How to distinguish tubal pregnancy from uterine pregnancy?
Sometimes the joy of the long-awaited pregnancy is overshadowed by the unpleasant news - the pregnancy is tubal and requires immediate termination. How to distinguish uterine fertilization from tubal fertilization and in what cases does this pathology occur?
Tubal and uterine conception - what is the difference?
In uterine pregnancy, which is the norm, the fertilized egg is attached to the wall of the uterus, where further embryonic development occurs.
T Rubbed pregnancy is a condition when a fertilized egg does not reach the uterus, but is implanted directly into the mucous membrane of the fallopian tube.
The clinical picture and severity of symptoms depends on where the tube has been inserted: in the beginning, in the middle or in the area of transition of the tube into the uterus. An ectopic pregnancy can be right-sided or left-sided.
Causes and symptoms of a dangerous condition
If a tubal pregnancy is listed in the medical history, we can say that the woman had one or more of the following problems:
- Inflammatory diseases of the reproductive organs: chronic salpingitis, adnexitis of infectious etiology, chlamydia and other genital infections;
- Installation of intrauterine contraception;
- Abortions at will or for medical reasons;
- Uterine neoplasms of various etiologies;
- Surgical interventions complicated by the formation of adhesions;
- Anomalies of development - excessive length or tortuosity of the fallopian tubes, impaired secretory function;
- Endocrine diseases;
- The use of drugs, in particular marijuana.
All these reasons lead to disorders of peristalsis mat intrauterine tubes or the appearance of adhesions and bends in them, in connection with which the ovum cannot enter the uterus in a timely manner, as a result of which a progressive tubal pregnancy occurs.
It is impossible to distinguish an ectopic state from a usual one in the first weeks. An increase in hCG levels occurs anyway. Toxicosis may occur with inherentwith symptoms: nausea, dizziness, change in taste.
With the growth of the embryo, pain occurs, which is most pronounced in the place of its localization, nausea increases, blood pressure decreases, and a periodic disorder of consciousness may occur. In this case, the pains are given to the lower rectum and lower back, become permanent.
If a woman does not go to the doctor in the early stages, then the fallopian tube ruptures, bloody discharge appears. If spontaneous termination of tubal pregnancy occurred within 8 weeks, the discharge is smearing, dark purple, almost black. When embryo development lasts up to 12 weeks, bleeding can be quite severe.
Diagnosis of a dangerous condition
The following steps are taken to establish a correct diagnosis.
They take blood for hCG, and if its level in the blood is increased, an ultrasound examination is performed. If an ovum is found in the fallopian tube and it is absent in the uterus during an ultrasound examination, an ectopic tubal pregnancy can be suspected.
However, examination on an ultrasound machine cannot give 100% guarantee to write to diagnose an ectopic pregnancy. In 10% of cases, the diagnosis can be erroneous - blood clots or mucus are taken for the ovum.
Laparoscopy is the most reliable and sparing type of diagnosis, and at the same time treatment. During it, the state of the uterus is assessed visually, the exact location of the ovum, the presence of blood in the abdominal cavity, cicatricial and adhesive changes are revealed. When an ectopic pregnancy is detected, a tubal abortion-type operation is performed, during which the ovum is removed and the tube is preserved.
The risk of a woman becoming infertile with such an operation is minimized.
Treatment of tubal pregnancy
Laparoscopic operations of this type are of 2 types:
- Tubotomy. During it, the ovum is removed, all its elements are cleaned, everything is evacuated from the abdominal cavity. The tube recovers quickly and fully retains its functions;
- Tubectomy . This surgery is performed if the term is already long. The tube remains, but loses its working capacity, and is unable to perform its functions in full, which in the future can provoke the recurrence of an ectopic pregnancy.
The doctor decides which operation should be performed.
During laparoscopy, the risk of adhesions is minimal, the abdominal cavity is cleared of impurities - mucus and blood. At the same time - if required - the patency of the second pipe is restored, the adhesions are removed.
In case of spontaneous rupture of the pipes, surgical intervention is carried out in the usual open way. It is required to immediately stop the blood lossri. Such an operation requires minimal preparation, it is carried out in emergency cases, but the pipe cannot be saved during it.
The following methods of treating the disease have not yet been found widespread, since these operations are in the pilot development stage:
- A drug is being introduced that stops the development of the embryo. In the future, the ovum is removed using laparoscopy or (for small sizes) goes into the uterine cavity by itself during the next menstruation. While medications of this effect cause many undesirable side effects;.
- With the help of a complex adjustment, the ovum - if it is fixed on the transition of the tube into the uterus - settles into the uterine cavity and the pregnancy is preserved. Laboratory tests of this method are going well, we hope their history will develop positively.
In the treatment of ectopic pregnancy at present, abortion - termination of pregnancy - cannot be avoided.
After surgery, the main thing is to avoid adhesions so that conception remains possible.
For this, the following physiotherapeutic methods are widely used :
- laser therapy;
- impulse exposure;
Be sure to use contraception within six months - hormonal or barrier methods. Hormone therapy can be started no earlier than a month after the operation.
The next pregnancy should be weighed and examined in advance. It is advisable to check the conduction of the tubes on an outpatient basis under ultrasound control or to undergo diagnostic laparoscopy. These examinations allow us to assess the condition of the pelvic organs, the severity of adhesions. When no contraindications are identified, conception is allowed after the next menstrual cycle.
If multiple adhesions are diagnosed, it is advisable to artificially implant an egg in the uterus.
Women's stories about an ectopic pregnancy
Women sometimes postpone accessing official medicine precisely because they do not have the correct information about a condition that poses a threat to health and life.
“ I have not taken hormones, so this cannot happen to me ". On the contrary, taking hormonal contraceptives reduces the risk of such a condition to a minimum.
" The baby will grow up a little and will go into place by himself ". This happens in 1 in 10,000 cases, usually an ectopic pregnancy ends with a ruptured tube.
“ The second strip in an ectopic pregnancy is light pink, not red ". The test reacts to the amount of chorionic gonadotropin, and not to the place of introductionembryo. Yes, there may be less hormone, and a light strip is really a sign that something is wrong with the embryo, but even with a bright red strip, a condition threatening a woman's life may occur.
The only correct statement is during menstruation with an ectopic pregnancy, there are mucous-bloody discharge with a positive test. And this is a signal that it is necessary to visit a antenatal clinic.
As soon as a pregnant woman feels atypical pain sensations for her condition, clearly expressed on one of the sides, she should definitely contact to the gynecologist. An ectopic pregnancy threatens not only health, but also a woman's life.