All nine months of pregnancy for many future mothers are under the flag of various fears that with the child or with them something is wrong. In the first trimester, pregnant women often worry about the embryo being properly entrenched and developing, and therefore study all possible ways how to determine an ectopic pregnancy on their own or in a hospital.
Ectopic, or ectopic, is called pregnancy, in which implantation of the fetal egg occurs outside the body cavity of the uterus, for example, in the fallopian tubes, ovaries, cervix or abdominal cavity. Such cases are observed in 1% of all pregnancies. The most frequent localization of ectopic pregnancy is in the tubes (more than 90% of cases). This pathology attracts so much attention of physicians because it always requires the provision of emergency care. At a belated address to doctors and untimely surgical intervention a fatal outcome is observed at every fourth patient.
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How ectopic pregnancy manifests itself, directly depends on where its development takes place and on what term the woman is. In ovarian and abdominal pregnancies, severe repeated painful attacks in the abdomen are observed, as the tissues of the ovary and peritoneum can not stretch for growth of the embryo. The fetus freezes in the early stages, massive internal bleeding occurs with shock phenomena.
This situation requires immediate surgery. With a fairly rare form of ectopic pregnancy that occurs between the ligament of the uterus, the fetus can develop to relatively large periods (up to five months). If a woman does not register with a gynecologist in a timely manner and has not been examined, such a diagnosis may be exposed during a diagnostic operation after the termination of pregnancy and the development of profuse bleeding into the abdominal cavity..
When the embryo is attached to the fallopian tube, two consecutive stages are clinically identified:
1. Progressive tubal pregnancy - the fetus is attached to the inner shell of the uterine tube and grows until the elasticity of its wall allows.
Symptoms at the earliest date of such attachment and development of the fetus will not be different from the usual complaints of pregnant women at the beginning of the first trimester:
As the fetus grows, periodic pain sensations appear in the pelvis. Closer to the middle of the first trimester, the pain syndrome in the lower abdomen can become permanent, and the character of pain from the aching will pass into acute and paroxysmal. Pain often passes into the rectum or internal surface of the thigh.
Because of the lower content of hormones in ectopic pregnancy, there is often a rejection of the inner uterine layer (endometrium), which is manifested by bloody discharge from the genital tract. A characteristic feature is that they can not be stopped with the help of medicamental blood-resuscitating therapy.
The uterus increases in size, but it is always less than it should be on the prospective term of pregnancy. In the area of the appendages or behind the uterus, it is often possible to grope a volume formation..
2. An aborted tubal pregnancy is a trumpet abortion (the fetus stopped and began to tear off into the abdominal cavity), the rupture of the fallopian tube.
This stage is always accompanied by a sharp cutting cramping pain in the abdomen until fainting. At the same time, internal bleeding of varying severity develops. Depending on the volume of lost blood, bleeding can be from slight to massive with the development of shock (a decrease in pressure, a pronounced pallor, a cold sweat, a loss of consciousness).
It is believed that more significant blood loss takes place with bruises and heavy physical work. Simultaneously there are symptoms of irritation of the peritoneum: bloating, tension and soreness of the abdominal wall.
In early terms at home with a delay in menstruation or when symptoms of early toxicosis can be tested for pregnancy. But the test can reliably solve the question whether this pregnancy is uterine or not, it will not be possible. The fact is that if the embryo is attached incorrectly, hormones are still formed, indicating that the woman is pregnant, albeit in a smaller amount. Therefore, if a high-sensitivity test is used at home, it will reveal even low values of the chorionic hormone and show pregnancy. In addition, even with a negative test, it is impossible to completely eliminate the ectopic pregnancy.
Also, if you suspect an ectopic pregnancy, you can feel for yourself a seal on the right or left in the lower abdomen. At home, an improperly developing pregnancy can be suspected by constant pain in the abdomen, as well as smearing spotting. Similar symptoms can also occur with the threat of abortion of the correctly attached fetus, and both of these situations require urgent examination in the conditions of the hospital and medical supervision.
The development of ectopic pregnancy can be indirectly judged by HCG and progesterone in the blood. HCG in the case of ectopic fetal localization will increase slightly, far below the norm for the duration of the expected pregnancy. In addition, the dynamics can be traced to the lack of its doubling every two to three days, which is always the case with a normal pregnancy. The amount of progesterone will also be lower than the expected rate, but its variations are more difficult to trace, than hCG, because a low level may indicate a threat of a miscarriage of a normally located the fetus..
Reliable diagnosis without ultrasound, relying only on the values of laboratory parameters of hormones, is not possible. Only an ultrasound examination can reveal an out-of-cavity fetal egg, indicate the stage of development (live embryo or stage of abortion), determine the approximate amount of discharged into the abdominal cavity blood. This effective and generally available research is used in dynamics at the initial stages of development pregnancy and in controversial cases (repeat ultrasound in two to three days to assess the condition and localization embryo).
If there is a suspicion of tube rupture and internal bleeding, an important diagnostic examination is a puncture of the posterior vaginal fornix, in which blood is detected in the punctate. But the most informative, and at the same time, therapeutic method is laparoscopy. During this operation, a special laparoscopic instrument is inserted through several micro-cuts into the abdominal cavity, which allow surgeon to see all the processes occurring in the abdominal cavity, eliminate the ectopic pregnancy, remove the poured blood and keep the uterine pipe.
Be sure to consult a doctor about when and how to get pregnant after an ectopic pregnancy will be possible in your case. On average, doctors recommend waiting half a year or a year for a complete recovery of the body. If the exact cause of the occurrence of ectopic implantation of the fetus (for example, adhesive and inflammatory processes) is known, it is necessary to undergo a course of treatment to eliminate this cause..
Previously, in the surgical treatment of such a pathology, one uterine tube was always removed, which reduced the chances of a new normal pregnancy by half. At present, with the introduction of laparoscopic technique, operations with ectopic pregnancy are almost always It is possible to save the woman's fallopian tubes, so the chances of getting pregnant again are almost the same level.
Even if the early period of pregnancy, in your opinion, is normal, do not postpone the first visit to the doctor, since the most reliable to recognize the ectopic pregnancy can only be a specialist. Timely diagnosis and treatment of such an impaired pregnancy will help to maintain your reproductive health and will give you the opportunity to feel the happiness of motherhood in the future.