- Ectopic pregnancy - deadly
- Pregnancy test
- On what term is defined
An ectopic pregnancy occurs when a fertilized egg attaches outside the uterus - usually in the fallopian tube. Accepted provide several basic types of ectopic pregnancy - a tube, ovarian, peritoneal and pregnancy in rudimentary horn of the uterus, which can not be called an ectopic, although the symptoms of these complications are similar.
In most cases, an ectopic pregnancy is characterized by fixing of a fertilized egg in ampullar peresheechnoy or part of the fallopian (uterine) tubes. Only 2-5% of all egg fixed in rudimentary horn of the uterus. This situation is considered to be very rare, and the most dangerous type of ectopic pregnancy.
Moreover, in one of seven thousand cases observed heterotopic pregnancy in which one fertilized egg in the uterus is located, and the other - regardless of the uterus.
- Inflammatory diseases of the pelvic organs can cause partial or complete closure of the fallopian tubes and prevent the passage of the egg through the tube, resulting in the implantation is carried out in the cavity of the fallopian tube. The formation of adhesions resulting from infection and inflammation caused by endometriosis
Endometriosis - a serious problem with serious consequences
It may also affect the occurrence of ectopic pregnancy.
- Ectopic pregnancy is frequently observed after the restoration of the fallopian tubes as a result of sterilization
Sterilization - may be temporarily
- Ectopic pregnancy occurs the treatment of infertility
Infertility Treatment - What principles are priority
- If a previous pregnancy was ectopic, the chance of complications in a subsequent pregnancy is much greater.
- Right-sided tubal pregnancy is more common than left-handed - presumably due to the infection spreading appendicitis.
The chance of an ectopic pregnancy increases with prolonged use of oral contraceptive preparations based on only progestin and installing intrauterine device.
IUD, a foreign body in the uterus and vagina, increases the risk of infection. Such a spiral is effective in preventing the normal uterine pregnancy, but much less effective in preventing ectopic pregnancy. Thus, if a pregnancy occurs with the introduction of the intrauterine device, it is considered an ectopic.
The occurrence of ectopic pregnancy
The first symptom of ectopic pregnancy - a pain in the left or the right iliac fossa, in the central region of the abdomen in the suprapubic area, sometimes accompanied by vaginal bleeding. For ectopic pregnancy in the first weeks characterized by the same symptoms as for a normal pregnancy - including a positive pregnancy test, absence of menstruation, increase in breast size and sensitivity. If an ectopic pregnancy led to the rupture of the fallopian tube, there is excessive bleeding and, in some cases, hypovolemic shock, accompanied by dizziness, loss of consciousness, fall of blood pressure, frequent weak pulse.
If an ectopic pregnancy is usually observed hypersensitivity suprapubic left or right of center. Vaginal bleeding may occur signs of peritonitis or acute abdomen syndrome.
Direct physical examination (vaginal examination) with an ectopic pregnancy can rupture the fallopian tube, so for the diagnosis of this type of pregnancy used other methods - such as transvaginal ultrasound. To confirm pregnancy applies quantitative measurement of the level of human chorionic gonadotropin. If gonadotropin less than one hundred units and ultrasound does not allow diagnosis of endometrial or tubal pregnancy, ascertain the pregnancy of unknown location.
In some cases, surgical intervention for ectopic pregnancy is not required. For mikroaborta applied injection of one dose of methotrexate (from fifty to ninety-milligrams) intramuscularly. Such a method of medical treatment of ectopic pregnancy is condemned, because it is not safe and could threaten the lives and health of women. After injection of the first dose of the fourth day and the seventh level measured chorionic gonadotropin - if hormone levels are not decreased by at least 15%, a second dose of drug. If after the first injection of hormone levels fell by less than 10%, surgical intervention is required.
In some cases, quite difficult to distinguish the pain caused by separation of the trophoblast, the pain caused by the rupture of the fallopian tube with the ectopic pregnancy. After injection of methotrexate can be observed toxicity symptoms - including stomatitis. After application of methotrexate for at least three months, you must use reliable methods of contraception to prevent re-conception.
Medical treatment of ectopic pregnancies is used only in cases where the initial level of human chorionic gonadotropin below three million units. At higher rates typically require surgical intervention.
With vigorous vaginal bleeding and signs of shock caused by blood loss due to rupture of the fallopian tube, to stabilize the condition of the woman requires laparotomy. In other cases, a laparoscopy
Laparoscopy - why is it necessary?
. Radical method of surgical treatment of ectopic pregnancy - salpingectomy (surgical removal of the fallopian tube) or salpingotomy (dissection of the fallopian tube), which increases the chances of a successful intrauterine pregnancy in the future.
Complications observed in 4 cases after salpingectomies% and 8% - after salpingotomy. The risk of persistence above, if the level of human chorionic gonadotropin to the operation exceeded three thousand units and the observed bleeding pipe. The usual method of treatment in such cases - an injection of methotrexate. In some cases, injections of methotrexate performed as prophylaxis during an operation on the tubes.
After successful treatment of ectopic pregnancy, the chances of subsequent ectopic pregnancy is 10-20%. Chances subsequent intrauterine pregnancy is 56-60%.
How can I prevent an ectopic pregnancy
Ectopic pregnancy does not occur if the fallopian tubes are normal, healthy state, so the main method of preventing ectopic pregnancy - early treatment of any disease that can cause damage to the fallopian tubes, including inflammatory diseases of the pelvic organs, and appendicitis.