Can an ectopic pregnancy be 2 times. Ectopic pregnancy: causes, signs and more

Ectopic, or ectopic, pregnancy is a serious pathology that threatens not only health, but also the life of a woman. In addition, even with timely diagnosis and treatment, it jeopardizes the normal development of all subsequent conceptions. How to avoid an ectopic pregnancy? To answer this question, you need to know the mechanism and the main causes of the pathology.

Ectopic pregnancy

Normally, after fertilization, the egg begins to move along the fallopian tube into the uterine cavity. Special villi help her in this - tubal fimbria. Upon reaching the uterus, the egg is implanted into the mucous membrane and begins to divide to form an embryo.

However, in some cases, the course of pregnancy is disrupted, and implantation occurs in a place that is completely unusual for this process. Such localization is called ectopic and is of the following types:

• cervical;
• pipe;
• ovarian;
• abdominal.

In almost all situations, an ectopic pregnancy is terminated early. Throughout the history of obstetrics and gynecology, doctors have had to observe only a few cases of successful bearing and childbirth with such a pathology. This is possible only with abdominal localization of the fetus and refers to casuistry.

Tubal pregnancy accounts for the largest percentage of all ectopic implantations. The reasons for this violation are varied.

Causes

As a rule, tubal pregnancy does not occur without prerequisites. For its development, the following conditions are necessary:

1. Disrupted work of the fimbriae, due to which the normal movement of the fertilized egg becomes impossible.
2. Narrowed tube lumen due to the adhesive process.
3. Anomalies in the development of internal genital organs.
4. Hormonal disorders

In any of these situations, the egg cannot easily reach the uterine cavity and is implanted into the tube, where it begins to divide. As the ectopic pregnancy progresses, the fallopian tube expands and becomes thinner, which inevitably leads to its rupture.

Structural or hormonal pathologies arise for various reasons. Most often they are the result of the following diseases or conditions:

• Inflammatory processes in the internal genital organs.
• Adhesive process in the abdominal cavity.
• Postponed abortions.
• History of ectopic pregnancy.
• Congenital or acquired structural anomalies, malformations.
• Endometriosis and dyshormonal diseases.

Inflammatory processes

Inflammatory processes in the internal genital organs are not uncommon. They can be the result of hypothermia, especially in adolescence and youth, when, for the sake of fashion, a girl neglects warm clothes.

But more often inflammation in this area occurs due to genital infections. They affect the ovaries, uterus and fallopian tubes with the development of chronic adnexitis, endometritis or salpingo-oopharitis.

The causative agents are most often chlamydia, ureaplasma, Trichomonas, gonococcus, herpes virus. The diseases caused by them are usually combined into one large group and abbreviated as STDs - "sexually transmitted diseases."

As a rule, these pathologies are quite difficult to diagnose, since most of them occur with erased clinical manifestations. Typical vivid symptoms are observed only in gonorrhea and genital herpes. They force a woman to go to a gynecologist or venereologist and start treatment on time. However, even after therapy, these infections can manifest themselves with complications such as adhesions in the fallopian tubes.

Chlamydia, ureaplasmosis and trichomoniasis most often occur with mild symptoms. Changes in the discharge of women are often attributed to thrush or do not pay attention to them at all. But meanwhile, these untreated diseases in most cases become the culprit of infertility or ectopic pregnancy due to partial obstruction of the tubes.

Preventive measures

Although preventive measures for pelvic inflammatory disease are simple, many girls and women neglect them. This often happens due to a lack of awareness of sexual hygiene or neglect of one's health.

However, in this situation, you need to clearly understand that even a single inflammatory process in the genital area can lead to ectopic pregnancy in the future.

It is important to prevent hypothermia of the body as a whole and the pelvic area in particular, to observe sexual hygiene, to consult a gynecologist in a timely manner when the slightest complaints appear and to undergo treatment. It is also important to see your doctor regularly every year, even in the absence of any symptoms. It will identify the initial, asymptomatic stage of the disease.

There are also preventive measures for STDs.

STD prevention

The prevention of sexually transmitted diseases is at the same time the prevention of infertility and ectopic pregnancy. Most often, these infections cause inflammation in the fallopian tubes, which disrupts the fimbriae. They may not move at all or in the opposite direction, which leads to the implantation of a fertilized egg in this particular area. Also, STDs cause the development of adhesions in the fallopian tubes, which is a mechanical obstacle to the advancement of the germ cell.

Avoiding sexually transmitted infections is easy. To do this, it is enough to follow certain rules:

1. Change sex partners as rarely as possible.
2. Get tested regularly for STDs.
3. Use contraceptives.

In a new relationship, it is important to offer testing for STDs and sexual partners, regardless of the degree of trust, love, and intimacy. A man may not even be aware of the presence of such diseases, and they are possible even after a single sexual intercourse.

In addition, contraceptives should be used until negative test results are obtained. It is important to choose those that protect not only from unwanted pregnancy, but also from genital diseases. These include condoms and special spermicidal ointments with antimicrobial action.

However, barrier contraceptives - condoms - are by far the most effective method of preventing sexually transmitted diseases. If there is spontaneous sex with an unfamiliar partner, it is better to use two methods at the same time.

In case of unprotected intercourse, post-exposure prophylaxis of STDs should be carried out, for example, with chlorhexidine or a similar agent. However, its effectiveness will be significantly lower.

The absence of inflammatory diseases in the genital area significantly reduces the risk of ectopic pregnancy. However, ectopic egg implantation can also occur with adhesions in the abdominal cavity.

Adhesion process in the abdominal cavity

Adhesions can also develop in the abdominal cavity. As a rule, it is the result of operations performed for appendicitis, peritonitis, ovarian apoplexy. Also, adhesions can form after removal of the ovarian cyst.

They arise due to widespread or localized inflammation in the abdominal cavity, as well as due to trauma to its organs during surgery. Often, doctors try to get rid of adhesions by cutting them, but often this only leads to an increase in the adhesion process.

The more extensive the disaster in the abdominal cavity, the greater the likelihood of this complication and the more pronounced it will be. That is why early diagnosis of surgical pathology and the minimum amount of surgical intervention significantly reduce the risk of adhesions.

With adhesions in this area, ovarian or abdominal ectopic pregnancy can occur. How can this complication be prevented?

Adhesion prevention

It is completely impossible to prevent the occurrence of adhesions in the abdominal cavity after surgery. No doctor can give a 100% guarantee, even with a perfectly performed operation. The severity of this complication depends on the volume of the intervention, the neglect of the disease and the individual characteristics of the organism.

As a rule, surgeons must treat the abdominal cavity with special solutions that prevent the formation of adhesions. Early physical activity after surgery is also an excellent preventive measure. Naturally, it is carried out with the permission of the attending physician and under his supervision.

Postponed abortions

Previous abortions, especially at a young age, in nulliparous women are a potential risk of both ectopic pregnancy and infertility. This is due to mechanical damage to the inner layer of the uterus, which often entails a sluggish inflammatory process with the formation of adhesions or disruption of the villi of the fallopian tubes.

Prevention of this complication is obvious. Abortion should be avoided by all available means. First of all, these include:

• Planning a pregnancy with a partner.
• Condom use.
• Avoiding casual and unprotected sex.

History of ectopic pregnancy

It is quite difficult to prevent an ectopic pregnancy if it has already been observed in the history. The risk of its recurrence ranges from 15 to 30%, and according to some sources - even up to 50% of cases.

In many countries, the surgical strategy for tubal pregnancy is only the removal of the compromised tube. Unfortunately, domestic doctors in most cases try to preserve the damaged organ in order to further increase the chances of a successful pregnancy.

But in practice, this only leads to an increased risk of ectopic egg implantation. And no diagnostic methods - hysterosalpingography or laparoscopy - can reliably confirm or deny the likelihood of this formidable complication.

How to avoid an ectopic pregnancy in such a situation? If the surgeons did not remove the damaged tube, it will forever remain a "time bomb" for a woman. At the same time, reproductive specialists recommend two options for action:

1. Continue planning your pregnancy as before and hope for the best.
2. Track ovulation using ultrasound and plan conception in the month when it occurs from the side of the healthy tube.

However, the second method does not help completely prevent the complication, since sometimes a mature egg comes out of one ovary, and fertilizes in the opposite tube.

The best preventive measure is to remove the tube in which the ectopic implantation took place.

Structural abnormalities

Structural abnormalities of the internal genital organs can be congenital or acquired - for example, due to trauma, surgery, adhesions. This is especially true for the fallopian tubes. The result is always difficult movement of the egg and a high risk of premature implantation.

Some structural abnormalities can be removed surgically. However, it is important to know that it is not enough to simply restore the lumen in the fallopian tubes. This will not help the fertilized egg to advance. It can reach the uterus only during normal operation of the fimbriae, which is not corrected by surgery.

Therefore, often with structural anomalies or gross malformations, the fallopian tubes are simply removed, and the woman is offered the option of IVF.

Endometriosis and dyshormonal diseases

Endometriosis is a dyshormonal disease of the female reproductive system. With it, the sections of the uterine endometrium are located in atypical places for it - for example, in the tubes, ovaries, abdominal cavity. It is not surprising that a fertilized egg is sometimes implanted in this area, because it is no different from the inner layer of the uterus.

Endometriosis treatment is a complex and time-consuming process. In this case, mainly hormonal therapy is used, but sometimes doctors have to resort to surgical intervention. Successful treatment is the main measure for the prevention of ectopic pregnancy in this pathology.

Other dyshormonal diseases of the female genital area can also lead to untimely ectopic egg implantation and require treatment by a gynecologist-endocrinologist.

As we have already said, the opportunity to get pregnant again after an ectopic pregnancy, but now only with a successful outcome, namely the birth of a healthy baby to the delight of mom and dad, is quite possible! And do not despair and give up if you find yourself in such a situation, and the first pregnancy was of a pathological nature. But before we move on to the medical aspects of preparing for a future pregnancy, I would like to reveal several issues that also affect a positive result. The fact is that after stressful situations, even the most insignificant ones, our body reacts with a certain defense mechanism, which does not manifest itself in any way at the moment of stress, but can remind of itself after a while.

And for women who may have faced all the complications of an ectopic pregnancy for the first time, it is very important that this protective mechanism does not interfere with planning a normal pregnancy in the future. Since scientists have proven that our negative thoughts and fears are redirected to our own health. And therefore, psychological assistance during the rehabilitation period after the treatment of an ectopic pregnancy is a necessary step for the future of a woman and her family.

Of course, at the time of being in the hospital, the attending physician who contacts the woman every day conducts basic psychological training, explaining in detail the causes of an ectopic pregnancy, a set of measures for which he prescribed for effective therapy to eliminate all associated complications. And it is imperative - what are the patient's chances, after a full course of treatment, to become pregnant again, with what possible outcome these pregnancies can be, and what needs to be done in order to reduce the risks of repeated ectopic pregnancy as much as possible.

However, being in a state of shock, confusion or loss of strength, a woman simply cannot perceive all the information that doctors provide to her for her speedy recovery. Often, after being discharged from the hospital, patients are afraid for a long time to have children, imagining that all subsequent attempts will end in failure. Or, in situations where, it would seem, the spouses are completely healthy, the woman underwent a rehabilitation course after treatment and is quite ready for a new pregnancy, but all attempts at fertilization, alas, were unsuccessful. And all due to the fact that even in the early stages of treatment, the woman clearly formed a protective instinct for fears associated with pregnancy, and all the risks that she entails, and the body simply “refuses” her attempts to get pregnant, supposedly “with good intentions ”, but in reality the opposite is true.

This is where qualified psychological help is required. It is as necessary as a common cold, a basic set of antiviral drugs, and raspberry tea. Some women are able to track the negative tendency of the body to the reaction of pregnancy, or pay attention to disturbing thoughts in their head, and consult a psychologist on their own. It was then, along with pregravid training at the antenatal clinic level, a visit to a psychologist will only speed up the process of successful fertilization.

But not every woman in our country has the ability to notice such stressful "echoes" behind herself. And therefore, they are desperately trying to get pregnant in vain, and as a result, they despair even more.

Only a psychologist will help to tell about all the good aspects of pregnancy, to work through all the anxieties and fears experienced during an ectopic pregnancy and the rehabilitation period. Do not be intimidated, and deliberately hang on yourself the stigma of "crazy". As we have already said, consulting a psychologist, as one of the types of medical care, does not carry any negative health consequences, but on the contrary, it promotes the process of planning pregnancy and happy motherhood in advance.

Now it is quite often possible to meet a psychologist's office even at the level of state polyclinics, the government of the country has finally turned its attention to a possible psychological barrier during a person's recovery, and every year it is increasingly promoting a program of free psychological assistance to the population at medical institutions. Therefore, it is possible that there is a qualified specialist near you who can solve all problems regarding past unsuccessful pregnancy attempts. It is enough just to inquire about the “soulful” doctors in your city, and perhaps a successful pregnancy will not be far off!

We wish you good health and peace of mind. We are waiting for responses, reviews and comments on the topic of the article. Do not forget to share links to the material on social networks.

Ectopic pregnancy is a pathology in which the fertilized cell is attached outside the uterine cavity. The condition is dangerous, as it threatens damage to internal organs and massive bleeding. Prevention of ectopic pregnancy is important for women of reproductive age.

Stubborn statistics

Ectopic pregnancy is rare

The frequency of ectopic conception is 0.25-1.4% among all pregnancies. Over the past decades, the prevalence of ectopic conception has increased. In some regions, the indicators have increased by 4-5 times.

Mortality due to complications of ectopic pregnancy reaches 1% in developed countries and 4.9% in developing countries. The main cause of death is an incorrect diagnosis or untimely visit to a doctor, lack of prevention.

Symptoms of an ectopic pregnancy may not appear immediately. The first signs of the disease appear in 20% of cases when there is internal bleeding. A decrease in the mortality rate is achieved by timely diagnosis and treatment, and competent prevention. This will prevent ectopic pregnancy.

Is it possible to re-become pregnant with an ectopic?

Secondary pathology is observed in 7 - 22% of women who have undergone earlier termination of an ectopic pregnancy. Compared to healthy patients, such patients have a greater risk of developing the disease in the absence of prevention. In 99%, such a pregnancy is noted in the segments of the fallopian tube. If the patient is left with one tube, she is at risk of infertility.

Pay attention to the reasons

The main factor of an ectopic pregnancy is a tube obstruction or a violation of its contractile functions. The condition occurs when the fertilized egg cannot reach the uterus. Most often, it is attached to the tube, less often - to the rudimentary horn, ovary, in the abdominal cavity. Outside the uterus, there are no conditions for the growth and development of the embryo, and pregnancy itself leads to life-threatening conditions.

Why is there obstruction of the pipe or violation of its contractility? There are many reasons.

Inflammatory processes

Acute or chronic salpingitis, infectious agents that penetrate the reproductive organs, and the absence of disease prevention lead to pathology. They cause structural and functional changes in the tissues of the tubes, against which it is difficult to move the fertilized cell, an ectopic pregnancy occurs.

Negative consequences of inflammatory processes:

• violation of the activity of the ciliated layer of the fallopian tubes;
• changes in the viscosity and composition of the secretion of epithelial cells;
• edema, narrowing the lumen of the tubes.

One of the reasons is inflammation

Adhesions

They usually occur after invasive interventions and in the absence of prophylaxis. Even if you use the best way to terminate an ectopic (ectopic) pregnancy - laparoscopy. Minimal interventions entail trauma to the organ; connective tissue is formed at the site of the rupture, which is not able to contract. It takes up a large volume in the pipe and affects its functionality.

Separately, it is worth mentioning such a method of preventing pregnancy as tubal ligation. The method involves the imposition of ligatures on the organ. This method of sterilization is not always effective, sometimes pregnancy does occur. But due to the deliberate narrowing of the lumen of the tube, migration of the ovum to the uterine cavity is impossible. This is how an ectopic pregnancy occurs.

Hormonal disorders

Hormones are important for the reproductive system and the full course of pregnancy. They control ovulation, conception, the advancement of the embryo to the uterus. Naturally, in the event of a failure, the processes can be disrupted, an ectopic pregnancy develops.

The hormones synthesized by the ovaries - estrogen and progesterone - are especially important for the female body. Their level is changed by:

• disruptions of the menstrual cycle;
• ovarian dysfunction;
• the use of contraceptives containing progestin;
• stress;
• autonomic and neurological diseases;
• stimulation of ovulation with hormonal agents (during the IVF procedure).

Endometriosis promotes ectopic conception

Endometriosis

With this pathology, areas of the endometrium are outside the organ (on the peritoneum, fallopian tubes). Endometrial cells take root outside the uterus, develop and form lesions that affect the menstrual cycle and the functioning of the reproductive system.

With endometriosis:

• connective tissue (adhesions) is formed in the lumen of the fallopian tube;
• the movement of cilia of the epithelium slows down;
• the likelihood of infection of the fallopian tubes increases.

It promotes ectopic pregnancy.

Genital anomalies

Possible disorders leading to ectopic pregnancy in the absence of prevention.

1. Congenital or acquired narrowing (stenosis) of the fallopian tubes. May cause infertility or contribute to the development of ectopic conception.
2. Genital infantilism. In this condition, the fallopian tubes are longer than usual, which increases the period of migration of the ovum to the uterus and the likelihood of its incorrect implantation, the development of an ectopic pregnancy.
3. Diverticula of the uterus and tubes. Bag-like protrusions significantly impede the movement of the egg, act as a chronic infectious and inflammatory focus.

Interrupted pregnancies in the past

Artificial or spontaneous interruptions earlier increase the risk of ectopic conception. They are especially dangerous for young women who have not given birth.

Experts associate the high risks of developing an ectopic pregnancy with endometrial changes. In the absence of prophylaxis, this causes sluggish inflammation, adhesions, and disrupts the work of the villi of the pipes.

ECO

One of the ways to combat infertility. In artificial insemination, the fusion of the egg with the sperm occurs outside the woman's body. Subsequently, viable embryos are artificially implanted into the uterus.

The method is associated with an increased risk of ectopic pregnancy. This is due to the preliminary use of hormonal drugs to stimulate ovulation, already existing pathologies of the tubes and other parts of the reproductive system.

Toxic effects

Toxins from cigarettes and alcohol also affect

Disrupts the work of many organs. The longer a woman is exposed to toxins, the more severe the consequences. Dangerous toxic substances contained in alcohol, drugs, cigarettes. According to statistics, they increase the likelihood of ectopic conception threefold.

Poisonous fumes, industrial dust during work in production also negatively affect reproductive function. Toxins can cause the following malfunctions leading to ectopic pregnancy in the absence of preventive measures:

• violation of the contractility of the fallopian tubes;
• delayed ovulation;
• decreased immunity and increased risk of infection;
• reduction of flickering movements of the villi of the epithelium;
• hormonal disruptions;
• circulatory disorders.

Who's at risk

Ectopic pregnancy can be prevented even before conception with one tube or two if you know who is at risk. Long-term studies have identified factors that significantly increase the likelihood of pathology:

• previous ectopic pregnancies;
• IVF (in vitro fertilization);
• infertility treatment;
• stimulation of ovulation;
• age over 35;
• smoking and excessive alcohol consumption;
• frequent change of sexual partners;
• contraceptives containing a synthetic analogue of progesterone;
• genital infections;
• sedentary lifestyle;
• frequent stress;
• neurological pathology;
• anomalies of the reproductive organs (acquired or congenital);
• previous interventions on the pelvic organs and abdominal cavity.

Less stress

What to do?

Ectopic pregnancy can be avoided if you are careful about your health. For prevention, it is important to regularly visit a gynecologist, to treat all inflammatory diseases in the pelvic organs. It is impossible to end the treatment without making sure that you have completely recovered.

Only a constant relationship with a doctor when planning a pregnancy will keep all body changes under control.

Regular examination by a gynecologist

During a clinical examination, the doctor examines the genitals, evaluates their condition, and detects abnormalities. Draws attention to the characteristic signs of an ectopic:

• some lag in the uterus in size;
• consolidation of the appendages on the right or left;
• bluish color of the vagina and neck;
• asymmetry, bend, softening of the uterus.

Check with a gynecologist

Examinations and analyzes

The following activities are required.

1. Analysis for the level of hCG. Gonadotropin is a specific pregnancy hormone, the concentration of which normally doubles every 48-72 hours after conception. When a hormone is detected in the body, pregnancy is diagnosed. The fact that it is ectopic may indicate a discrepancy between the amount of hCG and the expected date. There are different methods for determining hCG: in the blood, urine, using ultrasound.
2. Analysis for the level of progesterone. Recommended for pregnant women. Concentration below 25 ng / ml indicates the presence of pathology. If the hormone is less than 5 ng / ml, this is a sign of the nonviability of the fetus.

When planning pregnancy, you need to do tests for the presence of infectious diseases of the genitourinary system, which serves as a preventive measure:

• chlamydia;
• gonococci;
• ureaplasma;
• mycoplasma.

If such problems are detected, the patient is shown treatment for both sexual partners so as not to become infected again.

Ultrasound

Ultrasound is an important procedure

An important research method that allows you to track the state of the reproductive system. With the help of ultrasound, diagnostics is carried out in the clinic of the uterus, fallopian tubes, ovaries, rectum, bladder, and early pregnancy is determined.

Clinical diagnosis of ectopic (ectopic) pregnancy and tubal abortion by ultrasound involves the detection of:

• thickening of the lining of the uterus;
• enlargement of the uterus;
• seals in the area of \u200b\u200bthe appendages.

Of particular diagnostic value is transvaginal examination, with the help of which ectopic pathology is eliminated in the early stages.

Ultrasound for prevention allows you to detect a rupture of the fallopian tube, to differentiate this condition with other diseases accompanied by the clinic of an acute abdomen.

All women at risk for ectopic conception who have previously undergone tube removal surgery are subject to regular examination.

Diagnostic laparoscopy

The modern method is prescribed for suspicion of ectopic conception, when other diagnostic methods have not yielded results. This is a minimally invasive intervention in the pelvic organs. Through a small puncture in the abdominal cavity, the surgeon inserts a special instrument - a laparoscope. It allows you to assess the state of internal organs.

If suspected, prescribe diagnostic laparoscopy

The advantage of the method is that the treatment and termination of an ectopic pregnancy is performed using a laparoscopy operation. Ectopic conception is rarely eliminated without surgical intervention by a doctor.

In pathology, the surgeon detects the following deviations:

• rupture of the tube and accumulation of blood in the abdominal cavity;
• bleeding in the lumen of the abdominal cavity;
• seal in the fallopian tubes, their purple-bluish color;
• the fertilized egg outside the uterus.

If deviations are found, treatment is immediately carried out.

Can an ectopic be prevented?

Ectopic conception can be avoided by being regularly observed by a gynecologist and avoiding unprotected sex in the presence of adhesions, inflammation, endometriosis, etc.

The main thing is to monitor your health, if you detect a delay in menstruation or suspicious symptoms, immediately consult a doctor. The role of the nurse in the prevention of pathology is important.

With early diagnosis, it is possible to sparingly get rid of an ectopic pregnancy. Treatment without surgery or minimally invasive intervention is prescribed to avoid tube rupture and other complications, to preserve fertility.

Give up bad habits

Tips for preventing ectopic surgery from a gynecologist

Prevention consists in eliminating risk factors for ectopic conception. Compliance with the memo will help.

1. Prevent the possibility of contracting sexually transmitted infections. Gonorrhea, chlamydia and other diseases increase the risk of pathology.
2. Use barrier methods of contraception with every intimate act.
3. Have a measured sex life with a regular partner.
4. If infected, consult a doctor and undergo therapy.
5. Give up smoking and other bad habits to reduce your risk.
6. When planning a pregnancy, consider conditions such as infertility treatment, the presence of a coil, anomalies of the fallopian tubes or uterus.

If you have a history of risk factors, consult your doctor about individual preventive measures.

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Every woman should know about a dangerous pathology that, according to statistics, overtakes 10-15% of women - an 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 manuals dating back to the 11th century. Until recently, neglected forms led exclusively to death. Today, with the help of modern surgery, this problem is much easier to solve. Functional medical technology allows for operations and reduces the risks of operations to almost zero. However, gynecologists all over the world state an increase in the average cases, which are quite difficult to diagnose.

What is an ectopic pregnancy and how does it occur?

In normal pregnancy, the ovum, leaving the fallopian tubes, attaches to the uterus, where it continues to develop until the very birth. In pathological pregnancy, the fertilized egg does not enter the uterus. This common pathology never ceases to amaze doctors. From where only they do not have to extract the incorrectly attached fertilized egg. It can be fallopian tubes, ovaries, abdominal cavity. The most common ectopic tubal pregnancy.

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

Causes of an ectopic pregnancy

Why is this phenomenon happening? How does the egg get off the "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 any factors. This is almost always preceded by abortion or difficult childbirth, past or current inflammatory diseases of the genitals, infections. In a swollen state, the mucous membrane of the uterus sticks together in some places, the tubes lose their ability to contract.

An ectopic pregnancy can also occur in the case of insufficient development (infantilism). The infantile tubes are long, narrow and sinuous, with narrowed lumens. They are unable to contract and push the ovum forward towards the uterus. At a certain stage, villi begin to develop in the ovum in order to attach for development and receive a constant blood supply. If at a certain time the egg has not arrived in the uterus, it is attached in the place where it is. The thin and delicate walls of the tubes do not stretch like uterine tissues, so they soon rupture. This happens at about 4-6 weeks. As a result of the rupture, blood rushes into the abdominal cavity, nausea and severe pains in the lower abdomen, reminiscent of contractions, occur. Loss of consciousness often occurs. Torn large vessels can be fatal.

Sometimes the scenario takes place in the other direction, and the fertilized egg, bursting, flows into the abdominal cavity. And along with it, a certain amount of blood, nausea and bloody discharge can also be observed. A tubal abortion is accompanied by severe pain, which subsides after a while. 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 in order to exclude the possible development of peritonitis - a purulent inflammation of the abdominal cavity.

Does the test show an ectopic pregnancy?

The test shows an ectopic pregnancy just like a normal pregnancy! The difference can only be detected as a result of an ultrasound examination. All just a fertilized egg in the uterus will not be, and without finding it on an ultrasound scan, specialists will conduct additional checks and be able to diagnose pathology at the earliest possible date. Already in the second week of pregnancy, the deviation can be diagnosed by inserting an ultrasound probe into the vaginal cavity. Next, a diagnostic laparoscopy is prescribed, which gives the most accurate results. Another way is a hormonal blood test. After a significant increase, the level of chorionic hormone (hCG) may decrease during this time.

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

Among the first signs - spotting from the vagina (may be minor). Then painful sensations in the lower abdomen, growing as the pathology develops to very strong, sometimes cramping.

Is it possible to determine the most ectopic pregnancy?

It is difficult to make an accurate diagnosis to oneself, but one can suspect something was wrong based on the above signs. If even mild aching pains in the lower abdomen and at least small bloody discharge are added to the usual symptoms of pregnancy (delayed menstruation, irritability, toxicosis, violation of taste preferences, etc.), immediately RUN to a gynecological examination to exclude pathology.

At the slightest suspicion of an ectopic pregnancy, specialists offer hospital monitoring. This should not be denied, since the necessary examinations to determine the place 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.

Ectopic pregnancy treatment

There are several treatments available at different stages. At the slightest suspicion of an ectopic pregnancy, specialists offer hospital monitoring. This should not be denied, since the necessary examinations to determine the place 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 ovum still has a container. The desired instrument is inserted through a small incision in the skin. The device has a laparoscope optical system, so all manipulations and the operating field are displayed on the monitor of the device. This is a fairly safe operation. The surrounding tissues and organs are not touched, there is no risk of adhesions and scars, and there are practically no deaths. The device "sucks" the fertilized egg, acting as a mini-abortion. It is a great consolation for a woman that such an operation prevents trauma to the pipe, and after a course of treatment, after a while, the woman can become pregnant again.

Save or delete pipe?

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

In some women (4 - 8%), pregnancy tissue remains in the tubal cavity, so the doctor may suggest the introduction of a drug that stops tissue growth. This is methotrexate, a drug sometimes used as an alternative to surgery. It is used very early in pregnancy, while pregnancy hormones are still slightly increased. This narcotic leads to the absorption of the pregnancy tissues by the body. Several injections are required, after which bleeding occurs for several weeks. With early diagnosis of the disease and early surgery, this procedure may not be necessary. It is the physician who makes the best decision regarding the treatment.

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

After release from ectopic pregnancy, monitoring and "expectant tactics" are carried out. If only one of the tubes is damaged or removed, the chances of a new pregnancy are high. However, the unresolved cause of the disease can reduce them. It could be infection or inflammation. They must be cured without fail. With one working tube, you can get pregnant and carry your baby perfectly. Within about 18 months, 6 out of 10 women will become pregnant again.

How long should you wait?

Gynecologists recommend waiting at least three months before trying again. After major surgery, 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 recurring 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 organism and circumstances. It is almost impossible to insure against this. However, special attention should be paid to the treatment of infections, such as chlamydia, in order to exclude 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 send an ultrasound scan for examination. Make sure the embryo is developing correctly this time.

All girls, to varying degrees, have heard about ectopic pregnancy, but only a few know why this condition occurs. But the reasons are sometimes so commonplace. If a woman knows how to avoid an ectopic pregnancy, then it will be easier for her to protect herself from such a condition. After all, ectopic gestation is a very dangerous pathology that, even with timely detection, can threaten the patient's life and endanger all subsequent conceptions.

When planning, you must adhere to the principle of proper nutrition

Ectopic (ectopic) experts call a pregnancy in which a fertilized female cell is implanted outside the cavity of the uterine body. Such conception is very dangerous, because it leads to serious damage to the female reproductive system and can lead to fatal bleeding, so it needs urgent and qualified intervention by specialists.

In most cases, abnormal localization of a fertilized egg is observed in the fallopian tubes (≈ 98%), because after fertilization it moves to the uterine cavity precisely along the tubal lumen. In the remaining 2% of cases, the egg is fixed in the peritoneum, on the uterine neck or on the ovary. The earlier the pathology is detected, the more chances the patient has for favorable prognosis. But it is rather difficult to diagnose pathology in the early stages, because in half of the patients it is latent and asymptomatic. And the first signs begin to appear when any complication has already occurred or bleeding has opened.

According to statistics, such an anomaly occurs in 0.25-1.4% of cases among all pregnancies, including those that ended in miscarriage, stillbirth or abortion. It is scary that the number of patients with ectopic pregnancies is increasing every year, so it is so important to have at least a superficial understanding of how to prevent an ectopic pregnancy. Dies from an ectopic about 5% of patients.

Causes of the ectopic

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Ectopic conception does not arise out of nowhere, this condition is always preceded by certain pathological factors, often representing adhesions in the tubal passages, disrupting patency, hormonal disruptions or abnormal development of some intraorganic structures, as well as improper activity of the fimbriae (tiny hairs located on the surface of cellular structures), against the background of which the egg is deprived of the ability to fully move.

In any of the above conditions, the embryo cannot reach the uterine walls, therefore it is fixed in the fallopian tube, where it begins to grow. In this case, the pipe is initially stretched, but with further growth of the fetus, it simply breaks. It may happen that a tubal abortion occurs, then the embryo will simply come out with bleeding.

Abnormal implantation can be caused by violations of some mechanisms:

1. Violations of the contractile activity of the fallopian tubes, due to which sperm cannot move along them. As a result, fertilization occurs with a delay, the egg does not have time to reach the uterus and is fixed in the tube.
2. Spasm of the tubal isthmus. Spastic contractions help the egg to move forward, but if a spasm occurs, it can cause the embryo to remain in the tubal lumen. Usually, progesterone is responsible for these contractions, with a lack of which ectopic conceptions develop.
3. The movement of epithelial cilia is impaired. Normally, it is directed from the ovaries towards the uterine body, but with estrogen deficiency, it may be absent or have the opposite direction.
4. Contracting disorders for the movement of the ovum through the tubes.
5. Secretory disorders in the tubes. The secretory function creates a flow of fluid that helps the egg to move through the tube.

Although the ovum is fixed outside the uterine body, tissue development occurs normally, but in the future it is inevitably disrupted. It's just that placental tissues destroy the vascular system, causing profuse bleeding. Typically, these complications cause tubal abortion. If this does not happen, then the likelihood of rupture of the fallopian tube increases.

Adhesions

Often, ectopic conception is preceded by the active formation of adhesions in the abdominal cavity. Usually, it is caused by surgical interventions aimed at removing the appendix, apoplexy or cystic formations of the ovaries, or eliminating peritonitis. It provokes the development of adhesions, abdominal inflammation or traumatic damage to intra-abdominal organs during surgery. And an attempt to eliminate such a problem with the help of a surgical dissection of the formed cords causes an intensified opposite effect.

Therefore, to prevent ectopic it is recommended to avoid adhesions. And this can be achieved only with a minimal amount of surgical interventions on the abdominal organs and early diagnosis of pathological conditions. And after the intervention, patients are recommended early physical activity, which also perfectly prevents the occurrence of adhesions.

Inflammation

Inflammatory lesions of the genital internal organs are by no means uncommon. They develop against the background of hypothermia and genital infections, leading to the development of endometritis, adnexitis or salpingo-oophoritis. These pathologies are provoked mainly by herpes viruses, Trichomonas, chlamydia, gonococcus or ureaplasma, and the diseases they cause are sexually transmitted pathologies. Usually they are very difficult to identify, because they often occur latently with erased or mild symptoms. But even after detection and proper therapy, these pathologies can provoke adhesions in the pipes.

Therefore, the prevention of ectopic pregnancy is directly related to preventive measures against STDs. These pathologies disrupt the natural activity of the villi, leading to abnormal movement of the egg after fertilization. In addition, genital infections provoke the appearance of adhesions in the tubes, which also prevent the cell from moving. In order not to face STDs, it is recommended to have only one permanent sexual partner and to use contraceptive protection for each PA.

Dyshormonal pathologies and endometriosis

Endometriosis belongs to the category of dyshormonal pathologies of the woman's reproductive system, which is characterized by the formation of endometrial tissues in uncharacteristic places, for example, in the tubes or the cavity of the peritoneum, etc.

• After fertilization, the cell can be implanted precisely on this irregular area, which is completely identical to the uterine endometrium.
• Therefore, when a desire to become a mother appears, one must first be examined for this pathology and other hormonal diseases, so that the desired conception does not turn into a tragedy.
• Endometriosis therapy takes a lot of time and is based on hormone therapy; in severe cases, surgery is necessary. Only timely and successful treatment will help reduce the risk of ectopic conception.

In addition, other hormonal pathologies of the genital area can also provoke an ectopic. Therefore, the prevention of the abnormal location of the ovum in this case consists in the timely and qualified elimination of these conditions.

Having an ectopic in the past

According to the results of ultrasound, intrauterine development and growth of the fetus is determined

A very difficult situation is considered when the patient has already had an ectopic pregnancy, because the risk of recurrence, according to doctors' estimates, is about 15-50%. Usually doctors recommend removing the tube into which the fertilized cell was implanted, but some specialists try to save the compromised organ to increase the chances of successful fertilization. Although practice shows that such actions only increase the likelihood of an abnormal fixation of the egg.

The preserved tube will always pose an increased danger to the patient, therefore, reproductive experts recommend conducting ultrasound monitoring of ovulation in order to plan conception in those cycles when the cell matures in the opposite ovary. But even in such a situation, there is no one hundred percent guarantee that the cell will fix correctly. Therefore, patients usually hope for the best and plan to conceive at their own peril and risk. Therefore, in order to prevent recurrence of the ectopic tube, it is recommended to remove the tube together with the incorrectly implanted embryo.

Abortion and miscarriage

Spontaneous or artificial interruptions can also increase the risk of developing ectopic conception and even developing irreversible infertility. Such procedures are especially dangerous for young women who have not given birth before. Experts associate such high risks with mechanical damage to the endometrial uterine layer, often causing latent sluggish inflammation with adhesions and disruption of the activity of the villi in the tubes.

Structural deviations

Sometimes the cause of ectopic implantation is structural abnormalities, which can be acquired or congenital. The structure of the genital organs can be disturbed during adhesions, after surgery or traumatic injuries. This problem is especially relevant for the fallopian tubes, which ultimately leads to difficulties in the movement of the egg along the fallopian tube canal and causes premature implantation.

It is sometimes possible to get rid of the abnormal structural features of the genitals with the help of an operation, but ensuring tubal patency does not yet guarantee the safe movement of the embryo. This requires a well-adjusted work of the villi, which cannot be restored surgically. That is why, with such problems, spouses are advised to undergo IVF with preliminary removal of the woman's fallopian tubes.

Toxins

The influence of toxic substances leads to disruption of the functionality of all systems and organic structures.

• The longer a girl is under toxic effects, the more harmful substances penetrate inside, which means that the risk of developing serious disorders increases.
• Ectopic pregnancy can occur under the influence of a variety of toxins found in alcohol, tobacco smoke, or drugs, as well as heavy metals, toxic fumes, or industrial dust.
• Under the influence of these toxins, blood circulation is impaired and the onset of ovulation is delayed (and sometimes it is absent altogether), the immune defense falls and hormonal concentration changes, sexual organ activity in general is disrupted, etc.

Therefore, in order to prevent ectopic patients, it is necessary to avoid harmful industries and unhealthy habits.

Is it possible to avoid an ectopic

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Experts say that every patient is able to avoid such a dangerous condition. It is recommended to regularly undergo gynecological examinations, take laboratory tests, treat infectious and inflammatory pathologies in a timely manner, and also use contraceptives with a temporary reluctance to have children in order to avoid abortion - one of the main factors of ectopic.

The main thing is to monitor your health, and if you detect a delay in menstruation, immediately go to the gynecologist. With early diagnosis of ectopic conception, tubal rupture and other complications can be avoided. Pathology can be detected using ultrasound diagnostics, which in this situation is considered the most informative. With the help of ultrasound, pathological pregnancy is diagnosed at the earliest possible date.

Preventive measures

Preventive measures for ectopic conception are based on the maximum possible reduction in factors leading to the development of such an anomaly. To begin with, it is necessary to minimize the risks of contracting infections transmitted through sexual contact. These include chlamydia, gonorrhea and other diseases that increase the likelihood of ectopic implantation of the ovum. To do this, you need to use barrier contraception with each PA and have a measured sex life with one regular partner.

If the infection did occur, then you should not be ashamed of such a delicate situation and delay contacting a specialist, it is necessary to start treating the pathology as soon as possible. The sooner the patient receives proper therapy, the lower the risk of inflammatory complications, and, therefore, ectopic complications. Therefore, if suspicious symptoms such as painful urination or unpleasant-smelling discharge, itching of the genitals and soreness during sex appear, an urgent need to consult a doctor.

It is recommended to say goodbye to such an unhealthy habit as smoking. The more a girl has smoking experience, the higher the probability of an ectopic embryo fixation during conception. In addition, it is necessary to familiarize yourself with other risk factors, which include a history of ectopic, conception with a spiral, abnormalities in the tubal structure, therapy for infertility. If at least one of the above factors occurs, then it is necessary to consult a doctor regarding the individual prevention of pathological conception.

How to reduce the risk of recurrence

If the patient has previously experienced a similar pregnancy, then care must be taken to reduce the risk of recurrence of this condition and to exclude the likelihood of complications. For this it is recommended:

1. If there are suspicious signs hinting at an abnormal conception, it is necessary to contact the LCD urgently. Such signs include the presence of a delay, pain in the lower abdomen and lower back, abnormal vaginal bleeding. If the tube ruptures, the patient will feel acute pain in the area of \u200b\u200brupture and spasms, the pressure will drop, and loss of consciousness is possible. As for the early manifestations of pathology, they are similar to normal gestation, so if you delay, you urgently need to go to the gynecologist.
2. With an existing ectopic ectopic, it is recommended to choose a medication-based treatment method, if possible. Usually, in the early stages of ectopic gestation, methotrexate is prescribed, which causes the rejection of the ovum, i.e., miscarriage. If the doctor strongly recommends surgical measures, then it is better to agree to a laparoscopic procedure. It is less traumatic and is carried out through small punctures.
3. Tell your doctor about persistent abdominal pain, if any. Especially with pain after the ectopic. An inflammatory complication or infection may have occurred that needs immediate treatment.
4. When pregnancy occurs, do not delay registration in order to timely detect possible deviations and prevent unwanted consequences.

With ectopic implantation of the ovum, fetal death is inevitable. When such gestation is interrupted, pronounced bleeding opens, which cannot be stopped on its own. Only surgery can save the patient. As you can see, a lot depends on the woman herself, so be careful about your own sexual health - avoid stressful conditions and a hypodynamic lifestyle, unhealthy habits and abortions, genital infections and promiscuous relationships, then ectopic ones can be avoided.

If there has already been a pathological conception, then you need to take a responsible attitude to rehabilitation, fulfilling all medical appointments and prescriptions. A year after the operation, with a favorable outcome, you can start planning a new conception.