home » Alzheimer's disease

Is an ectopic pregnancy dangerous? Ectopic pregnancy: signs, symptoms and danger. Causes of pregnancy outside the uterus

Ectopic pregnancy is a pregnancy characterized by implantation and development of the ovum outside the uterus - in abdominal cavity, ovary, fallopian tube. Ectopic pregnancy is a serious and dangerous pathology, fraught with complications and relapses (reoccurrence), entailing a loss of fertility and even a threat to a woman's life. Localizing in addition to the uterine cavity, which is the only physiologically adapted for the full development of the fetus, a fertilized egg can lead to rupture of the organ in which it develops.

General information

The development of a normal pregnancy occurs in the uterine cavity. After the fusion of the egg with the sperm in the fallopian tube, the fertilized egg that started dividing moves into the uterus, where the necessary conditions for the further development of the fetus are physiologically provided. The gestational age is determined by the location and size of the uterus. Normally, in the absence of pregnancy, the uterus is fixed in the small pelvis, between the bladder and rectum, and is about 5 cm wide and 8 cm long. A 6-week pregnancy can already be identified by a slight increase in the uterus. At the 8th week of pregnancy, the uterus enlarges to the size of a woman's fist. By the 16th week of pregnancy, the uterus is defined between the bosom and the navel. In a 24-week pregnancy, the uterus is determined at the level of the navel, and by 28 weeks the bottom of the uterus is already above the navel.

At 36 weeks of gestation, the fundus of the uterus reaches the costal arches and the xiphoid process. By the 40th week of pregnancy, the uterus is fixed between the xiphoid process and the navel. Pregnancy for a period of 32 weeks of gestation is established both by the date of the last menstruation and the date of the first movement of the fetus, and by the size of the uterus and the height of its standing. If a fertilized egg for any reason does not enter the uterine cavity from the fallopian tube, a tubal ectopic pregnancy develops (in 95% of cases). In rare cases, the development of an ectopic pregnancy in the ovary or in the abdominal cavity has been noted.

V last years there is a 5-fold increase in the number of cases of ectopic pregnancy (data from the US Centers for Disease Control). In 7-22% of women, the recurrence of ectopic pregnancy was noted, which in more than half of the cases leads to secondary infertility. Compared with healthy women, patients who have undergone an ectopic pregnancy have a greater (7-13 times) risk of its recurrence. Most often, women from 23 to 40 years old have a right-sided ectopic pregnancy. In 99% of cases, the development of an ectopic pregnancy is noted in certain parts of the fallopian tube.

General information

Ectopic pregnancy is a serious and dangerous pathology, fraught with complications and relapses (reoccurrence), entailing a loss of fertility and even a threat to a woman's life. Localizing in addition to the uterine cavity, which is the only physiologically adapted for the full development of the fetus, a fertilized egg can lead to rupture of the organ in which it develops. In practice, there is an ectopic pregnancy of various localizations.

A tubal pregnancy is characterized by the location of the ovum in the fallopian tube. It is noted in 97.7% of cases of ectopic pregnancy. In 50% of cases, the ovum is located in the ampullar section, in 40% - in the middle part of the tube, in 2-3% of cases - in the uterine part and in 5-10% of cases - in the area of ​​the fimbriae of the tube. Rarely observed forms of development of ectopic pregnancy include ovarian, cervical, abdominal, intraligamentary forms, as well as ectopic pregnancy, localized in the rudimentary uterine horn.

Ovarian pregnancy (observed in 0.2-1.3% of cases) is divided into intrafollicular (the egg is fertilized inside the ovulated follicle) and ovarian (the fertilized egg is fixed on the surface of the ovary). Abdominal pregnancy (occurs in 0.1 - 1.4% of cases) develops when the ovum leaves the abdominal cavity, where it attaches to the peritoneum, omentum, intestines, and other organs. The development of an abdominal pregnancy is possible as a result of IVF with infertility of the patient. Cervical pregnancy (0.1-0.4% of cases) occurs when the ovum is implanted into the area of ​​the cylindrical epithelium of the cervical canal. Ends with profuse bleeding as a result of the destruction of tissues and blood vessels caused by deep penetration of the villi of the ovum into the muscular membrane of the cervix.

Ectopic pregnancy in the accessory horn of the uterus (0.2-0.9% of cases) develops with abnormalities in the structure of the uterus. Despite the attachment of the ovum intrauterinely, the symptoms of the course of pregnancy are similar to the clinical manifestations of uterine rupture. Intraligamentary ectopic pregnancy (0.1% of cases) is characterized by the development of the ovum between the leaves of the wide ligaments of the uterus, where it is implanted when the fallopian tube ruptures. Heterotopic (multiple) pregnancy is extremely rare (1 case per 100-620 pregnancies) and is possible as a result of using IVF (assisted reproduction method). It is characterized by the presence of one ovum in the uterus, and the other outside it.

Signs of an ectopic pregnancy

Signs of the emergence and development of an ectopic pregnancy can be the following manifestations:

  • Violation menstrual cycle(delay of menstruation);
  • Bloody, "smearing" character of discharge from the genitals;
  • Pain in the lower abdomen (pulling pain in the area of ​​attachment of the ovum);
  • Breast engorgement, nausea, vomiting, lack of appetite.

An interrupted tubal pregnancy is accompanied by symptoms of intra-abdominal bleeding due to the outflow of blood into the abdominal cavity. Characterized by a sharp pain in the lower abdomen, radiating into anus, legs and lower back; after the onset of pain, bleeding or brown spotting from the genitals is noted. There is a decrease blood pressure, weakness, frequent pulse of weak filling, loss of consciousness. On early stages it is extremely difficult to diagnose an ectopic pregnancy; since the clinical picture is not typical, treatment for medical help follows only with the development of certain complications.

The clinical picture of an interrupted tubal pregnancy coincides with the symptoms of ovarian apoplexy. Patients with symptoms of "acute abdomen" are urgently delivered to a hospital. It is necessary to immediately determine the presence of an ectopic pregnancy, perform surgery and eliminate bleeding. Modern methods diagnostics allow using ultrasound equipment and tests to determine the level of progesterone ("pregnancy hormone") to establish the presence of an ectopic pregnancy. All medical efforts are directed to the preservation of the fallopian tube. In order to avoid serious consequences of an ectopic pregnancy, it is necessary to observe a doctor at the first suspicion of pregnancy.

Causes of an ectopic pregnancy

Diagnostics of the ectopic pregnancy

In the early stages, an ectopic pregnancy is difficult to diagnose because clinical manifestations pathologies are atypical. As well as with uterine pregnancy, there is a delay in menstruation, changes from the side digestive system(perversion of taste, attacks of nausea, vomiting, etc.), softening of the uterus and the formation in the ovary of the corpus luteum of pregnancy. An interrupted tubal pregnancy is difficult to distinguish from appendicitis, ovarian apoplexy, or other acute surgical pathology of the abdominal cavity and pelvis.

In the event of an interrupted tubal pregnancy, which is a threat to life, a quick diagnosis and immediate surgical intervention... It is possible to completely exclude or confirm the diagnosis of "ectopic pregnancy" with the help of ultrasound (the presence of a fetal egg in the uterus, the presence of fluid in the abdominal cavity and formation in the area of ​​the appendages are determined).

An informative way to determine an ectopic pregnancy is the β-hCG test. The test determines the level of chorionic gonadotropin (β-hCG) produced by the body during pregnancy. The norms of its content during uterine and ectopic pregnancy differ significantly, which makes this diagnostic method highly reliable. Due to the fact that today surgical gynecology widely uses laparoscopy as a method of diagnosis and treatment, it has become possible with 100% accuracy to establish the diagnosis of an ectopic pregnancy and eliminate the pathology.

Ectopic pregnancy treatment

For the treatment of the tubal form of ectopic pregnancy, the following types of laparoscopic operations are used: tubectomy (removal of the fallopian tube) and tubotomy (preservation of the fallopian tube while removing the ovum). The choice of method depends on the situation and the degree of complication of an ectopic pregnancy. When preserving the fallopian tube, the risk of recurrence of an ectopic pregnancy in the same tube is taken into account.

When choosing a method for treating an ectopic pregnancy, the following factors are taken into account:

  • The patient's intention to plan a pregnancy in the future.
  • The feasibility of preserving the fallopian tube (depending on how pronounced the structural changes in the wall of the tube).
  • Repeated ectopic pregnancy in a preserved tube dictates the need to remove it.
  • The development of an ectopic pregnancy in the interstitial tube.
  • The development of an adhesive process in the pelvic area and, in connection with this, an increasing risk of repeated ectopic pregnancy.

With large blood loss, the only option to save the patient's life is an abdominal operation (laparotomy) and removal of the fallopian tube. With the unchanged state of the remaining fallopian tube, fertility is not impaired, and a woman may have a pregnancy in the future. To establish an objective picture of the state of the fallopian tube remaining after laparotomy, laparoscopy is recommended. This method also allows the adhesions in the pelvis to be separated, which serves to reduce the risk of re-ectopic pregnancy in the remaining fallopian tube.

Ectopic pregnancy prevention

To prevent the occurrence of an ectopic pregnancy, you must:

  • prevent the development of organ inflammation genitourinary system, and if inflammation has arisen - treat it in time
  • before the planned pregnancy, undergo an examination for the presence of pathogenic microbes (chlamydia, ureaplasma, mycoplasma, etc.). If they are found, it is necessary to undergo appropriate treatment together with the husband (permanent sexual partner)
  • protect during sexual activity from unwanted pregnancy, using reliable contraceptives, avoid abortion (the main factor provoking an ectopic pregnancy)
  • if it is necessary to terminate an unwanted pregnancy, choose low-traumatic methods (mini-abortion) at the optimal time (the first 8 weeks of pregnancy), to carry out the termination without fail in a medical institution qualified specialist, with anesthesia and further medical supervision. Vacuum abortion (mini-abortion) reduces the time of the operation, has few contraindications and significantly fewer undesirable consequences
  • as an alternative to the surgical method of termination of pregnancy, you can choose medical termination of pregnancy (taking the drug Mifegin or Mifepristone)
  • after an ectopic pregnancy, undergo a rehabilitation course to preserve the possibility of having the next pregnancy. To preserve fertility, it is important to be observed by a gynecologist and a gynecologist-endocrinologist and follow their recommendations. A year after the operation, you can plan a new pregnancy, in the event of which it is necessary to register for pregnancy management at an early date. At the same time, the forecast is favorable.

"Ectopic pregnancy" - all women in the world are afraid of such a terrible diagnosis. How to determine the state of health during pregnancy? How to avoid this stalemate in life? Is it possible to prevent abnormal fetal development in advance? This article will try to answer these questions.

This pathology does not arise by itself. There are a number of objective reasons and reasons on the basis of which an ectopic pregnancy appears. It is a number of prerequisites that predetermine the development of such a pathology.

An ectopic pregnancy is determined by the specific location of the fertilized egg. In some cases, the fertilized cell does not reach its finishing point in the cavity. In this case, implantation occurs in the fallopian tube, uterine horn, cervix, ovary or abdominal cavity.

Under such circumstances, the development of the egg after fertilization is not possible for normal growth and development of the fetus in the future. Such an abnormal phenomenon usually ends with multiple ruptures, tubal abortion, infertility.

In some cases, in the absence of medical care, a lethal outcome is possible.

Predisposing factors

  • Chronic or acute diseases female reproductive organs, bladder and other organs of the genitourinary system. The most dangerous infections are caused by ureaplasma, mycoplasma, chlamydia, gonorrhea.
  • Inflammatory processes in the ovaries and tubes, as a consequence of an abortion or difficult, difficult childbirth. This narrows the passages in the pipes.
  • Various inflammatory processes in the lining of the uterus. The most dangerous is endometriosis.
  • Surgery, such as plastic surgery of the genitals.
  • Congenital maldevelopment of the fallopian tubes - infantilism. Due to the irregular shape (tortuosity and narrowing in them), the movement of the egg cell is inhibited on the way to the uterus.
  • Hormonal changes. This changes the peristalsis of the tubes, causes endocrine disorders. Taking hormonal contraceptives without medical supervision increases the likelihood of pathologies of female organs.
  • Use for contraception for a long period in violation of the terms of use.
  • Tumors of different types: benign and malignant.

If there was a case of an ectopic pregnancy earlier, then there is a risk of recurrence of the abnormal development of pregnancy outside the uterus. This risk is nearly 25%.

There is a likelihood of developing an ectopic pregnancy in completely healthy people who do not have any potential for developing an anomaly.

Doctors suggest that an external negative effect on a woman's body can provoke the development of an ectopic pregnancy, for example, and alcohol.

Already at the 6th week of pregnancy, an ultrasound scan is performed with a special sensor through the vagina. During this study, the location of the embryo inside the woman's body is determined. Such an examination makes it possible to clarify and identify even an asymptomatic ectopic pregnancy.

Another diagnostic method is puncture of the posterior vaginal fornix. This method detects the presence of liquid blood in the abdominal cavity. This method is usually used in conjunction with other manipulations.

Only on the basis of numerous different analyzes, timely examination and quick response can the correct diagnostic conclusion be drawn.

Ectopic pregnancy symptoms

Symptoms of an ectopic pregnancy, with timely access to doctors, helps to identify the disease by making the correct diagnosis. What are the symptoms of ectopic pregnancy now?

The main signs of pathological anchorage of the egg outside the body of the uterus are:

  • with meager bloody discharge when indicated by test positive result pregnancy.
  • Drawing pain in the lower abdomen.
  • Bloody rare, smearing character.
  • Slow growth of hCG.
  • Fainting conditions.
  • Pain during sex.
  • Spasms like labor pains.
  • Heavy bleeding into the abdominal cavity causes pain radiating to the shoulder and shoulder blade.

Pregnancy is a very complex process, and sometimes there are malfunctions and even complications, one of which is an ectopic pregnancy. Due to the imperfection of our body, it can happen to almost any woman. An ectopic pregnancy occurs when a fertilized egg is not fixed in the uterus, where it should be, but in another place. Naturally, such a pregnancy cannot develop, therefore it is necessary to get rid of it. And the sooner this is done, the less painful sensations you will experience.

What is an ectopic pregnancy?

As we have already said, ectopic pregnancy is called a pregnancy in which a fertilized egg is fixed outside the uterine cavity. Depending on where the ovum is located, an ectopic pregnancy can be:

  • tubal, if the egg is anchored in the fallopian tube;
  • ovarian - when fixed in the ovary;
  • abdominal - when the ovum is attached in the abdominal cavity;
  • developing in the rudimentary horn of the uterus, which is rare in practice.

The so-called heteroscopic pregnancy is extremely rare. This is a situation when a woman has a uterine and ectopic pregnancy at the same time. Occasionally, in one month, women can ovulate two eggs at once, and both of them are able to fertilize. If one of the cells is not fixed where it should be, a heteroscopic pregnancy develops.

It is very important to determine the pathological pregnancy as early as possible.... This will prevent its most serious consequences - infertility and death for a woman. Often, during an ectopic pregnancy, the embryo freezes, but sometimes its development continues. In this situation, it must be removed as soon as possible. In the early stages, drug treatment is also possible, but with the progression of pregnancy, one has to resort to surgical treatment.

Reasons for improper fixation of the ovum (Video)

The unequivocal cause of the occurrence of an ectopic pregnancy has not yet been established, but there are a number of hypothetical ones. These include:

    • infectious and inflammatory diseases uterus, appendages and bladder;
    • anomalies, including congenital, of the structure of the fallopian tubes, which impede the normal movement of a fertilized egg and prevent it from entering the uterine cavity;
    • the consequences of surgical interventions on the fallopian tubes;
    • hormonal problems;
    • the consequences of curettage of the uterine cavity - for example, during abortion;
    • use as a means of protection against unwanted pregnancy;
    • long-term infertility treatment with hormonal drugs;
    • external endometriosis or proliferation of the endometrium outside the uterine cavity;
    • the presence of tumors in the ovaries or fallopian tubes;
    • the presence of adhesions in the small pelvis;
    • tuberculosis of the tubes of the uterus.

How to identify an ectopic pregnancy

Timely identification of an ectopic pregnancy is extremely important, so all women need to know characteristic symptoms and if they appear, immediately go to the doctor. The first signs of an ectopic pregnancy are no different from normal.... Of course, this is the absence of menstruation, new sensations in the chest, etc. But at the same time, pain in the lower abdomen and unusual spotting may appear.

If such symptoms appear, it is better to immediately consult a doctor in order to exclude or confirm incorrect implantation of the ovum. Usually, ultrasound diagnostics help to do this.

Many refuse ultrasound for early term, motivating this with possible harm to the fetus. Yes, there is such a risk, but believe me, an ectopic pregnancy is much more dangerous than exposure to ultrasound.

A significant factor for the recognition of this pathology is hCG level ... In normal pregnancies, it rises in everyone, but in case of ectopic growth, it may not be as rapid. In addition, if the hCG level is high - above 1500 mIU / ml, and a fertilized egg in the uterus is not observed during manual examination, this is a reason to immediately sound the alarm.

Consequences of improper implantation of the ovum

The most dangerous consequence an ectopic pregnancy is a ruptured fallopian tube... If the pregnancy progresses and the embryo grows, it begins to press on the walls of the tubes and simply ruptures them. Damage to the arteries and veins in the tube wall leads to bleeding and acute pain in the organs of the peritoneum and small pelvis. In such a situation, it is necessary to be in the hospital as soon as possible for the operation. Only timely surgical intervention can save a woman's life and even give her a chance to become a mother in the future.

Almost a third of all future ectopic pregnancies result in. This is due to frequent damage to the fallopian tubes, as well as their complete removal during surgery.

Sad statistics say that in the case of an ectopic pregnancy, its recurrence in carriers of the fetus is observed in 20 percent of cases. If the treatment was carried out not by surgery, but with the help of methotrexate, then the chances of a normal pregnancy will subsequently be much higher. But such treatment is possible only for a very short time.

Another undesirable consequence of ectopic pregnancy is the development of an adhesive process in the peritoneum and pelvic organs.

Diagnostic and treatment methods

As already mentioned, ultrasound usually helps to diagnose an ectopic pregnancy, but sometimes it turns out to be uninformative and then you have to do a puncture. If it does not provide the necessary information, then a diagnostic laparoscopy is performed, which, when the diagnosis is confirmed, goes into a therapeutic one.

Modern medicine does not know a single case of a favorable outcome (childbirth) in the case of an ectopic pregnancy. Therefore, no reasons, including religious ones, should stand in the way of the timely termination of such a pregnancy.

This operation is performed through small incisions in the abdominal wall and, of course, under general anesthesia. This is the most gentle surgical intervention, which in many cases allows you to preserve even the fallopian tube to which the ovum was attached, although only ten years ago it would have been recommended to be removed completely. In addition, after such an operation, practically no traces remain - only small dots on the abdomen.

If an ectopic pregnancy was detected too late, then an incision in the abdominal cavity and removal of the fallopian tube have to be performed. Another situation when the removal of the tube is necessary is the ingrowth of the ovum. In this case, it is unrealistic to remove it without damaging the pipes.

Even after removing one tube, a woman still has a chance to become pregnant, it just takes more time. If both tubes are removed, then the only way out is in vitro fertilization.

Possible drug treatment of ectopic pregnancy... To date, drugs have already been developed that can be used for conservative treatment... These drugs stop the development of the fetus and provoke its expulsion. They are used if the fetus is alive and continues to develop. But it must be borne in mind that such drugs have a very impressive list of side effects.

When using drugs for the treatment of ectopic pregnancy, liver and kidney damage is often recorded. Baldness and others are also possible unpleasant consequences... If we remember that the effectiveness of such treatment is relatively low, then the question may arise about the appropriateness of its use. When comparing the positive and negative effects of laparoscopic surgery and drug treatment, it becomes clear that the operation is still safer and more reliable. Therefore, today most doctors recommend surgical treatment ectopic pregnancy.

Normally, a week after fertilization, the embryo is attached to the wall of the uterus, implanted into the endometrium. If the embryo is implanted outside the body of the uterus, for example, in the fallopian tubes, an ectopic pregnancy develops. What are the signs of an ectopic pregnancy? What are the pains of an ectopic pregnancy? What medical attention is required? Why is it dangerous?

Why is an ectopic pregnancy dangerous?

- a diagnosis that sounds scary. This condition is dangerous by sudden changes in a woman's condition, with unpredictable consequences. Symptoms of this condition may long time be absent and appear only in a situation requiring urgent surgical intervention.

The danger of an ectopic pregnancy is as follows. The embryo implanted in the fallopian tube begins to actively develop there. This will inevitably lead to the fact that the fallopian tube is stretched. But the fallopian tubes are not adapted to such overload, and within a few weeks the degree of stretching will become critical. Typical symptoms will appear, including pain syndrome. Failure to intervene can cause the fallopian tube to rupture. When it ruptures, blood, ovum, mucus will enter the abdominal cavity. This condition is critical and life-threatening.

The fertilized egg can gain a foothold not only in the fallopian tube, but also on the ovary, peritoneum, in such cases the symptoms will be slightly different, but the threat of peritonitis also exists.

Pain during an ectopic pregnancy is her first alarming symptom. He requires immediate treatment for medical help... Not every case of such pregnancy ends with critical consequences. Often it is pain that makes a woman see a doctor in time before complications develop. In most cases, with timely treatment everything ends safely.

The sooner an atypical place of implantation of the ovum is identified, the less the risk of complications. Therefore, every woman should know the causes and symptoms of an ectopic pregnancy.

Causes of an ectopic pregnancy

The reasons why a fertilized egg can be implanted outside the uterus include the following:

  • chronic salpingitis: chronic inflammation fallopian tubes leads to a violation of their patency, and, as a result, the fertilized egg cannot penetrate into the uterine cavity and is implanted in the tube or abdominal cavity;
  • developmental anomalies: aplasia of the fallopian tubes, accessory tubes, additional holes in the tubes;
  • surgical interventions on the abdominal organs, adhesions;
  • taking hormonal drugs for emergency contraception, progestin-only contraceptives;
  • hormonal pathology;
  • tumors of the uterus, appendages.

Symptoms

The most common symptom of an ectopic pregnancy is pain. Any abdominal pain in early pregnancy should alert a woman. What is the pain of an ectopic pregnancy? It depends on the location of the embryo. In a tubal pregnancy, pain occurs on one side of the abdomen, in the case of a cervical pregnancy, in the lower middle. The pain may increase when walking, turning the body. Pain during an ectopic pregnancy can appear at different times, it depends on the location of the embryo. If the ovum is in the widest part of the tube, the ampullar, pain may appear in the eighth week. Ovarian, peritoneal pregnancies are characterized by an earlier onset of pain. With cervical pregnancy, there may be no pain for a long time, since the cervix is ​​capable of stretching.

One of the signs of an ectopic pregnancy is bleeding. This symptom is typical for cervical localization. The blood loss can be profuse and pose a threat to the patient's life.

Bleeding can also occur with tubal localization. It occurs when the wall of the fallopian tube is damaged.

In some cases, pain may only occur when the pipe ruptures. This condition is characterized by a pronounced intensity of pain syndrome. In such a situation, urgent surgical intervention is required.

Diagnostics

The most informative method for diagnosing an ectopic pregnancy is ultrasound. It allows you to determine the localization of the ovum. In the early stages, the ovum attached to the ovary or peritoneum is extremely difficult to visualize with ultrasound, but the fact of its absence in the uterine cavity against the background of hormone levels characteristic of pregnancy testifies in favor of ectopic localization.

Treatment

Very rarely, an ectopic pregnancy is detected at such an early stage when it is possible to interrupt it by taking hormonal drugs.

In most cases, patients seek help when an ectopic pregnancy is interrupted and the embryo has died. This is often due to ignorance of mild abdominal pain, and sometimes due to the absence of manifestations.

An interrupted ectopic pregnancy is characterized by severe pain... Required urgent care, therefore, you can not postpone the call to the doctor.

Treatment of an ectopic interrupted pregnancy is possible only by surgery. The operation can be performed in two ways:

  • laparoscopically - through a puncture in the abdominal cavity, using laparoscopic techniques, optical instruments;
  • laparotomically - an abdominal incision is performed.

Regardless of the type of access to the abdominal cavity, the scope of the operation can be as follows:

  • extrusion: if the ovum is localized close to the exit from the tube, it can be squeezed out with tweezers, while the bleeding is small;
  • salpingotomy - an incision of the fallopian tube is performed, through which the ovum is removed, and then the tube is sutured; this method also allows you to save the pipe;
  • resection of a segment of the tube - if the embryo has reached a large size, it is removed along with the section of the fallopian tube;
  • salpingectomy, or tubectomy - with repeated extrauterine pregnancy in the tube, it is completely removed, while the ovary is preserved;
  • removal of a tube with an ovary - performed in emergency situations in women who do not plan to become pregnant in the future. This intervention is easier to perform, therefore - more quickly, therefore, in life-threatening situations, it is precisely such an operation that is performed to save the patient's life.

After the operation, a recovery period is required. Pain after an ectopic pregnancy depends on the type of surgery. Faster rehabilitation after laparoscopic surgery. The pain is less intense and lasting. After removal of the ovum, the restoration of the hormonal system is required. It is imperative that a woman be under medical supervision, follow all recommendations, including on subsequent contraception and the timing of a possible next pregnancy.

Few women, let alone men, know that fertilization does not occur in the uterus, in the fallopian tube. Only then the future embryo is attached to the wall of the uterus and gradually develops there over the course of 9 months.

But sometimes it happens that the fertilized egg simply does not reach the place of its development, implanting to the ovary, fallopian tube or abdominal wall. If such a pregnancy is not terminated in time, then the consequences for female body can be tragic. So what is the danger of an ectopic pregnancy?

The embryo can grow and develop normally in the uterus - an organ specially designed for this by nature. In its other location, it is a threat to the health and life of a woman.

Dangerous consequences of abnormal pregnancy

The danger is the embryo that has settled in an inappropriate place. It grows, develops, stretching an organ that is not adapted to such loads.

Sometimes the resulting pain syndrome makes it possible to identify such an abnormal pregnancy at an early stage, and sometimes a tube or ovary rupture occurs with extensive blood loss and with all the ensuing serious consequences. A woman, if the operation is not performed on time, can die from blood loss and painful shock.

Long-term consequences of ectopic embryo development

Ectopic pregnancy, even detected on early stages development, is always a shock for the failed mother, and then the operation adds the risk of infertility. But is everything so tragic?

The consequences depend:

  • From the stage of detection of pathology. Later dates are followed by pain syndrome, bleeding. If a serious abdominal surgery was performed to save life, then the risk of infertility increases.
  • From the age of the patient. Young people get pregnant much easier than those over 30.
  • From the presence of diseases of the genital area. Various pathologies in these organs, they slow down postoperative recovery, provoke the development of adhesions.
  • From the general condition of the body.
  • From the technique of surgical intervention.

Types of operations and postoperative risks

The operation to remove the embryo can be carried out with the removal of the fallopian tube or its preservation.

When performing such interventions, gynecologists try to save the tube as much as possible, although this increases the risk of re-developing an ectopic pregnancy in it. The embryo is removed using a laparoscope: several punctures are made in the abdominal cavity, and the fetal bladder is removed from the tube or other abnormal implantation site. As a rule, most often ectopic conception is tubal.

Laparotomy

Lapooscopy is the least traumatic for the female body, but it is possible only in the early stages and with small size fetus. Unfortunately, not all hospitals have such equipment and specialists. If it is not possible to conduct laparoscopy, then a traditional laparotomy is performed through a cavity incision, but then the tube cannot be saved. An indication for laparotomy can also be the inconvenient position of the embryo, when it cannot be reached with the help of a laparoscope.

Of course, the consequences of such a gross interference in the internal female reproductive sphere will be more severe, but even here it is too early to despair. Many young healthy women, with the normal functioning of the second ovary, calmly become pregnant with one tube and carry children without much difficulty. It is more difficult for women over 35 years old to do this - they have ovulation processes much less often and many chronic diseases join.

Non-surgical abortion

This technique is used only in large cities, in specialized medical centers... For this, a drug is used that was previously used only for treatment in oncology:

  • it is toxic
  • when using it, there is a risk of developing uterine bleeding.

Before such treatment, the patient is fully examined and, if there are no contraindications, the medication is prescribed under medical supervision. With a favorable outcome, the fetus dies and dissolves within 1-2 months. The drug is very toxic and, for six months after taking it, you need to use contraceptives, otherwise children may be born with severe developmental pathologies. But these consequences of medical termination of pregnancy are much safer than surgery.

How to avoid repeated abnormal conception

Unfortunately, if this happened once, then the risk increases significantly (approximately doubled) that this can happen again. To avoid it and endure healthy child, it is necessary to find out the causes of the pathology.

It can be:

  • tubal obstruction,
  • various adhesive processes.

So, before getting pregnant, you must:

  • Complete a full inspection, check the pipes (or the remaining pipe) for patency.
  • Check for genital or other infections, because it is they that provoke the development of adhesions. Infections found should be treated.

If you suspect an "interesting situation", you should immediately contact the antenatal clinic to determine whether it is a uterine pregnancy or not. As a rule, gynecologists most closely monitor patients with a history of ectopic pathology - the first ultrasound is performed not in the usual 12 weeks, but at the first signs of conception. As a rule, women who have had an ectopic pregnancy, with proper medical supervision, carry and give birth to healthy babies without any problems.

But even the most serious consequences in the form of infertility cannot be a reason for despair. Modern medicine has gone far in its development, and if there is no way to get pregnant in the usual way, then there is always the opportunity to perform in vitro fertilization (IVF). Moreover, for medical reasons, this procedure is free of charge.

Thanks to IVF, women with adherent obstruction of the tubes, or even without them at all, had a chance to bear and give birth to a healthy baby, there would only be a healthy uterus. The procedure is performed like this:

  • Hormone therapy is performed, which stimulates the formation of several full-fledged eggs.
  • With the help of a laparoscope, a mini-operation is performed to take mature eggs from the ovaries.
  • The eggs are artificially fertilized with the sperm of the husband, boyfriend or donor and are implanted directly into the uterus.

The younger and healthier the patient, the higher her chances, in full compliance with medical recommendations, to endure and give birth to a healthy baby. But even women over 30 should not despair, they just need to more carefully monitor their condition after IVF, and the opportunity to become a mother is no longer a dream, but a reality.