An ectopic pregnancy is a pathological pregnancy that poses a serious threat to a woman's health and requires emergency medical care. The fertilized egg in this case develops outside the uterus. Most often, it is fixed in the fallopian tube, but there are cases of its localization in the ovaries or in the abdominal cavity.
According to statistics, 1-2% of all pregnancies, including those resulting from artificial insemination, are ectopic. The risk of this pathology increases in more mature women over 35 years of age. In view of this, the fair sex, who are of reproductive age, are quite often interested in whether an ectopic pregnancy is visible on ultrasound?
Options for ectopic pregnancy
According to the localization of the fertilized egg, ectopic pregnancy can be divided into the following types:
- Pipe arrangement. The spermatozoon overtakes the egg in the fallopian tubes, but due to a violation of the patency of the tubes, the embryo cannot penetrate into the uterus. As a result, tubal rupture may occur or an urgent termination of pregnancy is indicated.
- Location in the ovary. Fertilization occurs before the release of the egg from the follicle or the sperm overtakes the newly ejected female germ cell, which immediately attaches to the ovary. As a result, ovarian apoplexy may occur or the embryo is removed in a timely manner.
- Cervical attachment is a rare pathology that is very easily diagnosed. When examined, the uterus resembles an hourglass in its shape. The fetus can be found in the lumen. The prognosis is unfavorable - sometimes a hysterectomy is resorted to to save the patient's life.
- Location of the embryo in the peritoneum. Such a pathology occurs even less often, when a fertilized egg accidentally enters the abdominal cavity, implants and begins to develop. Or it can break away from the fallopian tube and go into the peritoneal cavity.
It is extremely rare to diagnose heterotopic pregnancy. It represents the coexistence of uterine and ectopic pregnancy.
When should you sound the alarm?
Signs of an ectopic pregnancy are important information for any woman. Primary ones include:
- delayed menstruation;
- the first signs of toxicosis;
- painful mammary glands;
- slightly elevated basal body temperature.
These signs will not help much, because they are one to one, like in a uterine pregnancy. But there is something that should alert a woman closer to the 4th week of the alleged pregnancy:
- The concentration of chronic gonadotropin (hCG) is below the norm for this period.
- Standard pregnancy tests do not show a positive result.
- Abundant discharge with an admixture of blood is observed from the vagina.
- Pain in the uterus and appendages.
- Decreased blood pressure and dizziness.
- Significant increase in body temperature.
A woman who is worried about her health and the future of her baby should definitely go to the antenatal clinic. Already there, a gynecologist's suspicion of an ectopic pregnancy may occur in such cases:
- The size of the uterus is somewhat smaller than it should be at this time.
- Ultrasound examination did not show the presence of a fetal egg in the uterus.
- Low hCG level.
- Pain sensations.
Moreover, if the uterus is smaller than it should be, then the gynecologist may recommend a follow-up examination after 7 days. If then everything remains unchanged, then the woman is sent for ultrasound and blood donation for hCG. Such symptoms do not always indicate an ectopic pregnancy. It can be a complete absence of pregnancy or a missed pregnancy.
In more than half of the cases, focusing on bleeding or pain, women turn to a specialist before serious complications can arise.
Diagnostics
An ultrasound using a transvaginal probe is the best way to determine the location of the embryo. If the pregnancy test stubbornly shows 2 strips, and a fetal egg is not found in the uterus, then they begin to suspect that the embryo is in the ovary or in the peritoneum.
The question remains relevant - at what time can an ectopic pregnancy be determined by ultrasound? Some experts argue that this diagnostic method makes it possible to detect the place of attachment of the fetal egg already on the 20th day of gestation. But still, the more common opinion is that objective information can only be obtained after 30 days.
It happens that a woman turns to a very short period and it is impossible to physically examine the fetal egg in the uterus. If there are serious reasons to suspect a pathological pregnancy, then the procedure is repeated after 5-7 days. And it is even more correct in this case to immediately hospitalize the woman and conduct a full medical examination.
In uterine pregnancy, ultrasound with a vaginal probe can show the embryo in the uterine cavity 5 weeks after the onset of a delay in the menstrual cycle. Whereas the fertilized egg can be seen after 14 days.
The technique of ultrasound examination through the anterior abdominal wall is less sensitive. Such an ultrasound shows an ectopic pregnancy only at 7-8 weeks.
Signs that can be seen on an ultrasound
The detection of a live embryo outside the uterus is an undeniable sign of a pathological pregnancy.
In addition, there are a number of additional signs that help to identify such a pathology:
- In the area of the fallopian tubes and ovaries, a pathological formation is visualized, which has a different shape and size.
- Despite the first signs of pregnancy, no embryo is found in the uterus.
- The body of the uterus has an enlarged size or other changes in the muscle layer of this organ, but at the same time there is no picture of a healthy pregnancy.
- Enhanced reflection of ultrasound by the internal mucous membrane of the uterus, against the background of exposure to chorionic gonadotropin.
- A false embryo is found in the uterine cavity.
- In the deepening of the parietal peritoneum, the accumulation of fluid is determined.
- A cyst is found, which occurs due to the accumulation of fluid at the site of a burst follicle and can sometimes contain blood.
The ultrasound picture of an ectopic pregnancy may differ in each case. Various factors can influence its formation:
- organic changes in the fallopian tubes (obstruction, salpingitis, dropsy);
- the formation of cysts at the site of a burst ovary;
- extensive hemorrhages in the abdominal cavity and small pelvis;
- close arrangement of loops in the small intestine;
- accumulation of benign tumors of the uterus.
On the monitor of the ultrasound machine or a photo taken for the patient, you can see a false fetal egg (there is no embryo inside). To save a woman's life, it is urgent to perform an operation to remove a fertilized egg from the fallopian tube or other organ.
In this case, there can be no talk of home treatment, timely hospitalization is the key to saving a woman's life
Inaccuracies and complications
And yet, concerned women are interested - will ultrasound show an ectopic pregnancy in the early stages in all cases? Or are there errors? No one can give a 100% guarantee, due to the following reasons:
- Too little gestation physically does not allow you to determine whether there is an embryo in the uterine cavity or not.
- Limited range of ultrasound machine capabilities.
- The imperfection of the equipment used and its possible malfunction.
- The specialist performing the diagnostic procedure did not have sufficient qualifications and experience.
Sometimes the accumulation of fluid or blood clot in the uterus looks like a fetal egg and the specialist mistakenly determines the uterine pregnancy. The woman calms down accordingly, and if the internal bleeding is insignificant, then the pathological pregnancy can be hidden for a long time and not have severe symptoms.
A frequent variant of the further development of events is a rupture of the fallopian tube. It happens suddenly and is accompanied by the following symptoms:
- There is a sharp pain in the lower abdomen, mainly on the side where the fetal egg was attached to the tube. The pain radiates to the area of the rectum, as well as the right collarbone.
- Often there are false urges to defecate or loose stools appear. The abdomen is swollen, painful on palpation.
- Decreased blood pressure, severe weakness, up to fainting. With severe bleeding, hemorrhagic shock develops.
- Paleness of the skin and mucous membranes, shortness of breath, the appearance of cold sweat.
- Apathy, lethargy, frequent, weak pulse.
Treatment in this case involves immediate surgical intervention. The damaged fallopian tube is removed laparoscopically, and if hemorrhagic shock occurs, then by laparotomy (open access to the abdominal cavity).
Ultrasound with the introduction of a vaginal probe is considered the most accurate diagnostic method in determining an ectopic pregnancy. But you should not expect a 100% guarantee from him either. Not in all cases this pathology will be visible and the correct diagnosis will be made. It is advisable to combine ultrasound diagnostics with other methods for greater accuracy.
For every woman, the most joyful moment in life is the moment when she finds out that she will soon become a mother. But, unfortunately, this period may be overshadowed by some disturbing reasons. Due to certain circumstances, the development of the fetus may occur with deviations, one of these pathologies is an ectopic (ectopic) pregnancy.
It would seem that from the name it immediately becomes clear what had to be faced, however, this anomaly requires a rather serious, responsible approach. What causes such a pathology? Who is at risk? How long does it take for the symptoms of HMP to show? And the most important question is how it can be diagnosed and what is the role of ultrasound diagnostics in this process?
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What is an ectopic pregnancy?
Specialists traditionally define such a pathology as the attachment of a fertilized egg outside the uterine cavity, in other words, the development of the fetus begins and continues in the fallopian tube, ovary or abdominal cavity. Outside the uterus, there are no adequate conditions for the development of the embryo, so an egg attached in the wrong place causes tissue damage, hemorrhage and rupture of the pelvic organs. There is definitely no future for such a fetus, often women go to the doctor with an already arbitrarily terminated ectopic pregnancy, but if the pathology has been identified up to this point, then immediate medical intervention is required.
Comparison of places of attachment of the fetal egg in normal and ectopic pregnancy
What signs of such a pathology are known to medicine?
Pathology is undoubtedly dangerous because in the early stages it is difficult to find any specific differences and one can confuse the abnormal course of the development of the fetal egg with the norm: a pregnant woman experiences traditional nausea, characteristic weakness; appetite increases and mammary glands increase.
But already at 3-8 weeks, alarming symptoms begin to appear:
- Constant sharp pulling or cramping pains in the lower abdomen on one side.
- Slight bleeding, which, however, is very long. A woman may confuse such bleeding with menstruation, but it will not stop spontaneously.
- Pallor, hypotension, loss of consciousness, bradycardia and arrhythmia.
The detection of at least one sign should serve as an alarm signal for a pregnant woman, who, in turn, should immediately seek qualified help from a specialist. Any delay in this situation can be fatal for the mother in the worst case, or serious damage to the pelvic organs.
Risk factors
Such factors exist, and there are quite a lot of them:
- Some inflammation of the pelvic organs, both in history and at the time of conception. Most often, the inflammatory process occurs against the background of sexually transmitted infections, therefore, when planning an addition to the family, partners should first take care of their own health.
- Contraception. The significance of contraceptives for the occurrence of such an anomaly is ambiguous, however, the statistics speak for themselves - on average, 22% of women with ectopic pathology used intrauterine contraceptives. Properly selected hormonal contraceptives do not pose a threat to the conception and development of the embryo, but taking hormonal emergency contraceptives (especially frequent) can provoke the occurrence of pathology.
- Fallopian tube surgery
- In vitro fertilization, with this procedure, the probability of an anomaly is 11%.
- Neoplasms of the ovaries (benign, malignant), which entail a violation of the functions of the fallopian tubes, squeezing them.
- Endometriosis (growth of cells of the inner layer of the uterus (endometrium) into the myometrium). Most often, pathology occurs when the endometrium grows into the fallopian tubes, disrupting their patency.
- Impaired synthesis of prostaglandins responsible for the movement of a fertilized egg.
- Sexual infantilism, characterized by too long tortuous fallopian tubes with a reduced lumen.
- Diseases of the endocrine system.
- Bad habits of both mother and father.
- Pathologies of the development of the pelvic organs.
Every woman, planning an addition to the family, should familiarize herself with this list and assess for herself whether she is at risk or not. It is advisable for a pregnant woman to immediately inform the attending physician about the presence of a predisposition to HMP.
Types of ectopic pregnancy
The location of the fetal egg relative to other organs of the reproductive system served as the basis for the classification of HMP.
So, experts distinguish:
- tubal (the most common variant that occurs in the vast majority of cases; the embryo begins to develop right in the fallopian tube, since it was attached there);
- ovarian (the fetal egg is located respectively in the ovaries);
- abdominal (the egg begins to develop in the mother's abdominal cavity. Attachment can occur both to the anterior abdominal wall and to the tissues of nearby organs);
- cervical (as the name implies, the development of the embryo begins directly in the cervix).
When should you see a doctor?
Any suspicion of such a pathology as an ectopic pregnancy is a reason to sound the alarm: the mother's life is in danger. A fertilized egg that develops outside the uterus should be urgently taken under the control of medical specialists, since delay in this situation can result in tragic consequences.
It is important that the pathology does not have to be confirmed only by a gynecologist, the HMB can also be detected by a specialist diagnostician. Moreover, ultrasound is practically the only way to make the only correct diagnosis.Significance of ultrasound diagnostics in anomaly detection
This pathological process is dangerous not only from the unnatural development of the fetus, but also threatens the life of the mother, so the detection of an ectopic pregnancy, if any, should occur as early as possible, and the diagnosis itself should be as accurate as possible. Ultrasound diagnostics in this case is the absolute favorite, other methods do not allow providing such a clear, and most importantly, objective picture.
How is the ultrasound process going?
The most common method that provides maximum diagnostic accuracy is transvaginal, which can be used to determine the HMP with maximum probability. A woman needs to undress below the waist, lie on her back on the couch, bending her knees. The diagnostician uses a special sensor for transvaginal ultrasound, which shows all the nuances, puts a special condom and lubricant on it, and only then introduces it into the body. The image is displayed on a special monitor, which shows the pelvic organs.
Ectopic pregnancy on ultrasound
In some cases, it may be necessary to conduct a transabdominal ultrasound (through the abdominal wall), which already requires special preparation - the study is done on a full bladder, only in this case a special sensor shows everything clearly. Transabdominal ultrasound is less informative, moreover, when using this method, an ectopic pregnancy is visible only at 6-7 weeks, and there is also a high probability of errors in the diagnosis. Therefore, it makes sense to do such a diagnosis only if there are contraindications to transvaginal ultrasound.
If there is a suspicion of HMB, the area of the uterine appendages is examined by the diagnostician in the first place. In this area, it is necessary to examine the tubal angles, the posterolateral surfaces of the pelvis and the surface behind the uterus.
Thus, the doctor examines the areas of the most likely localization of the embryo, if there is doubt about the healthy course of pregnancy or HMP. When an abnormal neoplasm is found outside the uterine cavity, there is no longer any doubt, sometimes this is even enough to determine the HMP. Most often, on ultrasound, you can see an oval formation in the lumen of the fallopian tube, in which the yolk sac is visualized. The diagnostician also evaluates the echogenicity of the structures of the pelvic organs.
For a more accurate diagnosis, specialists also use the color mapping method, which identifies and shows on the monitor the hypervascularization zone (blood flow, reflecting the intensive blood supply to the embryo outside the uterus). After the examination, the diagnostician analyzes the data obtained and draws up conclusions, attaching a picture if necessary.
What does this study provide insight into?
The most important thing that ultrasound can detect is the location of the fetal egg outside the immediate boundaries of the uterine cavity.
Other signs of HMB on ultrasound:- accumulation of fluid in the pelvic cavity.
- the volume of the uterus begins to increase, despite the fact that
fibroids are absent - a blood clot is found in the uterine cavity - a false fetal egg
- hypersecretion of uterine endometrial glands
- corpus luteum cysts
- neoplasms of various shapes and volumes located in the uterine appendages.
It is very important that sonography (ultrasound examination) shows and often allows you to accurately determine the specific type of anomaly. Giving an assessment of the ultrasound signs of pathology, it is possible to easily determine the cervical HMP: a fetal egg can be easily detected by a specialist, the cervix is enlarged, there is a specific reaction of the endometrium.
With abdominal HMP, the examination shows characteristic oligohydramnios, a thickened placenta, abnormal development of the embryo, abnormally high fetal position, broken contours of the placenta, and the uterine wall in this case are practically not visible on the monitor.
It is problematic to detect sonographic signs of ovarian HMP (especially before the 12th week of pregnancy), since the fetal egg looks like a follicle, but there is still a chance to see a human fetus.
Detection of ectopic pregnancy up to 12 weeks of gestation (early)
Many women are concerned about how long an ultrasound scan shows pathology. An undeniable advantage is the fact that ultrasound diagnostics allows you to determine the pathology at the earliest possible date. Already at the fifth week, you can see with the help of ultrasound the location of the embryo outside the uterus. It is because of the foregoing that ultrasound is extremely important as a diagnostic method and an aid in making a diagnosis. It is also worth noting once again that, given the possibility of detecting pathology in the early stages, women should not ignore ultrasound, timely medical assistance in an unfavorable case allows minimizing negative consequences, saving a woman’s health and life.
In this patient, 28 years old, no fetus was found, however, ultrasound doctors found accumulation of fluid in the right fallopian tube - a sign of an ectopic pregnancy
Are there errors in the diagnosis?
Given the specifics of the signs of an ectopic pregnancy, as well as the fact that it is often arbitrarily interrupted, it is necessary to make a differential diagnosis with the diseases listed below (otherwise, you can confuse the IUD with another pathology):
- Rupture of the ovary;
- Rupture of the cyst;
- Torsion of the fallopian tube or ovary;
- Benign and malignant neoplasms;
- cyst of the corpus luteum;
- uterine fibroids;
- Appendicitis.
Additional shots
Experts believe that a new pregnancy after an ectopic can be planned six months to a year after tubal surgery. Often, after an unsuccessful attempt that ended in surgery, a woman asks herself the question: what to do so that the next pregnancy ends more safely? For this, you should not waste time and emotions for nothing - you should direct them in a rational direction. For the time allotted until the next pregnancy, it is necessary, if possible, to find out everything about the causes of the onset of the previous ectopic pregnancy and, if possible, exclude them.
What is an ectopic pregnancy?
Normally, pregnancy develops in the uterine cavity, where a fertilized egg reaches through the fallopian tubes, which is introduced into the prepared uterine mucosa. It is interesting to note that the spermatozoon and the egg do not meet in the uterine cavity, but in the fallopian tube. They merge and give rise to a new life.
But in some cases (fortunately, not very often - no more than 1.5-2% of all pregnancies), the fertilized egg, for various reasons, does not enter the uterine cavity, but lingers in the fallopian tube (95% of cases of ectopic pregnancy). Sometimes, in rare cases, pregnancy can develop in the abdominal cavity, on the ovary, in the cervix and in other organs. However, the total proportion of these forms of ectopic pregnancy does not exceed 5% of all cases of this condition.
Many women are interested in the question: why is an ectopic pregnancy dangerous? The fact is that in the fallopian tube, the abdominal cavity and in other organs, in addition to the uterus, there is no developed special mucous membrane, which is necessary for the attachment and normal development of the fetal egg. With the progression of an ectopic pregnancy, the tube or other organ is stretched, and the villi of the chorion (fetal egg) sprout blood vessels and its wall, leading to the development of bleeding and rupture of the organ where the fetal egg is located. However, this is the end of an ectopic pregnancy, which can develop gradually, without showing anything unusual for many days and weeks.
Diagnosis of an ectopic pregnancy
With an ectopic pregnancy, there may be many signs of a normal one, i.e. uterine pregnancy, such as breast engorgement, changes in the sense of smell and taste, drowsiness, irritability, etc. However, in many cases, attention is drawn to the addition of a new group of symptoms, such as the appearance of bloody discharge from the genital tract of the "daub" type, the occurrence of pain in the lower abdomen of varying degrees of intensity. A woman may be disturbed by pains radiating to the rectum, severe weakness, nausea, loose stools are also possible. It should be noted that such complaints can also occur with the threat of termination of uterine pregnancy, in the presence of inflammatory diseases of the uterine appendages and in a number of other diseases of the female genital area. If intra-abdominal bleeding occurs in the event of a rupture of the fallopian tube, a third group of symptoms appears, such as sharp pains in the lower abdomen, radiating to the shoulder, shoulder blade, rectum, cold sweat, loss of consciousness is possible. When examining a woman in a similar condition, there is a drop in blood pressure, a frequent pulse. The pallor of the skin and visible mucous membranes is noteworthy. The abdomen is painful on palpation. In the presence of such complaints, it is necessary to consult an obstetrician-gynecologist in order not to lose precious time and prevent formidable complications from developing, such as intra-abdominal bleeding and shock due to rupture of the fallopian tube.
During the examination, the specialist can confirm or exclude the diagnosis of an ectopic pregnancy or prescribe additional research methods to clarify the diagnosis. As a rule, such diagnostic methods include ultrasound (ultrasound), the determination of a hormone such as the b-subunit of chorionic gonadotropin (b-CG), and a number of other measures.
Ultrasound of the pelvic organs is not always informative, especially in the early stages of ectopic pregnancy. At the same time, transvaginal ultrasound (the probe is inserted into the vagina) has an advantage over transabdominal ultrasound (the study is performed through the anterior abdominal wall). With transvaginal ultrasound, the diagnosis of ectopic pregnancy can be ruled out 4-6 days earlier than with transabdominal ultrasound. A fetal egg in the uterine cavity using transvaginal ultrasound can be detected at a gestational age of 4-4.5 weeks, which will correspond to a b-CH level corresponding to 1500-2000 mIU / ml. If, with such values of b-CHG, the fetal egg in the uterine cavity is not determined, then most likely we are talking about an ectopic pregnancy. It should be noted that during uterine pregnancy, the level of b-CHG in the blood doubles every 2 days, and during ectopic pregnancy, it is much slower. At the same time, a standard urine sample (i.e., the use of a home test) for pregnancy is negative in 50% of cases of ectopic pregnancy.
Causes of an ectopic pregnancy
After confirming this diagnosis, every woman begins to remember all the events in her life, looking for all sorts of explanations for the causes of ectopic pregnancy, which are now well known and well studied.
First of all, these are transferred inflammatory diseases of the uterus and its appendages - the fallopian tubes and ovaries. Attention is also paid to the narrowing of the lumen of the fallopian tube due to various diseases, such as benign tumors or; uterus - a benign tumor of the uterus, especially located in the place where the fallopian tubes depart from the body of the uterus; fallopian tube (growth of the inner layer of the uterus - the endometrium in the thickness of the fallopian tube); around the fallopian tubes. Conditions after surgical interventions on the uterus and its appendages are considered as an independent risk factor for the development of ectopic pregnancy. The cause of an ectopic pregnancy can also be a previous artificial interruption of pregnancy. Curettage of the uterine mucosa, carried out during an artificial termination of pregnancy, can cause a change in its normal structure. Often, after an abortion, inflammatory processes develop in the uterus and adjacent organs. can also develop on the background of intrauterine contraceptives.
With anomalies in the development of the fallopian tubes, the natural path of sperm and egg movement is changed, which can lead to the development of pregnancy in the tube.
Treatment of an ectopic pregnancy
When confirming the diagnosis of an ectopic pregnancy, an operation is necessary, the purpose of which is to remove the fetal egg, restore normal anatomy, stop possible bleeding, examine the pelvic organs and the abdominal cavity, and perform the necessary manipulations.
Before the introduction of laparoscopy (a method of surgical intervention in which an optical device and special surgical instruments are inserted through small punctures in the anterior abdominal wall), the main surgical method for treating ectopic pregnancy was abdominotomy (abdominal wall incision) and removal of the fallopian tube with a fetal egg. However, the rapid development of laparoscopy, which has been observed over the past 30 years, has changed the capabilities of specialists.
For laparoscopy, it is necessary to make only three small incisions about 12 mm in size in the umbilical region and 2 incisions 5-10 mm long in the lower abdomen - in the right and left iliac regions. Further, through these skin incisions, access is made to the abdominal cavity by piercing the abdominal wall with special instruments - trocars, which are tubes of various diameters. Trocars serve as working channels for special surgical laparoscopic instruments, primarily for a special video camera called a laparoscope, and other instruments - scissors, clamps, coagulators, etc. With the help of a laparoscope, an image of the abdominal cavity is transmitted to the TV screen - monitor. The surgeon operates, looking not at the operating field, but at the monitor screen. It should be said that for such operations it is necessary to have free space in the abdominal cavity, which is achieved by introducing carbon dioxide into it. After the end of the operation, the gas is completely removed from the abdominal cavity through the trocars. The operation, as a rule, is performed against the background of general anesthesia (the woman sleeps during the manipulations), it is also possible to use spinal anesthesia - an injection is made in the back at the level of the lower back, the medicine is injected into the spinal canal, the woman is conscious, but does not feel pain.
The advantage of laparoscopy in ectopic pregnancy is the use of a magnified image of the actual picture (figuratively speaking, this is "work under a microscope"), as well as the use of miniature instruments. This explains the less traumatization of the operation compared to abdominal surgery, which in many cases allows you to save the fallopian tube, if we are talking about tubal pregnancy, which is observed most often. This operation is called a tubotomy. Its essence lies in the dissection of the fallopian tube over the fetal egg, the removal of the fetal egg from it, the evacuation of the fetal egg from the abdominal cavity. Then coagulation (cauterization) of bleeding vessels is performed. In the future, the preserved fallopian tube can fully perform its functions - to receive and promote the fertilized egg towards the uterine cavity.
However, it is not always possible to save the fallopian tube, which is associated with the presence of hemorrhage near the fallopian tube, irreversible structural changes in the fallopian tube itself, which is especially often observed during repeated pregnancy in this fallopian tube and in a number of other cases. Sometimes you can try to save a pathologically altered fallopian tube, for example, in the presence of a single fallopian tube, but the patient herself and the attending physician must be aware that the risk of developing a second ectopic pregnancy increases several times, so the damaged fallopian tube often has to be removed.
In any variant of laparoscopic surgery, after the completion of the main stage of the intervention, a thorough hemostasis is performed, i.e. stop possible bleeding. The abdominal cavity is carefully washed from blood and clots using special solutions. If concomitant gynecological diseases (adhesions, cysts, endometriosis, etc.) are detected, then their surgical treatment is also performed. The entire abdominal cavity is also examined in order to wash it and identify possible concomitant diseases of other organs.
Minimal traumatization of laparoscopic surgery, thorough sanitation of the abdominal cavity, etc. contribute to the smooth course of the postoperative period with minimal use of painkillers, early activation of patients, as well as minimal postoperative adhesion formation, which in general is important for the rehabilitation of women and preparation for the next pregnancy.
Pregnancy after an ectopic pregnancy. We plan wisely
After surgery for an ectopic pregnancy, oral contraceptives are recommended before planning the next pregnancy. If possible, you should find out the cause that led to the pathology, undergo examinations for sexually transmitted infections, exclude uterine fibroids, endometriosis. For this, ultrasound and other studies are performed.
If it is assumed that the cause of an ectopic pregnancy was adhesions in the pelvic cavity, formed as a result of inflammation of the internal genital organs, then in the process of preparing for the next pregnancy, the doctor may prescribe a hysterography for a woman - a study during which a radiopaque substance is injected into the uterine cavity, and then X-ray. If the remaining single tube is passable, then spontaneous pregnancy may occur.
In case of tubal obstruction, laparoscopic surgery may be performed to attempt to restore tubal patency.
Do not despair in those cases when the patency of the pipes cannot be restored: then the method of in vitro fertilization comes to the aid of the expectant mother.
You have experienced a pregnancy outside the uterus and have undergone surgery. You need to be sure to know when pregnancy occurs after an ectopic pregnancy and what needs to be done for this.
What is this pathology and how to determine it
An ectopic pregnancy is a complication in which a fertilized egg does not attach in the uterus, but in the oviduct.
In the first weeks it is impossible to see an ectopic pregnancy. With her, there is also no menstruation, the test shows a positive result, there is toxicosis and the uterus is enlarged.
However, this violation can be assumed on the basis of the following signs:
- On ultrasound, there is no fetal egg in the uterus (read the article about when a fetal egg is visible on ultrasound >>>);
- The level of hCG in the blood is reduced.
Treatment of this disorder is only surgical. Now they are doing a laparoscopic operation, in which it is possible to save the fallopian tube.
Why does this pathology occur?
An ectopic pregnancy can occur for several reasons that lead to impaired patency of the oviduct. The causes of the pathology are:
- infections in the ovaries and uterus;
- gynecological operations;
- hormonal disorders;
- abortions and curettage;
- prolonged use of the spiral;
- external endometriosis;
- adhesions in the pelvis;
- adnexal tumor;
- uterine tuberculosis.
The embryo can be not only in the tube. A fertilized egg can attach to the ovary, to the cervix, to the abdominal cavity.
Pathology is manifested by the following symptoms:
- sharp pains in the lower abdomen (see also the article on the topic: Pregnancy 3 weeks, stomach hurts >>>);
- a sharp decrease in pressure;
- dizziness;
- dark red discharge after intercourse.
With these symptoms, urgent medical attention is needed!
Attention! You can not drown out the sharp pain with painkillers, it is better to urgently seek medical help. An ectopic pregnancy can be life threatening.
How is an ectopic pregnancy handled?
It is very difficult to diagnose this disorder at first, so a woman goes to the doctor already with obvious symptoms. This condition has consequences in which the tube bursts and internal bleeding begins, which can be fatal.
Know! With early detection of pathology, if the clinic has special equipment, then an operation is possible - fimbral sampling of the fetal egg.
Technically, it looks like this: the embryo is evacuated from the oviduct under vacuum from the side of the ampullary area near the ovary.
Recovery period after ectopic
- After surgery, anti-inflammatory therapy is prescribed, which prevents the adhesive process;
- Antibiotics are also required to prevent the spread of internal infection;
- In addition, physiotherapeutic procedures and hormone intake are prescribed;
- During the rehabilitation period, the patient is in the hospital under the supervision of a gynecologist;
- In the beginning, she has profuse discharge after an ectopic pregnancy;
- Within a month after the operation, sexual intercourse is prohibited;
- It is important to exclude heavy lifting, stress, heavy physical exertion and overstrain.
When can you get pregnant after an ectopic?
Plan the next pregnancy only after 6 months and be sure to undergo an additional examination.
Features of pregnancy planning after an ectopic
Is it possible to get pregnant with one tube after an ectopic?
If you have one tube removed, then your chances of conceiving a child are halved. In addition, a second pregnancy can again end in another ectopic or miscarriage.
To prevent this from happening, it is important to approach the issue of planning very seriously. First you need to give the body a little rest and protection.
Attention! It must be remembered that it is not worth getting pregnant a month after an ectopic. The body is still weak.
Situations are different. For some, it is enough to restore the menstrual cycle, catch ovulation and get tested for infections and you can plan, while someone has to undergo an HSG to remove adhesions in the oviduct, and then go for an ultrasound scan every month and monitor the growth of the follicle.
Surveys before planning
In order to easily conceive and bear a healthy child, you need to undergo a certain examination before planning your next pregnancy.
To prevent a recurrence of the situation, to determine the cause, the gynecologist will prescribe additional examinations for you:
- standard blood and urine tests;
- smear for infection;
- Ultrasound of the pelvic organs;
- procedure for the patency of the pipes;
- diagnostic laparoscopy (if necessary).
You should also consult with an endocrinologist.
How fast can you get pregnant
After completing all the diagnostics and finding out the cause of the violation, you can plan your next pregnancy.
- The probability of conceiving a baby after such a pregnancy is 60%. It all depends on how damaged the reproductive function is after the operation;
- When planning a conception after surgery, you need to follow a number of rules, since the probability of a favorable conception depends on this. To begin with, it is imperative to establish when ovulation occurs from the side of the whole organ.
In order to speed up normal conception after an unsuccessful attempt, you need to do the following:
- Do an ovulation test in the morning. Two clear stripes show the peak of ovulation;
- Measure basal temperature and draw up a graph that will show the period of ovulation;
- Go to an ultrasound folliculometry to make sure that the egg has matured on the right side;
- Listen to your feelings, during the period of ovulation in the ovary area there is discomfort or tingling;
- Monitor secretions. At the peak of ovulation, they are viscous and transparent.
With proper planning, you will quickly achieve the desired result.
did you get it
- After an ectopic pregnancy, a new pregnancy proceeds in the same way as a normal one. It is characterized by early toxicosis, nagging pain in the lower back (see article: Lower back hurts during early pregnancy >>>), mammary glands swell;
- During the period of bearing a child, pay attention to your diet so that the child receives all the necessary vitamins;
- At an early stage, it is better to do an ultrasound to make sure that the pregnancy is uterine and calm down.
In general, the prognosis for a normal pregnancy is very favorable. Fulfilling all the recommendations of the gynecologist, very soon you will become a happy mother.
