Unfortunately, such an unpleasant diagnosis as an ectopic pregnancy is experienced by 10-15% of women. The name speaks for itself. In the description, we will consider many questions: what is it, symptoms, causes, how an ectopic pregnancy hurts, and much more.
Ectopic pregnancy - the attachment of a fetal egg not to the walls of the uterus. A fertilized egg can remain in the ovary, attach to the cervix, or enter the abdominal cavity. The most common cases include the attachment of a fetal egg to the wall of the fallopian tube. Pregnancy is characterized by atypical localization, which threatens the health of a woman and requires emergency surgical intervention.
Description
During normal pregnancy, the egg is attached to the bottom or body of the uterus. The difference between an atypical pregnancy is that the egg is not in the uterus. It has a different localization: in the fallopian tubes, ovary, abdominal cavity. Such a pregnancy cannot develop, it is life threatening and is a medical indication for its termination. It was noted that the pain in an ectopic pregnancy in the early stages is very strong.
The woman herself can not suspect pathology. After all, it is clinically no different from a normal pregnancy. Many people ask questions: “Does the chest hurt during an ectopic pregnancy?” Is there any toxicosis? Is there sleepiness? ”
Yes of course! Everything is the same here: menstruation is delayed, the mammary glands are enlarged, milky passages are outlined, dizziness, weakness, nausea, vomiting, and salivation may occur. An alarming complication of such a pregnancy may be bleeding and loss of consciousness, while a woman needs to see a doctor immediately.
Causes
The cause of this pathology is an obstacle to the fertilized egg from the ovary to the uterus. This obstacle is associated with a decrease in the patency of the fallopian tubes (inflammation after abortion, endometriosis, miscarriage, use of the intrauterine device as a means of contraception), abnormalities in their development, as well as in the ovaries or uterus, oncological changes in the internal genital organs, hormonal disorders or severe births, after which adhesions form in the tissues.
In addition, women of the older age category (after 35 years) can also be classified as a risk group, since by this age a woman has a fairly “rich” set of both somatic and gynecological diseases and disorders, changes in hormonal status and often the presence of abortions in stories.
How to recognize
With ectopic pregnancy, chest pain test strips will show a positive result. Pathology is difficult to suspect. However, the level of hCG will constantly fluctuate and deviate from normal, corresponding to a certain period.
Such an interesting condition, as a rule, is accompanied by unilateral unpleasant pains in the lower abdomen. An unpleasant state may increase with a change in body position. Pain during ectopic pregnancy can be similar to menstrual or cramping.
But the only reliable method for determining the place of attachment of the future fetus is ultrasound diagnosis of transvaginal access.
With timely diagnosis and treatment methods, an ectopic pregnancy does not cause a significant blow to the body. And with qualified follow-up therapy, a woman can resume attempts to become a mother only 3-6 months after the termination of such a pregnancy.
Stopping the fetal egg in the fallopian tube is dangerous because its tissues are not flexible enough and cannot stretch at the same time as the embryo grows in size. There is a rupture of the tube, blood, along with tissues and a fetal egg, enters the abdominal cavity, which can lead to peritonitis. In addition, rupture of any organ will be accompanied by acute pain during ectopic pregnancy and heavy bleeding. This jeopardizes the woman’s life and requires immediate hospitalization in the intensive care unit under the constant supervision of doctors.
Removal of an ectopic pregnancy is usually carried out by a laparotomy. Through a small incision in the abdomen, the surgeon gets access to the ovum. Moreover, all tools have sensors, and any manipulation by a specialist is displayed on the monitor. Depending on the gestational age, the doctor can remove only the ovum, the egg with some of the damaged tissue, or the entire uterine tube. Therefore, the sooner a woman consults a doctor, the less harm will be done to her health. Pain after an ectopic pregnancy will remain in the woman's memory for a long time.
However, treatment does not end there. It is necessary to undergo a course of rehabilitation therapy, as well as eliminate the possible causes of the re-occurrence of an ectopic pregnancy. It is necessary to treat infections, inflammatory processes, restore hormonal imbalance.
With timely diagnosis and interruption, as well as competent subsequent treatment and rehabilitation, a woman will be able to forget the pain of an ectopic pregnancy in the early stages. She will be able to recover and give birth to a healthy baby.
Risk factors
There are cases in which the ovum is attached outside the uterus due to some kind of malfunction of the tube channel. This is a complication and is called an ectopic pregnancy. Unfortunately, such a fruit has no chance to survive. This phenomenon is very dangerous for a woman’s health, as it is fraught with bleeding and, if ignored, can cost lives.
Under normal conditions, a fertilized fetal egg descends into the uterus and attaches to its wall. But with an ectopic pregnancy, everything happens on the contrary, it moves in the direction from it and attaches either in the tube, or in the ovary, or in the abdominal cavity in general. The lack of a favorable environment for the development of the future baby provokes the growth of the fetus in the organ to which it is attached. As a result, internal bleeding occurs.
Such a pregnancy is divided into ovarian, tubal or abdominal. It all depends on the place of attachment of the embryo. Of course, such situations are extremely rare and occurs in 1-2 cases out of 100.
There are some risk factors:
- if there was an operation in the abdominal region;
- a malfunction in the hormonal background;
- due to diseases of the female genital organs;
- benign or malignant tumor of the reproductive organs.
It begins in the same way as usual, and the first weeks proceed in the same way. Suspicious symptoms begin to occur from 3 to 9 weeks. What are the pains of an ectopic pregnancy? These include such symptoms.
- Pain with aching, stitching pain during ectopic pregnancy. It occurs in the lower abdomen, in the area of attachment of the embryo. When emptying, pain may be present.
- There is bleeding in the vessels of the organ where the fetal egg is located, and there may also be uterine bleeding. Mostly reminiscent of menstruation, but not so plentiful.
Degrees
Doctors divide it into several degrees. The first is when the embryo, during its growth, digs into the walls of the tube and tears it. The second degree is divided into two types.
The first is when an ectopic pregnancy, where the pain is usually severe, is interrupted on its own, and the egg enters the abdominal region. Accompanied by spotting and pain. The uterus is enlarged, but does not coincide with the term. Such a pregnancy is usually accompanied by unilateral pain in the lower abdomen. Discomfort may increase with a change in body position. Pain during ectopic pregnancy resembles contractions or menstrual cramps. Bloody or spotting appears.
The second is a rupture of the fallopian tube. It happens on a period of 7-10 weeks. In this case, it is important to immediately seek help! It is life threatening.
A woman is required to undergo a rehabilitation course, which is aimed at restoring fertility after such an unsuccessful pregnancy. On average, a rehabilitation course lasts six months, after which a woman can start planning a child.
What causes this pregnancy?
A fertilized egg does not reach the uterus, resulting in its incorrect location and pathological development. Egg maturation can occur in the fallopian tube, ovary or abdominal cavity. The reason is:
- Abortion.
- Underdevelopment or abnormal development of the reproductive system.
- Lack or excess of hormones.
- Blockage of the fallopian tubes or a violation of their innervation.
- Diseases of the endocrine system.
- Contraception.
Symptomatology
At the very beginning, an ectopic pregnancy is difficult to distinguish from normal. The woman has identical symptoms: increased appetite - she can eat day and night, toxicosis - nausea can occur immediately or a little later, weakness, drowsiness, swelling of the mammary glands, lack of menstruation. Only after 3-6 weeks, symptoms begin to appear, indicating that the woman has a pregnancy pathology.
- Pain during ectopic pregnancy. A terrible state when everything is aching and there is no strength to endure all this. What are the pains of an ectopic pregnancy? Cramping pains in the abdomen. Usually they are aching and cramping in nature. Urination becomes painful, sometimes with an admixture of blood.
- Bleeding. Bleeding during an ectopic pregnancy occurs in the abdominal cavity. The occurrence of uterine bleeding is also possible. The reason for this is a sharp decrease in progesterone levels. It is the hormone progesterone in women that stimulates the growth of the uterus. It blocks uterine contractions, and during pregnancy stops the menstrual cycle.
- Shock state. A pregnant woman's blood pressure drops. A drop in blood pressure is also associated with a decrease in the level of the hormone progesterone. The skin is an unhealthy color, heavy bleeding begins, and as a result - loss of consciousness. There are also pains in the lower abdomen during an ectopic pregnancy.
How to diagnose?
A positive pregnancy test and the occurrence of at least one of the familiar symptoms should make a woman go to the doctor. Research procedures for diagnosis will be prescribed.
An ultrasound scan made by a transvaginal route will be more effective. The doctor will determine the concentration of chronic human gonadotropin. If the hCG level is 1500, but during diagnostic tests the fetal egg is not detected, then the diagnosis is made - pregnancy outside the uterus.
Treatment
The only way to solve the problem is through surgery. Laparoscopy is common. During the operation, the fetal egg, fixed outside the uterus, is removed. In case of difficulties, plastic surgery is used. Plastic surgery will restore the integrity of the fallopian tube. The fallopian tubes are significant for pregnancy.
An ectopic pregnancy diagnosed in the early stages is treated with chemotherapy. Gradual resorption of the ovum performs methotrexate. It is dangerous to remove the fallopian tube. This increases the likelihood of infertility, or repeated ectopic pregnancy.
What threatens an ectopic pregnancy?
As mentioned above, a fertilized egg enters the fallopian tube and begins to develop there. The problem is that the tube is not suitable for fetal growth, since its wall does not have sufficient elasticity and extensibility, and also has a relatively small diameter.
Accordingly, reaching a certain point (4-6th week of pregnancy), the chorionic villi grow into the wall of the tube, after which it ruptures and an outflow of blood into the abdominal cavity (hemoperitoneum with a possible further development of peritonitis) occurs. Clinically, this is manifested by a sharp "dagger" pain in the lower abdomen, pallor, dizziness, cold clammy sweat, loss of consciousness. When a large vessel ruptures, bleeding can be life-threatening, which requires immediate assistance.
In some cases, the wall of the fetal egg is torn, after which it is expelled into the abdominal cavity. The clinical picture corresponds to that of a pipe rupture, but may be less pronounced or develop longer in time.
Conclusion
After a certain period of time, the symptoms of the pain of an ectopic pregnancy subside, and the woman thinks that everything is fine, but this is a false well-being. After all, blood continues to flow into the abdominal cavity. That is why it is impossible to leave such a state without due attention. A woman should be urgently hospitalized and operated. It should also be noted that the likelihood of becoming pregnant naturally after such a pathology is reduced, and the risk of a repeated scenario increases.