In the very early stages of pregnancy, it is sometimes very difficult to determine whether it is an ectopic pregnancy, or a normally developing one. Even not all doctors can recognize any problems with the attachment of the ovum in the early stages, but there are certain symptoms and signs that will help both the doctor and the woman herself to determine such a pregnancy.
What is dangerous ectopic pregnancy? With a similar pathology of pregnancy, the fetus is attached not in the uterus, as usual, but in the tube. For various reasons, the fertilized egg remains in the fallopian tube, and does not move on. The fallopian tubes are very narrow, but they have a very developed circulatory system, so when they break open bleeding can be extremely dangerous for a woman’s life. In tubal pregnancy, the growing fetus stretches the surrounding tissue.
Just a little time, and a 5-week embryo ruptures the fallopian tube. Excessive internal bleeding can be stopped only in the operating room, which is why in this case it is impossible to delay, and the patient should be immediately transported to the operating table.
How to determine ectopic pregnancy
In the very early stages of gestation, the attachment and development of the embryo outside the uterus has the same signs as a normally developing pregnancy. That is, a woman feels nothing especially, except for the common accompanying symptoms that any pregnant woman feels in the first weeks, namely:
– toilet urges more often than usual;
– chest swells, itches and hurts;
– if you measure basal temperature, it is slightly elevated.
It would seem that there is nothing special. However, it should be remembered that this condition is dangerous in that tubal pregnancy cannot last for a long time – at 5 or 6 weeks of pregnancy a rupture of the uterine tube may occur and bleeding will open. And therefore, there must be some signs that indicate that all is not so well.
This is what you can feel from the 5th week of pregnancy, that is, at the end of the first month of the obstetric calendar:
1. The pregnancy test is positive, but the second strip is much weaker than the first, even if you are already sure that you are expecting a baby.
2. The hormone hCG has low rates: the doctor will notice that the level of hCG does not correspond to the duration of pregnancy.
3. A woman feels strange pains and discomfort in the ovaries. Such pains resemble ovulatory, or – with an ovarian cyst.
4. It is not only the basal temperature that grows, but also the temperature of the whole body.
5. You are concerned about weak brown discharge, or – with blood.
6. Blood pressure may be low, and you feel dizzy and weak.
Of course, such signs do not always indicate that something is wrong with you. For example, the last three symptoms can occur during normal pregnancy.
Usually, doctors do not take into account the subjective signs and sensations of women. For them it is important to check the level of hCG, and also – be sure to make an ultrasound of the uterus.
So, what does the doctor do for the diagnosis of ectopic pregnancy in the early stages:
1. Take blood for analysis to determine hCG.
Suspicion of GeEm
2. Conduct an ultrasound transvaginal probe.
3. Conduct a gynecological examination, palpating the abdomen of a pregnant woman to determine the height of the uterus. Even at this early stage, the gynecologist will be able to distinguish the pregnant uterus. In women with an ectopic pregnancy, the size of the uterus does not correspond to the duration of pregnancy.
In the early stages of gestation, with the normal localization of the ovum, the doctor will definitely see the embryo in the uterus, as well as listen to the heartbeat. For the doctor, this is an absolute sign that pregnancy is a uterine, and there is no cause for concern.
Another thing, if the fetal egg on the ultrasound is not visible. This is not yet a reliable sign of pathological pregnancy, however, hCG and gynecological examination will confirm the suspicion of the doctor.
Remember that with normal well-being, a woman goes through all these examinations within a few days. If the pregnant woman feels bad – she has fever, nausea and vomiting, severe abdominal pain, then the doctor will carry out all examinations instantly, and if an ectopic pregnancy is confirmed, then urgent surgical intervention is necessary.
Possible localization of the ovum during ectopic pregnancy. 8 – uterine pregnancy.
Symptoms of breaking the pipe
This is a very dangerous condition in which the victim needs the immediate help of an experienced surgeon. Be sure to remember these signs:
– sharp and sharp pain in the abdomen. Most often – in the area of the ovary, where the fertilized egg is located. Very often, pain gives to the back, is determined in the rectum, or gives to the leg.
– a woman feels pain during a medical examination: when the doctor is palpating the abdomen. On vaginal examination, the gynecologist can sometimes determine the position of the ovum in the adjacent tube.
– when the tube ruptured, the bleeding that has opened leads to hemorrhagic shock: there is pallor of the skin, perspiration, pressure decreases, confusion and fainting.
– in some cases, the woman observes the performance of blood from the genital tract.
The patient’s help consists in stabilization of pressure, hemostasis, surgery to remove the tube and the remains of the ovum. In case of heavy bleeding, sanitation of the abdominal cavity is necessary; also, the doctor prescribes a postoperative course of antibiotics for the patient to prevent inflammatory processes.
What to do if you suspect an ectopic pregnancy?
What to do if you feel all the above symptoms and signs, but can not be sure that your fears can be confirmed?
You need to calm down and call your doctor. Tell about the symptoms and ailments that torment you. If your condition seems suspicious to a doctor, you will be prescribed an examination.
Be sure to determine the level of the hormone HCG. If it is below normal, then the next examination is on the gynecological chair. If the size of the woman’s uterus seems less than necessary, then the doctor will prescribe an ultrasound scan to the patient, which can determine the localization of the ovum almost reliably.
However, we want to warn you that even a doctor will not be able to diagnose an ectopic pregnancy with one hundred percent certainty until she has surgery. Only surgery can accurately show that the pregnancy did not develop in the uterus, but in the tube.
However, if the doctor is almost sure that the woman has an ectopic pregnancy, then she is scheduled for surgery. How to spend it?
For surgery to remove the ovum, you do not need to make large incisions on the abdomen. It is enough to make a small incision and laparoscopy. The surgeon makes a small puncture on the patient’s abdomen, and inserts special tools into the woman’s abdominal cavity to examine the fallopian tubes. In the event that the doctor finds a fertilized egg in one of the tubes, it is removed.
Without special indications, the surgeon will not remove the fallopian tube, if it is whole, and the developing embryo has been detected in advance, and the tube has not yet broken. The fact is that without it, the chances of a woman for pregnancy are significantly reduced.
In the event that a rupture occurred, then it will no longer be possible to save it, and therefore surgeons have several tasks at once: remove the embryo and the ruptured tube from the abdominal cavity of the woman, perform sanation of the abdominal cavity and stop the bleeding.
Most often, the operation is of the classical type – that is, through an incision in the abdominal wall. This is done in late pregnancy, when the embryo is already very large, or when the fallopian tube has ruptured.
A mini-operation to remove the ovum is still possible: when the surgeon does not make incisions in the tube, but simply “squeezes” the embryo. However, this type of operation is performed very rarely, because it is an incredibly difficult task to diagnose an ectopic pregnancy at a very early date, and, most often, a similar diagnosis is made by chance when the doctor himself did not know about the possibility of such a pregnancy, and examined the patient for completely different diseases.
Unfortunately, it is impossible to avoid such a pathology of pregnancy. However, it must be remembered that such a pregnancy most often occurs in women with gynecological diseases in history, as a result of which there has been a change in the endometrium of the fallopian tubes or the uterine cavity. Or improper attachment of the fetus may occur due to adhesions in the tubes.
We advise you to visit the gynecologist more often, to undergo all examinations, and if you feel unwell, consult a doctor as soon as possible.
Site for expectant mothers
This does not wish any woman. This news certainly plunges into shock. Such diagnoses are always perceived on emotions. But we hurry to console you, as far as it is generally possible: an ectopic pregnancy is not a sentence yet.
In fact, ectopic attachment of the ovum is not such a rarity: it is not enough pleasant, but because of the frequency of occurrence, doctors have already learned how to quickly determine an ectopic pregnancy and take the necessary measures to prevent risks and minimize the consequences. However, future projections for women will depend on a number of factors.
Of great importance at what time the ectopic pregnancy makes itself felt, and how. Unfortunately, in 5-10% of all cases a woman really can no longer have children. But the actions taken on time help to avoid many ills, including maintaining the functionality of the female reproductive system. So, most importantly, do not miss the time.
Why is the egg not in the uterus?
When the sperm cell fertilizes the egg, the latter begins to move through the fallopian tube and at the end of the path is attached to the wall of the uterus for further development and growth – implantation occurs. So begins a normal pregnancy, during which the egg is improved, constantly divided, the fetus is formed, from which by the end of the term a full-fledged child grows, ready for life outside the womb of the mother. For this complicated process to take place, a certain “dwelling” for the egg cell and space for its growth are necessary. The uterus – the perfect option.
However, it happens that the egg does not reach the destination and settles earlier. In 70% of cases it is attached to the fallopian tube, but other options are possible: to the ovaries, to the cervix, to any of the abdominal organs.
Causes of ectopic pregnancy
There are several reasons why an egg can not reach the uterus:
- Violations in the state of the walls and functioning of the fallopian tubes (when they are badly reduced and are not able to move the egg further). This often happens due to previously transferred diseases of the pelvic organs, as well as chronic inflammatory diseases of the genital organs, in particular STDs.
- Anatomical features of the fallopian tube (for example, infantilism): too narrow, crimped, scarred or scarred tube complicates and slows the progress of the egg.
- Previous surgery on the fallopian tubes.
- Previous abortions, especially if the first woman’s pregnancy was interrupted by artificial means.
- The sluggishness of the sperm: the egg “awaits” fertilization, which is why it does not have time to get to the right place in time, that is, to the uterus – hunger forces it to settle earlier.
- Hormonal disorders in the body of a pregnant woman.
- Tumors on the uterus and appendages.
- Changing the properties of the ovum.
- Some technologies of artificial insemination.
- Constant nervous overexcitement of a woman, in particular, the fear of getting pregnant and unreliable methods of protection do not allow her to relax, which is why the fallopian tubes spasm.
Of course, ideally, it is necessary to try to exclude all possible causes of the development of an ectopic pregnancy at the planning stage.
Suspicion of micronus century on RFU morning
Symptoms of ectopic pregnancy
How to know that the pregnancy – ectopic? In fact, “see” it is not easy. The symptoms of this pregnancy are exactly the same as normal physiological: regular menstruation does not occur, the chest is poured, the uterus increases and can sip, toxicosis is possible, appetite and taste preferences change, and so on. But something can still cause some suspicion.
In an ectopic pregnancy, from the first days, a bloody dark discharge can be observed. It happens that the next menstruation occurs in due time or with a slight delay, only the discharge is weaker than usual. At the same time, the pulling pain in the abdomen gives to the anus, and if the fallopian tube ruptures, it becomes unbearably strong, acute, even to a loss of consciousness, the bleeding begins. With internal bleeding, weakness and pain are accompanied by vomiting and low blood pressure. In such cases, the woman must be urgently taken to the hospital for urgent surgery.
Ectopic pregnancy is most easily confused with the threat of miscarriage. But it is precisely with this that she makes herself felt: she begins to interrupt, which usually happens at 4-6 weeks. To avoid the worst, you must make a diagnosis in time. And therefore, as soon as you know that you are pregnant, immediately go through the examination by a gynecologist and an ultrasound scan. This will allow you to sleep peacefully, because in such cases the location of the ovum will immediately become known (in most cases).
How to determine ectopic pregnancy?
The success of resolving a situation in an ectopic pregnancy will depend on the stage of its development. Pregnant women are registered on the second or third month, and this is already a bit late … Therefore, as soon as you have the slightest suspicion that something was wrong, you should immediately make sure that the problem exists or eliminate it. This is done by examination.
First you need to make sure that the pregnancy really has come. The easiest and fastest way to do a home pregnancy test. However, it is not necessary to rely only on the test in any case: the gynecologist will be able to confirm the conjectures about the conception that took place during a full-time examination. However, this is not always: if the period is not large enough or the egg is still too small, then the only way to reliably find out whether a pregnancy has occurred or not will be a pelvic ultrasound with the introduction of a transvaginal probe and a blood test for hCG.
If it is too late to guess – there are all signs of a tubular rupture or abdominal bleeding – call an ambulance immediately: this condition is life-threatening! And in no case do not take any action yourself: do not drink painkillers, do not put ice warmers, do not put an enema!
Read also Signs of ectopic pregnancy.
Basal temperature in ectopic pregnancy
Women leading a basal temperature schedule may suspect a pregnancy at the earliest possible time. After conception in the body of the future mother, progesterone begins to be intensively developed, which is necessary to ensure the vital activity of the egg and create favorable conditions for its further development. It is an increase in the level of this hormone and is the cause of the growth of basal temperature. Indicators can only be guided when measurements are taken from month to month according to all the rules for at least 4-6 cycles in a row.
With the onset of pregnancy, the basal temperature rises to an average of 37.2-37.3 ° C (for different women, these figures may differ slightly) and is maintained at this level. This happens regardless of whether the pregnancy develops in the uterus or outside the uterus. The basal temperature in ectopic pregnancy is no different, since progesterone is produced in any case.
A decrease in basal temperature (below 37 ° C) occurs only when the fetus freezes, which often happens during ectopic pregnancy. But this is not necessary: often the indicators of BT remain at their previous levels in this case.
Does the test show an ectopic pregnancy?
This question can not be given an accurate answer. Firstly, not any test and not always shows the usual pregnancy. Secondly, in the case of attachment of the ovum outside the uterus, there may indeed be nuances.
So, almost all pregnancy tests show that fertilization took place. It does not matter where the egg cell stopped exactly: the level of the human chorionic gonadotropin hormone (hCG) will necessarily increase (as the developing placenta begins to produce it), to which the test systems actually react.
In principle, there are expensive cassettes, which in most cases are able to determine not only the pregnancy in the earliest terms, but also its ectopic development (read about this in the article Ectopic pregnancy and pregnancy test). But if we talk about the usual home tests, they can only establish the fact of pregnancy, and even then with reservations.
The test for ectopic pregnancy can “work” later than with the physiological one. That is, in the period when a normally developing pregnancy can already be diagnosed with a home test, the pathological pregnancy is sometimes still “hidden”. Ectopic pregnancy can often be determined using a test with a delay, that is, 1-2 weeks later than the usual situation. Or the second test strip appears very weak. What is the reason?
HCG level in ectopic pregnancy
It’s all about hCG. Wherever the fertilized egg is fixed, its shell (chorion) still begins to produce this hormone. That is why a pregnancy test will show a positive result even with an ectopic pregnancy. But doctors argue that in the latter case, the level of hCG is lower than during uterine pregnancy, and does not grow so rapidly. Therefore, at the time when the usual pregnancy home test already shows, with ectopic levels of hCG may still be insufficient to determine.
In the blood, the concentration of the human chorionic gonadotropin hormone increases earlier and faster than in the urine. Therefore, a more informative will be a blood test for hCG. If a woman has bad suspicions and the gynecologist after examination and consultation does not exclude the likelihood of ectopic pregnancy, it is better to pass this analysis and undergo an ultrasound.
By itself, a blood test for hCG cannot be a reason for making a definitive diagnosis, but together with an ultrasound can clarify the picture. HCG in ectopic pregnancy, although it rises, but not so rapidly and dynamically. Regular monitoring of the level of hCG in the blood (with a break of every 2-3 days) allows us to draw preliminary conclusions: during a normal pregnancy, it will double, while with a pathological pregnancy, it will only slightly increase.
Does the ultrasound shows ectopic pregnancy?
Transvaginal ultrasound allows you to see the location of the ovum already in the second week of pregnancy, although you can probably get reliable data from about the fourth week. If the embryo in the uterine tube or uterus is not detected (when the period is too short and the egg is not visible due to the extremely small size), and there is a suspicion of an ectopic pregnancy, the procedure is repeated some time later or the woman is immediately hospitalized and a medical examination is performed. According to the testimony, laparoscopy is even possible: the pelvic organs are examined under general anesthesia during the operation, which, upon confirmation of an ectopic pregnancy, is immediately transformed into a medical procedure.
Ultrasound with intravaginal insertion of the sensor is considered the most reliable method for the diagnosis of ectopic pregnancy. However, he does not give an absolute guarantee that the diagnosis will be made correctly. In 10% of all cases, when an ectopic pregnancy is performed by an ultrasound, it is not installed due to the fact that the accumulation of a liquid or blood clot in the uterus is considered to be a fertilized egg. Therefore, even such highly accurate diagnostics is recommended to be combined with other methods for greater reliability, in particular with a blood test for hCG.
Ectopic pregnancy: predictions
None of the organs of the female body is not intended for carrying a child, except for the uterus. Therefore, an embryo attached “in the wrong place” must be removed. If this is not done in advance, it may occur, for example, rupture of the fallopian tube (if the egg is fixed here), or it can get into the abdominal cavity when bleeding opens. Both situations are extremely dangerous for women and require immediate surgical intervention. When the uterine tube ruptures, the woman experiences severe acute pain, shock, fainting, and intra-abdominal bleeding are possible.
It is very important to detect an ectopic pregnancy in time to successfully solve the problem. Previously, in such cases, the fallopian tube was removed, which meant the inability to become pregnant and give birth in the future. Today it is an extreme measure. In most cases, during an ectopic pregnancy, an operation is performed, during which the fertilized egg is removed and the fallopian tube is sewn up to preserve reproductive abilities.
More and more doctors are studying and practicing drug treatment of ectopic pregnancy with the help of hormones. However, even if you have removed one damaged fallopian tube, you have every chance of getting pregnant and carrying out the child if the other one is saved.
True, you first need to undergo a restorative treatment course. As well as a woman who survived an ectopic pregnancy, you can not get pregnant yet, at least for six months. Be extremely careful when choosing a contraceptive method. You must understand that there are still quite high chances of repeating such an abnormal pregnancy. And in order to prevent this, it is imperative to find out the reason why the fertilized egg in your case cannot reach the uterus. Well, of course, eliminate it.
Especially for beremennost.net – Elena Kichak