Ectopic pregnancy in the early stages

In medicine, ectopic pregnancy refers to the development of a fetal egg not in the uterus, but other internal organs - the fallopian tube, abdominal cavity, ovary, etc. As a result of this, pregnancy is not physically possible until the end of the term, since all other organs are not adapted to such a load. Ectopic pregnancy has various consequences and threatens women with serious complications. Quite often, an ectopic pregnancy develops asymptomatically and manifests itself in a critical situation.

Ectopic pregnancy in the early stages develops as a result of the fact that the egg after fertilization for some reason is delayed and attached to the fallopian tube (or other organ). The development of an embryo in this situation ultimately leads to a stretching of the tube, since the appendages are not designed for such a load, the increase can reach a state in which the organ can break at any time. Such a state threatens a woman with the development of peritonitis, since blood, mucus, and embryo enter the abdominal cavity. At the same time a very strong inflammation develops with unbearable pain. Damaged vessels provoke severe internal bleeding. This condition requires inpatient treatment, sometimes in intensive care settings.

The most common form of ectopic pregnancy is tubal (when pregnancy develops in the fallopian tube), also the development of a fertilized egg can begin in the ovary or peritoneum, the cervix, while the signs of an ectopic pregnancy may be different, but the risk of organ rupture and peritonitis pose a danger to the woman in of the same degree.

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Causes of ectopic pregnancy in the early stages

Ectopic pregnancy develops in the vast majority of cases as a result of disturbances in the pathways followed by a fetal egg. In this case, the problem is that a large enough egg can not pass through the narrowed portion of the fallopian tube, whereas for small spermatozoa it is not difficult. In this case, the fertilized egg can not pass into the uterus and stops in the fallopian tube, where the embryo begins to develop. Interestingly enough, the fact that such a complication as the development of pregnancy outside the uterus is found only in humans.

Currently, experts have identified a number of factors that can contribute to the development of an ectopic pregnancy:

• inflammatory diseases in the genitals, in particular, having a specific character (tuberculosis, chlamydia, etc.). Inflammation helps to narrow the lumen in the fallopian tubes (sometimes completely blocking the stroke);
• Ectopic pregnancy in the early stages is provoked by contraceptives that are used directly in the uterus (spiral); - abortions practically always strongly injure the inner layer of the uterus, which in the future threatens with difficulties in fixing the embryo in the uterine cavity. Also, the cervix is damaged, which can lead to "failure" of the embryo and its development of the cervix. In addition, the artificial termination of pregnancy can lead to inflammation of the internal organs of the reproductive system;
• various formations in the appendages that reduce the lumen of the uterine tube, disrupt the formation of hormones that are necessary for the proper operation of the fallopian tubes; - endometriosis - a disease in which the inflammation affects the inner layer of the uterus, so fixing the fetal egg is difficult;
• operations on the organs in the small pelvis, after which the adhesive processes in the peritoneum may develop, as a result, the passableness of the fallopian tubes is impaired;
• operations on the fallopian tubes increase the risk of developing an ectopic pregnancy in the future by 25%;
• sexual infantilism and abnormal arrangement of internal organs (elongated fallopian tubes, impaired functional activity, hormonal disorders);
• with artificial insemination, the risks of developing an ectopic pregnancy increase by 5%.

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Symptoms of an ectopic pregnancy in the early stages

Ectopic pregnancy in the early stages can occur with moderate or severe soreness in the lower abdomen. Usually, pain sensations are observed only on one side of the abdomen, in the place where the embryo develops. If the development of the fetal egg occurs in the abdominal cavity or cervix, there are pains in the middle of the abdomen. Often, a woman feels an increase in pain when changes in body position, turns or walking, etc. The timing of the onset of symptoms indicating a pathological process of development of the fetal egg depends on where the fetus is located. If the development of the embryo occurs in the wider part of the tube, the signs may appear around the eighth week of pregnancy, if in a narrower period, then at the 5th-6th week the woman begins to feel soreness. When developing an embryo in the ovaries or peritoneum, a woman may not feel any characteristic symptoms in this case until 4 weeks. With the location of the fetal egg in the cervix, for a long time the pregnancy can go unnoticed, since it practically does not cause any symptoms.

Ectopic pregnancy in the early stages can be accompanied by moderate or abundant bloody discharge. With the development of the embryo in the cervix, the secretions can be copious and prolonged, since there are many blood vessels in the cervix of the uterus. In some cases, the loss of blood is so great that it can endanger the life of a woman. In addition, with cervical pregnancy, there is a high probability that it will be necessary to remove the uterus.

Most often, tubal pregnancy develops, the symptoms of which include pain, bleeding when the tube walls are damaged. Sometimes there is a trumpet abortion, when a fertilized egg detaches itself from the wall of the tube, while the woman suffers a severe bleeding.

Diagnosis of an ectopic pregnancy in the early stages

Normal pregnancy occurs with an increased amount of hormones in the body of a woman. In some cases, when a woman independently determines pregnancy using express strips, she can pay attention to the appearance of a weaker second strip, which may indicate an insignificant level of the hCG hormone that accompanies pregnancy from the second week. More detailed information on the amount of hCG in the body can be found using a blood test. In uterine pregnancy, the amount of the hormone increases daily, if there is a deviation, the doctor may suspect anomalies in the development of pregnancy.

Ectopic pregnancy in the early stages is determined by ultrasound, which is the most effective method of diagnosis, since the absence of an embryo in the uterus and positive laboratory tests can establish an ectopic pregnancy.

In some cases, ectopic pregnancy is determined by critical signs: when an embryo attached to the internal organ provokes its rupture. In this case, internal bleeding begins, which is a great danger to a woman's life. Internal bleeding is determined by sharp and severe pain in the abdomen, a sharp or gradually increasing weakness, severe pallor, sweating, dizziness and loss of consciousness, blood may be released from the genital organs. If there are any signs, you need to call an ambulance urgently.

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Treatment of ectopic pregnancy in the early stages

Ectopic pregnancy in the early stages is treated depending on which organ is attached to the fetal egg, the age of the woman, her desire to have a baby in the future, and also from concomitant diseases of the genitourinary system.

With minor blood loss, a laparoscopic operation is most often performed, in which a special instrument is inserted through a small incision on the skin, on which there is an optical system and the doctor can see his own manipulations and the place of the operation on the monitor. This operation due to the miniature tools and minimal damage allows the body to be whole and complete.

Tubotomy is an operation to open the uterine tube and remove the embryo, after this kind of interference, the tube remains practically intact and in the future can perform its functions in full.

Tubectomy is used when the fallopian tube has undergone irreversible changes, and there is no possibility to keep the body complete and workable. With such a pathology, tubotomy is possible, however, the uterine tube will be too damaged to function fully and, most likely, again provoke an ectopic pregnancy. Laparoscopic methods allow you to accurately assess the status of the uterine tube when developing a fetal egg in it, tu bectomy is performed only in extreme cases, when the safety of the pipe is more dangerous than its complete removal.

With laparoscopy, the peritoneum must be cleaned of the blood that has entered it to prevent the development of an adhesion process. In addition to the direct operation to remove the fetal egg, the surgeon can evaluate the condition of the other tube and, if necessary, restore the patency.

If a woman has lost a lot of blood, which is usually observed when the tube is ruptured, an urgent operation is performed to eliminate the negative consequences of an ectopic pregnancy. In this case, the method of laparoscopy is not applied, since such an operation requires preliminary preparation of the patient.

Previously, a medicamentous method of treating an ectopic pregnancy was used, when a drug blocking the development of cells was introduced into the fetal egg, but this method had many complications, so it is not used at present.

After the operation to eliminate the negative consequences of an ectopic pregnancy, a woman needs to restore her reproductive function. Usually, for these purposes, the adhesion process is prevented, the hormonal background is restored.

To prevent adhesions, physiotherapeutic procedures are used: low-frequency ultrasound, laser therapy, electrostimulation of fallopian tubes, an impulsive magnetic field, and the like.

After completing the course of anti-inflammatory therapy, a woman is recommended to use contraceptives. The duration of contraception is decided in each individual case, depending on the state of the childbearing function of a woman and her age. It is usually recommended to use hormonal contraception at least six months after the surgery.

After the rehabilitation of a woman after an ectopic pregnancy has ended, if a woman suggests re-conceiving a child, diagnostic laparoscopy is recommended, in which it is possible to assess the current state of the genital organs in the small pelvis, in particular the state of the fallopian tubes. If there are no pathologies in the diagnosis, then there are no contraindications to conception. Preventing ectopic pregnancy in the early stages

Ectopic pregnancy in the early stages, first of all, is prevented by appropriate and timely treatment of the arising inflammatory processes in the genitourinary system. If pregnancy is included in the nearest plans, it is necessary before conceiving a child to pass the necessary tests for infections that can trigger a pathological development process (ureaplasma, chlamydia, etc.).

The most important reason for most ectopic pregnancies is abortion. In this case, it is necessary to use contraceptives, the choice of which is now quite large. In case the pregnancy occurred "off-schedule", it is recommended to perform an interruption operation in the early stages, up to 8 weeks after the abortion, it is obligatory to undergo the post-abortive recovery course.

Ectopic pregnancy in the early stages of a fairly difficult condition, which threatens a woman infertility in the future. To reduce the risk of reproductive harm, timely treatment of pathology with a mandatory course of subsequent recovery therapy will help.