Ectopic pregnancy at what time is determined. Is it possible to see an ectopic pregnancy on ultrasound. The main causes of the condition

An ectopic pregnancy is an atypical condition in which the fetus does not develop as expected in the woman's uterus. A fertilized egg begins to form outside the uterus. Usually it is fixed in the fallopian tubes, the abdominal cavity. An ectopic pregnancy poses a great threat to the life of women. When such a situation is detected, urgent help from specialists is needed.

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Every woman should know what an ectopic pregnancy is and what are the main signs ectopic pregnancy.

1. Absence of menstruation.
2. Enlargement of the mammary glands.
3. Nausea.
4. Sharp pain in the lower abdomen.
5. Dizziness.
6. General state of weakness.
7. Bloody discharge from the genital tract, dark brown to scarlet.

Embryo at an early stage

The consequences of pathology in a woman

The walls of the fallopian tubes are not designed to carry a fetus, there is simply not enough space for it. Gradually, the walls are pulled over and a rupture occurs.

A little less often, it happens that the embryo enters abdominal cavity, and blood comes with it. When an ectopic pregnancy is interrupted by intra-abdominal bleeding, such signs of an ectopic pregnancy as shock, fainting, and sharp pains may also appear. In this case, urgent help from specialists is needed.

Such a problem always entails negative consequences. A large number of factors influence the future - these are the qualifications of the personnel who performed the surgical intervention (if any), subsequent diseases, the lifestyle of both partners, etc. Modern doctors know what an ectopic pregnancy is, as well as all the necessary ways to help the patient.

Consider the consequences of pathology.

1. Timely termination.

Not every woman, when planning a child, monitors her cycle. This means that not always a woman can determine her condition in time. With due attention, you can isolate yourself from unpleasant consequences.
If you have been diagnosed with an ectopic pregnancy early dates, but the fetus develops, tissue ruptures are possible, where the embryo is located. A woman can die from severe bleeding, pain shock. Such consequences can be avoided if medical assistance was provided on time.

2. Removal of one pipe.

An ectopic pregnancy leads to consequences that can later turn into infertility. But it is not always the case. A young healthy woman between 28 and 30 years old can get pregnant with ease and with one fallopian tube, given the excellent functionality of the ovaries. For an older woman from 35 years old, it will be more difficult to conceive, due to the fact that she ovulates less often, especially this condition is aggravated by the presence of chronic diseases. For them, IVF would be a great option. They simply take eggs from the ovaries, in an artificial environment they are fertilized and implanted directly into the uterus. The fallopian tubes will not play any role here.

3. The fallopian tubes were preserved.

Now there are many techniques that allow you to save the fallopian tubes. In this case, the consequences of infertility occur less. But there are other side effects. A tubal pregnancy can recur, with increased risks. But experts still try to save the fallopian tubes, if possible.
The risks that appear when a recurrence of the situation occurs are less for the occurrence of infertility. When a woman no longer plans to have a child, the doctor removes one tube, bandages the second, but this is done for women over 35 who have at least two children.

4. non-surgical intervention.

If there are signs of an ectopic pregnancy, you should know that it is possible to get rid of its consequences with non-surgical intervention. Let's use medicines. But this can be done only after the exact diagnosis of the doctor, and under his supervision, because such an intervention can also be dangerous. With proper use, the fetus stops its development and resolves within one or two menstrual cycles. Efficiency conservative method depends on the level of hCG.

The main causes of the condition

Fetal development

Whatever the causes of abnormal pregnancy, it is always easier and much safer to prevent such cases. But if the pathology has happened, it is necessary to contact specialists. According to statistics, only four percent of women face such a problem.

The main reasons are:

• disease of the uterus, appendages or Bladder that the woman suffered;
• inflammation of the ovaries, uterine tubes;
• miscarriage, difficult delivery.

Subsequently, this can lead to fibrosis, cicatricial changes, and the appearance of adhesions.

Any surgical intervention can also lead to pathology. Often this happens after the ligation of the fallopian tubes, plastic surgery, which can lead to inflammation of the internal organs.

Another reason is the congenital underdevelopment of the fallopian tube. This disease is called infantilism. Ectopic pregnancy, the consequences that may follow, is often caused by this disease. The tubes cannot function properly due to too much tortuosity or length - this prevents the egg from reaching the uterus.

Changes in hormonal development female body also lead to the above pathology, which contributes to the narrowing of the pipes, their change. Often it is:

• endocrine disorders;
• the use of drugs that affect the hormonal background;
• long-term use of ovulation inducing or fertility products.

The presence in the body of both benign and malignant worsens the patency of the pipes and can lead to the development of pathology.

The manifestation of pathology near the uterus

There are certain risk groups that are more prone to the formation of a displaced pregnancy:

• woman's age from 35 to 45 years;
• women who have chronic inflammatory diseases that were caused by infectious diseases (chlamydia, mycoplasma, ureaplasma);
• those who have been treated for tubal or hormonal infertility;
• those who use an intrauterine device for contraception.

Further actions of specialists

Often it is impossible to determine the state of abnormal development of the fetus, that is, there are no signs. Then the discomfort begins, which causes growth gestational sac, stretching of the fallopian tube. There is severe pain in the groin, weakness and other signs.

When they appear, it is necessary to contact specialists. The doctor knows how to correctly determine the state of tubal development of the embryo. In laboratory diagnostics, they rely on hCG, do a blood test, ultrasound.

There are several ways of ultrasound of the genital organs - research with a vaginal sensor and a sensor that is located on the front surface of the abdomen. Using the first method, the abnormal condition is determined from the sixth week of the term, in the second case, it is possible to determine the abnormal development of the fetus only from the seventh, eighth week.

It is impossible to delay in such a situation, therefore the first method is more often prescribed.

If there are signs and in the future the doctor confirms that the woman's embryo is located outside the uterus, treatment is prescribed. An operation is performed during which the fetal egg is removed without injuring the tube, or part of it is removed (completely).

It all depends on the location of the fetus inside. With the help of modern technologies, it is possible to preserve the pipes completely and full recovery their functions. Even with the complete removal of one tube, there are good chances of becoming a mother in the future.

The appearance of pain

Pregnant woman

Those patients who, with a positive test, have pain in the lower abdomen, are pre-determined as women with a potential displaced pregnancy. This continues until proven otherwise.
Before the internal rupture, the clinical symptoms in a woman can be very diverse. But the most common manifestations are pain, delayed menstruation, uterine bleeding.

The level of pain during ectopic pregnancy and its nature varies from the degree of development of the fetus, from the presence of additional complications. When a rupture occurs, the pain intensifies. It can give to the shoulder joints when walking.

It is very difficult to say how long the pipe will burst. This can happen in the sixth week or the fifteenth. There are many different factors, from where exactly the egg is located, to how long. But all this is taken into account in the aggregate.

Methods of prevention and recovery

How to make sure that an ectopic pregnancy does not happen again? The first thing to do is to determine why it happened or could happen, that is, to find out the reasons.

How the fetus develops

Every pregnancy, whether it is the first or third, must be planned in advance. Should.

1. Contact a specialist for both the expectant mother and father.
2. Check the condition of the internal organs and, if necessary, treat.
3. Exclude different types sexual infections.
4. Do not overcool your body.

If there have been cases of ectopic pregnancy, specialists more carefully monitor the health of future parents. The first ultrasound is recommended to be done at the twelfth week. Not always such problems lead to significant health consequences. Everything will depend on the prevention and future lifestyle of the couple.

Features of the recovery period are as follows.

1. Learn about the different treatment options.
2. You should learn in detail from the doctors what needs to be done in the future. Usually the time for recovery depends on what you did, whether there was surgery or not. The average recovery period from surgical laparoscopy intervention is two to three weeks. With a laparotomy (where an incision is made in the abdomen), recovery can take up to six weeks.
3. Emotional recovery. After all the necessary procedures have been completed, many women experience mixed feelings, not always assessing the situation adequately. Many are angry because they lost a child, someone is sad. So emotional recovery can take much longer than physical recovery. If you can not cope on your own, you should contact the experts.

: Borovikova Olga

gynecologist, ultrasound doctor, geneticist

Often, an ectopic pregnancy is discovered when a critically ill woman is taken to the hospital by ambulance. Late diagnosis may result in death or infertility for the patient. Therefore, it is better to know in advance that the fetus has “settled” in the wrong place. At what time can an ectopic pregnancy be determined with 100% accuracy?

What week is an ectopic pregnancy determined by medical diagnostic methods? A conventional ultrasound (using a gel) will show that the fetal egg has attached itself outside the uterus, at 6-7 weeks from the moment of conception. Vaginal ultrasound will help detect such a pathology a little earlier - at a period of 4-5 weeks of pregnancy. A laboratory blood test for hCG can be carried out as early as 2-3 weeks - its results can confirm a pathological pregnancy.

Usually, diagnosis for an ectopic pregnancy is carried out from 4 to 9 weeks.

How to detect an ectopic pregnancy earlyby symptoms and test strip?

Does this mean that a woman will not suspect an ectopic pregnancy until 4 weeks? Not at all. She may notice some alarming symptoms that distinguish an extrauterine pregnancy from a normal one.

The first sign of any conception is a delay in menstruation. If a woman is sexually active, and menstruation does not occur on time, then this usually indicates pregnancy. Confirmation of the "interesting situation" (but not an ectopic pregnancy) is an hCG test. It can be performed after 1 day of delay.

If 2 stripes appear (but the second one is weakly colored), but suddenly menstruation begins (or its likeness - dark, scanty discharge of a smearing nature) and pain in the lower abdomen, then run to the gynecologist! Such manifestations may be indirect signs of an ectopic pregnancy. It is better to take a test strip with you - it will help the gynecologist in making a diagnosis.

If there are no periods, and the test is negative and pain, weakness or signs of pregnancy appear, then you should not hope for a miracle and postpone visiting a doctor up to 4 weeks of delay. It is better to make an appointment no later than 10-14 days.

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DetermineDoes the gynecologist have an ectopic pregnancy on examination?

In the absence of menstruation and the presence of questionable results of home pregnancy testing, and especially when pain occurs, an examination by a female doctor is mandatory! Can a gynecologist determine an ectopic pregnancy based on complaints and examination in a gynecological chair? It depends on the place where the fetus is attached, and on the qualifications of the doctor.

The doctor will listen to complaints and upon examination can detect such features:

• an increase in the uterus and a change in its color and elasticity (which is typical for pregnancy);
• if the egg is attached in the tube, then pressure on the area of ​​​​the appendages will cause pain;
• the size of the uterus may not match the expected date of conception.

But the gynecologist is unlikely to be able to say for sure whether there is an ectopic pregnancy. Definitely an additional examination will be scheduled.

Can an ultrasound be trusted?

Conventional ultrasound is not suitable for early diagnosis of ectopic pregnancy. It can show such a pathology only from the 6th week, and the rupture of the organ where the fetal egg is attached often happens earlier than this period.

One of the reliable methods by which an ectopic pregnancy can be detected early enough (from 4 weeks) is transvaginal ultrasound (the sensor is inserted directly into the vagina). An experienced diagnostician recognizes a false ovum and sometimes even detects an embryo that develops in the fallopian tube.

But this is not a 100% diagnosis. It is believed that an intravaginal ultrasound will give an absolutely reliable result only from the 5th week of pregnancy.

TO how to determine an ectopic pregnancy by hcg: Evaluation of the result of a blood test

The question may arise: what is the point of taking an analysis for the same hormone chorionic gonadotropin (hCG) if a woman has already tested at home? The fact is that the laboratory will check the content of the hormone in the blood, and the analysis itself is carried out not only on the basis of the presence of such a hormone: the ratio of the quantitative indicators of its different isoforms is also taken into account.

If the egg is localized outside the uterus, then hCG will rise slightly. If during normal pregnancy the amount of this hormone increases every 2 days, then during pathological pregnancy - about once a week. Thus, the content of hCG will significantly lag behind the norm.

The conclusion will be made on the basis of a comprehensive examination or laparoscopy.

Any expectant mother is afraid to hear the diagnosis of "ectopic pregnancy" from the doctor. It is necessary to understand what it is and how it can be dangerous. An ectopic pregnancy is a pathology in the process of development of which the egg is attached not to the uterus, where it should be, but in another place:

• in the walls of the fallopian tubes;
• in the ovaries;
• in the peritoneum.

Features of the course of pathology

In an ectopic pregnancy, the embryo enters the fallopian tubes. Most often this is due to a violation of the normal functioning of this body. During the passage of the embryo towards the uterus, it is delayed and implanted in the wall of the fallopian tube. If the pregnancy breaks the pipe, then you have to urgently resort to surgical intervention.

An ectopic pregnancy essentially differs from the standard one in that in such a situation, the mother cannot bear the fetus and give birth to a child. In any case, you will need the help of qualified obstetricians who will determine the timing of the operation. The consequences of an ectopic pregnancy can be the most negative, especially if the disease was not diagnosed in a timely manner. According to statistics, about two percent of all pregnancies are ectopic.

The danger of pathology

If a fertilized egg develops in the mucous membrane of the fallopian tube, then the diameter of the latter will begin to increase over time. This is a completely natural process under such circumstances. Appendages are not designed for such a load, therefore, after short period the walls of the pipes will stretch so much that the pathology will become noticeable to a pregnant woman.

If you do not intervene in this process in a timely manner and do not take the necessary measures, stretching can lead to a rupture of the shell. As a result, unwanted substances such as blood and mucus will enter the abdominal cavity. This is where the fertilized egg comes out. The problem is that the abdominal cavity needs to be as sterile as possible, otherwise the risk of infection greatly increases. Such cases often end with the development of peritonitis and excruciating pain.

An ectopic pregnancy is accompanied by massive bleeding, which is caused by damage to blood vessels. This condition is considered critical, since the treatment of a pregnant woman requires immediate hospitalization. A similar danger exists not only for tubal, but also for other pathological course of pregnancy.

Now experts identify several key reasons that can serve as an impetus for the development of an ectopic pregnancy. Often the basis for the disease are any problems with the normal functioning of the fallopian tubes. It's connected with:

• infectious diseases - chlamydia, gonorrhea, etc.;
• inflammatory diseases - adnexitis;
• surgical interventions - for example, after surgery, the risk of ectopic pregnancy increases;
• procedures to restore normal tubal patency;
• medical treatment for infertility;

There are situations when even experts cannot explain why the pregnancy turned out to be ectopic. However, it should be borne in mind that if a woman has already encountered such a problem once, then she is at an increased risk.

In this case, it is necessary to be extremely scrupulous about pregnancy: regularly visit an ultrasound scan, during which the presence of a fetal egg in the uterus will be confirmed. It is important to remember that in the early stages of gestation, the egg is extremely small in size, so it is quite difficult to notice it during one examination.

Precautionary measures

In order to prevent an ectopic pregnancy, you must be very careful about your health. This is primarily due to gynecological diseases that are sexually transmitted. Usually they are accompanied by vaginal discharge, but some of them are extremely insidious and do not have pronounced signs.

Women are accustomed to identifying the problem by pain in the abdomen, bleeding, problems with menstruation, but sometimes the disease that can lead to an ectopic pregnancy is asymptomatic. That is why it is so important to visit the gynecologist twice a year for a preventive examination.

When can a pathology be diagnosed?

In most cases, the disease becomes apparent after an artificial or natural termination of pregnancy, which most often takes the form of a rupture of the fallopian tube or tubal abortion. There is a possibility for this different terms, however, the period from 4 to 6 weeks of gestation becomes especially dangerous.

The next time you can detect pathology around the third or fourth week. Alarm signals should be the presence of hCG and the absence of any signs of uterine pregnancy during ultrasound examination.

In a situation where the fetus is localized in the rudimentary horn of the uterus, it is possible to determine the pathology only at the tenth to sixteenth week.

Contacting a specialist

Timely intervention by medical professionals is key in an ectopic pregnancy, but for a successful outcome, a woman should see a doctor even before complications appear. Currently, two methods of treatment are used, which are widely practiced in medicine: surgical and medical.

Not so long ago, doctors removed the affected organ along with the uterus, which completely deprived the woman of the opportunity to become a mother in the future. Modern technologies allow operations to be carried out in such a way that the integrity of the structure is in the first place.

In medical practice, there are drugs that allow you to treat an ectopic pregnancy without surgery. Specialists use medications that stop the development of the fetus. In other words, they are used in cases where the fetal egg continues to grow.

The disadvantage of the conservative method of treatment is that it is fraught with a large number side effects: from kidney damage to baldness. The desired result can be achieved only in some cases. That is why the operation to this day continues to be the safest method to terminate a tubal pregnancy.

The success of therapy directly depends on the stage at which the pathology of the location of the fetal egg was detected. That is why it is so important that every woman knows how an ectopic pregnancy manifests itself in the initial stages of development.

Clinical manifestations of ectopic pregnancy

Specialists cannot identify obvious symptoms that would categorically indicate the development of a tubal pregnancy. Diagnosis is hampered by the fact that the symptoms of this pathology are often present in the early stages of a standard pregnancy. This is due to the inability to see the fetal egg during an ultrasound examination.

Laparoscopic surgery is required to accurately determine the diagnosis. However, for its implementation, a set of signs indicating the development of an ectopic pregnancy is necessary.

Laparoscopic surgery, due to its characteristics, is not only a diagnostic, but also a therapeutic procedure, but you should not bring it to the point where it becomes necessary. In the event of a sharp decline blood pressure, pain in the abdomen, severe weakness and loss of consciousness, you should immediately call a doctor for admission to the hospital.

Pregnancy test and pathology

To determine the development of the pathology is obtained by a conventional pregnancy test, but this method should not be fully trusted. It reacts to a special hormone called human chorionic gonadotropin. In the case of pathology, its concentration is significantly lower than in traditional pregnancy.

Women who are faced with pathology can identify alarming signals by the nature of menstruation. During menstruation, a bloody substance is released from the genital tract, which, by and large, is not even menstruation. In some cases, the secretions contain fragments of the decidua, which was rejected by the body.

Among the main signs it should be noted:

• scanty menstruation;
• a strong delay in menstruation;
• painful pulling pains in the abdomen (this is a consequence of an increase in the diameter of the pipe);
• plentiful bloody issues;
• early toxicosis;
• enlarged and painful breasts;
• pain radiating to the rectum and lower back.

Experts are convinced that with due attention, it is possible to determine an ectopic pregnancy even before the delay of menstruation. This is facilitated by competent history taking and timely examination.

At the first suspicion of a pathology, which can be determined by the signs listed above, you should immediately contact a gynecologist. The doctor should conduct an examination, during which the degree of softening of the cervix and its bluish color is revealed.

In the process of palpation, a specialist can determine how much the delay in menstruation corresponds to the size of the uterus. If a pathology is noticed, then he prescribes a mandatory additional examination:

• Ultrasound of internal organs;
• hCG analysis;
• analysis of progesterone concentration.

It is also extremely important to know the signs of internal bleeding in order to have time to call doctors in a timely manner. Symptoms include:

• severe pain in the lower abdomen;
• a sharp deterioration in the state, apathy;
• pale skin;
• increased sweating;
• dizziness;
• bloody issues.

Internal bleeding usually indicates that internal organs women are severely damaged.

Types of pain in the lower abdomen and possible pathologies

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