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 a woman's uterus. A fertilized egg begins to form outside the uterus. Usually it is fixed in the fallopian tubes, abdominal cavity. Ectopic pregnancy is a great threat to the life of women. If a similar situation is found, urgent assistance from specialists is needed.

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

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

Early embryo

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 room for it. Gradually, the walls are pulled over and a rupture occurs.

A little less often it happens that the embryo enters the abdominal cavity, and blood also enters with it. When an ectopic pregnancy is interrupted by intra-abdominal bleeding, signs of an ectopic pregnancy such as shock, fainting, and severe pain may also appear. This requires urgent assistance from specialists.

This problem always has negative consequences. The future is influenced by a large number of factors - these are the qualifications of the personnel who performed the surgery (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 interruption.

Not every woman monitors her cycle when planning a child. This means that not always a woman can determine her condition in time. With due attention, you can insulate yourself from unpleasant consequences.
If an ectopic pregnancy is diagnosed in the early stages, but the fetus is developing, tissue ruptures are possible where the embryo is located. A woman may die from severe bleeding, painful 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 this is not always the case. A young healthy woman from 28 to 30 years old can get pregnant with ease and with one fallopian tube, taking into account 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 an excellent 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 have been preserved.

Now there are many techniques that allow you to preserve the fallopian tubes. In this case, the consequences of infertility are less. But there are other side effects. A tubal pregnancy may recur, and the risks increase. But experts still try to preserve the fallopian tubes, if possible.
The risks that arise when a recurrence occurs are less for the occurrence of infertility. When a woman no longer plans to have a child, the doctor removes one tube, the other bandages, but this is done for women over 35 years old 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 by non-surgical intervention. Let's say with the help of 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. When used correctly, the fetus stops developing and dissolves within one or two menstrual cycles. The effectiveness of the conservative method depends on the level of hCG.

The main causes of the condition

Fetal development

Whatever the reasons for a pathological pregnancy, it is always easier and much safer to prevent such cases. But if a pathology has happened, you need to contact a specialist. According to statistics, only four percent of women face this problem.

The main reasons are:

• disease of the uterus, appendages or bladder that the woman has suffered;
• inflammation of the ovaries, uterine tubes;
• transferred abortion, difficult labor.

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

Any surgical interventions can also lead to pathology. This often happens after ligation of the fallopian tubes, plastic surgery, which can lead to inflammation of the internal organs.

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

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

• endocrine disorders;
• the use of drugs that affect hormonal levels;
• long-term use of products to stimulate ovulation or to improve fertility.

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

The manifestation of pathology near the uterus

There are certain risk groups that are more susceptible to the formation of an offset pregnancy:

• a woman's age is 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. Further, unpleasant sensations begin, which causes the growth of the ovum, stretching of the fallopian tube. There is severe pain in the groin, weakness and other signs.

When they appear, you must contact a specialist. The doctor knows how to correctly determine the state of the tubal development of the embryo. For laboratory diagnostics, they rely on hCG, do a blood test, ultrasound.

There are several ways of genital ultrasound - examinations with a vaginal probe and a probe 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, the abnormal development of the fetus can be determined only from the seventh, eighth week.

It is impossible to hesitate in such a situation, therefore, the first method is 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 ovum is removed without injuring the tube, or a part of it (completely) is removed.

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

The appearance of pain

Pregnant woman

Those patients who, with a positive test, develop pain in the lower abdomen, are determined in advance as women with a potential displaced pregnancy. This continues until they prove otherwise.
Before an internal rupture, a woman's clinical symptoms can be very diverse. But the most common manifestations are pain, delayed menstruation, uterine bleeding.

The level of pain in an 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 off to the shoulder joints when walking.

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

Prevention and recovery methods

How to prevent ectopic pregnancy from recurring? The first thing that is necessary is to determine why this happened or may happen, that is, to find out the reasons.

How the fetus develops

Every pregnancy, be it the first or third, needs to be planned in advance. It follows.

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

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

The features of the recovery period are as follows.

1. You need to learn about the different treatment options.
2. You should learn in detail from the doctors what you need to do in the future. Usually, the time to recover depends on what you did, whether there was surgery or not. The average recovery period from a surgical laparoscopy intervention is two to three weeks. With a laparotomy (when 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 that they have lost a child, some are sad. So emotional recovery can take much longer physically. If it is impossible to cope on your own, you should contact a specialist.

: Borovikova Olga

gynecologist, ultrasound doctor, geneticist

Often, an ectopic pregnancy is detected when a critically ill woman is rushed to the hospital by ambulance. Late diagnosis can result in death or infertility for the patient. Therefore, it is better to find out in advance that the fruit has "settled" in the wrong place. How long does it take to determine an ectopic pregnancy with 100 percent accuracy?

In what week is an ectopic pregnancy determined by medical diagnostic methods? A conventional ultrasound (using a gel) will show that the ovum is attached outside the uterus, 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 performed as early as 2-3 weeks - its results can confirm a pathological pregnancy.

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

How to identify an ectopic pregnancy in the early stages by symptoms and test strip?

Does this mean that a woman will not in any way suspect an ectopic pregnancy until 4 weeks? Not at all. She may notice some disturbing symptoms that differentiate 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 in due time, then this usually indicates pregnancy. Confirmation of the "interesting situation" (but not ectopic pregnancy) is a test for hCG. It can be completed after a 1 day delay.

If 2 stripes appear (but the second is poorly colored), but suddenly menstruation begins (or its semblance - dark, scanty smearing discharge) and pain in the lower abdomen, then run to the gynecologist! Such manifestations can 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 is no monthly, and the test is negative and pain, weakness or signs of pregnancy appear, then you should not hope for a miracle and postpone a visit to the doctor until 4 weeks of delay. It is better to make an appointment no later than 10-14 days.

Read also:

Will determine whether the gynecologist has an ectopic pregnancy on examination?

In the absence of menstruation and the presence of questionable results of home pregnancy testing, and especially when pain appears, 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, may find the following features:

• an increase in the uterus and a change in its color and elasticity (which is typical for pregnancy);
• if the egg is attached to the tube, then when pressing on the area of \u200b\u200bthe appendages, pain will occur;
• the size of the uterus may not match the expected time of conception.

But the gynecologist is unlikely to be able to say for sure if there is an ectopic pregnancy. An additional examination will definitely be assigned.

Can you trust ultrasound?

Conventional ultrasound is not suitable for early diagnosis of an ectopic pregnancy. It can show such a pathology only from 6 weeks, and the rupture of the organ where the ovum 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 fetal egg and sometimes even detects an embryo that develops in the fallopian tube.

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

TO how to determine ectopic pregnancy by hCG: evaluating the blood test result

The question may arise: what is the point of being tested 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 various isoforms is also taken into account.

If the egg is located outside the uterus, then hCG will increase slightly. If during normal pregnancy the amount of this hormone increases every 2 days, then in 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 "ectopic pregnancy" from the doctor. You should figure out what it is and how it can be dangerous. An ectopic pregnancy is called a pathology, during the 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

With an ectopic pregnancy, the embryo enters the fallopian tubes. Most often this is due to a violation of the normal functioning of this organ. In the process of passing the embryo towards the uterus, it is delayed and implanted into the wall of the fallopian tube. If the pregnancy ruptures the tube, 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 the child. In any case, the help of qualified obstetricians will be required, 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.

Danger of pathology

If a fertilized egg develops in the mucous membrane of the fallopian tube, the diameter of the latter will begin to increase over time. This is a completely natural process under these circumstances. The appendages are not designed for such a load, therefore, after a short period, the walls of the tubes will stretch so much that the pathology will become noticeable for 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 rupture of the shell. As a result, unwanted substances such as blood and mucus will enter the abdominal cavity. The fetal egg also goes there. 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 vascular damage. 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 is any problem with the normal functioning of the fallopian tubes. It's connected with:

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

There are situations when even specialists 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 in a high-risk group.

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

Precautions

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

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

When can pathology be diagnosed

In most cases, the disease becomes apparent after the artificial or natural termination of pregnancy, which most often takes the form of a ruptured fallopian tube or tubal abortion. The likelihood of this exists at different times, but the period from 4 to 6 weeks of gestation becomes especially dangerous.

The next time, pathology can be detected at about the third or fourth week. Alarming signals should be the presence of hCG and the absence of any signs of uterine pregnancy during an ultrasound examination.

In a situation where the fetus is localized in the embryonic horn of the uterus, the pathology can only be determined at the tenth to sixteenth week.

Contacting a specialist

Timely intervention by medical professionals is key in ectopic pregnancy, but for a successful outcome, a woman must see a doctor before complications develop. Currently, two methods of treatment are used that are widely practiced in medicine: surgical and drug.

Not so long ago, doctors removed the affected organ along with the uterus, which completely deprived a 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 comes first.

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 when the ovum continues to grow.

The disadvantage of a conservative treatment is that it is fraught with many 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 ovum was identified. That is why it is so important that every woman knows how an ectopic pregnancy manifests itself at the initial stages of development.

Clinical manifestations of ectopic pregnancy

Experts cannot identify obvious symptoms that would categorically indicate the development of tubal pregnancy. Diagnosis is complicated 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 ovum when undergoing an ultrasound examination.

A laparoscopic operation is required to accurately determine the diagnosis. However, for its implementation, a set of signs is required that indicate the development of an ectopic pregnancy.

Laparoscopic surgery, due to its characteristics, is not only a diagnostic, but also a therapeutic procedure, but it should not be brought to the point when it becomes necessary. In case of a sharp drop in blood pressure, pain in the abdomen, severe weakness and loss of consciousness, you should immediately call a doctor for hospitalization in the hospital.

Pregnancy test and pathology

Determine the development of pathology is obtained by a conventional pregnancy test, but this method should not be completely trusted. It responds to a special hormone called 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 has been rejected by the body.

Among the main features 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);
• profuse spotting;
• 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 a delay in menstruation. This is facilitated by the competent collection of anamnesis and timely examination.

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

In the process of palpation, the 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 the concentration of progesterone.

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 condition, apathy;
• pallor of the skin;
• excessive sweating;
• dizziness;
• bloody issues.

Internal bleeding most often indicates that a woman's internal organs are significantly damaged.

Types of pain in the lower abdomen and possible pathologies

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