develops with the fertilization of the egg in the follicular cavity. This pregnancy is called primary. In some cases, it is an implantation of an already fertilized egg after the pipe abortion, in this case we are talking about secondary ovarian pregnancy. There are several characteristic signs of ovarian pregnancy. First, the uterine tube on the affected side is not changed. A fruit egg is located in the projection of the ovary, which is visible on the ultrasound. Treatment of ovarian pregnancy surgical and comes down to the removal of a fetal egg with a wedge-shaped resection of the ovary. In rare cases, ovariectomy may be necessary, this is when the trofoblast fabric amazes the entire ovarian tissue, visually healthy ovarian fabric is not determined. The ovarian pregnancy is not a risk factor for re-ectopic pregnancy.
In the primary form of abdominal pregnancy - the implantation of the fertilized egg is initially occurs in the abdominal cavity. With a secondary form, the fruit egg turns out to be in the abdominal cavity after the so-called pipe abortion, that is, the primary place of implantation of the trophoblast (fetal egg) was a fallopian tube, namely her fimbrial department. Rarely abdominal pregnancy develops to large terms. In this case, severe complications are possible - massive bleeding due to the detachment of the placenta or damage to the internal organs. Abdominal pregnancy can be suspected if in the early periods of pregnancy. In physical examination, small pieces of the fetus are easily palpable and located separately the uterus of small sizes, usually the size of the uterus does not exceed 8 weeks, with ultrasound, the fruit is visualized separately from the uterus.
In normal pregnancy formation, fertilization occurs in the ampular portion of the uterine pipe (Fig. 1). It was there that the spermatozoa should meet with an egg, which during ovulation transformed and out of the ovary. In the uterine pipe, the processes of crushing the formative embryo come from where it moves to the uterine cavity. At the end of the first week of development, implantation (nidiation) of the embryo into the mucous membrane of the uterus, where the embryo, and then the fruit grows and develops throughout the pregnancy. So the uterine pregnancy is formed.
Ectopic pregnancy - a pregnancy, in which the implantation of the fertilized spermatozoa of the egg occurred not in the uterine cavity (Fig. 2). In 99% of cases, the embryo reservoir is a piping pipe (tubular pregnancy). Implantation is also possible in the ovary, the neck of the uterus, an additional rogue of the uterus, the abdominal cavity, the scar on the uterus and even on the intestine. Rarely, about 1 per 40,000 pregnancies, a heterotopic pregnancy occurs - a combination of uterine and ectopic pregnancy. Approximately 1-2% of all pregnancies, including after Eco, are ectopic.
There are also less obvious reasons, the unambiguous relationship of which with the risk of development of ectopic pregnancy is clearly not established. These include tumors of the uterus and its appendages; anomalies of the development of genital organs; endometriosis; Endocrine disorders.
Factors that reduce the risk of ectopic pregnancy: the use of hormonal contraception or Navy. It is worth debating a steady myth about intrauterine contraceptives (spirals). The use of Navy reduces the risk of both uterine and ectopic pregnancy, but if pregnancy occurs, the likelihood that it will be ectoped, more. However, the absolute risk of ectopic pregnancy in a woman using the Navy is significantly lower compared to a woman who does not use contraception.
Email (ectopic) Pregnancy is one of the most terrible and life-threatening diseases of women of reproductive age. With an ectopic pregnancy, the fruit egg is implanted and begins to develop not in the uterus. Most often, with an ectopic pregnancy, a fruit egg is located in a fallopian tube, however, although extremely rarely, abdominal, ovarian, and cervical forms of ectopic pregnancy are found.
In most cases, previous factors for ectopic pregnancy are previously transferred operations on abdominal organs, inflammatory diseases of the uterus and appendages, abdominal spikes, eco and performed reconstructive operations in the uterine pipes, but sometimes this disease may occur And with absolutely healthy women. Ectopic pregnancy is always an emergency, life-threatening situation, even suspicion of this disease is an indication for immediate hospitalization.
Ectoped pregnancy is not treated and do not observe at home or outpatient. Ectopic pregnancy can not be preserved and ending, early or late the interruption of pregnancy followed by bleeding. Very often at small deadlines, the progressive ectopic pregnancy does not show anything and flows as an ordinary pregnancy.
The diagnosis of progressive ectopic pregnancy is similar to the diagnosis of uterine pregnancy at small timing. It includes a conversation with a patient, finding out the timing of the last normal menstruation, gynecological inspection, execution of the express test of pregnancy, ultrasound of the small pelvis organs, the study of the level of chorionic gonadotropin in serum (V-hgch), etc. When performing a diagnostic algorithm, a professional doctor There will always be suspected the presence of not normal pregnancy and will offer hospitalization.
The symptoms of the interrupted ectopic pregnancy are most often pain in the abdomen, nonypical acyclic blood discharge from sex tract in violation of the menstrual cycle, long delay of the expected menstruation, as well as in severe cases, the appearance of sharp pains in the lower parts of the abdomen with loss of consciousness .
In 29 urban clinical hospital, research and manipulation for the diagnosis of ectopic pregnancy are carried out around the clock. Doctors of our clinic have a tremendous experience of treating this pathology and perform the entire spectrum of operations during ectopic pregnancy. The absolute majority of operational interventions are carried out laparoscopically, if possible with preservation of uterine pipes (Milking, Tubotomy). After the endoscopic operations conducted, there are no rough scars and hospitalization periods rarely exceed 3-4 days.
Ectopic pregnancy happens only in 2-3% of cases, but it carries a serious threat to the reproductive health of a woman and her life. The sooner it is diagnosed and eliminated, the higher the woman has a chance to be successfully pregnant again and give birth to a healthy child.
What is an ectopic pregnancy and what is her symptoms? How do treatment and prevention? The doctor obstetrician-gynecologist of the Higher Category of the Adonis Medical Center, an ultrasonic specialist, a gynecologist-endocrinologist with experience of more than 20 years old, Elena Petrovna Domnichy, answered these and other issues.
- Ectopic pregnancy occurs in the case of an implantation of a fruit egg outside the uterus. It can be gaining in the uterine pipes, in the ovarian area or in the abdominal cavity. Accordingly, tube pregnancy, ovarian and others.
- It is impossible to say for sure that the patient will have an ectopic pregnancy, as well as it is impossible to completely exclude its probability. In the risk group there are women with chronic diseases of the appendages. During their development, certain obstacles appear to promote the fertilized egg to the uterine cavity.
- In the early time, the signs of uterine and ectopic pregnancy does not differ in any way. In both cases, a woman has a latency of menstruation, and a pregnancy test shows a positive result. Also, she can swell the chest, the morning nausea and other symptoms appear.
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