonal changes, can show the risk of developing an ectopic pregnancy and the risk of a threatened miscarriage. Everything is based on immunochromatographic analysis.

If you suspect an ectopic pregnancy, you should immediately consult a doctor. After all, a timely detected pregnancy can save the pipes from rupture. To verify the presence or absence of an ectopic pregnancy, your doctor may order tests for the hCG hormone.

1. HCG hormone. As mentioned, the hCG hormone normally increases several times every two days. If the levels of this hormone do not increase or increase slightly, this is one of the serious indicators of the presence of an ectopic pregnancy.
2. Ultrasound. Already at 6-7 weeks, the fertilized egg can be seen on an ultrasound machine. Using an ultrasound, the doctor determines the location of the fertilized egg. If no seals are found in the uterine cavity, the specialist expands the search area and, in the event of an ectopic pregnancy, finds an accumulation of free water in one of the tubes. If even the egg itself is not visible, the tube is dilated during an ectopic pregnancy. But sometimes a specialist may mistake a blood clot in the uterus for a fertilized egg, especially in the early stages of pregnancy (4-5 weeks). In this case, it is necessary to perform laparoscopy for a more accurate result.
3. Laparoscopy is a modern and accurate way to diagnose and treat abdominal organs. Laparoscopy is a procedure in which a tiny incision is made in the patient's abdomen through which a thin tube with a lens at one end is inserted. On the other side there is an eyepiece through which you can observe a picture of the patient’s insides. If instead of a lens there is a mini video camera at the end of the tube, then the image is projected onto the screen. Laparoscopy is considered an accurate diagnostic method also because internal organs can be viewed from all angles, moving and sliding them. This procedure is accurate and reliable in detecting ectopic pregnancy.
4. Puncture. This method is quite old-fashioned due to its pain and unreliability. Its principle is as follows. A needle is inserted through the woman's anus into the uterine cavity. From there the liquid is taken for analysis. If blood is found in the fluid, this indicates the presence of an ectopic pregnancy in the woman’s body. However, this diagnostic method is not 100% reliable, and it is also very unpleasant and painful. Therefore, today it is practically not used.

How to remove an ectopic pregnancy

Diagnostics confirmed the presence of an ectopic pregnancy in the woman’s body. What's next? And then laparoscopic surgery is necessary to remove the fertilized egg from the tube. An ectopic pregnancy never goes away without cleaning. If possible, doctors try to save the integrity of the tube, but if it is completely ruptured, it is removed along with the fetal body.

1. If the fertilized egg is located near the entrance to the pipe, Milking is done - the egg is squeezed out without damaging the pipe.
2. If extrusion is impossible, salpingotomy is performed. In the place where the fertilized egg is located, the tube is cut, the egg is removed, and the incision is stitched. If the embryo is large enough, it is removed along with part of the tube. The functional ability of the tube is then preserved - the woman will be able to get pregnant.
3. In cases of tube rupture, a tubectomy is performed - removal of the fallopian tube along with the fertilized egg. If there is a risk to the patient's life, the tube can be removed along with the ovary.
4. If an ectopic pregnancy is detected in the early stages, chemotherapy is possible. A woman is given special drugs (for example, Methotrexate) that sharply suppress fetal development. The drug is used until 6 weeks of fetal development, until it has cardiac activity. However, Methotrexate is a rather crude medicine that has many side effects - from kidney and liver damage to complete hair loss. This type of treatment is almost never used in Russia. This type of treatment is only possible for women who no longer plan to become mothers.

After surgery, it is very important to undergo a course of rehabilitation treatment, which will prevent the appearance of adhesions and scars on the tubes. After all, any obstructions in the tubes in the future can become another cause of ectopic pregnancy. After removal of an ectopic pregnancy, you cannot plan to conceive a child for at least six months.

If a woman suffers from an ectopic pregnancy, this does not mean that she cannot become a mother. After all, every woman has two fallopian tubes, and if, in the worst case scenario, one tube is removed, she is left with a second, completely reproductive one. Most women who experience an ectopic pregnancy are subsequently able to give birth to healthy children. And only 6-8% remain infertile after an ectopic pregnancy.

An ectopic pregnancy is not a death sentence. Conceiving and carrying a baby is a long and complex process, during which anything can happen. Ectopic pregnancy occurs in only 2% of all pregnancies. And if this happened to you, don’t despair. Timely diagnosis and proper treatment will restore your body. And then you will be able to turn this difficult page of your life and move on, becoming a mother more than once!

Video: ectopic pregnancy - signs, symptoms and advice from doctors

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 a normal pregnancy begins, during which the egg improves, constantly divides, a fetus is formed, from which by the end of the term a full-fledged child grows, 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 get to the right place in time, 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 birth control, do not allow her to relax, which is why the fallopian tubes spasm.

Of course, ideally, it is necessary to try to exclude all possible causes of the development of an ectopic pregnancy at the planning stage.

Symptoms of ectopic pregnancy

How do you know that the pregnancy that has occurred is ectopic? In fact, it’s 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 cause some suspicion.

With an ectopic pregnancy, dark spotting and spotting may be observed from the first days. It happens that the next menstruation occurs on time or with a slight delay, only the discharge is weaker than usual. In this case, the nagging pain in the lower abdomen radiates to 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. It will be easier and faster to do home test for pregnancy. 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 is a pelvic ultrasound 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 heating pads, 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 (for 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 the period is still too short and the fertilized egg is not visible due to its extremely small size), and there is 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, the fallopian tube was removed, which meant the inability to become pregnant and give birth in the future. Today this is a 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.

Intrauterine or classic pregnancy is a normal physiological process of carrying a child in the womb. Ectopic pregnancy (ectopic) occurs in 2% of all pregnant women.

And, despite the fact that the probability for any representative of the fair half of humanity is small, everyone can face such a problem. What signs of an ectopic pregnancy indicate that nature has committed a terrible mistake?

Atypical start of the process or what happens?

During the female cycle, after ovulation, the egg penetrates the fallopian tube - the place where it meets the carrier of male genes. The fallopian tube is the site of fertilization, from where the formed zygote gradually moves towards the walls of the uterus for implantation.

If a fertilized egg, for some reason, has stopped moving towards the main female organ, and penetrated into the mucous membrane of the place of its movement, which means an ectopic pregnancy has occurred. At this level, it is not yet possible to recognize the first signs.

In some cases, befriended particles of sexual partners are pushed out of the woman’s genitals for implantation in other organs, which helps classify ectopic pregnancy:

• pipe;
• ovarian;
• implantation of the zygote in the abdominal cavity;
• heterotopic pregnancy (the presence of two fertilized eggs - in the uterus and outside it).

According to doctors' statistics, 98% are tubal pregnancies. The remaining options, in particular implantation in the abdominal cavity, are rare and account for about 2%.

The most “popular” ectopic pregnancy is tubal, and has the ability to terminate on its own (positive pregnancy outcome). Do not be alarmed in advance, there is no rupture of the tube, and the implanted egg separates on its own - tubal abortion.

Why possible? No doctor can name the exact reasons why conception occurs this way, but there are risk groups that may have an ectopic pregnancy:

• Chronic inflammatory processes female reproductive system. They contribute to disruption of the functionality and anatomy of the fallopian tubes, for example, a decrease in their contractility, which means their ability to push through the egg that finds the sperm is reduced. Consequently, implantation will be on some part of the tube or in the abdominal cavity, and an ectopic pregnancy occurs;
• Anatomical features of the fallopian tubes - excessively tortuous, long, “obstructed”;
• Violation of the properties of the fertilized egg itself;
• Unreliable contraception against the background of diseases of the female streak system;
• After using modern reproductive technologies - in vitro fertilization;
• Tumor formations on the uterus and its appendages, abdominal organs, disrupting the patency of the fallopian tubes;
• Hormonal imbalance;
• Early surgical operations on the abdominal and pelvic organs.

Symptoms for an ectopic pregnancy can be exactly the same as for a normal one.

Almost every second woman asks herself the question: will a pregnancy test be able to determine the resulting pathology - ectopic or intrauterine pregnancy? Solving this issue is very simple. Even if the fertilized egg has attached to the lining of the fallopian tube, ovary or abdominal cavity, the pregnancy test will still be positive. The tests do not determine whether you have a normal or abnormal pregnancy. Thus, the first signs of an ectopic pregnancy, like an intrauterine pregnancy, appear after the test.

The pregnancy test responds to an increase in the classic hormone for pregnant women - human chorionic gonadotropin, or hCG in short. In conditions of ectopic pregnancy, hCG increases in accordance with the development of the implanted zygote. The only one hallmark may become a weakly visible second line on the test. A negative pregnancy test cannot be ruled out. This often happens at 3 - 4 weeks of ectopic pregnancy, when human chorionic gonadotropin was not synthesized at all. But even at this time, the symptoms of an ectopic pregnancy will not differ from normal.

If the test is negative, even after a delay, girls simply forget about possible deviations from the norm and do not consult a doctor. Remember, the test may be negative, but this is not a sign of absence of pregnancy. An ectopic pregnancy requires emergency medical attention.

Old grandmother's methods, signs, pregnancy tests - not a single method will give an exact answer as to what kind of pregnancy occurred and the symptoms of an ectopic pregnancy will not determine what is happening in the body. They are identical to normal pregnancy.

How to recognize an ectopic pregnancy? If you have any suspicions - after a delay in menstruation, malaise and other symptoms occur - consult a doctor.

Ectopic pregnancy symptoms in the early stages

Although ectopic pregnancy is a dangerous condition for the female body, in 65% of cases there are no consequences, and the woman can then give birth to beautiful babies. Much to the good fortune of doctors, if the test is negative, but there are certain symptoms of an ectopic pregnancy, the woman will seek medical help before complications occur.

Previously, to get rid of an ectopic, not only the site of implantation of the fertilized egg was removed, but also the uterus. Now new gentle methods - surgical or medicinal - make it possible to preserve the integrity of the structure of the female body for the birth of children later. Of course, everything depends on the moment of the woman’s appeal. Early detection of an abnormally attached fertilized egg is a guarantee of a positive outcome of treatment therapy. Therefore, every woman should know the symptoms of ectopic pregnancy.

Signs of an ectopic pregnancy in the early stages are not much different from the classic implantation of a fertilized egg. Initial symptoms:

• After a long delay in menstruation, pregnancy tests are positive;
• There may be toxicosis;
• Enlargement of the mammary glands, their soreness;
• Increased number of urinations;
• Basal temperature is slightly increased.

Of course, such symptoms will not alert the woman and will not help to suspect the ectopic location of the ovum.

Specific symptoms of ectopic pregnancy:

1. Scanty, or after a long delay, menstruation;
2. Immediately after a missed period, severe cutting pain occurs in the lower abdomen. Pay special attention - in 95% of cases, pain is localized on one side (in accordance with the lesion of the fallopian tube), less often in the central region (implementation in the cervical part of the fallopian tube).
   pain occurs or occurs when changing body position, physical activity, etc. The appearance of pain directly depends on the timing of pregnancy and the location of the fertilized egg: 1) the fertilized egg is attached to the ampullary part of the fallopian tube - pain appears at 8 weeks; 2) the isthmus is involved - at 6 weeks; 3) ovarian pregnancy or in the abdominal cavity - manifestations at 3 weeks. Cervical ectopic pregnancy can be painless for a long time;
3. Constant dizziness, loss of consciousness, general weakness;
4. The pregnancy test, although positive, raises doubts - the second line is not clearly defined. A repeated test after some time produces a similar result;
5. The discharge is bloody and may be brownish-brown. The longest and most abundant discharge occurs during the cervical attachment of the fertilized egg. This is explained by the peculiarity of the place - a rich network of blood vessels. Blood can accumulate both in the abdominal cavity and be released outside. The main thing is not to confuse uterine bleeding with the onset of menstruation, after a long delay;
6. Large blood losses determine a decrease in blood pressure, which results in fainting.

With such symptoms, you need to rush to the doctor, otherwise the detached fertilized egg will cause irreparable damage to the woman’s health.

A sensitive hormonal test is positive, there is constant pain on the right or left, spotting after a delay, a preliminary diagnosis is ectopic pregnancy. Previously, women with this diagnosis were immediately operated on for life-saving reasons, since it was impossible to establish the cause of the symptoms before 8 weeks. Fortunately for our generation, it is now possible to find out such a diagnosis earlier. Hormonal tests, ultrasound, and diagnostic laparoscopy help with this.

In case of ectopic pregnancy, clinically proven signs:

• HCG test. As mentioned above, human chorionic gonadotropin is specific only for pregnant women (produced by embryonic tissues). In a normal pregnancy, hCG levels rise every 2 days. A slow increase in hCG is a symptom of a poorly proceeding intrauterine pregnancy or its development outside the main female organ. An identical picture is a test for the percentage of progesterone in the body. Clinically, a slow increase in these hormones means, perhaps, an ectopic pregnancy, the signs are relative;
• Ultrasound is a classic modern method for determining ectopic pregnancy. It has been proven by trial and error that the implanted set of chromosomes in a normal location is clearly visible near the walls of the uterus during ultrasound, with a corresponding level of human chorionic gonadotropin above 1800 IU/l. Thus, an ultrasound specialist examining the uterus, noticing the absence of a fertilized egg, expands the search region.
  responsibly, an ultrasound is performed if pregnancy is suspected. Such an accurate diagnosis is not possible in all cases. In this case, dilated fallopian tubes and the presence of free fluid in the pelvic cavity or abdominal cavity serve as a guide. A photo of the site of attachment of the fertilized egg is proof of the correctness of the diagnosis. When performing an ultrasound, there are a number of features - accumulation of fluid, blood clots in the uterus - reminiscent of a fertilized egg. Then after the ultrasound the diagnosis differs from the real picture. To understand exactly where the zygote has attached, you need to perform a laparoscopy. A vaginal ultrasound is effective already at 4-5 weeks of pregnancy, and with an abdominal ultrasound, it is possible to recognize the presence of an unborn child at 6-7 weeks. Even the fact that an ultrasound does not show the fertilized egg in the uterine cavity already means an ectopic pregnancy;
• There are cases when hormonal tests and ultrasound cannot visualize the overall clinical picture, then diagnostic laparoscopy is performed. Through a small round hole in the anterior abdominal wall, a laparoscope is inserted and the pelvic organs are examined. Laparoscopy is the optimal way to solve the problem of ectopic pregnancy, while preserving the fallopian tube.

Critical symptoms of ectopic pregnancy are rupture of the fallopian tubes, disruption of the integrity of the ovarian membrane, intestinal loops, bladder, and intra-abdominal bleeding.

Treatment Options for Ectopic Pregnancy

The most convenient, modern and gentle method of treatment is laparoscopic surgery. The goal is to determine the degree of damage to the fallopian tube, ovary or other organ by the fertilized egg, then a decision is made - removal of the fertilized egg while preserving the fallopian tube, or tubectomy (complete excision of the tube).

Postoperative recovery

Even with an excellent operation, you should undergo a rehabilitation course - drug treatment, magnetic therapy. And, most importantly, strict adherence to contraception for 6 months after surgery. It is impossible to determine the likelihood of a repetition of the situation; it depends on the anatomical characteristics of the woman.

Any expectant mother is afraid to hear from a 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 you have to urgently resort to surgical intervention.

An ectopic pregnancy essentially differs from a standard one in that in such a situation the mother cannot carry the fetus to term 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 take the 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. This is where the fertilized egg comes out. 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 that 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. This is due to:

• 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 in the early stages of gestation the egg is extremely small in size, so it is quite difficult to notice it during one examination.

Precautions

In order to prevent ectopic pregnancy, you need to be very careful about your health. This is primarily due to gynecological diseases that 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. The likelihood of this exists at different periods, but 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 embryonic 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 surgery. 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.

Clinical manifestations of ectopic pregnancy

Experts cannot identify obvious symptoms that would categorically indicate the development of a 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 during an ultrasound examination.

To accurately determine the diagnosis, laparoscopic surgery is necessary. 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 warning signs by 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);
• profuse bleeding;
• 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.
It is also extremely important to know the signs of internal bleeding in order to call doctors in a timely manner. Symptoms include:

Types of pain in the lower abdomen and possible pathologies

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

Video - How to diagnose and treat ectopic pregnancy