Symptoms of intrauterine pregnancy in the early stages. Cramping pain in the iliac region

An ectopic pregnancy is a complicated pregnancy in which the zygote attaches outside the uterus, for example, in one of the fallopian tubes, ovary, cervix, or even the abdominal cavity. In this case, it will not be possible to bear fruit. In addition, there is a real threat to the woman’s life. In order to diagnose the pathological condition in time, it is necessary to know the early symptoms of ectopic pregnancy.

Causes of ectopic pregnancy

There are quite a large number of reasons that can trigger the occurrence of pathological pregnancy. For clarity, they are presented in the table.

Signs of pathology

Pregnancy with pathologies can proceed in different ways. Therefore, the signs do not appear immediately or are absent at all, until an emergency situation develops when bleeding occurs, a pipe ruptures, etc. Therefore, it makes no sense to wait for negative symptoms.

The first symptoms are similar to intrauterine pregnancy:

• menstruation is delayed;
• general weakness of the body and drowsiness;
• swelling of the mammary glands;
• Toxicosis immediately begins, which is manifested by nausea and vomiting.

However, there are some differences:

• Spotting. When the fertilized egg is fixed in the uterus, slight bleeding may also appear, which lasts less than a day. If the embryo attaches elsewhere, the discharge will be longer and more intense.
• Pain. During a normally developing pregnancy, pain in the lower abdomen is of a pulling nature and develops due to increased tone of the uterus. With an abnormally developing pregnancy, pain makes itself felt in the place where fertilization occurred. Later the pain spreads throughout the abdomen. In addition, its intensity increases - at first the pain is almost unnoticeable, but after a few days it is sharp and cramping.
• General malaise. During a normal pregnancy, there is a decrease in working capacity and drowsiness appears, however, with an ectopic pregnancy, this condition will be more pronounced, accompanied by dizziness and fainting.
• Toxicosis. Also, its manifestations (nausea and vomiting) are much more pronounced.

The longer the period, the stronger and more pronounced the symptoms become. In a critical situation, a sharp decrease in pressure occurs in combination with an increase in body temperature.

When the fallopian tube ruptures, bleeding occurs, which is accompanied by severe pain, shock and loss of consciousness. In this case, you must urgently seek medical help.

Each type of ectopic pregnancy can be recognized by characteristic signs:

1. 1. During tubal pregnancy, pain appears on the side on which fertilization occurred. If the embryo is implanted in the tube itself, then symptoms will appear only at the 8th week, if in the isthmus - then at the 5-6th week. The pain becomes more intense during movement.
2. 2. Ovarian may not manifest itself in any way for quite a long time. This is due to the fact that the ovary is able to increase for some time to the size of the growing embryo. In the future, when the organ can no longer stretch further, severe pain will appear, localized in the area of ​​the ovary. Gradually, the pain spreads to the lumbar region and intestines. Pain occurs during bowel movements. The attack lasts from several minutes to several hours, combined with dizziness and loss of consciousness.
3. 3. Cervical and isthmus pregnancy does not cause pain. But there is bloody discharge - from minor to heavy, which poses a threat to life. An enlarged cervix interferes with the process of urination.
4. 4. Symptoms of an ectopic pregnancy located in the abdominal cavity cannot always be distinguished from normal pregnancy. But as the embryo grows, disturbances occur in the gastrointestinal tract - the woman feels sick, constipation, vomiting, severe pain and bloating appear.

Bleeding during early pregnancy - in what cases should you urgently call a doctor?

At what stage and how is an ectopic pregnancy determined?

The sooner the fact of a pathological pregnancy is established, the more successfully it can be eliminated. Typically, a woman comes to the clinic to register between 8 and 12 weeks after conception. But for a pathological pregnancy, this period is too long; by this time, tubal rupture or other dangerous complications will already have occurred.

You can suspect an ectopic pregnancy using the following methods.

Measuring basal temperature. BT during ectopic pregnancy can be:

• Reduced if the fetus stops developing.
• Increased in the presence of an inflammatory process.
• Normal. During embryo development (no matter where), BT remains at 37.2-37.3 degrees Celsius. Therefore, these temperature indicators do not exclude ectopic pregnancy.

A pharmacy pregnancy test is quite sensitive. It can be used 3-4 days before the expected delay. The level of the hormone hCG (human chorionic gonadotropin) increases during any type of pregnancy. But there are signs due to which you can suspect an ectopic pregnancy:

• In this case, hCG rises much more slowly, so a positive test result will be visible much later (about 3-4 days). Perhaps in the first days of the delay the test will be negative.
• After the delay, the test strip will not be bright. It is also associated with a slow rise in hCG levels.

If you suspect an abnormally developing pregnancy, you should consult a specialist. He will order a series of studies.

Blood test for hCG. This hormone grows more actively in the blood than in the urine. It is already possible to confirm the presence of pregnancy using this test on the 5-6th day after conception. To find out whether the pregnancy is developing normally, you will have to take this test several times and compare the results. Normally, this hormone should increase by 2 times every 2 days. In other cases, hCG increases slightly. HCG norms are indicated in the table.

Blood test for progesterone. This hormone is produced by the corpus luteum and supports pregnancy. With ectopic attachment of the fetus, progesterone levels will be lower. Normal levels of this hormone are shown in the table.

These indicators are relative. HCG and progesterone will also be reduced if the pregnancy is not developing and there is a threat of miscarriage.

To clarify the diagnosis, the specialist will recommend undergoing instrumental examinations:

1. 1. Ultrasound performed transvaginally. Using ultrasound, the fetus is detected when the hCG level is above 1500 IU/l (approximately 4-5 weeks). If the specialist cannot determine the position of the ovum, then a repeat examination is scheduled after a few days. In some cases, a woman is hospitalized for constant medical supervision. Ultrasound is the most reliable way to determine an ectopic pregnancy. A gynecologist will never make this diagnosis without an ultrasound. But this study can give false results in approximately 10% of cases: if the fertilized egg is determined to be a blood clot. Therefore, ultrasound is performed simultaneously with hCG analysis.
2. 2. Laparoscopy. This procedure is carried out only on the direction of a doctor, when tests indicate any violations, but this cannot be confirmed by ultrasound. Laparoscopy is performed under general anesthesia. Punctures are made using special instruments. A special tube with a camera and light is inserted into them. Thanks to this, the doctor examines the organs. If a fertilized egg is detected outside the uterus, it is immediately removed. It happens that during the operation the fallopian tube itself is removed. It depends on the time frame. The last period when complications can be avoided is 6-8 weeks.

During the examination, the doctor will notice that the uterus is not increasing in size, because the fertilized egg is located outside of it, which is also a sign of pathology. Therefore, if you detect any unpleasant symptoms, you should immediately contact a gynecologist.

An ectopic pregnancy is a complicated pregnancy in which the zygote attaches outside the uterus, for example, in one of the fallopian tubes, ovary, cervix, or even the abdominal cavity. In this case, it will not be possible to bear fruit. In addition, there is a real threat to the woman’s life. In order to diagnose the pathological condition in time, it is necessary to know the early symptoms of ectopic pregnancy.

Causes of ectopic pregnancy

There are quite a large number of reasons that can trigger the occurrence of pathological pregnancy. For clarity, they are presented in the table.

Signs of pathology

Pregnancy with pathologies can proceed in different ways. Therefore, the signs do not appear immediately or are absent at all, until an emergency situation develops when bleeding occurs, a pipe ruptures, etc. Therefore, it makes no sense to wait for negative symptoms.

The first symptoms are similar to intrauterine pregnancy:

• menstruation is delayed;
• general weakness of the body and drowsiness;
• swelling of the mammary glands;
• Toxicosis immediately begins, which is manifested by nausea and vomiting.

However, there are some differences:

• Spotting. When the fertilized egg is fixed in the uterus, slight bleeding may also appear, which lasts less than a day. If the embryo attaches elsewhere, the discharge will be longer and more intense.
• Pain. During a normally developing pregnancy, pain in the lower abdomen is of a pulling nature and develops due to increased tone of the uterus. With an abnormally developing pregnancy, pain makes itself felt in the place where fertilization occurred. Later the pain spreads throughout the abdomen. In addition, its intensity increases - at first the pain is almost unnoticeable, but after a few days it is sharp and cramping.
• General malaise. During a normal pregnancy, there is a decrease in working capacity and drowsiness appears, however, with an ectopic pregnancy, this condition will be more pronounced, accompanied by dizziness and fainting.
• Toxicosis. Also, its manifestations (nausea and vomiting) are much more pronounced.

The longer the period, the stronger and more pronounced the symptoms become. In a critical situation, a sharp decrease in pressure occurs in combination with an increase in body temperature.

When the fallopian tube ruptures, bleeding occurs, which is accompanied by severe pain, shock and loss of consciousness. In this case, you must urgently seek medical help.

Each type of ectopic pregnancy can be recognized by characteristic signs:

1. 1. During tubal pregnancy, pain appears on the side on which fertilization occurred. If the embryo is implanted in the tube itself, then symptoms will appear only at the 8th week, if in the isthmus - then at the 5-6th week. The pain becomes more intense during movement.
2. 2. Ovarian may not manifest itself in any way for quite a long time. This is due to the fact that the ovary is able to increase for some time to the size of the growing embryo. In the future, when the organ can no longer stretch further, severe pain will appear, localized in the area of ​​the ovary. Gradually, the pain spreads to the lumbar region and intestines. Pain occurs during bowel movements. The attack lasts from several minutes to several hours, combined with dizziness and loss of consciousness.
3. 3. Cervical and isthmus pregnancy does not cause pain. But there is bloody discharge - from minor to heavy, which poses a threat to life. An enlarged cervix interferes with the process of urination.
4. 4. Symptoms of an ectopic pregnancy located in the abdominal cavity cannot always be distinguished from normal pregnancy. But as the embryo grows, disturbances occur in the gastrointestinal tract - the woman feels sick, constipation, vomiting, severe pain and bloating appear.

Bleeding during early pregnancy - in what cases should you urgently call a doctor?

At what stage and how is an ectopic pregnancy determined?

The sooner the fact of a pathological pregnancy is established, the more successfully it can be eliminated. Typically, a woman comes to the clinic to register between 8 and 12 weeks after conception. But for a pathological pregnancy, this period is too long; by this time, tubal rupture or other dangerous complications will already have occurred.

You can suspect an ectopic pregnancy using the following methods.

Measuring basal temperature. BT during ectopic pregnancy can be:

• Reduced if the fetus stops developing.
• Increased in the presence of an inflammatory process.
• Normal. During embryo development (no matter where), BT remains at 37.2-37.3 degrees Celsius. Therefore, these temperature indicators do not exclude ectopic pregnancy.

A pharmacy pregnancy test is quite sensitive. It can be used 3-4 days before the expected delay. The level of the hormone hCG (human chorionic gonadotropin) increases during any type of pregnancy. But there are signs due to which you can suspect an ectopic pregnancy:

• In this case, hCG rises much more slowly, so a positive test result will be visible much later (about 3-4 days). Perhaps in the first days of the delay the test will be negative.
• After the delay, the test strip will not be bright. It is also associated with a slow rise in hCG levels.

If you suspect an abnormally developing pregnancy, you should consult a specialist. He will order a series of studies.

Blood test for hCG. This hormone grows more actively in the blood than in the urine. It is already possible to confirm the presence of pregnancy using this test on the 5-6th day after conception. To find out whether the pregnancy is developing normally, you will have to take this test several times and compare the results. Normally, this hormone should increase by 2 times every 2 days. In other cases, hCG increases slightly. HCG norms are indicated in the table.

Blood test for progesterone. This hormone is produced by the corpus luteum and supports pregnancy. With ectopic attachment of the fetus, progesterone levels will be lower. Normal levels of this hormone are shown in the table.

These indicators are relative. HCG and progesterone will also be reduced if the pregnancy is not developing and there is a threat of miscarriage.

To clarify the diagnosis, the specialist will recommend undergoing instrumental examinations:

1. 1. Ultrasound performed transvaginally. Using ultrasound, the fetus is detected when the hCG level is above 1500 IU/l (approximately 4-5 weeks). If the specialist cannot determine the position of the ovum, then a repeat examination is scheduled after a few days. In some cases, a woman is hospitalized for constant medical supervision. Ultrasound is the most reliable way to determine an ectopic pregnancy. A gynecologist will never make this diagnosis without an ultrasound. But this study can give false results in approximately 10% of cases: if the fertilized egg is determined to be a blood clot. Therefore, ultrasound is performed simultaneously with hCG analysis.
2. 2. Laparoscopy. This procedure is carried out only on the direction of a doctor, when tests indicate any violations, but this cannot be confirmed by ultrasound. Laparoscopy is performed under general anesthesia. Punctures are made using special instruments. A special tube with a camera and light is inserted into them. Thanks to this, the doctor examines the organs. If a fertilized egg is detected outside the uterus, it is immediately removed. It happens that during the operation the fallopian tube itself is removed. It depends on the time frame. The last period when complications can be avoided is 6-8 weeks.

During the examination, the doctor will notice that the uterus is not increasing in size, because the fertilized egg is located outside of it, which is also a sign of pathology. Therefore, if you detect any unpleasant symptoms, you should immediately contact a gynecologist.

Treatment

Treatment in this case is mandatory. Otherwise, infertility and even death are possible. At 2-3 weeks, the embryo is removed using medications.

At a later stage, surgical intervention will be required. Most often, laparoscopy is used for diagnosis and treatment. In addition, the following methods are used in gynecology:

1. 1. Tubotomy is a gentle operation, due to which the functioning of the fallopian tubes is not disrupted.
2. 2. Tubectomy is an operation that is performed in case of violation of the integrity of the fallopian tubes. The consequences after a tubectomy are not very good - the fallopian tube will not be able to function normally and the likelihood of pregnancy is reduced by 2 times. But if it is not fulfilled, the woman may die.

After surgery, treatment continues with physiotherapy - laser and ultrasound therapy, as well as electrical stimulation.

Before planning a new pregnancy, the patient must undergo all examinations to determine the condition of the reproductive organs. If no deviations are identified, then with the doctor’s permission, planning can begin.

The chances of repeating an ectopic pregnancy a second time are 10-15%. It all depends on the body of a particular woman and the condition of the reproductive organs. Therefore, before a new attempt, you should undergo all the necessary studies and tests to reduce the chances of a recurrence of a pathological pregnancy.

Pregnancy

Ectopic pregnancy without symptoms is rare. What should you pay attention to to avoid serious complications?

If the fertilized egg implants in the ovary, abdomen, fallopian tubes, or anywhere else but not in the uterus, the pregnancy is called ectopic. In this case, bearing a fetus is impossible, and an ectopic pregnancy cannot end with the birth of a child.

In obstetric practice, the diagnosis of “ectopic pregnancy” always sounds frightening, threatening the pregnant woman with a sudden deterioration in her condition and unpredictable consequences. Alas, sometimes there is a particularly “insidious” ectopic pregnancy, the symptoms of which may not manifest themselves for a long time and only manifest themselves in an emergency situation.

Danger of ectopic pregnancy

What is the reason for such a high danger of this pathology? The fact is that if, for one reason or another, a fertilized egg stops, say, in the fallopian tube, attaches to its mucous membrane and begins to develop there, this will sooner or later lead to an increase in the diameter of the tube. Considering that the structure of the appendages is not designed for such a load, within a few weeks the stretching will become critical, signs of an ectopic pregnancy will appear, and if proper attention is not paid to them, the lining of the fallopian tube may rupture. In this case, blood, mucus and fertilized egg will enter the abdominal cavity, which must be absolutely sterile, infection will occur, very severe, almost unbearable pain will develop, and peritonitis will develop. In addition, vascular damage often leads to massive bleeding into the abdominal cavity. This is a critical condition in which treatment is carried out only in intensive care conditions, under constant medical supervision.

A similar situation arises if it is not a tubal (the most common) but an ovarian or abdominal ectopic pregnancy that develops, the symptoms of which will be different, but there will also be a risk of peritonitis.

See a doctor at the first sign!

Fortunately, not every case ends so badly. In more than 60%, symptoms of ectopic pregnancy such as bleeding or pain force the woman to see a doctor before complications arise. This is the most favorable outcome of the situation, implying timely detection of pathology and surgical or medicinal treatment. It is worth noting that if several decades ago the affected organ was removed, often along with the uterus, now in medical practice very gentle methods are used, which in some cases make it possible to preserve the integrity of the structure. Of course, the earlier the abnormal location of the ovum is detected, the greater the chances of successful therapy. Therefore, knowing the first signs of an ectopic pregnancy is very important for every woman.

It is noteworthy that in about a third of cases complications occur against the background of excellent health, but most often patients simply do not pay attention to the first signs of ectopic pregnancy or do not give them due importance.

Symptoms of ectopic pregnancy

So, you should definitely be alert to any pain in the lower abdomen in the early stages of pregnancy - these are the most common symptoms of an ectopic pregnancy. Usually, painful sensations occur on one side of the abdomen, in the place of the affected fallopian tube, but sometimes, in the case of cervical pregnancy or the location of the fetus in the abdominal cavity, the middle part of the abdomen may hurt. Pain is often associated with changes in body position and intensifies when walking and turning the body. The period at which these signs of ectopic pregnancy appear depends on the location of the fetus. If it develops in the ampullary, the widest part of the fallopian tube, the pain begins to bother you at about 8 weeks of pregnancy, if located in the narrowest part of the tube - the isthmus - already at 5-6 weeks. If there is an ovarian or abdominal ectopic pregnancy, there may be no symptoms for the first four weeks. Cervical pregnancy, in which implantation occurs in the cervix, is accompanied by pain very rarely and can go unnoticed for a long time.

Signs of an ectopic pregnancy in the early stages include spotting. Cervical pregnancy leads to heavy, prolonged bleeding from the vagina, since the attachment of the fertilized egg occurs in an area very rich in blood vessels. Sometimes the blood loss is enormous and poses a threat to the woman’s life; in addition, with this placement of the embryo, there is a high risk that the uterus will have to be removed to save the pregnant woman.

Much more common than others is tubal ectopic pregnancy, the symptoms of which also include bleeding, indicating damage to the wall of the fallopian tube. The most favorable situation, when the tube does not rupture and the fertilized egg spontaneously detaches, is called tubal abortion and is always accompanied by bloody vaginal discharge.

Methods for determining ectopic pregnancy

Other, more reliable methods for determining the abnormal location of the embryo are also relevant. It is known that a normal pregnancy occurs with a more significant increase in hormones than an ectopic pregnancy, the signs of which can be detected in the laboratory (read the article “”). Already when determining pregnancy using a test strip, a woman sometimes pays attention to a weak second line. This may indicate a hormone that appears during pregnancy. Quantitative determination of the level of hCG in the blood will help clarify the situation - when the embryo is located in the uterus, the concentration of the hormone correlates with the period and increases every day, and deviations from normal values ​​allow one to suspect an abnormal location of the embryo.

However, the most revealing method for determining the position of the embryo is ultrasound, when the position of the fertilized egg in the uterus is visually confirmed using a vaginal sensor. By the way, it is difficult to detect an embryo in the abdominal cavity or appendages, but the fact that with positive laboratory pregnancy tests the fertilized egg is not detected in the uterus allows us to establish a diagnosis of ectopic pregnancy.

There are also the most critical signs of ectopic pregnancy, which occur at any site of attachment of the fertilized egg and indicate significant damage to organs - rupture of the tube, surface of the ovary, intestines or bladder during abdominal pregnancy. Internal bleeding occurs, which is extremely life-threatening. It can be identified by such signs as sharp, intense pain in the lower abdomen, sudden or gradually increasing severe weakness and pallor of the skin, sweating, loss of consciousness or dizziness, and blood discharge from the genital tract. This condition requires immediate hospitalization.

Learn more about the causes of ectopic pregnancy.

Among the reasons leading to this pathology are those that the woman is not aware of. Such as, for example, low sperm motility, or congenital constitutional features of the structure of the genital organs. However, according to statistics, most often such pregnancies occur in those women who are either hereditarily burdened - their mothers, aunts or grandmothers faced similar problems, or resorted to abortion, or suffer from inflammatory diseases of the appendages, which led to adhesions, scars, irregularities walls and kinks of the fallopian tubes. In addition, it should be noted that the risk of abnormalities increases with age, and signs of ectopic pregnancy in women over 35 years of age should be assessed with renewed attention. These categories constitute the so-called “risk group”, and they may be recommended to undergo an ultrasound two weeks after a positive pregnancy test to reliably confirm that the fertilized egg is in the uterine cavity. In addition, undergoing an ultrasound examination at 3-4 weeks of fetal development is advisable for every woman who experiences symptoms of an ectopic pregnancy. This preventive measure will help prevent possible complications in a timely manner, and a positive result will give you confidence in the normal development of your unborn baby.

Questions for the article

It showed that everything is normal, only the uterus is located towards the back...

My stomach hurt very much, as if I was in labor during labor. 6.06 after...

Let’s lie a little, we’re not the same as always. What could this be?!...

The next day I also did 2 tests, one showed 2 stripes, and...

I have periods, but they are intermittent. There is a strong pull in the lower abdomen, and...

I've already done 8 tests late, all negative, my stomach looks like...

Currently the delay is 2 days. (usually the cycle is 26-28 days). Exactly from that...

Right side. Could it be an ectopic?...

I started to be delayed and lasted 3 days. I took the test on the first day...

Day, as before. The next ones arrived on October 29, 2016, the cycle turned out to be 31 days, until...

Negative. We don’t protect ourselves. and now 11/27/16 something is tingling...

Right. It hurts to go to the toilet. Walking and standing up also hurt...

The tests were negative, on the third day of the delay I took a test...

It started on 09/15/16 after which I didn’t have periods, I had irregular...

We protect ourselves. In the first weeks there was a little nausea, I wanted...

Regular test strips, all 4 of them showed a pale second stripe....

Result. There was blood. I went to the gynecologist and they said simple...

At the moment there is no menstruation, and pregnancy tests...

Started 2 days earlier. And they were bright scarlet, after 3 days...

Occurred 5 days after the end of menstruation. Not plentiful...

Positive After examination on the chair 7.09 the doctor writes pregnancy...

Discharge? I've had severe pain in my groin on the right side for two days, but...

The hCG test on 09/01/16 showed 52.2, from 09/02/16 I began to sip and a little...

Uterine. This time there was a delay of 4 days, the test was negative, after...

Discharge, then red, but it wasn’t there all day, but it could have been...

It hasn’t started yet, but it’s been smearing for more than a week (similar to...

Discharge, my gynecologist said that during ovulation, which...

The negative ones were planning to go for an ultrasound tomorrow, but since yesterday...

This time, and today dark brown spots appeared...

Prerequisites for PMS or pregnancy, what it could be. I'll go for an ultrasound...

Days. But my lower left side hurt for about a week, I thought it wasn’t gas...

The test shows only one line; there seem to be no symptoms....

Pregnancy negative (did it twice), the day before yesterday after...

I had my period on June 3. There were no problems before. This month I had...

It arrived six months later and a son was born (he is 2 years old). Both...

Electronic 2-3 weeks, was in ear, they said there was an egg in the uterus, but...

I have been spotting for three days now. Ultrasound showed a yellow body in the right...

Break and again 63 days... and erosion treatment was planned for the fall......

The operation, and then there are delays. Pregnancy test...

When I got my period, it wasn't there, but the first time I got my period it was brown...

My next period was 9 days late in June. After...

Smear scarlet blood. On the 23rd day they come abundantly, as with M. Pulls at the bottom...

It's been 2 weeks already. 7 had sexual intercourse, and 8 in the morning I took an extra pill....

There was a delay of a day, a pale stripe appeared, a good one appeared only on the 5th day. 5...

DC, brown discharge appeared, took a test - positive,...

31.05, but now it’s 04.06 and they are not there. I did a test and the second line was weak....

Menstruation. Hormones rise slowly. The fetus is not visible in the uterus. Eat...

The right side is such that it will grab and release, mainly when...

The test showed 2 lines, one pale one, my lower back started to hurt...

Moscow. The last time the cycle was 19.03 as of today according to the calendar...

The discharge was brown for three days, then white started...

With a barely visible stripe. There is pain in the groin area, a feeling...

I noticed that it began to seethe some more. It hurts more when walking...

By parents. My last M was on 03/29/16 after which I...

Two pregnancies ended in spontaneous miscarriage... In...

Abdomen, after sexual intercourse. This happened before too, but...

Side (feels similar to pain during menstruation)....

A little longer. A couple of days ago after overeating the next...

We were going to go on 25.02 but didn’t go, on 1.03 some scanty discharge started, and...

A constant pancreatic cycle began and became constant +- 2 days. Last...

My period started a few days earlier, but spotting and...

11.02. On February 23, pain began in the right lower abdomen, there was pain when...

Child, now there is a slight delay of two days, but a couple of days ago it was...

14mm, a small amount of light liquid behind the uterus. What is it...

The cycle was off, menstruation happened once every 3-4 months. Not long ago, everything...

Time mentored regularly. Now there is a delay, very...

At the gynecologist. She said that everything was fine and the chances of pregnancy...

January, after the end, it continued to smear, sometimes more, sometimes less...

Basal temperature, two weeks before menstruation it fluctuated...

Back, at night I really wanted to go to the toilet, and when I went...

It showed one pale and one bright stripe, but after two weeks...

Sex during menstruation, after sex there was pain in the lower abdomen, and...

My last period on 11/7/15 is now late, I took 3 tests on different...

I'm worried about pain in the lower abdomen... my breasts have started to hurt.....

Let's protect ourselves! After ovulation, there was a brown spot for 3 days!...

Can we say that pregnancy is intrauterine? Or do I need to submit more...

Positive, ultrasound shows a corpus luteum (on the right), the uterus is up to...

Yesterday I tested hCG 502. I went for an ultrasound today, the doctor doesn’t see five in...

Another day of delay, the test is positive. On the 7th day the delays began...

How did I find out about this? On the day when your period was supposed to start, and...

The last day is the beginning of the cycle. Pregnancy test positive...

The test was positive, I did an ultrasound on the same day, there was no pregnancy...

It hurts, especially on the left. I saw the doctor, she said that the uterus...

He stayed inside, I pulled him out, and drank “escapelle” just in case....

Education (fetus.egg?), the gynecologist cannot understand what it is. Tests...

But during these I have pain in my lower abdomen. My period has passed and...

To the “salty”, increase and increased sensitivity...

Pregnancy-positive. The ultrasound was sent for control after 10...

Urologist) menstruation became scanty, black caked blood, pain in...

Bloody. The doctor says it's like pregnancy. ultrasound there is nothing...

Days from 18.02. started to smear: pinkish discharge... test for...

Abdomen occasionally and weight gain may be an ectopic...

I took 2 tests from different companies - negative. there are discharges...

Discharge. We have been without protection for 1.5 months now. Sometimes I feel sick...

There was already a delay of 16 days. I had pain in the lower abdomen not so much...

Large pinkish discharge, yesterday was day 5...

Days. test negative. cycle 30-32 days. before such long periods...

Normally, on 11/12/12 my period started again....

High blood pressure, mood swings, depression. Is it possible to...

My stomach hurts like before my period, but I had my period 10 days ago....

In September I arrived on a long business trip 1100 km south...

We did the opposite, the test again shows two stripes...

Test every three days, negative. My chest hurts, it hurts...

Bleeding and spotting, on the 3rd day of bleeding there was a fever...

Personally, it was difficult, because... The menstruation passed, but continued very...

More important: Remaining months 01.07. Zavagitnila...

Tests for B show a negative result, dizziness,...

Visions. delay 12 days. what could it be?...

This month my period came a week earlier, my period passed, and...

The test showed a negative result. Could this be...

Which ended in spontaneous abortion. No medicines...

Pipe. Now the test shows 2 lines, bloody...

When a fertilized egg begins to develop outside the main female reproductive organ, this phenomenon is not considered normal and is called an ectopic pregnancy.

Why is it important to recognize an ectopic pregnancy as early as possible?

A tubal pregnancy is often diagnosed, in which the growth of the fertilized egg begins in one of the fallopian tubes. Much less often this is observed in the abdominal cavity, in the cervical region of the uterus.

It is important to know! Absolutely every woman of reproductive age should know how to determine an ectopic pregnancy at home, since no one is immune from this problem. And the lack of timely medical care is fraught with serious consequences for life.

In this condition, the death of the fetus is unambiguous, since further development of the fertilized egg is impossible. The most important thing is to save the woman’s life. Death is possible due to rupture of the fallopian tube followed by internal bleeding. Peritonitis often occurs.

The sooner you consult a doctor, the easier it will be to cope with this problem and with minimal losses to your health. With an early, correct diagnosis, it is possible to prevent rupture of the fallopian tube, and in some cases even preserve it during surgery to terminate a pathological pregnancy.

How is it possible to determine such a pathological condition at home?, as an ectopic pregnancy, is significant due to the risk of developing the following complications:

• the occurrence of inflammation in the reproductive organs;
• infertility;
• adhesive process;
• general disturbances in the functioning of the female reproductive system.

Important to remember! In the absence of basic knowledge about how to recognize this pathology on your own, undesirable consequences are most likely to occur.

How to determine ectopic pregnancy at home: main symptoms

The most important danger of such a deviation is that the course of a normal pregnancy is almost the same as a pathological one. Similar symptoms are observed.

Not everyone knows how to determine an ectopic pregnancy at home, but if you pay close attention to your body, it is quite possible.

It is important to pay attention to the following symptoms in combination with classic signs and a positive test:

• acute painful sensations in the lower abdomen, which only get worse every time;
• soreness can spread throughout the abdomen, especially after a fallopian tube ruptures;
• presence of bloody discharge, which do not occur during a healthy pregnancy;
• pain, extending into the anus, difficulties with stool and urination;
• poor health, dizziness, even loss of consciousness, such symptoms intensify after a tube rupture.

The fertilized egg grows, as a result of which the patient’s condition worsens.

Symptoms of ectopic pregnancy in the first week

At the very beginning, this condition is similar to the state of health of a woman with a healthy pregnancy. The only thing that may bother you is minor vaginal discharge containing blood. But as the fertilized egg grows, the symptoms of a pathological pregnancy become more pronounced.

Symptoms of ectopic pregnancy at 6-8 weeks

The progression of the problem under consideration is very dangerous, and if at the initial stage the disease is difficult to distinguish from ordinary pregnancy, then after 6 weeks it is impossible not to notice this pathology.

From 6 to 8 weeks, a woman is usually worried about the following signs:

• intense pain in the lower part of the abdomen, localized on one side, depending on which pipe is damaged;
• in other cases there is a feverish state;
• general deterioration health, weakness, loss of performance.

Be careful! You should not immediately take painkillers to feel better. In this way, you can simply remove one of the symptoms, but the pathological process will continue.

Since it is after the 6th week that the risk of destruction of the fallopian tube is most likely, it is very important to understand how and by what signs you can independently determine an ectopic pregnancy at home.

Symptoms of VMB for 8 or more weeks

VMB is most often diagnosed after 6 or 8 weeks, when the pathological symptoms become more pronounced. The sooner you seek medical help, the more favorable the outcome of this disease will be.

The following symptoms are typical for week 8:

• frequent cramping pain in the abdomen;
• pale skin;
• decreased blood pressure, dizziness;
• spread of pain that can reach the shoulder in a horizontal position.

In the most severe condition, a woman may faint. These symptoms may indicate internal blood loss due to destruction of the fallopian tube.

Determination of ectopic pregnancy by test

Express tests usually indicate the presence of pregnancy in the body, regardless of where the fertilized egg began to develop. But in a pathological pregnancy, the hCG content is usually an order of magnitude lower, so tests do not always give a true result.

Note! If the pregnancy test is negative, but all other characteristic signs are present, then this is a sufficient reason to urgently go to the doctor.

The result of recent medical developments is a special test cassette that determines the presence of a pathological pregnancy. It can be purchased at any pharmacy at a relatively affordable cost.

How to determine ectopic pregnancy by hCG level

Detection of hCG levels is considered the most reliable way to determine the presence of pregnancy, especially in combination with an ultrasound examination.

When, after the fertilization process, the egg is fixed in the uterine space, the hCG content, as a rule, increases every 2 days. However, when the fertilized egg grows outside the uterus, such dynamics are not observed.

Therefore, if there is the slightest hint of a disease, repeated blood tests for hCG are usually performed.

Signs of tubal rupture during ectopic pregnancy

Rupture of the fallopian tube occurs due to the growth of the embryo, when its size increases so much that the tube is no longer able to stretch and ruptures. During this process, the woman usually feels severe cutting pain, which is accompanied by dizziness and weakness.

The temperature may rise, and women often lose consciousness. This condition requires urgent hospitalization as there is a danger to life.

When you need to see a doctor urgently

If initial symptoms of pregnancy occur, such as a delay in menstruation, weakness, breast swelling, nausea and loss of appetite, it is better to immediately consult a gynecologist to conduct a series of diagnostic tests to determine the presence of a fertilized egg in the body.

This is important in the very early stages, since the egg does not always attach to the wall of the uterus, resulting in a pathological ectopic pregnancy.

VSD is a dangerous condition that can lead to death. Therefore, in order to avoid significant health problems, it is important to identify and eliminate the pathology in a timely manner.

How to detect an ectopic pregnancy at home. The signs will be explained in this video:

How to identify an ectopic pregnancy in the early stages, as well as how the operation is performed, see this video:

The physiological development of pregnancy occurs only in the uterine cavity. However, the possibility of an atypical, ectopic localization of the embryonic egg cannot be excluded - outside the uterus, in the cervix, in the ampullary section of the fallopian tube, located in the muscles of the uterus, simultaneously in the uterus and the ampullary section of the fallopian tube. An ectopic pregnancy is one that occurs as a result of implantation of a fertilized egg outside the uterine cavity.

Causes and mechanism of development

Types of pathology and health hazards

Depending on the location of the fertilized egg, ectopic pregnancy is divided into:

1. Tubal, which occurs on average in 1.5% of women and 95% of all variants of ectopic localization. A tubal pregnancy can develop in any part of the fallopian tube.
2. Ovarian, capable of developing on the surface of the ovary or inside the follicle.
3. Abdominal, which occurs in the abdominal cavity initially or as a result of the expulsion of a fertilized egg from the fallopian tube.

Why is an ectopic pregnancy dangerous?? It occurs in 1.5-1.9% of women and often leads to infertility. But its main danger lies in the threat to the woman’s life due to the growth of the embryo and tissue rupture at the site of the fertilized egg or spontaneous abortion. Rupture of the fallopian tube or other fetal site (in the ovary) on average in 13-14% ends in death as a result of heavy blood loss and is the main cause of death in women in the first trimester.

Risk factors

To date, the causes of ectopic pregnancy represent one of the most controversial aspects of the field of obstetrics and gynecology. Despite the fact that many of them are beyond doubt, some questions still remain unanswered.

Sometimes, for unexplained reasons, an ectopic pregnancy can develop in the absence of visible pathological abnormalities. However, the basis of its mechanism are pathological conditions that disrupt the physiological properties of the fertilized egg and/or its movement along the fallopian tube. Therefore, in practical gynecology, not so much the causes as the risk factors for the development of ectopic pregnancy are considered.

The most probable of them are combined into 3 groups according to their underlying characteristics:

1. Anatomical.
2. Hormonal.
3. Doubtful or controversial.

Anatomical changes are the cause of dysfunction of the tubes associated with the transport of the fertilized egg. They may arise as a result of:

• Inflammatory processes in the fallopian tubes or in the pelvic cavity, which occupy a leading place in the structure of ectopic pregnancy. On average, half of women who have had an ectopic pregnancy have suffered primarily from salpingitis or adnexitis in the past. These diseases lead to damage to their muscle layer and receptor apparatus, disruption of the secretion of nucleic acids, glycogen and protein complexes necessary for the normal functioning of the egg, as well as damage to the synthesis of steroid hormones by the ovaries.
• Use of intrauterine contraceptives (3-4%). Moreover, the longer their use, the longer their use, the higher the risk of ectopic implantation of an embryonic egg - two-year use increases the risk by 2, and longer use increases the risk by 2.5-4.2 times. This is explained by the almost complete destruction of the ciliated epithelial cells of the mucous membrane in the fallopian tubes after 3 years of use of intrauterine contraception.
• Surgical interventions for pelvic diseases, inflammatory processes, tubal plastic surgery for infertility, etc., leading to.
• Tumors and surgical method of sterilization.

Hormonal risk factors include:

• Endocrine diseases and hormonal disorders in the body, leading to.
• The use of hormonal drugs for somatic and autoimmune diseases.
• Use of hormonal contraceptives.
• The use of ovulation stimulants in order to prepare for in vitro fertilization - human chorionic gonadotropin, clomiphene, GnRH agonists.
• Impaired synthesis of prostaglandins, which affect the processes of contraction and relaxation of the muscle fibers of the fallopian tubes.
• Excessive biological activity of the embryo membranes.
• Migration of an egg from one ovary to the contralateral (opposite) ovary through the abdominal cavity.

Controversial risk factors:

• Congenital anomalies of the uterus and genetic disorders.
• Deviations in the concentration of sperm prostaglandins.
• Sperm quality, including increased sperm activity.
• Presence of endometriosis and diverticula in the fallopian tubes.

A combination of various factors is also possible, which further increases the risk of pathology.

Idea of ​​the development mechanism

It allows you to understand the signs of an ectopic pregnancy, the development of which in the fallopian tube occurs as a result of the introduction of a fertilized egg into the mucous membrane and the formation of a habitat for the embryo. From the side of the tube lumen, the mucous membrane envelops the fertilized egg, forming the inner capsule, and the serous and muscular layers - the outer capsule.

Termination of pregnancy is caused by the inability of the walls of the fallopian tube to nidate the egg and develop the embryo:

• insignificant thickness of the muscle layer, unable to withstand a significant increase in internal volume;
• the absence of tubular glands in the mucous membrane and its division into the main and functional layers, which is characteristic of the walls of the uterus;
• lack of resistance to the destructive proliferation of cells in the outer layer of the embryo membrane.

Further development of the embryo is accompanied by the destruction of the vessels of the mucous membrane of the fallopian tube by the villi of the fetal membrane, the formation of hemorrhages and disruption of its blood supply, the gradual destruction of the membrane of the embryo from the side of the tubal lumen and gradual detachment from the walls.

As a result of this, the embryo dies and is expelled by contractions of the fallopian tube into the abdominal cavity, which is accompanied by bleeding. This option is called a tubal abortion. The second possible outcome is an increase in the size of the fertilized egg and destruction of the walls of the tube, followed by their rupture, which is accompanied by significant bleeding and pain.

The duration of tubal pregnancy is 5-8 weeks, ectopic (in the isthmic department) - 10-12 weeks.

Symptoms of ectopic pregnancy

Clinical signs of a progressive ectopic pregnancy are drowsiness, weakness and lethargy, nausea and vomiting, changes in taste and olfactory sensations, lack of menstruation on time (in 73%), engorgement of the mammary glands. That is, these are the same dubious and probable signs that accompany a normal intrauterine pregnancy. However, in the 2nd – 3rd week the following may occur:

1. Pain in the lower abdomen of varying nature and intensity (in 68%). Usually they are in the nature of paroxysmal contractions. Often the pain in the lower abdomen radiates to the rectum.
2. Slight intermittent dark spotting (49%).
3. The combination of these two symptoms with delayed menstruation (65%). In some cases, there is not a complete delay in menstruation, but the appearance of very slight bleeding.

Resolution of tubal pregnancy can occur according to the following type:

1. Tubal abortion, which occurs 10-12 days after the start of the due period of menstruation. It occurs as a result of rupture of the membranes of the fetal sac, usually proceeds in a protracted form and is erased in nature - the general condition does not worsen, the pain is aching, constant and unexpressed, blood is gradually released from the genital tract. If more than half a liter of blood accumulates in the abdominal cavity, the general condition worsens somewhat.
2. A rupture of the fallopian tube, in which a significant amount of blood is poured into the abdominal cavity. The rupture is accompanied by acute sudden pain in the abdomen above the womb from the pathological process and its further spread to the entire lower half of the abdomen. Nausea and vomiting, the urge to defecate, a sharp deterioration in general condition, expressed in pallor and wetness of the skin, an increase in heart rate and a decrease in blood pressure, and loss of consciousness occur. In the absence of emergency surgical care, rapid development of hemorrhagic shock with an unfavorable outcome is possible.

Diagnostics

Diagnosis of the developing process of pathological localization at the initial stages is difficult due to the absence of obvious specific symptoms. Suspicion of an ectopic pregnancy may occur if:

• presence of risk factors;
• delay in menstruation and the presence of doubtful and reliable signs of pregnancy itself;
• even slight pain over the womb or, moreover, the appearance of bloody discharge.

Will the test show an ectopic pregnancy? There are various express tests designed for home use. They are based on the determination of hCG (human chorionic gonadotropin) in urine. But the “home” express method is only qualitative, not quantitative testing, that is, it determines only the presence of an increased amount of hCG, and not its numerical value. Therefore, this method cannot serve as a source to suggest the presence of ectopic implantation of the fertilized egg.

Carrying out a quantitative blood test for hCG during an ectopic pregnancy can serve as an important objective confirmation of its development. Human chorionic gonadotropin is a hormone produced by the fetal membrane of the embryo and ensures the relationship between a woman and her unborn child. Normally, its concentration in the blood is less than 5 IU/l. It begins to increase in the very early stages of pregnancy. From the 6-8th day after fertilization to the end of the third week, hCG increases from 5.8 to 750 IU/l, reaching 155,000 IU/l by the 8th week.

The amount of the hormone between the second and fifth weeks of normal pregnancy doubles every 36 hours. Determining it in the blood is the most reliable in terms of diagnosing its early stages.

If the initial content of the hormone in the blood is below the norm corresponding to the duration of pregnancy, or the increase in its concentration in 3 studies occurs more slowly than normal, then this most likely suggests the presence of ectopic implantation and development of the embryo, the threat of miscarriage, placental insufficiency, undeveloped pregnancy. The information content of the method is 96.7%.

To clarify the diagnosis, it is carried out, with the help of which it is still impossible to determine the exact location of the fertilized egg. But scanning provides an opportunity to assume, based on indirect signs, the presence of pathology. If necessary, diagnostic laparoscopy is performed to more accurately determine the site of implantation of the fertilized egg.

Treatment of ectopic pregnancy

If an ectopic pregnancy is disrupted, emergency surgery is always indicated. During endoscopic diagnosis or in case of tubal abortion, but the woman’s condition is satisfactory, it is possible to remove an ectopic pregnancy laparoscopically, which can to some extent reduce the likelihood of subsequent disorders or infertility. If the tube ruptures or the general condition is severe, laparotomy is performed, its removal and bleeding are stopped. Sometimes, in order to preserve it, it is possible to “squeeze” the fertilized egg out of the tube or remove the latter through an incision in it, followed by suturing the wall.

In recent years, work has been carried out to study the possibility of conservative treatment of developing ectopic pregnancy. However, so far there is no general consensus regarding medications, their dosages and effectiveness.