Ectopic pregnancy: signs and symptoms in the early stages. What should you do to avoid an ectopic pregnancy? Clinical manifestations of ectopic pregnancy

An ectopic or ectopic pregnancy is a pathology in which the fertilized egg is fixed outside the cavity of the reproductive organ. This condition is dangerous and requires mandatory monitoring. It is important to identify the first signs of ectopic pregnancy in the early stages.

The fallopian tube is not intended for bearing a fetus and can rupture, so a woman cannot avoid surgical intervention.

Ectopic pregnancy is a fairly rare pathology that can occur in women for various reasons. After the fertilized egg enters the uterine cavity, it begins to attach to the walls of the organ, and pregnancy develops. In the event that any malfunctions occur in the body, the fertilized egg attaches itself to other organs without entering the cavity of the reproductive organ.

A woman should know what an ectopic pregnancy is, the signs and symptoms of such a pathology, and the possible consequences.

Reasons for development

Experts name reasons that may:

• Inflammatory processes in the appendages and fallopian tubes. Mucous exudate accumulates on their surface, partial destruction of the villi and loss of sensitivity are observed. As a result, the processes that promote the fertilized egg to the uterus are inhibited, which disrupts its implantation.
• Tumors. Neoplasms of a malignant and benign nature lead to the lumen of the oviducts being blocked. As a result, the zygote cannot enter the cavity of the reproductive organ and in some cases attaches to the abdominal cavity.
• Anatomical abnormalities. A bicornuate uterus or double fallopian tubes can lead to an ectopic pregnancy. Such pathologies are easily diagnosed by ultrasound and serve as a reason to classify the patient as a risk group.
• Violation of hormone levels in the body. Pathologies such as polycystic ovary syndrome, malfunctions of the thyroid gland and hormonal cycle disorders can cause a stop in the peristaltic movements of the oviducts. The consequence of this is the fact that the fertilized egg cannot move normally into the uterine cavity.

Often, ectopic pregnancy is diagnosed in women who have previously undergone gynecological operations. Any intervention in the pelvic area and inflammation of the organs of the reproductive system can cause adhesions and disrupt the patency of the fallopian tubes.

Signs of an ectopic pregnancy in the early stages

A rather dangerous type is an ectopic pregnancy, in which two fertilized eggs are implanted. One embryo is attached in the uterine cavity, and the other is attached anywhere outside it. Diagnosing such a pathology in the early stages is quite problematic, since the embryo is in the uterus and no abnormalities are noticeable at first. The second fertilized egg actively grows, which leads to rupture and serious consequences.

Every woman should know the symptoms of an abnormal pregnancy, which will allow her to seek medical help in a timely manner.

When do they appear?

As medical practice shows, there are no special signs of ectopic pregnancy at an early stage of its development. It successfully disguises itself as a normal pregnancy and is accompanied by such symptoms as delayed menstruation and swelling of the mammary glands.

Typically, pain is localized on one side of the abdomen in the area where the fallopian tubes are affected. If there is a cervical pregnancy or the fetus develops in the abdominal cavity, the patient may feel pain in the middle area of ​​the abdomen.

Women should know how to understand that the embryo has attached outside the uterine cavity. The pathology may be accompanied by the development of the following clinical picture:

• when positive ;
• acute and cramping pain, indicating rupture of the fertilized egg;
• spotting in the middle of the cycle.

In a situation where the embryo detaches and dies, the woman develops internal bleeding. Characteristic signs of this pathological condition are weakness of the body and increased pallor of the mucous membranes of the mouth and lips.

When an ectopic pregnancy is terminated, the embryo begins to disintegrate and causes an inflammatory process in the peritoneum. A characteristic manifestation of improper attachment of a fertilized egg can be a sharp rise in body temperature and a drop in blood pressure. In addition, the level of hemoglobin is greatly reduced, which leads to the development of anemia.

Is it possible to find out before the delay?

It is impossible to independently determine that a pregnancy is ectopic. Usually its course is accompanied by the same symptoms as during normal pregnancy. The woman notes minor changes in the condition of the mammary glands and... In addition, there is an aversion to certain foods and smells.

In order to determine an ectopic pregnancy, it is necessary to register with a doctor. He will prescribe all the necessary studies and diagnose the pathology in a timely manner.

It is possible to determine pregnancy without a test by measuring it, which is recorded in a special chart. With successful conception, it never drops below 37 degrees. A situation where there is no menstruation and the temperature remains elevated may indicate pregnancy.

Video about pathology

What will the test show?

To be sure of an ectopic pregnancy, you need to do a test. In the early stages, it is recommended to perform the test at frequent intervals, preferably every day. With proper pregnancy, hCG levels in the blood will rapidly increase, and the strip will become brighter.

If a woman does test after test, but the stripes remain faded, this may indicate fertilization outside the uterus. Will the test show an ectopic pregnancy?

When to go to the doctor?

The first symptoms for which you need to call an ambulance:

• acute pain in the abdomen, which radiates to the lumbar area and leg;
• a sharp drop in blood pressure;
• increased weakness of the body;
• loss of consciousness;
• copious from the genital tract.

One of the most accurate studies that can help determine an ectopic pregnancy is ultrasound. The device allows you to scan each organ, determine dark spots and identify the exact location of the embryo, if present.

In no case does an ectopic pregnancy end in childbirth, since the tube always ruptures. This pathological condition leads to profuse bleeding and the development of hemorrhagic shock. In the absence of timely medical care, an ectopic pregnancy can be fatal.

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 levels 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 detected, then planning can begin with the doctor’s permission.

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.

Normally, pregnancy should develop in the uterine cavity - this is the only organ in which the most favorable conditions are created for the life of the fetus for 9 months. But in some cases, the fertilized egg does not implant into the wall of the uterus and begins to grow in a place where it not only cannot survive, but will also become a direct threat to the woman’s life.

An ectopic pregnancy is a pregnancy that develops in the fallopian tube, attaching to its wall. The embryo may be genetically absolutely healthy, but it is doomed to death due to the inability to bear it: the fallopian tube will either rupture or be surgically removed.

Quick page navigation

Development mechanism

Sperm, once in a woman’s vagina, enter the fallopian tubes within a few hours. During ovulation, the egg leaves the capsule of the dominant follicle into the abdominal cavity and, with the help of a chemical signal, enters the funnel of the fallopian tube. Through the microscopic villi with which it is covered from the inside, the egg moves towards the uterus.

On this way, she meets sperm, one of which manages to fertilize her. Within a few hours, the cells of the fertilized egg will begin to divide, and it will rapidly increase in size.

If there are adhesions in the fallopian tube, they can prevent the embryo from entering the uterus.

*Formation of the first signs of ectopic pregnancy (photo)

As a result, it will be forced to implant itself into the wall of the fallopian tube and begin to develop there. In this case, a woman may experience absolutely all the first signs of pregnancy and until a certain time not realize that the fertilized egg has attached in the wrong place.

What is the danger for a woman?

The diameter of the fallopian tube is approximately 3 – 4 mm. Already at the 5th week of pregnancy, the embryo and its membranes become larger than the normal size of the lumen of the oviduct.

• This is the period when a woman may notice spotting and consult a doctor.

If you take an hCG test during an ectopic pregnancy, you can diagnose it at 3–4 weeks. The longer the period, the stronger the pain becomes on the side where the fertilized egg is attached.

If medical assistance is not provided, then at 8–9 weeks the fallopian tube ruptures, causing extensive internal bleeding, which can lead to the death of the woman.

The first signs of an ectopic pregnancy may appear at 4–5 weeks and intensify as the size of the fertilized egg increases.

1. Aching pain in the lower abdomen. Occurs at 4 weeks, when the embryo and its membranes cause stretching of the walls of the fallopian tube.
2. Daggering pain in the lower abdomen. Many pregnant women experience periodic shooting pain on the right or left. Usually they mean the active work of the corpus luteum, which remains after ovulation and nourishes the embryo. But with an ectopic pregnancy, the acute pain becomes unbearable and is extremely difficult to suppress with analgesics.
3. Bloody discharge. They appear at 5–6 weeks and mean either a violation of the integrity of the fallopian tube, or a tubal abortion, in which the fertilized egg dies on its own.
4. Loss of consciousness. It occurs several hours before the rupture of the oviduct, or when its integrity is already compromised.

Since such a pathology poses a direct threat to the patient’s life, the question of determining the first symptoms of an ectopic pregnancy in the early stages becomes relevant. Doctors recommend assessing not only your own feelings, but also relying on the results of the examination. If ovulation occurred 3 weeks ago, then an atypically located pregnancy may not have any external manifestations.

Therefore, in the early stages, the algorithm for identifying symptoms should be as follows:

• 3 weeks after ovulation (21 DPO) you need to visit the ultrasound room. Usually at this stage the fertilized egg is already noticeable and the doctor can see it during a transvaginal examination. If tests show bright stripes, but there is no embryo in the uterine cavity, this is a reason to be alarmed.
• It is necessary to donate blood for hCG and see the results of the analysis over time. If the level of the hormone increases steadily, but on the 21st day from conception the fertilized egg in the uterus is not detected by ultrasound, then you should be wary.

These two factors are the most important criteria for suspecting an ectopic pregnancy. If a repeat ultrasound on the 25th day from conception still does not see a fertilized egg in the uterine cavity, then you should urgently consult a doctor.

How will the test behave?

The test responds to the release of the hormone hCG, which begins to be produced from the moment the fertilized egg is implanted into the wall of the uterus. But this hormone can be steadily released into the blood and urine even if the embryo is attached to the fallopian tube.

The only difference is that its level will be slightly lower than during normal pregnancy. This can only be diagnosed by laboratory blood tests, and tests performed later than 20 days after ovulation will show bright stripes with progressive ectopic pregnancy.

Therefore, if you are thinking about the question of how to determine an ectopic pregnancy at an early stage using hCG, then this can be done only evaluating the results of the analysis, rather than the reaction of a conventional test.

Treatment and removal of ectopic pregnancy

At the moment, a non-surgical method of treating the pathology is only in the form of chemotherapy, as a result of which the fertilized egg dissolves and independently leaves the fallopian tube. However, in Russia this technique is not used and pregnancies developing outside the uterine cavity are removed surgically.

The main question when choosing a method for surgical removal of an ectopic pregnancy is whether it is possible to save the patient’s fallopian tube or not.

Organ-preserving operations

Possible in rare cases, if an ectopic pregnancy has characteristic signs for up to 6 weeks and the clinical picture meets the following criteria:

1. The dimensions of the fertilized egg are no more than 40 mm in diameter.
2. The integrity of the pipe is not compromised.
3. The patient does not have significant bleeding.

Linear salpingotomy

The surgeon makes several punctures in the abdominal cavity in order to bring a camera and the necessary surgical instruments to the affected area. Using a laser, electrode or surgical scissors, the fallopian tube is cut lengthwise and the fertilized egg is removed.

Particular precision is required when separating the membranes from the implantation site. Unprofessional actions can lead to bleeding. The oviduct is then washed, left unsutured, and the operation is completed.

Segmental tube resection

The fallopian tube is fixed, then it is coagulated as close as possible to the place where the fetus is attached. Thus, only the segment with the fruit receptacle is cut out from the oviduct. After this, the second stage of the operation begins, which involves reconstructing the pipe from the remaining sections.

VPY method (squeezing out the fertilized egg)

During operations, in some cases, doctors discover an incipient miscarriage: there are signs of detachment, the presence of blood clots. This is a favorable condition for squeezing out the fertilized egg.

Using surgical instruments, the embryo is squeezed towards the distal part of the fallopian tube. After removing the embryo and membranes, the oviduct is sanitized in order to clear it of blood clots.

Not everyone can notice the pathology in the early stages; some women have menstruation during an ectopic pregnancy and they think that conception has not occurred.

Therefore, the need for surgical intervention becomes clear when the fertilized egg has reached a critical size and there are several hours left before the rupture of the oviduct. Such circumstances do not allow organ-preserving surgery to be performed and doctors have to remove the embryo along with the tube.

Surgical intervention aimed at amputating the fallopian tube is called salpingectomy. 3 punctures of different sizes are made in the anterior abdominal wall, no more than 1 cm in length. The fallopian tube with the embryo is removed using an endoloop or electrocoagulation. The amputated oviduct is removed and the abdominal cavity is sanitized. Sutures or staples are placed at the amputation site.

Forecast

A positive result on the test strip indicator can sometimes turn into an unexpected problem: the fertilized egg begins to grow and develop outside the uterus. The difficulty of diagnosis lies in the lack of certain clinical data in the initial period. Signs of an ectopic pregnancy at an early stage of 2 weeks have a certain character.

You need to know the danger signals to avoid serious complications. The cause of the pathology may be due to the presence of chronic inflammatory processes, which resulted in adhesions, affecting the patency of the egg. Reasons also include malformations of the reproductive organs, hormonal imbalance and too “slow” sperm. The nature of the signs indicating pathology depends on the site of attachment of the egg. From the first week of pregnancy, it is very difficult to determine the anomaly. The manifestation of toxicosis is a normal picture in the symptoms of pregnancy.

The manifestation of symptoms directly depends on places where the fertilized egg is attached. The more space there is for its growth, the longer the patient may not experience the characteristic symptoms of pregnancy developing under abnormal conditions.

From the second week of pregnancy, aching and pulling pain signals a problem. This may indicate that the egg is attached to the fallopian tube. According to statistics, this picture occurs most often. When the embryo is localized in a wide area of ​​the tube, obvious signs are noticeable during the period of 7-8 weeks. And in the cervical area, symptoms may appear much later.

Signs of pregnancy in the early 2 weeks may be indistinguishable from physiological manifestations. In the second - third week, anxious moments are expressed as follows:

At the first signs indicating abnormal development, immediate medical attention is required. Pathology threatens women's health. If you do not consult a doctor in a timely manner, there is a risk of developing peritonitis (inflammation of the peritoneum), rupture of the fallopian tubes and bleeding.

At a period of 2 weeks or more, pathology is determined due to implantation of the embryo in the narrow lumen of the tube or ovary. Sometimes there is spontaneous separation of the fertilized egg, which leads to tubal abortion. This situation is relatively favorable because it does not entail pipe rupture.

The gestational age is calculated from the end of the last day of the menstrual cycle. It may not coincide with the value based on ultrasound examination. At what stage of pregnancy can you see on an ultrasound, many women are interested. The fetus in the uterus can be seen from the 3rd week. This is the difficulty in determining the development of the embryo in the tube or ovary. Sometimes, before the 5th week, it is not possible to determine the abnormal position of the ovum. That's why Ultrasound in the early stages does not provide a 100% guarantee of diagnosis. An important aspect for accurate diagnosis is a set of special measures.

HCG for ectopic pregnancy norm by week table

From the moment of fertilization, the female body begins to produce a hormone called gonadotropin (hCG). Laboratory tests allow you to monitor the increase in gonadotropin readings. During physiological pregnancy, the increase in hCG is expressed at 1 unit per day. Sometimes, when the embryo is localized outside the uterus, the hormone continues to increase until a critical moment.

Below are the physiological norms for the growth of hCG in pregnant women.

Subject to change, the weekly rate is tracked in the table. Hormone value 0 to 5 is considered negative.

A deviation from normal values ​​of 20% requires a re-examination of the hormone level. A change of 50% upward or downward is considered critical. This situation indicates pathology.

The diagnostic complex includes ultrasound, monitoring the hCG level, bimanual examination, monitoring the level of progesterone growth in the blood serum. Progesterone levels in ectopic embryos significantly lower than during a normal pregnancy. During a bimanual examination, the presence of copious secretions, cyanosis of the mucous membranes of the cervix and its slight thickening are noted.

Painful sensations are localized in the area where the fertilized egg is attached. After 2 weeks, clinical manifestations are revealed that indicate the position of the egg in the fallopian tubes or ovary (isthmic, interstitial, ovarian). Later, at a period of 5 to 8 weeks, pregnancy is diagnosed, developing in the abdominal cavity, in a wide area of ​​the fallopian tube (fimbrial, ampullary). The biggest threat is cervical location of the egg. Such a pregnancy can be asymptomatic for a long time, which poses a threat to the woman.

Can determine the location of the fertilized egg diagnostic ultrasound examination, carried out for a period of 5 weeks. Earlier, in particular at a two-week period, there is no guarantee of an accurate result, which complicates the identification of the pathological process.

Signs of an ectopic pregnancy in the early stages of 2 weeks - intense and prolonged pain. Such manifestations should not be ignored.

The presence of discharge is a dangerous symptom; if it appears, you should consult a gynecologist

• in most cases, spotting and spotting is characteristic;
• when bleeding into the abdominal cavity, blood discharge from the genitals appears.

These symptoms are always accompanied by aching pain.

A pregnancy is called ectopic when a fertilized egg implants in the fallopian tube, ovary, abdomen, or cervix. In this case, it is impossible to carry and give birth to a child; in addition, the pathology poses a danger to the health and life of the woman herself. Therefore, it is important to detect symptoms of ectopic pregnancy, diagnose and treat them as early as possible.

The severity of symptoms may vary. Sometimes women already identify the manifestations of pathology in their early stages. But there are situations when ectopic implantation of the fertilized egg becomes known after a sharp deterioration in health and an ambulance is called.

But there are several signs that may indicate ectopic implantation of the embryo:

• Often the test works later than in a normal pregnancy. This is due to the fact that the concentration of hCG increases slowly. If the embryo is located ectopically, the timing of diagnosis is shifted by 2-3 days compared to normal.
• After the first day of delay, the second test strip appears. This is also explained by the slow rise in hCG levels in the urine.

If a specialist suspects the development of an ectopic pregnancy, the following studies are prescribed:

1. Laboratory blood test for hCG . Human chorionic gonadotropin increases more dynamically in the blood than in the urine. Therefore, pregnancy can be confirmed in this way at an earlier date: 5-6 days after fertilization. To find out whether it is ectopic, it is necessary to compare data from several studies. During normal pregnancy, the level of hCG doubles every 2 days; in pathological pregnancy, the changes are insignificant.
2. Transvaginal ultrasound . Using ultrasound, the position of the embryo can sometimes be determined from the 3rd week of pregnancy, but most often it is detected only by 4-5. If the doctor suspects an ectopic pregnancy, but the fertilized egg is not visible (its size is extremely small), then a repeat examination is prescribed or the woman is hospitalized so that she is under constant medical supervision. Transvaginal ultrasound is the most reliable method for diagnosing ectopic pregnancy, but in 10% of cases it also gives an error: the fertilized egg is considered as a blood or fluid clot. Therefore, the examination is always carried out in combination with a blood test for hCG.
3. . The procedure is carried out as a diagnostic procedure only according to indications: when there is a serious suspicion of an ectopic pregnancy (symptoms, hCG dynamics), but it cannot be confirmed using ultrasound. Laparoscopic surgery is performed under anesthesia; small punctures are made using special instruments, where a tube with a camera and light is inserted, and the doctor examines the organs through an image on a monitor. If an ectopic pregnancy is detected, then therapeutic measures are immediately taken (removal of the fertilized egg, etc.).

Symptoms

Since ectopic pregnancy occurs in different ways, specific symptoms may appear gradually, late or completely absent until an emergency condition develops (with bleeding, rupture of the fallopian tube, etc.). Therefore, you should not hope only for a deterioration in your health; it is necessary to carry out diagnostic procedures in parallel: determination of hCG, ultrasound.

The first symptoms of an ectopic pregnancy coincide with those of a normal pregnancy: general weakness, drowsiness appears, and the mammary glands swell. Pathological implantation does not manifest itself in any way at first. A woman may also experience: nausea, vomiting, dizziness.

At this stage, an ectopic pregnancy can sometimes be determined by testing the level of hCG in the urine. As noted above, in this case, its results may be delayed for several days, since the hormone is produced more slowly than usual. Therefore, if a woman notices signs of pregnancy, but the test gives a negative result, it is likely that the fertilized egg has settled outside the uterus.

An ectopic pregnancy in the early stages has the same symptoms as a normal one, but their nature is somewhat different:

• . Symptoms of an ectopic pregnancy before a missed period are spotting or slight bleeding. When the embryo is implanted into the wall of the uterus, they are short-lived, lasting several hours. But if it is established outside of it, this symptom will be more intense and lasting.
• . Often such sensations occur in the lower abdomen. During normal pregnancy, they are tugging and develop due to increased tone of the uterus. With ectopic, they accompany the process of implantation and development of the embryo, and can be localized in different areas - where the fertilized egg is attached. Later the pain spreads to the entire abdomen. Its intensity constantly increases - from barely noticeable at first, to sharp, cramping after a few days.
• General malaise . Normal pregnancy in the early stages may be accompanied by decreased performance, increased drowsiness, and fatigue. With an ectopic, all these symptoms are more pronounced, in addition, dizziness and fainting develop.
• Toxicosis . Nausea and vomiting often accompany normal pregnancy. In a pathological condition, these manifestations are more pronounced and intensify every day.

At later stages, the symptoms of ectopic pregnancy increase faster, and in a critical situation - rapidly. A woman’s blood pressure drops sharply, she experiences frequent dizziness, and her body temperature rises. Sometimes there are signs of anemia due to decreased hemoglobin levels.

If the fallopian tube ruptures and internal bleeding develops, this is manifested by very severe pain, shock, and loss of consciousness. Urgent medical attention is required.

For each type of pathological fixation of the ovum, there are characteristic symptoms:

• Pipe An ectopic pregnancy is manifested by pain on the left or right side, depending on where the implantation of the fertilized egg occurred. If it is fixed in the wide ampulla part, then the symptom appears at 8 weeks, if in the narrow part (in the isthmus) - then at 5-6. The pain intensifies while walking, turning the body, and sudden movements.
• Ovarian An ectopic pregnancy does not show any pathological symptoms for a long time. This is explained by the fact that the follicle can stretch to fit the size of the embryo. But when the limit of elasticity is reached, severe point pain appears in the lower abdomen, gradually spreading to the lower back and large intestine area. Defecation becomes painful. The attack lasts from several minutes to hours and is accompanied by dizziness and faintness.
• Cervical and cervical-isthmus ectopic pregnancy occurs without pain. Bloody discharge comes to the fore - from spotting to copious, profuse, posing a threat to life. Due to the increase in the size of the cervix, urination disorders develop (for example, frequent urge).
• Ectopic pregnancy in the abdominal cavity in the early stages it has symptoms that are no different from those during normal pregnancy. But as the embryo grows, dysfunctions of the gastrointestinal tract appear (constipation, diarrhea, nausea, vomiting), signs of an “acute abdomen” (severe pain, bloating, fainting).

What is an ectopic pregnancy and what symptoms are typical for it? With this pathology, the fertilized egg is implanted outside the uterus: most often in the fallopian tube, less often in the ovary, abdominal cavity, and cervical region.

An ectopic pregnancy can be detected from 4-6 weeks using a blood test for hCG and ultrasound. Symptoms in the early stages are almost the same as during normal pregnancy, but gradually they become more pronounced and specific (localization and intensity of pain, bleeding, disturbances in the functioning of other organs).

Useful video about the symptoms of ectopic pregnancy