Ectopic pregnancy is a fairly common abnormality in modern gynecology. This condition with a late diagnosis and the lack of timely treatment can lead to terrible consequences that can carry a direct threat to the life of a woman.
To prevent the development of complications, it is necessary to have an understanding of the main symptoms and their development in the early stages of the process.
The concept of pathological implantation
Ectopic pregnancy is the process of implantation of the ovum outside the uterus or in its additional cavities in the presence of anomalies of the female reproductive system.
The most frequent places of its localization in this case may be:
- oviduct;
- ovary;
- abdomen.
Types of ectopic pregnancy
Depending on the place of implantation of the ovum, a pregnancy that does not develop in the uterus itself may be:
- Tubal - fetal egg does not come out of the fallopian tube during its peristalsis, but is implanted directly into its cavity. The most frequent type of ectopic tubal location is the right side, the ampullary part;
- The ovary is divided into: intrafollicular - the fertilized egg remains directly inside the follicle itself, and the ovarian is fixed on the surface of one of the ovaries;
- Cervical - the ovum is implanted in the thickness of the cylindrical epithelium of the cervical canal. With the progression of pregnancy, the chorionic villi penetrate deep enough into the muscle layers, destroying the vascular network, causing bleeding of varying intensity;
- Intra-ligamentous - a fertilized egg is fixed in the thickness of the wide ligament of the uterus. It develops due to rupture of the fallopian tube, which was previously;
- Localized in the abdominal cavity - the ovum can be fixed in the thickness of the omentum, peritoneum, on the intestinal wall and other organs of the abdominal cavity;
- Localized in the secondary uterus horn - a rare location associated with an anomaly of the main reproductive organ;
- Heterotopic - this type is characterized by the development of several fetal eggs (two or more) with different places of localization, one of which is located in the uterus, and the other in one of the atypical places.
Causes of development
Causes of ectopic pregnancy can be caused by: various inflammatory diseases, hormonal imbalance, previous intake of certain drugs, congenital developmental anomalies and acquired defects, as well as diseases that ultimately lead to disruption of the process of moving the ovum to the physiological implantation site.
Among the main etiological factors should be highlighted:
- Spontaneous and medical abortion in history;
- Contraception using the intrauterine device and / or hormonal pharmaceuticals. Women who use the intrauterine device for 5 years or more should be included in a special risk group;
- The use of assisted reproduction techniques (IVF) and / or ovulation stimulation;
- Development of ectopic pregnancy earlier;
- Surgical treatment of organs of the reproductive system in history;
- Transferred diseases of inflammatory genesis, especially those that lead to a narrowing, deformation of the fallopian tubes, as well as the violation of their motility and patency;
- Tumor neoplasms on the pelvic organs;
- Congenital malformations and anatomical features: accessory horn of the uterus, excessive length and tortuosity of the fallopian tubes, etc .;
- Endometriosis, especially with a chronic course;
- Underdevelopment of reproductive organs: infantilism, etc.
The first symptoms of abnormal location of the ovum, especially
An ectopic pregnancy may not manifest itself for some time. In the earliest terms of its development, a woman can notice only the following signs:
- violation of the menstrual cycle (delayed expected menstruation);
- engorgement, enlargement, increased sensitivity of the mammary glands;
- taste perversion, loss of appetite, moderate toxicosis.
As the pregnancy progresses, join:
- bloody spotting from the genital tract;
- the appearance and progression of pain syndrome with the growth of the ovum. The pain is one-sided, can be aggravated by walking and changing the position of the body.
The main features of a pregnancy that develops outside the uterus are the atypicalness of its clinical symptoms and the difficulty of diagnosis.
Symptoms of aborted ectopic pregnancy
Sooner or later, in the absence of timely diagnosis, an ectopic pregnancy is interrupted spontaneously, and then the basis of the clinical picture is dominated by such phenomena as:
- sharp, intense pain in the abdomen, radiating to the lumbar region, anus, sometimes to the lower limbs;
- bleeding from the genital tract of varying intensity;
- pallor of the skin, cold sticky sweat;
- hypotension, tachycardia, weak filling of the pulse and its filament;
- dizziness, loss of consciousness episodes.
Symptomatic due to intra-abdominal bleeding due to rupture of the ovum.
Can a test determine ectopic pregnancy
There is no specific test for the diagnosis of intrauterine pregnancy at home. The classic pregnancy test can also give a positive result if there is an ectopic localization of the ovum.
This is due to the fact that chorionic gonadotropin - a pregnancy hormone is synthesized in the placenta - one of the new organs of a pregnant woman, and not in the uterus itself.
A pale second strip with repeated testing is not a 100% symptom of implantation of the ovum outside the uterus, but rather is considered a reason for seeking advice from a qualified specialist.
In addition, even in the presence of an ectopic pregnancy, the test can fix a negative result, since the level of β-human chorionic gonadotropin in this state is much lower than in the physiologically developing one.
Diagnosis, at what time noticeable changes
It is extremely difficult to diagnose an ectopic pregnancy in the early stages of its development. This is due to the atypical and inexpressive clinical symptoms, as well as its initial similarity about many other diseases (not only the reproductive system).
Even a terminated ectopic pregnancy needs to be able to differentiate from the acute surgical pathologies of the abdominal organs.
It is possible to diagnose the development of pregnancy, in which the fertilized egg is localized in a non-physiologically correct place for itself, until a bright clinical picture related to its interruption appears, using:
- Ultrasound of the pelvic organs. The most informative method is considered transvaginal ultrasound, which allows you to detect the ovum in the uterus at an earlier gestational age (3-5 weeks) compared with transabdominal;
- determination of β-chorionic gonadotropin. Its level in blood serum during normal pregnancy and ectopic is significantly different with the same time delay. In the first case, it is significantly higher than in the second;
- diagnostic laparoscopy - allows you to detect the exact place of implantation of the ovum and, if necessary, simultaneously remove it.
The period at which an ectopic pregnancy can be determined directly depends on where the fertilized egg is implanted:
| Implant site | The onset of symptoms |
|---|---|
| Ampular division of the fallopian tube | 8 weeks |
| Isthmus | 5-6 weeks |
| Ovary or abdominal cavity | 6 weeks or more |
| Cervix | Approximately 6 week |
Transvaginal ultrasound allows to suspect the development of a non-physiologically located fertilized egg as early as 3-5 weeks.
Recommendations of specialists
Every woman who is concerned about the state of her health, including the childbearing function, should undergo a routine check-up at the gynecologist 1-2 times a year. Special attention should be paid to this ritual by women who have problems with the reproductive organs earlier, as well as those who have already encountered atypical implantation of the ovum.
If a woman has a history of ectopic pregnancy, then at the first signs of pregnancy, you should consult a doctor for diagnosis and further follow-up.
If pregnancy develops outside the uterus, mandatory treatment is indicated: either by conservative means (medications provoking a spontaneous miscarriage are prescribed) or operatively (removal of the ovum, partial or complete removal of the uterine tube).
The earlier this phenomenon is diagnosed and treated, the greater the chances of a favorable rehabilitation period, the absence of complications and a high risk of pregnancy in the future.
Reviews of early manifestations
Our readers have left the following reviews about the manifestation of symptoms of ectopic pregnancy in the early period.
4 years ago, faced with such a problem as an ectopic pregnancy. Diagnosed completely by chance during a routine medical examination. The period of menstruation has not yet come, but when viewed in the mirrors, the doctor suspected a possible pregnancy.
I was sent to an ultrasound scan, where no fetal egg was found in the uterus, then my doctor told me to repeat the study in 1-2 weeks. During this time I made a test that showed 2 bars, the second of which was barely visible.
Repeated ultrasound showed nothing again. A decision was made on diagnostic laparoscopy. During the intervention and was diagnosed tubal pregnancy. For all this time, only appetite deterioration has paid attention to itself.
Olga, 32 years old, Moscow
Last year I was diagnosed with an ectopic pregnancy. As the doctor said, the ovum is located right in the ovary. I went to the doctor because there was a slight delay in the menstruation, but it was not she who disturbed me the most.
At a certain moment, I noted the appearance of dull, aching pains in the right side of my stomach, which either appeared or disappeared without taking painkillers. Then there was some connection with the change in body position in space and physical activity.
The pains began to intensify with twisting and turning of the body, as well as with fast walking. At first I turned to a surgeon, and from him was sent to a gynecologist, who diagnosed and prescribed treatment.
Marina, 26 years old, Syktyvkar
Conclusion
- Ectopic pregnancy is a condition from the development of which no woman is insured. And although this form of implantation is not so common, in order to prevent its development, it is extremely important to constantly monitor the state of your reproductive health and visit a gynecologist;
- A fetal egg can have several non-physiological implantation sites;
- The symptoms of this phenomenon are hidden and do not bother a woman for a long time;
- Diagnosis of this phenomenon is extremely difficult, but possible;
- Late diagnosis and lack of treatment can lead to the development of terrible consequences: some of them can cause infertility, and some - and the death of the patient.
Additional information about the signs of ectopic pregnancy - in the next video.
