Ectopic pregnancy

Ectopic pregnancy is a common phenomenon that requires attention from both doctors and women themselves. Over the past decades, the pathology has become 2-4 times more common. Weak or atypical signs of ectopic pregnancy prevent early diagnosis.

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What is an ectopic pregnancy?

An ectopic pregnancy occurs when a fertilized egg implants outside the uterus. Most often, this occurs in the fallopian tubes, and less commonly in the ovaries, cervix, or abdominal cavity. This condition occurs in 2% of cases and is a serious threat due to the high risk of internal bleeding.

Causes of ectopic pregnancy

The main cause is a malfunction of the fallopian tubes. These hollow organs are lined with microscopic villi that help the egg enter the uterus. If their function is disrupted, the egg is attached in the wrong place.

Factors that increase the risk:

  • Abnormalities in the development of the uterus
  • Inflammation of the appendages
  • Adhesions, which block the movement of the egg
  • Abortions that damage the lining of the uterus
  • Endometriosis
  • Hormonal imbalance
  • Smoking

There is also a high probability of an ectopic pregnancy in women who have previously had an ectopic pregnancy and in those who use intrauterine contraceptive devices.

Causes of ectopic pregnancy

Symptoms of an ectopic pregnancy

The following symptoms are typical for an early ectopic pregnancy:

  • Delayed menstruation
  • Brown vaginal discharge
  • Pulling or sharp pain in the lower abdomen
  • General signs of pregnancy are nausea, breast swelling, loss of appetite

If you notice any unpleasant symptoms, consult a doctor and undergo a comprehensive examination.

Types of ectopic pregnancy

There are 3 types of ectopic pregnancy:

  • Abdominal. The egg attaches to the omentum, liver, uterosacral ligaments, or the area between the uterus and rectum. This type of pregnancy increases the risk of severe bleeding and damage to internal organs. The fetus often develops serious birth defects.
  • Tubal. The most common form of ectopic pregnancy, in which the egg attaches to the wall of the fallopian tube. Complications include arrest of embryonic development and rupture of the tube with severe bleeding.
  • Ovarian. It is detected in less than 1% of all ectopic pathologies. It is accompanied by the attachment of the egg to the ovary, an inflammatory process, and damage to the ovary. There is a high probability of developing peritonitis

In rare cases, cervical pregnancy occurs. It is characterized by the attachment of the egg in the cervix, a high probability of sudden bleeding due to the proximity of large vessels.

The table presents the types of ectopic pregnancy with a description of the features and possible risks.

Type of pathology Where the egg is attached Features Possible risks
Abdominal Organs of the abdominal cavity:
  • Omentum
  • Liver
  • Uterosacral ligaments
  • Rectal pouch
  • It can be primary (implantation in the abdominal cavity) or secondary (after exiting the tube)
  • The embryo sometimes develops until late stages
  • Severe bleeding
  • Organ damage
  • High risk of fetal malformations
Tubal Falling tube
  • The most common form
  • Implantation occurs in the wall of the tube
  • Tubal rupture with bleeding
  • Embryo growth arrest
  • Threat to the woman's life due to blood loss
Ovarian
  • Ovarian surface
  • Inside the follicle
  • Rare type (less than 1% of cases)
  • Implantation and development occur on the ovary
  • Risk of inflammation and damage to the ovary
  • Peritonitis is possible if ruptured
Cervical Cervical canal (cervical canal) Can be caused by abortions, cesarean sections, or fibroids
  • Heavy bleeding due to large vessels
  • Complex in treatment

General information

Diagnosing an ectopic pregnancy

Diagnosing an ectopic pregnancy involves the use of the following methods:

  1. Pregnancy test. Most often, it shows a positive result, but the second strip is weakly expressed. In rare cases, the test remains negative even if there is a pregnancy
  2. Blood test for hCG. Determines the level of human chorionic gonadotropin, the pregnancy hormone. In case of pathology, its level drops below normal or remains within acceptable values
  3. Ultrasound of the pelvic organs. Allows you to detect the presence of a fertilized egg in the uterus. In case of an ectopic pregnancy, it is located in the fallopian tube or near the ovary. Ultrasound also reveals fluid in the abdominal cavity, a sign of bleeding
  4. Puncture of the posterior vaginal fornix. It is performed if internal bleeding is suspected. A needle is inserted through the vaginal wall to check for blood in the abdominal cavity

Laparoscopy is actively used in clinical practice - a minimally invasive procedure that allows you to examine the pelvic organs with a camera. Laparoscopy not only confirms the diagnosis, but also helps to determine the extent of damage to the fallopian tube.

Treatment of ectopic pregnancy

If pathology is suspected, the woman must be urgently taken to the hospital. Rupture of the tube and other complications usually occur unexpectedly. Treatment is performed surgically. The method is chosen depending on the patient's condition and the stage of the disease.

  • Tubectomy. It is performed when the tube ruptures or is severely stretched. The doctor completely removes the damaged tube along with the fertilized egg
  • Tubotomy. If pathology is detected early and the tube is slightly stretched, an incision is made and the embryo is removed. The tube can be preserved
  • Laparoscopy. It is performed through small punctures in the abdominal wall, which helps to minimize injuries. During the operation, the fertilized egg and the damaged part of the tube are removed
  • Laparotomy. If laparoscopy is not possible due to adhesions, heavy bleeding or obesity, the operation is performed through an incision in the abdominal wall

Laparoscopy reduces the risk of recurrent ectopic pregnancy, speeds up recovery and minimizes trauma after surgery. Women return to their normal lives in 5-7 days.

At the K+31 clinic in Moscow, you can receive qualified assistance with an ectopic pregnancy. Experienced gynecologists accompany patients at all stages of treatment. Call our medical center or make an appointment on the website.

Complications

After an ectopic pregnancy, problems with conception arise, including infertility. The risk is especially high if one of the fallopian tubes had to be removed. Inflammation in the reproductive organs and the formation of adhesions - connective tissue formations that interfere with the normal functioning of the organs - are also possible.

Rehabilitation

Recovery after treatment of the pathology takes 2-3 months. It consists of several stages:

  1. Antibacterial therapy. Prescribed to prevent infections
  2. Nutrition correction. A balanced diet strengthens the body and speeds up recovery
  3. Physiotherapy procedures. Electrophoresis, galvanization, ultrasound therapy improve blood circulation, reduce the risk of adhesions, restore patency of the tubes

Rehabilitation helps not only to restore health, but also to increase the chances of a successful pregnancy in the future.

Prevention of disorders

To reduce the likelihood of an ectopic pregnancy, it is important to follow simple recommendations:

  1. Regularly do an ultrasound of the pelvic organs to detect any changes and prevent complications
  2. Timely treat infectious diseases
  3. Monitor hormonal levels and consult a doctor if necessary
  4. Choose the right contraception. If hormonal agents cause side effects, it is worth discussing other options with a doctor
  5. Reduce the number of abortions. If termination of pregnancy is inevitable, it is better to carry it out in the early stages with a qualified specialist
  6. Avoid intimacy during menstruation to reduce the risk of infection

When planning a pregnancy, be sure to get tested for sexually transmitted infections. If they are detected, undergo a full course of treatment.

Answers to popular questions

Doctors from “K+31” answered the most pressing questions about ectopic pregnancy.

How does an ectopic pregnancy affect a woman's ability to have children?

After an ectopic pregnancy, more than half of women can successfully conceive and carry a child to term. Sometimes pregnancy causes serious complications. If one of the fallopian tubes had to be removed, the chances of conception are significantly reduced. In addition, the risk of a repeat ectopic pregnancy increases. The ability to conceive a child is affected by the condition of the remaining fallopian tube, the presence of inflammation or adhesions. To increase the chances of successful conception, it is important to undergo rehabilitation and follow the doctor's recommendations.

When can you return to training after treatment for an ectopic pregnancy?

Light physical activity is allowed from the 2nd–4th week. Intensive cardio and strength training should be postponed for a period of 1–1.5 months.

What are the main risks for uterine pregnancy?

An ectopic pregnancy can trigger a miscarriage in the first trimester, preeclampsia (high blood pressure in late pregnancy), gestational diabetes, and urinary tract infections.

Does a woman's age affect the likelihood of an ectopic pregnancy?

Yes, it does. Women under 25 have a lower risk of pathological pregnancy. At the age of 30 to 40, the likelihood increases by about 2–3 times. After 40 years, the risk becomes even higher, especially if there are diseases of the pelvic organs or surgeries on the fallopian tubes.

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