Most modern women are familiar with the concept of "ectopic pregnancy", but not everyone knows where it can develop, what are its symptoms and possible consequences. In the article, we consider what ovarian pregnancy is, its symptoms and treatment methods.
Definition
Ovarian pregnancy is fertilization, which occurred at a time when the egg had not yet managed to get out of the dominant follicle. In this case, it attaches to the ovary without going into the cavity of the fallopian tube and without invading the uterus. Ovarian pregnancy can be of two types:
- Intrafollicular - when fertilization occurs inside the follicle.
- Epiophoral - in case the fetal egg is attached to the surface of the ovary. A photo of an ovarian pregnancy shows the place of attachment of the ovum.
Both types of ectopic pregnancy are equally dangerous for the life and health of women.
Causes of occurrence
In most cases, an ectopic pregnancy occurs for no apparent reason, but experts identify the following factors that can lead to improper attachment of an egg:
- The presence in the past or present history of a woman of infectious diseases that adversely affected the reproductive system.
- Operations on the uterus or appendages.
- Acquired or congenital obstruction of the fallopian tubes.
- Hormonal disorders.
- The presence of benign or malignant neoplasms in the uterus or fallopian tubes.
- Anomalies in the development of internal genital organs.
- Genetic disorders.
In addition, such a pathology can occur if a woman has been selected the wrong therapy for infertility.
Symptoms
Ovarian ectopic pregnancy may occur with the following symptoms:
- Positive pregnancy test.
- Soreness when pressed into the iliac region from the implanted egg, which increases with an increase in gestation.
- Pain in the abdomen, which gives off to the anus and tailbone. It occurs abruptly and makes a woman change her body position.
In addition, with such a pregnancy, all uterine symptoms are noted - menstruation delay, nausea, vomiting, swelling and tenderness of the chest. It is pain in an unusual place that should alert a woman and serve as an excuse for contacting a gynecologist. When aggravating the painful symptoms of ovarian pregnancy, urgent hospitalization is necessary, as they may indicate an ovarian rupture.
Diagnostics
An integrated approach is required to determine an ectopic pregnancy of the ovarian type:
- A medical examination and examination, during which the symptoms that arise in a woman are clarified.
- An ultrasound scan of an ovarian pregnancy can help make the correct diagnosis. However, unfortunately, this method does not guarantee 100%. This is due to the fact that the fetal egg is similar to a cystic formation.
- To prevent the cyst from becoming an ovarian pregnancy, a diagnostic laparoscopy is prescribed - a minimally invasive operation that is performed using a laparoscope.
Blood is also given for hCG and a general urine test is performed. Despite the fact that during an ultrasound scan of an ovarian pregnancy, the photo of which is issued immediately, it may seem like a cyst or other neoplasm. The doctor draws attention to the increased level of hCG hormone in the blood and the presence of a delay in menstruation, as well as to characteristic pain when the stomach is pressed from the side on which the fetal egg is attached.
Treatment
Unfortunately, with this pathology, only surgical elimination of the problem is indicated. The removal method is selected depending on the following factors:
- desire of a woman to have children in the future;
- size of the ovum;
- ovarian conditions (whole or burst).
Most often, instead of an open abdominal operation, laparoscopy is performed:
- through small incisions, an apparatus is inserted into the abdominal cavity;
- an incision is made on the ovary;
- the fetal egg is removed;
- tools are removed and stitches are applied.
In most cases, such operations are successful and the natural functions of the organ are preserved. Exceptions are only when the symptoms of ovarian pregnancy were noticed too late and the ovum increased to a large size. In this case, the ovary bursts, which is an indication for its removal. Ovarian pregnancy, like any other ectopic, cannot be considered a normal condition - this is a pathology that requires urgent surgical intervention.
Preparation for surgery
Despite the fact that surgical intervention by laparoscopy is less traumatic, a woman still needs to undergo some training, which includes such moments:
- delivery of urine and blood;
- electrocardiogram performance;
- ultrasound examination ;
- consultation of the therapist, gynecologist and anesthetist.
If necessary, an emergency operation, laparoscopy is replaced by abdominal intervention.
Postoperative period
The time after laparoscopy or abdominal surgery is very important for the proper healing of damaged internal organs. The postoperative period consists of taking the following medications:
- painkillers;
- antibiotics to prevent the development of a bacterial infection;
- anti-inflammatory drugs to relieve inflammation.
The discharge time after laparoscopy comes after 3-4 days of hospitalization, and after an open operation is about two weeks. During this time, doctors monitor the condition of the woman and the healing of the sutures.
In addition, after surgery, it is important to monitor the level of hCG, as the fetal egg may not be completely removed. A tumor may subsequently develop from it. Normally, the level of hCG is reduced by 50% for 2-3 days after surgery.
Rehabilitation
An ectopic pregnancy is a rather complicated pathology that requires a long recovery period, especially if a woman plans a pregnancy in the future. Along with taking medications prescribed after surgery, the patient should monitor her diet: on the first day, only drinking water is allowed, on the second day drinking yoghurts are allowed, on the third day it is possible to switch to easily digestible food - cereals, broth, boiled meat and fish, crackers.
For the speedy recovery of the body, the following physiotherapy procedures may be indicated:
- magnetotherapy;
- electrophoresis;
- ultrasound therapy;
- mud baths;
- paraffin therapy.
In the period of several weeks after surgery, any physical activity, even the most insignificant, is completely prohibited. It is strictly forbidden to lift weights.
The resumption of sexual activity is allowed only a month after laparoscopic surgery and 3 months after abdominal. At the same time, a woman should be protected with the help of oral contraceptives, which will not only prevent pregnancy, but also help restore the hormonal background. Mandatory contraception with drugs is necessary within 6-9 months after surgery. Only after this period a new pregnancy is possible. Also, there is a high probability of infection in the postoperative period, so doctors advise using condoms for every sexual encounter.
Menstrual cycle recovery
Reviews of ovarian pregnancy report that the first menstruation after surgery is normal occurs after 28-40 days. If menstruation began earlier, then we can talk about ovarian, uterine or tubal bleeding, and if later, then about hormonal disorders or the presence of complications.
It is very important for women who have had an ectopic pregnancy to carefully plan the subsequent bearing of the baby, since there is a high probability of relapse. Practice shows that the best time for this is the period 1 year after the operation.
Possible complications
It is difficult to imagine any ectopic pregnancy that will go without consequences. Ovarian pregnancy, depending on the severity, has the following complications:
- Torn ovarian tissue. In this condition, complete organ removal is indicated.
- Large blood loss to the abdominal cavity that accompanies ovarian rupture. In this case, the woman feels acute pain, blood pressure is disturbed.
- The development of infertility due to the absence of one of the ovaries.
In rare cases, death from major blood loss is possible.
Signs of ovarian rupture
Symptoms of an ectopic ovarian pregnancy are greatly enhanced if it is a violation of the integrity of the ovary:
- Pain in the lower abdomen, which occurs due to irritation of the abdominal cavity. Unpleasant sensations occur in the affected ovary and gradually spread throughout the abdomen. They are permanent and very strong.
- Weakness and loss of consciousness develop amid oxygen deficiency due to large blood loss.
- Frequent urge to defecate and loose stools indicate irritation of the walls of the rectum, pouring blood inside.
- Nausea and vomiting occur due to the negative effects of oxygen deficiency on the nervous system.
- Hemorrhagic shock is a condition in which a woman feels cold sweat, shortness of breath, clouding of her mind, pallor of her skin, and apathy. In this case, a decrease in blood pressure up to critical levels is noted. This condition develops due to large blood loss and is life-threatening in nature.
If these symptoms are detected, it is necessary to call an ambulance as soon as possible and deliver the woman to the hospital, where an operation will be urgently performed to clean the abdominal cavity and remove the pathological ovary.
Is it possible to have a baby with an ectopic pregnancy?
The only organ where the fetus can develop is the uterus. Attaching a fetal egg to the ovary, fallopian tubes and other places not intended for this is a pathology. The structure of the ovaries is not adapted to stretch along with the fetus, as a result of which the organ ruptures.
To date, there are no methods that would help women to have an ectopic pregnancy. This condition is pathological and poses a direct threat to the life of a woman.
Prevention
Unfortunately, it is possible to prevent the appearance of an ectopic pregnancy only in the complete absence of intimate relationships. However, you can significantly reduce the risks if you adhere to such recommendations of gynecologists:
- From the beginning of sexual activity, it is necessary to regularly visit a female doctor for a routine examination, even in the absence of complaints.
- Keep a calendar of menstrual cycles, and consult a specialist if they are abnormal.
- Timely and efficiently treat all possible diseases of the reproductive system. Including minor inflammation, as well as infectious diseases.
- Pregnancy planning to begin with a routine examination by a gynecologist.
- Prevent urinary tract diseases or treat them in a timely manner.
- Avoid abortion using modern contraceptives to prevent unwanted pregnancy. They contribute to the development of adhesions, which do not allow the embryo to attach in the proper place for this, as a result of which it attaches to the ovaries, tubes, cervix, abdominal cavity.
In addition, as a preventive measure, it is recommended to adhere to a healthy lifestyle, as well as completely stop smoking and drinking alcoholic beverages.