In this article, we suggest that you get acquainted with laparoscopy during ectopic pregnancy, which is quite common, in about 5%. Unfortunately, it will not be possible to save the child, the sooner the interruption measures are taken, the greater the chances of saving the appendages or even the woman’s life. If you feel signs of pregnancy, then you should immediately go to the gynecologist. The sooner the ultrasound is done, the faster and easier it is possible to get rid of unpleasant consequences. In addition, ultrasound can help determine the implantation site of the ovum. If the ultrasound revealed that the pregnancy is an ectopic, then you need to act immediately (interrupt). How can this be done? What is laparoscopy of an ectopic pregnancy? You will find the answer to all these questions in this article.
Ectopic pregnancy
To begin with, we will understand how fertilization occurs. This is the fusion of two germ cells (egg and sperm) in the fallopian tube. After this process, the already fertilized egg passes into the uterine cavity and is fixed on the wall. This is an example of a normal pregnancy, which occurs in ninety-five out of a hundred cases. In other cases, the fertilized egg is delayed in the fallopian tube and is fixed somewhere outside the uterine cavity. Where the embryo can be fixed:
- in the fallopian tube;
- in the abdominal cavity;
- in the ovary.
This improper location of a fertilized egg is called an ectopic pregnancy. In this case, saving the child will not work, the doctor must prescribe a procedure for interrupting it. Laparoscopy for ectopic pregnancy is the most popular and gentle treatment. If measures are taken in time, then after the operation, after some time, you can begin to plan the birth of a child.
Ectopic or ectopic pregnancy is a pathology in which a fetal egg is implanted outside the uterine cavity. It is worth noting that recently the number of cases is only growing.
What are the reasons provoking this pathology? These include the following:
- infectious diseases of the uterus;
- sick appendages;
- disorders or inflammatory processes occurring in the bladder;
- congenital malformation of pipes;
- operations carried out on the fallopian tubes;
- hormonal disbalance;
- frequent abortions;
- the presence of a spiral (method of contraception);
- a long course of treatment with hormonal drugs;
- genital endometriosis;
- swelling of the fallopian tubes and so on.
Laparoscopy of the tube with an ectopic pregnancy, which develops in the fallopian tubes, is simply necessary. The sooner you diagnose this pathology and perform an operation, the greater the likelihood of retaining the appendages. In addition, you need to find out the cause and take treatment to avoid recurrence.
Types of Ectopic Pregnancy
You can give the following classification of ectopic pregnancy (at the place of fixation of the ovum):
- pipe;
- ovarian;
- abdominal
- cervical.
The first type is the most common (98% of all cases). With tubal ectopic pregnancy , one of the fallopian tubes is fixed on the mucosa. In this case, the tubular view can be divided into several subspecies (due to the location in the fallopian tube):
- ampullar;
- isthmic;
- interstitial;
- fimbrial.
The remaining three species from the listed are quite rare cases. With ovarian ectopic pregnancy, the follicle is fixed in the cavity, with the abdominal cavity in the abdominal cavity, and with the cervical cavity in the cervix.
Treatment methods
It is very important to identify the presence of an ectopic pregnancy in time. Her symptoms will help. At first, a woman may feel aching pain, perhaps she will give back to the lower back. If you do not consult a doctor at this stage, then the pain will soon become acute. It should not be removed with painkillers, as this can interfere with the diagnosis of ectopic pregnancy. Also, a woman can feel severe weakness, dizziness and nausea.
Pay attention to the discharge, they may have a bloody color, this indicates internal bleeding due to damage to the appendages. If the pregnancy test is positive and you notice these symptoms, then be sure to go to the gynecologist. Note that loss of consciousness is also a symptom of this pathology.
The doctor must send you for ultrasound, as a result of which the place of implantation of the fetal egg will be detected. After receiving the results, the gynecologist prescribes treatment. Ways to get rid of an ectopic pregnancy:
- laparotomy (surgery, which involves opening the abdominal wall, removing the embryo along with a tube or even an ovary);
- laparoscopy (with ectopic pregnancy, this is the best and less dangerous method, during the operation they make a single small puncture);
- drug treatment.
Now let's talk a little more about each method.
Laparotomy is the removal of a fetal egg, which can lead to the removal of a tube or ovary. This method was used earlier, before the appearance of laparoscopy. However, in some clinics it is practiced to this day. These may be the following cases:
- lack of the necessary modern equipment;
- there is no specialist who can perform a laparoscopy operation;
- critical condition of a woman, dangerous to her life.
Laparotomy is performed in several ways:
- milking;
- tubotomy;
- tubectomy.
The first method allows you to save and protect the fallopian tube from the incision. A fetal egg is squeezed out, this is possible if it is near the exit of the tube. After the operation, the woman will be able to become pregnant.
Tubotomy involves cutting or removing part of the tube along with the fetal egg. This method is resorted to if it is not possible to extract the fetal egg by extrusion. The likelihood of repeated pregnancy in a woman after surgery remains, but is significantly reduced.
A tubectomy is the removal of the fallopian tube and, if necessary, the ovary. Of course, a woman has no chance of becoming pregnant, but she can save her life. As a rule, this method is used only in emergency situations, when the count goes on for seconds.
Now let's move on to the more popular method at present, this operation is laparoscopy with an ectopic pregnancy. She is considered less dangerous and sparing. We will devote much more time to this method below.
The last way is a medication. It is worth noting that the doctors do not trust him, preferring surgery. This method is used extremely rarely and with a very short time. Its essence lies in the introduction of the drug "Methotrexate", which kills and breaks down the embryo. The likelihood of becoming pregnant after a successful medical treatment is practically not reduced compared to that which was before him.
Laparoscopy
As mentioned earlier, laparoscopy with ectopic pregnancy is the best treatment method. It can immediately be noted that it is less traumatic. Laparoscopy helps to completely get rid of an ectopic pregnancy, that is, one that develops outside the uterus. During surgery, a woman cannot feel any pain or discomfort, as she is done under general anesthesia.
The surgeon must make a small puncture in the abdominal cavity and introduce a special tool with which he can remove the fetus from the fallopian tube. The whole operation is done under control on an ultrasound machine.
As it has already become clear, a child cannot survive laparoscopy of an ectopic pregnancy. But in time, the operation performed helps save the woman's life and health. At the first suspicion of an ectopic pregnancy, go to the doctor. The sooner ectopic pregnancy treatment measures are taken, the more chances a woman has in the future to have children.
Already during the operation, the doctor decides whether to save the tube or not. It all depends on some factors. The fallopian tube is maintained if:
- short gestation;
- the fallopian tube is not much affected.
If these two important conditions are met, the doctor makes a small incision to remove the fetal egg. After such an operation, the woman quickly recovers and maintains her reproductive health. Otherwise (if the fetal egg is quite large and severely injured the fallopian tube), the doctor decides to remove part or all of the tube.
Once again, we draw your attention to the fact that the sooner you turn to a gynecologist for help, the greater the chance of maintaining your reproductive health. Be careful and listen to the signals of your body. To summarize this section, I want to highlight the advantages of a modern operation called laparoscopy:
- low blood loss;
- quick recovery after surgery;
- rare postoperative complications;
- lack of scars.
This operation has some more advantages:
- with laparoscopy, the abdominal cavity is washed off from the blood (blood causes adhesions, the latter, in turn, can lead to a repeat ectopic pregnancy);
- after the operation, the surgeon can assess the condition of the second tube and appendages;
- reconstructive intervention is possible (dissection of adhesions, restoration of patency of the pipes).
The sooner you are prescribed laparoscopy, the more likely it is to conceive a healthy baby in the future.
Pipe preservation
Laparoscopy with ectopic pregnancy with preservation of the tube is performed subject to certain rules: the gestational age is small, the tube was not affected. In other cases, the doctor will not be able to leave the tube, because it can cause a recurrence of the pathology, since it will no longer fulfill its intended purpose.
Laparoscopy during ectopic pregnancy with preservation of the tube is possible only with timely treatment in a medical institution. Listen to your body signals. The development of an ectopic pregnancy is dangerous because the walls of the fallopian tube stretch as the fetal egg grows. As a result, they do not withstand and are torn. At this stage, it is important to preserve not the pipe, but the woman’s life.
If you feel the first symptoms of an ectopic pregnancy, then contact a gynecologist. Its diagnosis is reduced to several points:
- blood test for HCG;
- ultrasonography.
With an ectopic pregnancy, a test, even performed at home alone, will show a positive result. However, during the ultrasound, a fetal egg in the uterine cavity will not be detected. In this case, you need to urgently go for laparoscopic diagnosis. If this is done in time, then the chances of saving the tube and maintaining reproductive health are very high.
Pipe removal
The operation of laparoscopy of an ectopic pregnancy with removal of the tube is simply necessary in some cases. You will learn about them in this section of the article.
The operation itself is completely safe and has a fast recovery period for a woman after it. It is done under general anesthesia. For its implementation, it is necessary to make three punctures (diameter of not more than one centimeter) for laparoscopic tubes and a laparoscope. The second is necessary in order to display the picture, which is necessary for assessing the state of organs.
Laparoscopy has two types:
- tubotomy (we talked about it above, the surgeon cuts the fallopian tube and removes the fetal egg, preserving the function of the tube);
- tubectomy (removal of the fallopian tube).
Laparoscopy of the fallopian tubes during ectopic pregnancy with removal of the tube is needed in emergency and very difficult situations (if the preservation of the fallopian tube carries a greater risk than its removal). You can save it if there are no structural changes, otherwise it is pointless and dangerous.
So, a tubectomy is done if:
- there are irreversible changes in the fallopian tube;
- repeated ectopic pregnancy with implantation in the same tube as before after tubotomy;
- adhesions in the pelvis.
During the operation, the mesosalpinx and isthmic section are excised. The fallopian tube is removed along with the fetal egg. Assess the condition of the "pregnant" pipe helps inspection of the second. After the examination, the surgeon makes a decision: you can leave the diseased tube or it is better to remove it.
To maintain reproductive health and the opportunity to become pregnant and give birth to a healthy baby, do not postpone a visit to the gynecologist. Timely treatment and treatment is the key to your happy future.
Recovery
So, laparoscopy is the removal of an ectopic pregnancy, which, with timely treatment, is more gentle. We have previously identified the advantages of this operation. One of them is the quick recovery of a woman after laparoscopy. Removing an ectopic pregnancy using this method consists of piercing small holes for the introduction of special devices. In this regard, the sutures are removed already on the fifth or seventh day after surgery, provided there is no inflammatory process.
Recommendations of doctors in the postoperative period:
- treatment of wounds with iodine for two weeks;
- two weeks only shower;
- Do not eat fatty and spicy;
- sex is possible only after the restoration of the menstrual cycle;
- pregnancy planning is discussed with your doctor (you should wait from 1 month to 4).
Bleeding
In this section, we discuss bleeding after laparoscopy of an ectopic pregnancy. Many women who underwent this operation noticed that after 20-30 days bleeding opens. They attribute this to the side effect of the prescribed treatment. The following is a sample list of drugs for rehabilitation:
- calcium chloride;
- "Metrogil";
- "Actovegin";
- Cycloferon;
- "AGT";
- Diclofenac
- Gluconate SA;
- "Voebenzim";
- "Rotramycin";
- Viferon.
The course of treatment must be started immediately after the operation, use the drugs prescribed by the attending physician. Blood clots may appear before the bleeding opens, which is quite normal after laparoscopy. Open bleeding is nothing more than a period.
Discharge
Spotting after laparoscopy of an ectopic pregnancy indicates the arrival of menstruation. Immediately after the operation, do not be alarmed if the discharge has a “smearing” character. If spotting appeared earlier than 25-30 days after surgery, then this indicates uterine bleeding. Be sure to consult a doctor.
Also, do not postpone the visit to the gynecologist if there is no discharge for more than a month after the operation. This may indicate that hormonal balance is disturbed and a special course of treatment is necessary.
If there is an infection in the body, then the discharge will have an unpleasant odor. By consistency, they resemble porridge. Be sure to go through the examination and treatment.
Monthly after surgery
Menstruation after laparoscopy of an ectopic pregnancy arrives no later than thirty days after surgery. Do not worry if you see blood clots.
The absence of menstruation indicates a hormonal failure after surgery. Contact your healthcare provider. He is obliged to send you for analyzes that confirm or refute this theory. In case of any deviations from the norm, immediately consult a gynecologist.
Pregnancy after laparoscopy
Pregnancy after laparoscopy of an ectopic pregnancy is quite possible. Please note that you must consult with a gynecologist about this. If there are no contraindications, then you can start planning for pregnancy as early as next month.
It is worth considering that to prevent the recurrence of an ectopic pregnancy, you need to undergo a full examination and find out the cause of its occurrence. After identifying and eliminating the problem, you can safely make another attempt to conceive a baby.
A long-awaited pregnancy after laparoscopy of an ectopic pregnancy may not occur for a long time. In this case, the IVF procedure comes to the rescue of women. It is important to mention that even girls and women who have had their fallopian tubes removed during the operation can become pregnant in this way.
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