Ectopic ovarian pregnancy. What is ovarian pregnancy

The pathology discussed in this article refers to one of the types of ectopic fertilization of the egg. Ovarian pregnancy is diagnosed quite rarely and accounts for only up to one percent of all cases outside intrauterine pregnancy.

ICD-10 code

O00.2 Ovarian pregnancy

Causes of ovarian pregnancy

This clinical picture is observed if the egg does not have time to leave the ovary and is released from the follicle, but has already been fertilized by a sperm. Further planned maturation of the egg begins, while it no longer moves further, but continues to develop, attached to the ovary.

There are no changes in a woman’s body that lead directly to the pathology in question, but we can speak, in general, about sources that can provoke various types of ectopic pregnancy.

The causes of ovarian pregnancy vary. As studies and observations conducted in this area have shown, the deviation in question from the normal course of pregnancy can be provoked by:

• A previous infectious disease that occurred in the uterine tissues, as well as in the case of inflammation of the endometrium.
• Colds genitals.
• With the development of obstruction fallopian tubes.
• This may be the consequences of surgery performed on the pelvic organs or genitals.
• Ovarian pregnancy can be triggered by changes affecting the genetic and endocrine areas of the human body.
• The presence of a cyst or polycystic formations.
• Congenital or acquired underdevelopment of the ovary.
• Consequences of medical therapy with the use of potent medications.
• Therapy carried out to rid a woman of infertility.

As observations have shown, nine out of ten cases arose without any obvious reasons, that is ovarian pregnancy developed “accidentally”.

Symptoms of ovarian pregnancy

The course of pregnancy of the type in question is progressing, without any negative symptoms. The development of the embryo itself proceeds without obvious deviations, with virtually no deviations from a natural intrauterine pregnancy. Even on later the woman begins to feel the baby moving. Such periods are achieved due to the fact that the ovarian tissue is quite elastic and capable of stretching to a certain point. But such an idyll occurs for the time being.

At the moment when the size of the embryo has reached critical parameters (the walls of the ovary are not able to stretch further, having reached their limit), the woman begins to feel the symptoms of ovarian pregnancy, which begin to appear:

• Appearance obvious signs early toxicosis.
• Enlargement of the mammary glands and their increased pain.
• Prolonged spotting and spotting from the vagina.
• Severe pain in the lower abdomen, point pain localized at the site of pregnancy.
• The pain begins to gradually radiate to the lumbar region and/or large intestine (anus). An attack can last from a few minutes to a number of hours. During the attack, weakness, dizziness, and nausea appear.
• A sharp drop in blood pressure.
• The appearance of painful bowel movements.
• The pregnant woman's body goes into a faint or pre-fainting state.

Somewhat later, when the size of the fetus has increased further, the woman begins to experience internal bleeding and the pain becomes more intense. Its increase can provoke loss of consciousness from painful shock. These symptoms may be accompanied by an increase temperature indicators woman's body. The complex of manifestations listed above indicates organ rupture.

Even at the first appearance of a uncomfortable condition, a pregnant woman should seek advice from her obstetrician - gynecologist who is leading the pregnancy. And if the situation gets out of control and the symptoms worsen, it is necessary to urgently call an ambulance.

Diagnosis of ovarian pregnancy

It is necessary to immediately clarify the fact that ectopic pregnancy, and the type of development specifically discussed in this article is very dangerous. It poses a threat not only to the health of the unborn baby and his mother, but also increases the risk of death for the woman.

In most cases, the child does not survive, but timely provision of medical care to the victim increases the woman’s chances of survival. After all, at the moment of rupture of the ovary, severe bleeding occurs. And if it is not stopped in time, the patient will simply bleed to death.

Therefore, even at the slightest suspicion of an ectopic pregnancy, the woman in labor must be immediately hospitalized. An internal rupture can be suspected if a sharp, acute pain occurs in the iliac region. Mostly, such symptoms occur four weeks after the moment of a missed period - but this is not a dogma.

At the same time, a visual examination of a woman by an obstetrician-gynecologist on a chair using a special mirror shows the doctor the softness of the tissues of the uterus and its cervix (which indicates the presence of pregnancy). At the same time, their tint gives off a bluish tint.

During palpation, an experienced gynecologist determines a unilateral increase in size and increased soreness of the ovary. In this case, the organ is not clearly contoured.

The specialist begins to compare the time of the last menstruation and the size parameters of the uterus. Their discrepancy is the reason for prescribing a targeted additional examination.

Accuracy in making the correct diagnosis is possible only with the help of ultrasound examination(ultrasound) of a woman's genital organs. The diagnostician, using a special medical device, carefully examines the pelvic organs, the uterine cavity, and the condition of the endometrium. Ultrasound allows you to identify the fertilized egg and the place of its attachment.

If, despite all the signs of pregnancy, the embryo is not found in the uterus, and the diagnostician observes the presence of blood clots and fluid in the peritoneal cavity or in the area behind the uterus, the doctor makes a diagnosis of ectopic pregnancy.

A pregnant woman must also take a urine and blood test to check for human chorionic gonadotropin human (hCG), as well as to determine the level of progesterone. Human chorionic gonadotropin is a special hormonal protein produced by the membrane cells of the growing fetus throughout gestation. His presence and sufficient quantity allows you to maintain normal course pregnancy. It is hCG that inhibits the process that provokes the appearance of menstruation, allowing you to save the baby.

There are certain standards by which comparisons are made. At the same time, a qualified specialist knows that the progesterone level in the case of an ectopic pregnancy is slightly lower than in the case of a normal pregnancy.

The test is repeated after 48 hours. There is a comparison hCG indicators. If its characteristics remain unchanged, then this fact only confirms ectopic fertilization of the egg.

Ovarian pregnancy on ultrasound

After production expectant mother to be registered with a gynecologist at the antenatal clinic, the specialist must prescribe an ultrasound scan of the uterus for his patient. This study, carried out in the early stages of pregnancy, should protect against the further development of any pathological abnormality.

It should also be noted that a clinical picture may arise when the test showed two stripes, which corresponds to a positive response to fertilization of the egg, while an ultrasound examination says the opposite - there is no embryo in the uterus. This discrepancy is one of the indications of a developing ectopic pregnancy.

Therefore, the research is carried out more carefully. Ovarian pregnancy is determined by ultrasound if the fertilized egg is located in the projection of the ovary. In this case, the diagnostician usually observes that the embryo and the uterus are directly connected by the ovarian ligament.

But it’s worth reassuring women a little. The presence of pain symptoms is not a mandatory indicator of ovarian pregnancy. This symptomatology can also manifest itself as a result of a number of other diseases (for example, polycystic disease).

Treatment of ovarian pregnancy

If there is even a slight deterioration in the pregnant woman’s health, she should immediately consult her obstetrician-gynecologist for examination. If a woman’s condition rapidly deteriorates, urgent health care.

If an ectopic pregnancy is not detected in a timely manner, then after some time (usually this period is about a month), the pregnant woman may experience acute abdominal pain and uterine bleeding.

In such a situation, the clock is already counting down to hours and minutes.

Today, depending on the severity of the clinical picture of the pathology, doctors have two methods for treating ovarian pregnancy: surgery and drug therapy.

In the light of drug treatment, a reception is carried out medicines specific pharmacological orientation. One of these drugs is methotrexate, injections of which can provoke the death of the embryo and the resorption of tissues that have already formed. The use of this medicine allows you to keep the ovaries and folic tube of the failed mother in a healthy state. This treatment enables the woman to conceive a child again in the future and carry it safely to term.

Today, this drug is not yet so actively used in the treatment of ectopic pregnancy: CIS countries provide only 5 to 8%, while this indicator in foreign clinics it ranges from 25 to 33%.

Cytostatic drug compound from the antagonist group folic acid prescribed by a doctor if a number of mandatory conditions are met:

• Stable hemodynamic condition of the pregnant woman.
• She has no hemodynamically severe bleeding.
• Ultrasound confirmed diagnosis - ectopic localization ovum.
• Lack of uterine location of the fertilized egg.
• No constant pain symptoms.
• If there are no contraindications for taking methotrexate.

Wherein medicinal technique treatment of ovarian pregnancy is possible only if an ultrasound examination shows the size parameters of the fetal egg no more than 3.5 mm, as well as human chorionic gonadotropin (hCG) readings below the level of 5000 mIU/ml.

Methotrexate is prescribed to a pregnant woman after diagnosing ectopic embryo development in the form of an injection solution administered intramuscularly or intravenously.

The injection is performed once. After three to four weeks, a woman usually starts her first period.

Surgical treatment involves a method of getting rid of the problem by curettage of the embryo. At the same time, the organ in which the fetus developed can be removed. In this case, the ovary.

Mostly, if the question arises about a surgical solution to the problem, a gynecologist surgeon performs an operation to remove the embryo and wedge resection of the ovary. In this case, partial excision of the ovary occurs. After some time, it completely restores its functions, allowing further woman It is normal to conceive, carry and give birth to a baby.

But if the situation has gone too far and doctors observe a severe clinical picture, surgical intervention will have more severe consequences. The surgeon has to perform an oophorectomy - an operation to remove the ovary involved in an ectopic pregnancy.

Prevention of ovarian pregnancy

Not a single representative of the fair sex of childbearing age is insured against ectopic pregnancy. But some recommendations that determine the prevention of ovarian pregnancy can still be given:

• Worth sticking safe sex to prevent infection with sexually transmitted diseases. This will help protect the woman’s genitals from damage.
• Early diagnosis and timely treatment of sexually transmitted diseases.
• Maintaining healthy image life. Refusal bad habits.
• If a woman is planning to have a child, but is at risk, it is worth visiting a gynecologist before conception, undergoing an examination and, after conception, being under constant medical supervision.
• If you experience the slightest discomfort during pregnancy, you should immediately contact a specialist for consultation and examination. The faster the pathology in question is detected, the easier the consequences of its relief.

If an unpleasant diagnosis has been made, it is now worth fighting to preserve the reproductive organs. To do this, without delay, you should:

• Conduct a urine test to determine the level of human chorionic gonadotropin (hCG), after two to three days this test should be repeated.
• It is necessary to undergo an ultrasound examination to determine the type of pregnancy: uterine or ectopic. Based on the results, undergo treatment if necessary.
• Self-diagnosis and self-medication in case of suspected pathological pregnancy are unacceptable. Losing time can cost a woman in labor not only her health, but also her life.

Ovarian pregnancy prognosis

If a woman is responsible for her health and the health of her unborn child, then at the slightest ailment she immediately turns to a qualified doctor. This step allows her to make the prognosis for ovarian pregnancy quite favorable. Subsequently, she remains fully capable of conceiving, bearing and giving birth. healthy child. Statistics show that 50–85% of such women were able to become mothers in the future. 10 – 20% of cases show a repeat ectopic pregnancy.

If the situation is advanced and doctors observe a rather severe clinical picture of the pathology, aggravated by severe bleeding, then the risk of developing serious complications, or even death of the victim, increases sharply.

Not a single woman who wants to become a mother and give birth to a healthy baby is immune from the diagnosis of ovarian pregnancy. But the point is not that such a pathology can affect everyone, but to take timely and adequate measures to solve the problem. Therefore, it is better to play it safe and consult a doctor than to ignore the body’s signals and lose not only the baby, but also your health, and possibly your life. That's why, dear women, be more attentive to your health and more responsible. After all, delaying seeking help from a qualified doctor can be too expensive. And you will have to pay with your health, and sometimes with your life!

It is important to know!

During pregnancy, a woman's body undergoes many changes. Some of them are visible to the naked eye, while others are so hidden that they can only be detected with the help of an ultrasound examination or laboratory diagnostics.

Ectopic ovarian pregnancy is rare view pathology, upon diagnosis of which the patient must be provided with urgent and qualified assistance, which will help her maintain not only the functioning reproductive system, but also life. This condition is detected in a situation where the fertilized germ cell is attached not to the wall of the uterus, but inside or on the surface of the ovary.

In most cases, the pathology in question practically cannot be detected on early stage, since there are no characteristic symptoms. If the pathology is severely neglected, then in the later stages you can even feel the fetus moving and not suspect a threat. Let's take a closer look at why ectopic pregnancy occurs in the ovary, how it is treated and diagnosed.

This type of pathological attachment of the embryo occurs in no more than 1% of women who saw the long-awaited two stripes on the test. Depending on the area of ​​implantation, ovarian and intrafollicular types of gestation develop. In the first case, the location of the fertilized egg is marked on the surface of the organ, and in the second it is located inside the gonad.

Types of ectopic pregnancy. Source: blog-zdorovya.ru

An important feature of the ovaries is that they are created from tissues that have high level elasticity. Thanks to this they long time stretch without rupture, so ectopic pregnancy progresses for a long time. If there is a strong tension, then organ rupture and severe blood loss cannot be ruled out.

Causes

Ectopic pregnancy on the ovary in in rare cases can be explained from a medical point of view. In most cases, pathological attachment occurs without any obvious reason. The same thing happens in the case of embryo implantation in the peritoneum or fallopian tube.

At the same time, gynecologists were able to identify a number of unfavorable factors that can contribute to the development of pathological pregnancy:

1. Previously, the patient suffered from an infectious disease, which affected the quality of functioning of the reproductive system;
2. The woman underwent diagnostic or therapeutic surgical interventions on the uterus;
3. There is a factor of fallopian tube obstruction;
4. There are pathologies endocrine system and hormonal instability;
5. Benign tumor neoplasms develop in the reproductive organs;
6. The patient has a delay in the development of the genital organs and abnormalities in their structure.

Experts also note that pregnancy on the ovary sometimes develops in women who have been taking potent medications for a long time. This can happen if done incorrectly drug treatment infertility.

Symptoms

In most cases, ectopic pregnancy develops without characteristic symptoms. The only thing that can encourage a woman to think about pathological development fetus, this is the appearance of bloody vaginal discharge. You can suspect early fertilization based on the absence of menstruation and a positive test.

However, in the case of an ovarian ectopic pregnancy, the presented signs are classified by doctors as uninformative. Throughout the first trimester, the fetus can develop normally, without pronounced differences.

In case of an ectopic pregnancy, the test will be positive. Source: otvet.mail.ru

Accordingly, the following symptoms will be observed:

• Delay of menstrual bleeding for more than seven days;
• The occurrence of nausea and vomiting, which indicates early toxicosis;
• On the test performed, two stripes are clearly visible;
• The mammary glands become painful and swollen;
• The hCG level according to the results of the study shows 25 or more units.

It is by the last parameter that you can determine whether the pregnancy is developing normally. In women who are not carrying a child, the readings will be in the range of 0-5 mU/ml. However, numbers in the range from 5 to 25 mU/ml cannot clearly confirm that fertilization has occurred, so the analysis is repeated after 2-3 days.

Interrupt

After a certain period of time, the embryo will reach a critical size at which the walls of the ovaries can no longer stretch. In this case, the patient will experience acute painful sensation in the lower abdomen, persisting even at rest. Along with this, heavy bleeding will occur, dizziness will occur, and loss of consciousness is possible.

There will also be some discomfort in the area of ​​the lumbar back, and in the area of ​​the large intestine there will be severe colic, which will complicate the process of defecation. Attacks of pulsation can be short-term or long-lasting (about 2-3 hours), which will contribute to the appearance of unpleasant sensations in the anal area.

This condition clearly affects general health, which worsens significantly. The woman feels weak and unwell, nausea and vomiting appear, and her blood pressure rapidly decreases, causing fainting to begin. In such a situation, the patient requires emergency medical care which will make it possible to avoid negative consequences.

Complications

The main complication of the pathology is that ectopic pregnancy and rupture of the left or right ovary are considered integral companions of each other. If the woman is not taken to the hospital in a timely manner, the possibility of death cannot be ruled out. Given this fact, it is necessary to be very attentive to the signals of your body in the early stages of gestation.

If left untreated, the ovary may rupture. Source: simptomy-i-lechenie.net

Among the most frequent complications The following states are noted:

1. Rupture of ovarian tissue;
2. Opening of heavy bleeding;
3. The need to remove the gonad;
4. Spontaneous embryo rejection;
5. Development of infertility.

Regardless of what kind of discomfort a woman felt in the first trimester, she should definitely go for an examination to a gynecologist. Thanks to this, it will be more likely that an ectopic pregnancy will be diagnosed at an early stage, and the problem can be solved by taking medications.

If the diagnosis is late and the fetus has reached a large size, then surgical removal embryo. A complication in this case is that such operations often involve complete removal of the gonad, which results in partial loss of reproductive function.

It is very important to establish the reason why an ectopic pregnancy formed on the ovary. If this was not done, but negative factor is not eliminated, it is possible that after the next fertilization pathological implantation of the embryo will also be noted or there will be miscarriage. Probability normal development Pregnancy rate is only 50%; the remaining patients experience relapses and develop infertility.

Diagnostics

Initially, a gynecologist can diagnose pathological attachment of the embryo through a bimanual manual examination of the uterine cavity.

To determine the location of the embryo, diagnostic laparoscopy is used.

Normal development of the fetus inside the womb is possible only in the uterine cavity, so any other place of conception is considered an anomaly. Ovarian pregnancy is a type of ectopic fertilization when the embryo begins its formation in the ovary.

Mechanism of development of ovarian pregnancy

Ovarian pregnancy is a rare type of ectopic conception, when the egg, for various reasons, is not released from the follicle, but is fertilized and forms an embryo in the ovary. Further movement to the uterine cavity is difficult, so this pathology is dangerous for the woman’s life.

The mechanism of ectopic ovarian gestation can be of two types, depending on the location:

• fertilization of the egg with sperm directly in the follicle, the embryo begins to grow, which makes further movement through the tubes to the uterus difficult;
• the fertilized egg is implanted precisely in the ovarian mucosa.

As the embryo grows and develops, doctors often perceive such a pathological conception as a tumor. But after a thorough diagnosis, the exact cause is determined that will require emergency surgical intervention.

Causes of ovarian pregnancy

An abnormal site of embryonic development often occurs without any obvious cause, so any abnormality in functioning female body can be attributed to etiological factors, but the main risk groups are:

• infectious and inflammatory diseases reproductive system;
• surgical interventions that lead to obstruction of the fallopian tubes, damage to the endometrium of the uterus, including curettage and abortion;
• congenital ovarian diseases;
• pathologies of the endocrine system;
• diagnosis of cyst or polycystic disease.

An additional factor provoking ovarian pregnancy is the use of potent medications shortly before conception.

Symptomatic manifestations

On initial stage the formation and development of the embryo, a pregnant woman, as a rule, is not bothered by anything. Due to the fact that the walls of the ovary are quite elastic, the fetus develops within normal limits with characteristic features pregnancy. This situation lasts until the baby is actively growing, then obvious symptoms of ectopic conception appear:

• decreased blood pressure;
• constant spotting from the vagina mixed with blood;
• inability to have normal bowel movements due to fetal pressure on the rectum;
• severe pain from egg implantation as the embryo grows painful sensations increase significantly.

The stretching of ovarian tissue has its limits, so at the maximum point a rupture of the internal reproductive organ, which will lead to death due to excessive bleeding and subsequent sepsis, emergency surgery will be required.

Diagnosis and treatment

When contacting antenatal clinic To check for pregnancy, a woman is first of all palpated; in this way, an increase in the size of the ovary on one side can be noticed. During the examination, the doctor compares the normal indicators of the uterine cavity with the actual ones; in the case of ovarian fertilization, the gestational age does not correspond to the size of the uterus.

For a more accurate diagnosis, it is necessary to use ultrasound. An ultrasound can examine the attachment site of the fertilized egg; this pathology is often mistaken for polycystic disease, so a blood test for hCG will be required.

Treatment of ovarian pregnancy involves only surgical intervention, in most cases it is possible to keep the ovary intact. If the fetus has reached a large size or if there are complications, a decision may be made to remove the organ along with the embryo. The consequences of such an operation include a long recovery and a decrease in the chances of conception, but the lack of intervention on the part of doctors leads to death.

Collapse

Ovarian pregnancy (gestation) is a rare type of pathology that requires emergency medical care to preserve the health and life of a woman. The problem is the implantation of an embryo, which may implant not in the uterine cavity, but on the surface or inside the ovary. The tricky thing is that the course of such a pregnancy at first has no specific features. In the later stages, a woman may even feel the movement of the fetus, not realizing the existence of a threat.

Classification

A similar deviation is observed in 0.8-1% of the total number of pregnancies. There are 2 types of ovarian gestation according to the location of the embryo:

1. intrafollicular (true);
2. ovarian

In the first case, fertilization of a mature egg occurs in the depths of the follicle. Subsequent development of the embryo will occur here - in the ovary:

During ovarian gestation, the embryo is not located inside the gonad, but on its surface:

Ovarian tissue is elastic and can stretch, which is why an ectopic pregnancy can take quite a long time to develop. But with excessive tension on the membrane, the risk of organ rupture increases, which is fraught with significant blood loss.

Causes of pathology

Fixing an embryo in the wrong place cannot always be justified from a medical point of view. In 30-50% of cases, ovarian gestation, as well as ectopic pregnancy in the tube or abdominal cavity, occurs without obvious reasons. However, factors that can provoke incorrect embryo implantation have been identified:

• previously suffered infectious diseases that negatively affect the reproductive system;
• complications caused by surgical interventions performed on both the genital and pelvic organs;
• transport dysfunction of the fallopian tubes (obstruction);
• endocrine diseases in which the production of hormones is disrupted
• neoplasms (cysts, tumors) in the area of ​​the uterus, ovarian appendages and tubes;
• genital infantilism, implying delayed development of the genital organs, and other anomalies.

Ovarian pregnancy can occur due to long-term use of potent medications. Incorrectly selected therapy for infertility often leads to this result.

Clinical picture

Symptoms with any other form of ectopic gestation are usually associated with the active release of blood clots from the vagina. An equally significant indicator is the absence menstrual cycle. But during ovarian pregnancy, these criteria are recognized by experts as uninformative. In the first trimester, the process of embryo development does not have very pronounced differences. For a woman, pregnancy progresses without obvious deviations from the norm and is accompanied by typical changes:

• significant delay in the menstrual cycle;
• early toxicosis, manifested in the form of nausea and vomiting;
• positive result of a pregnancy test;
• elevated pain syndrome in the area of ​​the mammary glands, increasing their size;
• the presence of human chorionic gonadotropin (hCG) in the body, quantitatively exceeding the norm of 25 mU/ml.

U non-pregnant women blood test values ​​for hCG should not exceed 5 mU/ml. But results ranging from 5 to 20 mU/ml are also not a basis for establishing the fact of gestation. In order to obtain reliable confirmation of pregnancy, the study is repeated after 2-3 days.

Spontaneous interruption algorithm

Over time, the size of the embryo will reach a critical size, and the walls of the ovaries will no longer be able to stretch. Then the woman will begin to experience intense pain in the iliac region (lower abdomen) even with light pressure. Signs of an ectopic pregnancy will replenish heavy bleeding, dizziness and lightheadedness. There will be discomfort in the lumbar spine.

Colic will appear in the segment of the large intestine, which may result in difficulties during bowel movements. Pulsating attacks can be short-term or can last up to 2-3 hours, causing discomfort near the anus. Against the background of such “outbreaks”, weakness in the body and nausea appear. A sharp drop in blood pressure is observed, causing fainting.

On at this stage the woman will urgently need medical care and qualified monitoring of her well-being in order to avoid negative consequences.

Possible complications

Ovarian ectopic pregnancy is extremely dangerous to health and can cause death for a woman. That is why a pregnant woman’s body must be monitored from the first weeks of gestation to prevent complications such as:

• internal bleeding due to rupture of ovarian tissue;
• complete removal of the gonad;
• onset of infertility;
• spontaneous abortion.

The reason to contact an obstetrician-gynecologist is any discomfort that manifests itself in the first trimester. This is the only way to establish an ectopic pregnancy at an early stage of its development, when the use of drug therapy is permissible. With late diagnosis and large sizes fetal embryo surgical intervention is prescribed in the ovary. Such measures are fraught with the removal of an organ and suppression of reproductive function.

If the causes of the pathology have not been identified, then even after successful treatment there is always a risk of recurrent miscarriage. The probability of a normal gestation after an ovarian pregnancy is no more than 50%. Among the remaining 50%, relapses and infertility are observed in approximately the same proportion.

Diagnostic measures

During a clinical visual examination of the expectant mother, the deviation can be determined through a bimanual digital examination. If a pathology is suspected, the patient is prescribed a set of procedures:

1. blood test for hCG, which will demonstrate increased concentration hormones that do not correspond to the duration of pregnancy;
2. performing an ultrasound, which is not very informative, since it does not always reveal the fertilized egg in the ovarian cavity;
3. Laparoscopy is a minimally invasive method that allows you to see the body of the fetus and establish the correct diagnosis.

Laparoscopic examination of the uterus and reproductive organs is the most accurate tool for diagnosing ectopic pregnancy.

Therapeutic techniques

Drug treatment is successfully implemented using the drug "". This scheme is allowed for use only when positive results ultrasound examination, according to which the diameter of the ovum should not exceed 3.5 mm.

In all other cases it is prescribed surgery by laparoscopic method:

1. wedge resection, in which small incisions are made on the surface of the ovary and the embryo is removed;
2. unilateral oophorectomy, in which the affected ovary is subject to irreversible removal without the possibility of restoration.

The most preferable option is to preserve the ovary, since reproductive function will return after a long rehabilitation period.

Prices for services

Name of service	Moscow		Saint Petersburg
	Multidisciplinary clinic "Miracle Doctor"	DKB named after Semashko	St. Petersburg State Budgetary Healthcare Institution "Center for Family Planning and Reproduction"	St. Petersburg State Budgetary Healthcare Institution Hospital of St. George
Laparoscopic wedge resection	from 18,700 to 29,700 rub.	from 10300 to 15500 rub.	from 23,000 rub.	from 17,000 rub.
Laparoscopic oophorectomy	from 18,700 to 30,800 rub.	from 15170 to 17640 rub.	from 23,000 rub.	from 16,000 rub.

The cost of such operations in Russian regions may be 10-15% lower.

You can see what the process of diagnosis and subsequent removal of the embryo from the right ovary using a laparoscopic method looks like in the video.

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Ectopic pregnancy in the ovary refers to pathologies in which the fertilized egg is implanted not in the uterus, but in the cavity of the follicle. This type of ectopic pregnancy is rare and is diagnosed in only one percent of patients with improper attachment of the fertilized egg.

Causes of ovarian pregnancy

An ovarian ectopic pregnancy occurs when the egg does not have time to release from the follicle and leave the ovary. In this case, the ovary remaining in the follicle is fertilized by sperm. The development of the embryo in this case occurs in the ovary, since the egg is not able to move further. The reasons for this pathology may be different. According to research and medical observations, fixation of a fertilized egg in the ovary is possible in the following cases:

1. Transferred infectious disease in uterine tissues or inflammation of the endometrium.
2. Colds affecting the genitals;
3. A previous operation performed on the genitals or pelvic organs.
4. Endocrine or genetic nature, provoking changes in the girl’s body.
5. The presence of polycystic or cystic formations in the ovaries.
6. The use of potent medications used to treat complex diseases.
7. Acquired or congenital underdevelopment of the ovary.
8. Unsuccessful therapy aimed at treating infertility.

In some cases, ovarian pregnancy occurred without any obvious reason.

How to independently determine ovarian pregnancy?

Can the ovaries hurt in the early stages during pregnancy if the fetus develops outside the uterus? Symptoms and signs of ovarian pregnancy in the early stages are almost never obvious. The process of embryo development in this case proceeds in the same way as during the natural attachment of the embryo in the uterus. As in the case normal pregnancy, women with this pathology feel the baby moving at a later stage. This is possible due to the fact that ovarian tissue has an elastic structure and has the ability to stretch to a certain point. However, normal fetal development ends when the size of the embryo becomes too large. This leads to limiting stretching of the walls of the ovary, so the woman begins to feel signs of improper attachment of the fetus, namely, acute pain in the ovary. Symptoms of ovarian pregnancy are easy to determine by:

• the appearance of severe early toxicosis;
• a sharp drop in blood pressure;
• painful bowel movements;
• frequent pre-fainting or fainting conditions;
• development of the mammary glands and their excessive pain;
• prolonged bloody or spotting vaginal discharge;

Note: As well as severe pain in the lower abdomen or pinpoint pain that appears in the place where the embryo develops. This pain sometimes extends to the large intestine and lower back. In this case, attacks can last several minutes or hours. Pain in the lower abdomen is accompanied by nausea, dizziness and general weakness.

As the fetus grows, internal bleeding and increased pain are more likely to occur. Increasing pain often provokes loss of consciousness and painful shock. These symptoms are accompanied elevated temperature. All this points to a break internal organs. To prevent a critical condition, it is recommended to go to the hospital at the first feeling of discomfort for a thorough examination. If symptoms worsen, you should immediately call an ambulance.

Medical diagnostic methods

Ovarian pregnancy is very dangerous for a woman, so she early diagnosis allows you to avoid serious consequences. In any case, it is not possible to save the fetus, but timely detection of this type of ectopic pregnancy increases the patient’s chances of survival. If this diagnosis is not made early, the ovary may burst, causing it to open. heavy bleeding. Therefore, if even slight suspicions of ovarian pregnancy are detected, the woman should be hospitalized immediately. A rupture can be identified by the appearance of a sharp pain in the iliac region. This symptom in most cases occurs four weeks after the delay. However, this does not always happen. In this case, when examined in a chair, the gynecologist will be able to notice the softening of the tissues of the cervix and the uterus itself, which is characteristic of normal pregnancy. The difference lies only in the shade of the tissues, which become bluish when the fetus is fixed in the ovary.

Note: Experienced doctor upon palpation, you will be able to feel the increased size and blurred shape of the ovary on one side. During examination, patients with ovarian pregnancy complain of painful palpation on the side on which the embryo is attached. The size and condition of the uterus in this case do not correspond monthly cycle and delay times.

All this is a reason to conduct an additional and more thorough examination. An accurate diagnosis can only be made through an ultrasound of the genital organs. Such diagnostics allows you to find a fertilized egg and determine the place in which it is attached. This type of ectopic pregnancy also involves the absence of an embryo in the uterus and the presence of fluid or blood clots in the area behind the uterus. Define ectopic conception it is also possible based on the results of the analysis on hCG level. If the level of this hormone does not increase over several days, it means that the embryo has not implanted correctly.

After the delay and confirmation of the conception of the baby, the woman must visit a gynecologist to register. At the same time, in mandatory An ultrasound is prescribed, which makes it possible to exclude at an early stage any pathological deviation from the norm, including the attachment of a fertilized egg in the ovary. It is possible to see an ovarian pregnancy on an ultrasound only if the body of the fertilized egg is visible in the projection of the ovary. An experienced doctor will notice that the embryo is connected to the uterus by the ovarian ligament.

What to do if a pregnancy is detected in the ovary?

It happens that a pregnant woman does not visit a gynecologist and carries the embryo in the ovary until obvious symptoms of the pathology appear. If there are sudden or severe pain, you should consult a doctor as soon as possible or go to the hospital by ambulance. During ovarian pregnancy, regardless of the duration, actions are always aimed at removing the embryo. At a later date it is carried out emergency interruption pregnancy surgically. If pathology is detected in the first weeks after the delay, drug therapy may be prescribed. The gynecologist will select a drug that provokes the death of the embryo. Many medications in this group make it possible to eliminate an incorrectly located embryo without serious consequences for the woman’s body and promote the resorption of tissues that have already formed. The use of such drugs is not dangerous to the health of patients and in most cases does not reduce the chances of conceiving in the future and carrying a baby without problems. Medication interruption ovarian pregnancy is possible only if an ultrasound showed that the size of the ovum does not exceed 3.5 millimeters, and the indications hCG results less than 5000 mIU/ml.

Important! Most often, the use of the drug to terminate an ectopic pregnancy involves the administration of one injection. A woman's first menstruation after such treatment may begin within a few weeks. If it is discovered at a later date that the embryo has attached outside the uterus, the embryo is curetted. Often, the ovary in which it developed is removed along with the fetus.

The most favorable outcome of this pathology is the option when it is possible to preserve the ovary. In this case, the surgeon performs only a partial excision of the organ, which after some time will begin to work again. This method allows women after surgery to conceive a baby without problems.

In more difficult cases When ovarian tissue stretches and bursts due to the fetus developing within it, more serious surgery is required. The surgeon will be forced to perform an oophorectomy, which involves removing the ovary in which the embryo is attached.

Is it possible to avoid ovarian pregnancy?

Not a single woman of childbearing age is insured against ovarian pregnancy, like any other ectopic pregnancy. However, there are some recommendations that can reduce the chance of this pathology occurring. So, you should avoid unprotected sexual relations, which can lead to diseases affecting the reproductive organs. Should be taken regularly gynecological examination and get tested for infections. It is recommended to give up bad habits and unhealthy eating before planning a child. If a woman is found gynecological diseases, after conceiving a baby, it is worth constantly visiting a doctor who can determine in advance the attachment of the embryo outside the uterus.

If, nevertheless, a diagnosis of “ovarian pregnancy” is made, a decision should be made as soon as possible regarding its medication or treatment. surgical termination. This will preserve the reproductive organs and the possibility of becoming pregnant in the future. Self-diagnosis and self-medication in this case are unacceptable, because wasting time can cost a pregnant woman her health, and in the worst case, her life.

What to expect after an ovarian pregnancy?

If, after confirming pregnancy, a woman treats her health responsibly and, at the slightest sign of discomfort, immediately consults a gynecologist, the outcome of an ovarian pregnancy most often turns out to be very favorable. In this case, it is possible to eliminate the embryo developing in the ovary without surgical intervention. This allows you to preserve the woman’s reproductive organs and conceive a child in the future. According to statistics, from 50 to 85 percent of women, after a timely interrupted ectopic pregnancy of this type, were able to carry and give birth to healthy children without problems. In ten to twenty percent of cases, women experience a repeat ovarian pregnancy.

In situations where it was possible to detect the attachment of the embryo in the ovary at a later stage, and the pathology was already accompanied by bleeding, the outcome was not so positive. Many women with untimely detection of such pathology developed serious complications which led to ovarian rupture, infertility or death of the patient. Of course, almost every woman planning to become a mother can experience pregnancy outside the uterus. However, the point is not to prevent such a pathology, but to solve the problem in a timely manner. Therefore, if you feel unwell or have at least the slightest suspicion that the pregnancy is not proceeding correctly, it is better to consult a doctor as quickly as possible.