Ectopic pregnancy, symptoms and consequences

July 28, 2012

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An ectopic (ectopic) pregnancy   quite justified is considered one of the most dangerous pathologies in the field of gynecology. After all, with untimely diagnosis, wrong diagnosis and therefore, without adequate treatment, a woman who develops an ectopic pregnancy, can die as a result of blood loss and painful shock. The incidence of ectopic pregnancy is about 2% of all pregnancies .

There are two stages of ectopic pregnancy: progressive   and Interrupted . Once the fertilized egg is implanted at ectopic pregnancy mostly in the fallopian tube, in pregnant there are changes that are typical of normal pregnancy. Further egg increases, thus there is a stretching of the pipe wall. Gradually, it is destroyed, and there is termination of pregnancy. This often happens pipe rupture and internal bleeding that threatens a woman's life.

Causes of ectopic pregnancy

To distinguish three types of ectopic pregnancy: it is abdominal . ovarian . Pipe . The main difference in this case is exactly where localized fertilized egg. In the normal development of the process of conception and subsequent implantation of fertilized egg in the end into the wall of the uterus. However, if there are some constraints, it may not reach the target, and the implantation takes place in an adjacent organ. The most common tubal ectopic pregnancy happens. However, each of the above types of ectopic pregnancy occurs due to the same reasons. The most common reason for this becomes the presence of women obstruction of the fallopian tubes or one pipe. As a result, it becomes impossible to achieve the goal of a fertilized egg, and it develops outside the uterus.

Fallopian tubes, in turn, occurs in women as a consequence of certain diseases and disorders. In particular, the pipe may become impassable due to the development chronic salpingitis . This disease manifests as a consequence of infectious diseases, sexually transmitted diseases, the treatment of which was not conducted in a timely manner. It is also the cause of the disease may be surgery on the tubes, inflammation provoked held abortion   or exposure to a long stay in the uterus spiral.

Pathology of the fallopian tubes in women can also be congenital. Sometimes tubes are initially aborted, otherwise they appear in them additional openings. Such phenomena may be caused as a consequence of genetic factors and the result of changes that have occurred because of the harmful effects of external factors. It is therefore essential to plan a pregnancy, to avoid such effects.

Decided to allocate certain categories of women who are at risk of increased likelihood of ectopic pregnancy. These are the women whose birth occurred with the use of IVF ; women using intrauterine systems as a means of contraception; Women taking birth control as minipill , Reducing the motility of the fallopian tubes. Ectopic pregnancy may occur in women who suffer from various disorders of the reproductive glands, as well as those who have symptoms of undeveloped sexual apparatus. A higher risk of ectopic pregnancy is present in those women who had already experienced ectopic pregnancy and have not figured out exactly what the reason was the predisposing to its development. In addition, ectopic pregnancy is more common in smokers, leading unhealthy lifestyle of women. Increasing the chances of ectopic pregnancy in women who were diagnosed with a variety of tumor   in the pelvis. Such education may mechanically compress the fallopian tubes.

Also increases the risk of developing this disease in women who are over 35 years old, and while they have at one time been diagnosed infertility . The fact that the number increases with age adhesions   in the fallopian tubes. But if this approach to planning pregnancy with utmost responsibility, it is possible to avoid unpleasant consequences.

Symptoms of an ectopic pregnancy

To have the most detailed information on how to identify an ectopic pregnancy, it is important to know exactly what kind of symptoms of this condition occur during its development. To diagnose an ectopic pregnancy in the early stages is difficult because the symptoms of an ectopic pregnancy is not always clearly expressed. However, doctors distinguish some symptoms that should alert a woman to become a prerequisite for immediate treatment to the doctor.

So signs of an ectopic pregnancy in the early stages include, above all, the presence of negative or weakly positive pregnancy test . Sometimes a woman observes the growing signs of a developing pregnancy: menstruation does not occur, it appears early toxemia . But this test is not yet confirmed that conception has occurred. It is important that in this case were excluded other causes of negative test: too short a period of pregnancy, improper conduct of the test, a low-quality copy of the test. Therefore, you should verify correct execution of all actions and, if necessary, to re-test for ectopic pregnancy.

If, however, after several tests, there are doubts, accurate information about the presence or absence of pregnancy will help get analysis chorionic gonadotropin . Signs of ectopic pregnancy with the help of such an analysis can be determined even in the early stages, as the blood concentration of this hormone increases since 8-10 days after the time when conception occurred.

Around the third week of a delay monthly specialist already defines gestational age during a pelvic exam. If the examination conducted by a doctor with extensive experience, the size of the uterus, he very accurately determine the time of conception. But if it is assumed gestational age did not match the size of the uterus, it requires an additional ultrasound examination.

If a woman's uterus is small size, and the analysis reveals a decreased level of hCG in this case may appear symptoms of ectopic pregnancy and symptoms of non-viable pregnancy. If during ultrasound fertilized egg in the uterus is detected, possible or occurred previously miscarriage Or attachment of the ovum in any other organ. It is extremely important to the immediate treatment of women.

At the same time the symptoms of an ectopic pregnancy in the longer term is expressed more clearly. Women are constantly worried about the appearance of vaginal discharge, which are either bloody or anointing character. This may be discomfort or pain in the abdomen, as well as where there is a body in which the fertilized egg implanted. All other displays are no different from the most common signs of pregnancy: can nagrubat breasts, morning sickness, etc. occur. A woman who develops an ectopic pregnancy, can periodically suffer from sudden bouts of nausea, dizziness , Fainting. However, these signs of an ectopic pregnancy during and may be absent. If you can not determine what is the development of an ectopic pregnancy, then the continued growth of the ovum can happen rupture of the body in which it is implanted

If such a phenomenon occurs, then at the time the woman feels very strong and sharp pain in the body. It may fall sharply   arterial pressure That leads to a state of syncope. Lower abdominal pain appears suddenly. In addition, a woman much pale, drenched in cold sweat, her sick. In this case, it is important to immediately seek medical help.

It might appear as a vaginal or internal bleeding. Both of these conditions are very dangerous. It is important to promptly stop the bleeding that can only be achieved by means of surgery. Otherwise likely fatal.

Methods of treatment of ectopic pregnancy

With the development of ectopic pregnancy in women treatment is required only if the pregnancy has ceased to evolve independently. It is relatively rare. If you were diagnosed with an ectopic pregnancy, the fertilized egg and continues to grow, it is important to begin treatment immediately.

To date, there is a possibility of suspension of development of the embryo by receiving medicament. The preparation Methotrexate Used for this purpose is an antagonist folic acid . This is a rather toxic drug, so its reception is possible only if the woman is fully confident that the ectopic pregnancy. After his admission should not become pregnant over the next three months. It is important that the size of the gestational sac was small - no more than 3, 5 cm. The drug is contraindicated in women who suffer ulcer . kidney or liver failure . leukopenia and other diseases. The drug can not be used mothers who feed the baby breast milk.

But the conservative therapy for an ectopic pregnancy is now used relatively rarely. Most often, this pathology is eliminated by surgery. Surgical intervention may be in different cases suggest a different approach to the treatment of ectopic pregnancy. Thus, the possibility of salpingectomy   - Removal of the fallopian tubes; sometimes suitable salpingostomy   - Removal of the ovum; In some cases, surgery is the removal of the pipe segment in which was implanted fertilized egg.

As a rule, women spend laparoscopy   or laparotomy   At laparoscopy, the abdominal wall is not opened, therefore, the operation is less traumatic for a woman .  Performing such an operation is carried out with the help of special tools, which are administered through small punctures .  Laparoscopy allows you to save the fallopian tube where there is a development of the ovum .  Yet there is often a risk of subsequent adhesion formation in the operated tunnel .  So sometimes the doctor makes the decision about the removal of the pipe .  After the operation carried out in the fallopian tubes, women should not be sexually active for two months .  In the process of rehabilitation after surgery is supposed purpose of the course of antibiotic treatment to prevent possible inflammation .  It is also fully justified the appointment of physiotherapy, which contribute to the prevention of occurrence of pelvic adhesions .  Also in the complex treatment includes reception vitamins . iron supplementation .

Depending on exactly how and where the fruit is, ectopic pregnancy can be donoshen to different terms. In rare cases, ovarian, cervical or abdominal location of the fetus shows signs of pregnancy or there is an interruption, even in the second or third trimester. When tubal pregnancy which occurs most frequently interrupt occurs 6-8 weeks.

It is important to realize that the sooner a woman is diagnosed with an ectopic pregnancy, the more likely that the termination of her body will suffer minimal damage.

Implications of ectopic pregnancy

The most serious consequences of ectopic pregnancy - is an increased risk of recurrence of a similar situation in the future. Thus, according to medical statistics, women who have undergone removal of a fallopian tube may have an ectopic pregnancy again in 5% of cases. If the pipe has been saved, then this risk has increased to 20%. Therefore, every woman, at one time had suffered an ectopic pregnancy, should work with your doctor to determine how you can minimize all existing risk factors. Only then can plan the next attempt to get pregnant.

Furthermore, as a consequence of ectopic pregnancy can occur inflammation in the pelvis, abdomen. It is also possible the development of adhesions. Sometimes an ectopic pregnancy leads to the development of infertility in women.

Prevention of ectopic pregnancy

To prevent this disease, a woman must, above all, to minimize the possibility of the factors that provoke ectopic pregnancy. So, there is an obstruction of the fallopian tubes as a consequence of gynecological diseases and infections that are sexually transmitted. When planning the conception and the presence of an increased risk of ectopic pregnancy should be screened tubal patency. In performing this procedure, which is called hysterosalpingography Also can detect the presence of adhesions in the tubes. They can be removed by a simple surgical procedure.

In the absence of fallopian tubes woman recommended IVF.

General preventive measures aimed at preventing the development of an ectopic pregnancy include the careful attitude to health, the right way of life, the absence of frequent change of sexual partners, early conception and birth of the baby.

Before you plan a pregnancy, a woman should be screened for the presence of mycoplasmas . Chlamydia . ureplazmu and promptly cure all diseases detected. Future father is also being examined.

Another important preventive measure - the right approach to Contraception As ectopic pregnancy is often a consequence of an abortion performed in the past.

If a woman has gone through surgery for ectopic pregnancy, after its implementation is very important to fully rehabilitated before making an attempt to get pregnant the next time. According to doctors, optimally plan conception a year after surgery on the fallopian tubes.