The ectopic pregnancy ends. Symptoms of ectopic pregnancy in the early stages. Previous termination of pregnancy

With the increase in the number of inflammatory processes in women of reproductive age, the number of diagnosed pathologies of pregnancy increases. One of current problems modernity –

The natural function of the uterus is to bear the fetus, the ovaries to form follicles and eggs, and the tubes to transport the fertilized egg into the uterine cavity. A woman’s organs work harmoniously for the healthy process of conception and gestation. But sometimes factors such as:

• inflammatory processes;
• developmental anomalies internal organs;
• heredity;
• physiological changes (removal of a tube, ovary).

In such cases, the harmonious reproductive process is disrupted. Frequent complication– formation of ectopic attachment of the zygote.

Ectopic formation - attachment and further development fetus outside the uterine body. This can be either the peritoneum or the fallopian tube (most often).

Women at risk

Gynecologists determine a conditional risk group of women who may develop this pathology more often than others. It includes:

• diabetics;
• hypertensive patients;
• women with a predisposition to multiple births (heredity);
• patients with previous operations to eliminate ectopic pregnancy;
• women who have undergone uterine surgery: C-section, removal of fibrous formations, tumors, cysts;
• patients with chronic inflammatory processes of the reproductive organs: endometritis, inflammation of the fallopian tubes, obstruction;
• women with impaired muscle activity of the uterus at the time of ovulation;
• girls with disabilities menstrual cycle, amenorrhea of ​​any type.

Causes

Depending on classification ectopic pathology, it is worth considering, which preceded the attachment of the zygote in an unsuitable place. Doctors identify several factors that provoke the development of complications.

Congenital pathologies of the reproductive organs

Anomalies in the development of a woman’s internal organs are common causes of the formation of an inappropriate (ectopic) fetus.

Bend of the uterus

Congenital bending of the uterus anywhere leads to abnormal or insufficient muscle tone, which is necessary for transporting a fertilized egg. The sperm, entering the uterus, fertilizes the egg, but its attachment is not carried out in the right place. Ectopic fertilization occurs, most often developing in.

Muscular activity of the uterus: “cilia” are atrophied

There is little activity of the sperm to attach the fertilized egg. The muscular activity of the uterus itself, or rather its cilia, which are located at the exit of the tube into the uterine cavity, is also necessary. If there is weak muscle activity, the egg does not reach the right place and is attached to the pipe.

Bend of the fallopian tube

One of the congenital pathologies is a bend of the fallopian tube, or obstruction. In this case, fertilization is either possible in a healthy uterus from an egg from a healthy tube, or impossible.

Contraceptives as a cause of ectopic pregnancy

Taking contraceptives does not lead to ectopic development of the zygote, but misuse drugs entails a pathology of attachment of the fertilized egg.

Intrauterine device

Perhaps the most common cause of formation is improper use of the intrauterine device. This method of protection from unplanned pregnancy after the expiration date, it works in a radically opposite way - it promotes pregnancy. However, the presence of part of such a drug in the uterine cavity is a direct prerequisite for the attachment of the fetus in an unsuitable place.

There are frequent cases of carrying a healthy pregnancy in the presence of a spiral in the body of the uterus. If the fruit is attached in a convenient place, then the spiral itself will not interfere normal development. Removing the contraceptive is not recommended.

Taking oral contraceptives

Contraceptive drugs that are prescribed by a doctor, taking into account the characteristics female body and the state of her hormonal levels cannot contribute to the formation ectopic pregnancy.

Mini-pill

Mini-pills are popular drugs that prevent the formation and fertilization of an egg. regular, but fertilization does not occur due to the fact that the components of the drug interfere with the formation of the yellow body, and accordingly, the egg is not formed.

Physical changes

Along with congenital pathologies, a number of physical changes in the female reproductive organs.

Inflammatory process of the ovaries and tubes

Inflammation in the uterus or elsewhere reproductive organ women entails thickening of the walls, the formation of adhesions, and scars. In the presence of such anomalies, pregnancy pathologies occur, since the zygote is attached in the wrong place.

Chronic salpingitis or inflammation of the pelvic organs is 50% of the causes of pregnancy outside the uterus.

Endometriosis

Inflammation of the lining of the uterus is common cause ectopic development of pregnancy. The inflammatory process occurs in the following cases:

• infections;
• chronic dysbacteriosis;
• venereal diseases;
• postpartum or abortive injuries;
• frequent abortions.

Tumors

It is extremely difficult to get pregnant in the presence of any tumor processes, since such a formation (malignant or benign) entails changes in the functioning of the entire system. But if fertilization does occur, then there is a risk of ectopic development of the fetus.

If the patient is registered at the oncology center, it is necessary to manage the pregnancy taking into account all the recommendations of the oncologist and the leading physician. In some cases hormonal background women during pregnancy provokes an exacerbation of the process of growth of a malignant tumor, metastases develop.

Surgeries to remove pregnancies in the past

A previous operation to remove part of the pipe as a result of ectopic development the fetus increases the chances of a relapse by exactly half. The most dangerous period is the first year after. This factor should be taken into account when planning.

Could hormonal imbalance be the cause of an ectopic pregnancy?

Hormonal imbalance in itself cannot contribute to the formation of pathology.

But if this condition is not treated for a long time, then inflammatory processes occur, which are the main cause of ectopic development of the fetus.

Can a man cause an ectopic pregnancy?

Often the reason for the development of the fetus outside the uterus is weak activity of the head of the sperm. Fertilization occurs late, the egg itself was already preparing to be released. In such cases, an isthmic or interstitial pregnancy occurs (one that develops in the tube near the exit to the uterus).

If weak sperm activity is detected, it is necessary to treat the man, and only then plan a pregnancy. Often the only sure way to conceive is IVF.

Why does ectopic pregnancy occur during IVF?

The process of artificial insemination is the penultimate opportunity for most couples to conceive and give birth to their own baby. However, such a decision can turn against a woman in some cases. at the same time, it increases the risk of pathology formation by 18%.

This is due to the fact that an already fertilized egg is released into the uterine cavity, which, due to circumstances or in the presence of pathology of the organ, is attached in an unsuitable place.

IVF is monitored at all stages, so pathology is often detected before the 4th week of gestation, Negative consequences minimal.

Probability of relapse

The great fear of a woman who has experienced the removal of a fetus outside the uterus is to experience such a situation again, and such fears do not appear without reason. The risk of developing recurrent pathology doubles and is 50%. The percentage is large, and therefore it is recommended to carry out everything necessary research and plan a new pregnancy with an interval of no earlier than one and a half years.

Are there any prevention options?

The basic rule for preventing improper attachment of the zygote is to eliminate the reasons why this pathology is possible. If main reason- this is obstruction of the pipes, then such an anomaly must be treated initially surgical method, and only then plan conception.

In some cases, the main problem of this pathology is the inflammatory process present in the woman’s pelvic organs. Often the process continues for a long time, developing into chronic form. The most common cause, which is discovered, for example, during routine diagnostic laparoscopy, is chronic salpingitis, which is not diagnosed under normal conditions.

How to avoid in the future

To enjoy the laughter of your child in the near future, you need to understand that the main ectopic pregnancy is:

• healthy lifestyle;
• timely treatment of all inflammatory processes;
• regular sexual partner;
• lack of sex during menstruation;
• protection during the treatment of inflammation.

These preventive actions will help bring you closer to main goal- carry and give birth to a full-fledged child healthy baby without pathologies.

There are always reasons for ectopic pregnancy, you just need to be able to identify them. Timely, correct and effective treatment, stable sex life with one partner increases the chances of giving birth healthy child. But even if you have an ectopic pregnancy, you should not despair, the main thing is this positive attitude and proper treatment.

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Every woman should know about dangerous pathology, which according to statistics occurs in 10-15% of women – ectopic pregnancy. In order to avoid complications, it is necessary to have some knowledge about its occurrence and course. First of all, you need to understand that the occurrence of an ectopic pregnancy is quite unpredictable.

This pathology has been described in medical textbooks since the 11th century. Until recently running forms led exclusively to fatal outcome. Today, with the help of modern surgery, this problem can be solved much easier. Functional medical technology allows operations to be performed and reduces the risks of operations to almost zero. However, gynecologists around the world note an increase in average cases that are quite difficult to diagnose.

What is an ectopic pregnancy and how does it occur?

In normal pregnancy ovum, emerging from the fallopian tubes, attaches to the uterus, where it continues to develop until birth. At pathological pregnancy the fertilized egg does not enter the uterus. This common pathology never ceases to amaze doctors. Wherever they have to remove an incorrectly attached fertilized egg. This could be the fallopian tubes, ovaries, or abdominal cavity. The most common ectopic tubal pregnancy.

The retention of the egg in the tubes indicates their insufficient patency. Already a month after the fertilized egg attaches to the wall of the pipe, having increased in size, it can lead to rupture of the pipe. In this case, there is a very high probability of bleeding with blood entering the abdominal cavity. From this moment on, the woman's life is under threat. This is why it is so important when planning a pregnancy to go through full examination and eliminate possible violations.

Causes of ectopic pregnancy

Why does this phenomenon occur? How does an egg go off course and end up in a place not intended for development? It's all about the fallopian tubes, the patency of which is impaired as a result of some factors. This is almost always preceded by abortion or difficult childbirth, past or current inflammatory diseases of the genitals, and infections. The mucous membrane of the uterus in a swollen state sticks together in some places, the tubes lose the ability to contract.

Ectopic pregnancy may also occur in case of their insufficient development (infantilism). The infantile tubes are long, narrow and tortuous, with narrowed openings. They are not able to contract and push the fertilized egg forward to the uterus. At a certain stage, the fertilized egg begins to develop villi in order to attach for development and receive a constant blood supply. If in certain time the egg has not arrived in the uterus, it is attached to the place where it is located. Thin and delicate walls of the tubes do not stretch like uterine tissue, so they soon rupture. This happens around 4-6 weeks. As a result of the rupture, blood rushes into the abdominal cavity, causing nausea and severe pain in the lower abdomen, reminiscent of contractions. Loss of consciousness often occurs. Broken large vessels can be fatal.

Sometimes the scenario occurs in the other direction, and the fertilized egg bursts and flows into the abdominal cavity. And with it a certain amount of blood, nausea and bloody issues. Tubal abortion occurs accompanied by severe pain, which subsides after some time. A woman can relax, thinking that everything is over. However, it is too early to rejoice. In any case, it is necessary to urgently consult a specialist to exclude the possible development of peritonitis - purulent inflammation of the abdominal cavity.

Does the test indicate an ectopic pregnancy?

The test shows an ectopic pregnancy just like a normal pregnancy! The difference can only be detected by ultrasound examination. There will not be a simply fertilized egg in the uterus, and if specialists do not find it on an ultrasound, they will carry out additional checks and will be able to diagnose pathology already at the most early stages. Already in the second week of pregnancy, the deviation can be diagnosed by inserting an ultrasound sensor into the vaginal cavity. Next, diagnostic laparoscopy is prescribed, which gives the most accurate results. Another way - hormonal analysis blood. After a significant increase, the level of human chorionic hormone (hCG) may decrease at this time.

What are the signs (symptoms) of an ectopic pregnancy?

Among the first signs is bloody vaginal discharge (which may be minor). Then painful sensations in the lower abdomen, increasing as the pathology develops to very strong, sometimes cramping.

Is it possible to detect an ectopic pregnancy yourself?

It is difficult to make an accurate diagnosis for yourself, but you can suspect something is wrong based on the above signs. If in addition to the usual symptoms of pregnancy (delayed menstruation, irritability, toxicosis, violation taste preferences etc.) even mild ones are added aching pain in the lower abdomen and even slight spotting - immediately RUN for a gynecological examination to rule out pathology.

At the slightest suspicion of an ectopic pregnancy, specialists suggest observation in a hospital. This should not be abandoned, because necessary examinations To determine the site of embryo implantation, it is easier to carry out in a hospital setting. On early stages detection, doctors will be able to interrupt it in gentle ways.

Treatment of ectopic pregnancy

There are several treatment methods used at different stages. At the slightest suspicion of an ectopic pregnancy, specialists suggest observation in a hospital. This should not be abandoned, since the necessary examinations to determine the site of implantation of the embryo are easier to carry out in a hospital setting. In the early stages of detection, doctors will be able to interrupt it in gentle ways.

A low-traumatic method (laparoscopy) is offered in the case when the fertilized egg still retains its container. Inserted through a small incision in the skin the right tool. The laparoscope device has an optical system, so all manipulations and the surgical field are displayed on the device’s monitor. This is a fairly safe operation. The surrounding tissues and organs are not affected, there is no risk of adhesions and scars, and there are practically no deaths. The device “sucks out” the fertilized egg, acting like a mini-abortion. A great consolation for a woman is that such an operation prevents injury to the tube, and after a course of treatment, after a while the woman can become pregnant again.

Should I keep or remove the pipe?

You can save the pipe if the rupture has not yet occurred or is minor. Salpingotomy is a closed surgical operation. After it, recovery occurs much faster, less blood leaks, and the patient spends much less time in the hospital, and the procedure itself is less painful. Removing the tube during examination is called a salpingectomy. This procedure greatly reduces the risk of repeated pregnancy loss.

Some women (4 - 8%) still have pregnancy tissue in their tubes, so your doctor may suggest an injection. medicine, stopping tissue growth. This is methotrexate, a drug sometimes used as an alternative to surgery. It is used in the very early stages of pregnancy, while pregnancy hormones have still increased slightly. This narcotic causes pregnancy tissue to be absorbed into the body. Several injections are required, followed by bleeding for several weeks. At early diagnosis illness and surgery in the early stages, this procedure may not be necessary. The best solution According to the prescription of treatment, the doctor accepts it.

Is pregnancy possible after an ectopic pregnancy and what are its features?

After liberation from an ectopic pregnancy, monitoring and “expectant management” are carried out. If only one of the tubes is damaged or removed, the chances of another pregnancy are quite high. However, the unresolved cause of the disease can reduce them. It could be an infection or inflammation. They definitely need to be cured. With one working tube you can get pregnant and carry a child to term perfectly. Within about 18 months, 6 out of 10 women become pregnant again.

How long do you need to wait?

Gynecologists recommend waiting at least three months before trying again. After a serious surgical intervention You should wait six months for all scars to heal. After using methotrexate, you must wait three cycles to ensure that the drug is completely eliminated from the body.

What are the chances of recurrence of an ectopic pregnancy?

The chances of recurrence of an ectopic pregnancy are almost the same as with the first violation: 10-15%. The prognosis is rather vague, since everything depends on the woman’s specific body and circumstances. It is almost impossible to insure against this. However, it's worth Special attention Focus on treating infections, such as chlamydia, to prevent further damage to the fallopian tubes. If a new pregnancy is detected, it is better to consult a doctor as soon as possible so that he can refer you for an ultrasound examination. Make sure that this time the embryo develops correctly.

Ectopic pregnancy is one of the most dangerous gynecological pathologies. In case of untimely diagnosis and without urgent assistance medical care, a woman may die from painful shock and large blood loss. Let's look at what types of ectopic pregnancy exist, why this pathology occurs and who is most susceptible to its occurrence, how to diagnose this condition at the earliest stages and what are the consequences.

Types and causes of occurrence. Main risk factors

There are three types of ectopic pregnancy: ovarian, abdominal, and tubal. As you may have guessed, these species differ in the different localization of the fertilized egg. Normally, it is implanted into the wall of the uterus, but under certain obstacles it may not reach its destination and be implanted into a neighboring organ. The most common type of ectopic pregnancy is tubal. Any type of ectopic pregnancy has the same causes. The main one is obstruction of the fallopian tubes (or one of the tubes); the fertilized egg simply cannot reach its goal and begins its development outside the organ created for this. So why do pipes become impassable?

1. Chronic salpingitis. This is a disease of the fallopian tubes, which can occur for a number of reasons: due to untreated sexually transmitted infections, operations on the tubes, inflammatory phenomena (caused, for example, by an artificial termination of pregnancy or a spiral standing in the uterus for a long time), etc. Accordingly, all of the above are the initial causes of ectopic pregnancy.

2. Congenital pathologies fallopian tubes These may be additional holes, or the pipes may be underdeveloped. These pathologies arise in utero and are caused either genetic factors, or are the result of teratogenic effects. That is why all doctors vying with each other to recommend that women plan children, so that it does not suddenly happen that in the early stages (when all the organs and systems of the embryo are formed) the mother took medications that were contraindicated in her position, received doses of radiation unacceptable for pregnant women (for example, X-ray), etc.

1. Women who became pregnant using IVF.

2. Those using intrauterine systems as contraception (the risk is much lower if a mechanical and hormonal IUD is used - Mirena).

3. Those using non-combined oral contraceptives that do not contain estrogen as contraception. These are the so-called mini-pills (Exluton, Microlut, Charozetta, etc.). They are usually prescribed to women who have any contraindications to taking combination drugs. oral contraceptives. The increased risk is due to decreased motility of the fallopian tubes, along with the weak contraceptive effect of the drugs.

4. Women who have already had an ectopic. More precisely, those who, without finding out exactly its causes and without treatment, became pregnant again.

5. Ladies over 35 years old, especially those who have been diagnosed with infertility. Unfortunately, we do not become healthier with age, and the reasons that contribute to the development of adhesions in the fallopian tubes become more and more common the older we get. However, with proper pregnancy planning, the risk of developing VD in middle-aged women is no greater than in 20-year-old representatives of the fair sex, who are not particularly concerned about issues of contraception and their health in general.

Main symptoms and signs. Medical and home diagnostic methods

In the early stages of an ectopic pregnancy, the signs are not always obvious; its diagnosis is quite difficult, but there are still several relative symptoms, which indirectly indicate well-being, and which cannot be ignored.

1. Negative or weak positive test for pregnancy. It often happens that such signs of an interesting situation as delayed menstruation, toxicosis and others have already appeared, the woman is sure that she is expecting a child, but for some reason the test does not confirm this. Of course, this does not always indicate pathology. For example, the period may be too short (this happens when late ovulation), or the test may be of poor quality. Do not forget about violating the instructions when performing. For example, if you evaluate the result not after 5-10 minutes, as manufacturers recommend, but after 1 hour or more, the second stripe, which was initially quite bright, will fade.

2. You can confirm or refute your doubts by taking a human chorionic gonadotropin test. This is the same hormone whose presence is detected by the test. Only the analysis option is more reliable - it is possible to identify signs of ectopic pregnancy in the early stages, when other methods are not informative. HCG concentration begins to increase in the blood from 8-10 days after conception. And hCG increases almost 2 times every day. On the Internet you can find signs that indicate the duration of pregnancy and the normal concentration for each period. human chorionic gonadotropin. If it is significant less than normal, then one can suspect some kind of pathology: perhaps the matter is a fetus that has stopped developing, or a lack of progesterone. Also similar phenomena in the body are perceived as signs of an ectopic pregnancy in the first days after conception.

3. From about 2-3 weeks of delay in menstruation, the doctor can determine the gestational age using a gynecological examination. It has its own parameters, its own nuances. Experienced doctor Based on the size of the uterus, it can determine the due date accurate to the day. However, if the expected gestational age does not coincide with the size of the uterus, the size of this organ is too small, the doctor sends the woman for an ultrasound. Small size uterus + reduced hCG level- not only symptoms of an ectopic pregnancy, but also of a frozen pregnancy. It is very important to make a correct diagnosis. If on ultrasound examination There is no fertilized egg in the uterine cavity, then it is very likely that either a miscarriage has occurred (but then the woman would have noticed discharge from the genital tract), or the fertilized egg has attached itself to another organ, and then it is necessary to urgently diagnose and treat this pathology. It should be noted that when viewing the internal genital organs with a vaginal sensor, in the case of intrauterine pregnancy, the fertilized egg is clearly visible in the cavity when the hCG is above 2500 IU/l. With the abdominal type of conduction (when looking through the abdominal wall), at a level above 6500 IU/l.

4. At longer periods, ectopic pregnancy symptoms are more obvious. As a rule, this is bloody or spotting discharge from the vagina. In most cases, the discharge is accompanied by pain in the lower abdomen and in the area of ​​the organ in whose tissue the egg was implanted. Other symptoms are similar normal pregnancy. This may be toxicosis, engorgement of the mammary glands, a little elevated temperature body, etc. But sometimes these signs are absent... If the VB is not interrupted spontaneously (sometimes the fetus itself stops developing), and the symptoms of an ectopic pregnancy were not noticed in the early stages, a rupture of the organ into which the egg was implanted may occur. Only one female organ is suitable for bearing children. reproductive system- uterus. In other organs, the tissues are not so stretchable and are not adapted to bearing children.

5. At the time of organ rupture and after, the woman experiences very severe pain in the area of ​​the damaged organ. Blood pressure drops sharply, and may occur fainting. Vaginal bleeding maybe, maybe not. In many cases, internal bleeding begins, but it is no less dangerous. If the bleeding is not stopped in time, and this can only be done surgically, the woman may die.

Treatment methods

As we wrote above, ectopic pregnancy does not require treatment only in case of arrest of development. In quite rare cases, this occurs spontaneously, without medical intervention. If not, then you can stop the development of the embryo with the help of a medicine. This method actively used in Europe.

A drug that allows you to get rid of an ectopic pregnancy non-surgically is called Methotrexate. This is the antagonist folic acid, an indispensable companion to fetal development. Initially, Methotrexate was used for chemotherapy in cancer patients. Because, as you probably already guessed, it is quite toxic. Before dispensing the drug, the doctor must make sure that the woman is not pregnant, or more precisely, that pregnancy is definitely not developing in the uterus. For this reason, in some cases, curettage of the uterine cavity is performed first. If the problem is successfully resolved conservative method, it is not recommended to become pregnant for the next 2-3 months. Methotrexate can only be used if the size of the ovum does not exceed 3.5 cm. The smaller the size of the ovum and hCG, respectively, the greater the likelihood that everything will go well. Especially good results observed if the level of human chorionic gonadotropin is below 1000 IU/l, not yet available obvious signs which are caused by an ectopic pregnancy, a pregnancy test does not count. There are also contraindications to the use of this medicinal product: renal and (or) liver failure, peptic ulcer of the stomach and rectum, leukopenia, as well as some other diseases and pathological conditions. Methotrexate should not be used during lactation. If there is no other choice, then breastfeeding will have to be stopped. But if by that time the woman had only one oviduct, or age over 35 years, you need to try by all means to preserve your reproductive health if you still plan to have children in the future.

Conservative treatment of VB appeared not so long ago, and it is not widely used. Surgical termination is much more often performed - laparoscopically or laparotomically. In the first case, some consequences of an ectopic pregnancy can be avoided, since the operation is performed without opening abdominal wall, which means the recovery period is noticeably shorter, the woman gets back into shape faster and becomes productive. Laparoscopic operations are performed using special instruments that are inserted inside through small punctures. Unfortunately, not all Russian hospitals have the opportunity to carry out such gentle surgical interventions, and this is not always possible... With laparoscopy, it is possible to preserve the fallopian tube in which the fertilized egg has developed. This is good in the sense that it is still easier to get pregnant with two fallopian tubes than with one... Especially for women over 35 years old who have any chronic diseases. But after surgery, in quite rare cases, the tube remains well passable; adhesions may form again, which is the main cause of ectopic. In some cases, it is better to remove the pipe than to leave it.

It is impossible to remove the fertilized egg laparoscopically if it has exceeded the dimensions permissible for this operation (the diameter of the fallopian tube is no more than 5 cm) or is located in certain places of the fallopian tube (in the rudimentary horn), since this is very risky in terms of possible severe bleeding, as well as already interrupted WB, heavy bleeding and when the woman is in serious condition.

Regarding the terms up to which an ectopic pregnancy can be carried. It all depends on the location of the fetus. Yes, when rare forms VB - ovarian, cervical or abdominal, obvious signs appear or interruption occurs in the second trimester, and sometimes in the third. However, diagnosis can be difficult, and an accurate diagnosis is made only on the basis of data obtained from histological examination of the material. The most common tubal pregnancy is terminated, usually at 6-8 weeks.

Possible consequences of ectopic pregnancy, preparation for subsequent pregnancy

One of the main consequences of WB is increased risk repetition of the situation. Those women who have had their fallopian tube removed have a 5% risk of repeating the situation, while those who have retained their fallopian tube have a risk of up to 20%. That is why all representatives of the fair sex, who have experienced this nightmare at least once, should, together with their attending physician, minimize all risk factors and only then plan a child. Until this point, you should carefully protect yourself from pregnancy.

The most common cause of VD is obstruction of the fallopian tubes. First of all, you need to get rid of risk factors - as a rule, these are sexually transmitted infections and various gynecological diseases. Next, it is advisable to check the patency of the fallopian tubes (or the remaining one). This procedure is called hysterosalpingography, abbreviated as HSG. The procedure is slightly unpleasant, but not painful, and is usually performed without anesthesia or anesthesia. A special solution is injected through the cervix into the uterus and tubes using a flexible cannula, and after they are completely filled, the doctor takes X-ray images. If adhesions are visible in the pictures, then the lady will be recommended a simple surgery(laparoscopic) to remove adhesions. Then a previous ectopic pregnancy is unlikely to have negative consequences.

If the remaining fallopian tube is in a very poor condition, or if both tubes are missing, a woman who wants to carry and give birth to a child on her own is recommended to undergo the IVF or ICSI procedure. In order to become a mother in this way, a woman does not need fallopian tubes. First, special hormonal preparation is carried out, as a result of which the woman produces several eggs at once. They are artificially fertilized with the partner’s sperm (or donor sperm, if the lady is single), and the already fertilized eggs are placed in the prepared endometrium of the uterus. 1-3 eggs are implanted. But failures also happen when the procedure needs to be repeated, and it’s quite expensive... But what would you not do to become a mother? Unfortunately, not everyone understands what an ectopic pregnancy is - its signs and consequences seem vague. If you take care of your health from a young age, use proper protection, do not change sexual partners often and do not delay having children, the risk of developing an ectopic pregnancy will be minimal.

When leaking classic pregnancy the fertilized egg attaches to the uterus, but there are frequent cases of attachment outside it. This condition is called ectopic fetal development, which can be caused by: various factors. It is useful to know what causes a deviation in the attachment of the egg.

How does an ectopic pregnancy occur?

Approximately 1.5% of all fetal development occurs outside the uterus. Blockage of the fallopian tube or its disruption is the main reason why a fertilized egg does not enter the uterus after conception. Because of this, it attaches to the place where it stopped - this could be the wall of the fallopian tube, ovaries, cervical or abdominal cavity. These organs do not have the function of fetal development, their walls do not stretch, so there is not enough space for the embryo.

If the development of the embryo outside the uterus is overlooked, then at week 5 the outer membrane of the embryo will develop and grow into the walls of the organs with their rupture. Excessive bleeding occurs sharp pains, reminiscent of contractions, she becomes ill, dizzy, and the woman loses consciousness. If a large vessel is damaged, the woman is at risk of death due to blood loss.

In the case when it is not the wall of the organ that ruptures, but the membrane of the fertilized egg, it exits into the abdominal cavity. This condition is called tubal abortion accompanied by severe pain in the lower abdomen, general weakness, dizziness. These symptoms are not as severe as with a pipe rupture and occur more slowly. Gradually the pain goes away, which gives the impression that the body is in a normal state, but the bleeding continues. It may lead to severe consequences, so it is better to go to the doctor at any stage of the development of weakness.

The development of the fetus outside the uterus becomes dangerous because it is impossible to detect it in the early stages. It has similar symptoms to the uterine uterus - delayed menstruation, nausea, softening of the uterus, formation corpus luteum in the ovary. Even with bleeding and rupture of organ walls, the pathology can easily be confused with appendicitis, ovarian apoplexy or other acute pathologies requiring surgical intervention.

The only way detection is considered to be an ultrasound, in which the doctor determines the location of the fertilized egg, fluid in the abdominal cavity, and formation in the appendages. A reliable laboratory way to detect deviations is a test for the level of human chorionic gonadotropin, the norm of which differs in its digital indicators for different stages of gestation.

Treatment of pathology is carried out by operations:

• tubectomy - laparoscopy, removal of the fallopian tube, increases the risk of recurrent defect;
• tubotomy - laparoscopy, removal of the fertilized egg with tubal preservation, separation of adhesions;
• laparotomy - abdominal surgery with cutting out the fallopian tube.

Why does ectopic pregnancy happen?

The main causes of ectopic pregnancy are:

• inflammatory processes in the ovaries and tubal cavities after abortion;
• congenital underdevelopment of the fallopian tubes;
• hormonal abnormalities.

Physiological causes of ectopic

The most common causes of ectopic pregnancy are physiological deviations from the norm. Women have tubes that are too long, tortuous, or short, underdeveloped, which interfere with the passage of the egg that was fertilized by the sperm. As a result, it develops and attaches not to the uterine cavity, but to its tube. Also obstructing the process of passage are cysts in the ovaries, tumors, inflammation of the pelvic organs, defects and delays in the development of the genital organs.

Why does ectopic pregnancy occur during IVF?

The IVF assisted reproduction method is a reason why there may be an ectopic pregnancy. As a result of stimulating the body with hormones and planting several fertilized eggs into the uterus in order for at least one to engraft, the first fertilized egg can become fixed in the uterus, and the rest outside it. This occurs rarely compared to the conditions of the uterine process.

Why does ectopic pregnancy occur in diseases?

The most common cause of fetal development outside the uterus is the presence of tubal adhesions or in the abdominal cavity. They are formed due to transferred inflammatory process or chronic inflammation of the fallopian tubes. The causes of inflammation are decreased immunity, hypothermia, and dishonest attitude towards health and hygiene. Inflammation becomes chronic with untreated sexually transmitted infections.

Another stimulating factor in the development of pathology is the previous operation - laparoscopy, abdominal intervention. All this creates obstacles in the path of a fertilized egg. Reasons include chronic cystitis, inflammation of the urethra, endometriosis. To avoid normal course pregnancy, a woman needs to take responsibility for her health, visit a gynecologist and get tested.

What causes ectopic pregnancy with endocrine disorders

Other common causes of ectopic pregnancy are endocrine abnormalities and disorders. These include hormonal levels that cause a narrowing of the lumen of the tube and a slowdown in its contractions, long-term use of hormones, oral contraceptives, insertion of an IUD, and stimulation of ovulation. To reduce the risk of their exposure, you need to take medications as prescribed by a doctor, under his supervision, and avoid self-medication.

Video: what causes ectopic pregnancy

One of the most complex and dangerous birth pathologies is ectopic pregnancy. It is found in 2% of women in labor and always ends unfavorably for the mother and fetus. What is the essence of this anomaly and what measures need to be taken?

What is an ectopic pregnancy?

When an egg unites with a sperm, fertilization occurs. Normally, the zygote (fertilized egg) moves through the fallopian tubes into the uterus and attaches to its walls - this is where the development of the embryo begins. When this does not happen for some reason and the embryo does not reach its destination, it is said to be an ectopic pregnancy. In this case, the fertilized egg can stop in the fallopian tubes, ovaries or any other part of the abdominal area. Since no organ of the female body except the uterus is adapted to allow the fetus to form and grow normally, there cannot be a normal course of pregnancy and childbirth: either a miscarriage occurs, or treatment is prescribed that provokes a stop in the development of the embryo.

In 97.7% of cases of ectopic pregnancy, the embryo is localized in the fallopian tubes - this is the so-called tubal pregnancy. The remaining fractions of percent are due to ovarian, abdominal, interligamentous, cervical, interstitial or pregnancy in the rudimentary horn of the uterus. The danger of this condition is very high, and if prolonged, it can lead to organ rupture.

Why does an ectopic pregnancy develop?

If the embryo cannot reach the uterus, it is prevented by hormonal or physiological factor. The main reasons are as follows:

1. Inflammatory processes of the uterine appendages. Inflammation of the tubes or appendages leads to the formation of scars and adhesions, which act as barriers to the movement of the embryo. Transportation of the fertilized egg is carried out due to alternating jerky movements of the tubes, i.e. peristaltics. If there are physiological defects in the tubes, the embryo simply cannot overcome the obstacles.
2. Inflammation of the fallopian tubes. The fallopian tubes connect the uterus to abdominal cavity. For inflammation nerve endings lose sensitivity, and protective villi are partially absent. Because of this, the transport function is disrupted and, accordingly, the egg cannot move into the uterine cavity.
3. Anatomical abnormalities- "extra" pipes or holes in appendages - appear during the period intrauterine development. If the girl’s mother smoked or drank alcohol during pregnancy, the likelihood of these defects in the girl increases. Hence the problems with pregnancy in the future.
4. Consequences of surgery or abortion. After operations in the pelvic area, a woman is left with scars and adhesions, which also prevent the embryo from moving.
5. Hormonal imbalances. During pregnancy and its planning, a woman’s hormonal background undergoes enormous changes. If any hormone is in excess, not enough, not at all, or its activity is reduced, many problems of the reproductive system arise, including weakening of the muscles and the inability of the egg to implant in the uterus. This is the most common cause of ectopic pregnancy.
6. Tumors. The presence of benign and malignant formations (fibroids, cysts, cancer) in itself makes it impossible for the uterus to attach. In addition, neoplasms cause hormonal dysfunction, which further complicates the process of embryo implantation.
7. One of the pipes is missing due to surgery.
8. Infectious diseases of the pelvic organs(tuberculosis, external endometriosis).
9. Long-term use hormonal drugs or intrauterine contraception.
10. Infections, sexually transmitted.

Symptoms of early ectopic pregnancy

In the early stages, it is quite difficult to determine an ectopic pregnancy, but it is possible. The point is that on initial stages all the signs of normal pregnancy are present: toxicosis, delayed menstruation, change taste preferences, mood swings, breast swelling. Initially, the test shows that the girl is not pregnant, but for all short term This is fine. Alarming symptoms which may indicate an ectopic pregnancy:

• Pain and discomfort in the lower abdomen. It can be on one side or spread everywhere in the peritoneum, radiate to the shoulder, shoulder blade, back, and intensify when walking and sharp turns of the body.
• Uncharacteristic discharge: scanty brownish or copious bloody, dark burgundy with bloody impurities, etc. Abundant bleeding may indicate bleeding.
• Chills and fever.
• Nausea and vomiting.
• Pallor skin, decrease blood pressure, fainting.

In the early stages, an ectopic pregnancy can only be detected using ultrasound. During pregnancy, each body behaves uniquely: one woman will not feel any alarms, another will immediately pay attention to the country of discharge, for some the test will immediately show two stripes, for some - after a couple of weeks. All this is very individual, so any of these symptoms should be good reason visiting a doctor.

Does the test indicate an ectopic pregnancy?

There are two types of tests.

The first is the usual and affordable tests, which are sold in pharmacies and even some supermarkets. Their action is based on the detection of hCG, a hormone that appears with the onset of pregnancy. But such tests only record the fact of fertilization, regardless of where the embryo is located.

More modern and accurate tests determine the ratio of intact and modified hCG. This type of test helps to suspect an ectopic pregnancy starting from the 5th week. If the test confirms a possible pathology of embryo attachment, it is recommended to perform an ultrasound.

Consequences of ectopic pregnancy

An ectopic pregnancy never goes away without a trace. In what cases are negative consequences possible?

1. The ectopic pregnancy was not terminated on time. If the fetus continues to develop outside the uterine cavity, this can lead to organ rupture (tubes, ovaries), excessive internal bleeding, painful shock and even to death.
2. During the operation, one fallopian tube was removed. This also happens, as a rule, if a woman delays diagnosis, and only this option of termination of pregnancy is possible. Removal of one of the tubes is not at all synonymous with infertility: in further woman It is quite possible for her to conceive a child if the ovary on the side of the remaining tube functions well and the woman is not at the most favorable age for conception (up to 28-30 years). In other cases, IVF saves the situation.
3. During the operation, the fallopian tube was preserved. No matter how paradoxical it may sound, preserving the pipe also entails undesirable consequences. There are usually no problems with conception, but the risk of a repeat ectopic pregnancy is very high.
4. After abortion by artificial or naturally there is a risk of infertility.

How to avoid ectopic pregnancy?

Preventive measures to avoid ectopic pregnancy are to eliminate the influence of factors that provoke this pathology.

Firstly, at any age, a girl needs to visit a gynecologist at for preventive purposes at least once every six months and take tests for the presence of atypical cells, flora and do colposcopy.

Secondly, hormone tests will never be superfluous. Hormonal dysfunction is extremely difficult to notice on your own, because a deficiency or excess of any hormone negatively affects the entire body. A sign of hormonal imbalance can be simple fatigue, irritability and chronic fatigue syndrome, so visiting an endocrinologist for preventive purposes is also a preventive measure.

Thirdly, a girl should avoid promiscuity and always use contraception to avoid sexually transmitted diseases.

Pregnancy planning plays a huge role. If a woman has decided to become a mother, the first thing to do is contact a gynecologist and undergo the necessary examinations.

Finally, we must not forget about elementary rules lifestyle. You need to follow the regime proper nutrition, provide motor activity and be responsible for intimate hygiene.

Ladies who have had inflammatory diseases in the past should be especially attentive to their health. genitourinary tract, diseases of the pelvic organs, multiple births or difficult pregnancy, caesarean section, abortions and operations in the peritoneum and pelvic organs.

On the list serious pathologies reproductive system and labor activity ectopic pregnancy occupies one of the leading positions. The insidiousness of the situation is that it is almost impossible to determine it yourself, and in this case, every day counts. To avoid ectopic pregnancy and resulting complications, it is enough to follow simple measures prevention, take care of your health and pay attention to the signals of your body.

Especially for- Elena Kichak