Ectopic pregnancy is one of the most serious gynecological diseases, since interruption is accompanied by significant intracavitary hemorrhage and requires emergency care for a woman.
Among the reasons that lead to violations of the transportation of the egg, and as a result of this ectopic pregnancy, the main are the anatomical changes in the tissues of the fallopian tubes, which arise due to inflammatory processes. Inflammation of the mucous membrane, its swelling and the presence of inflammatory exudates cause changes in the function of the fallopian tubes, associated with the appearance of adhesions, adhesions, kinks of the tube, closure of its ampullar end. The defeat of the muscular membrane and changes in the innervation of the tubes lead to disruption of their peristalsis and a delay in the movement of the fertilized egg. Significant anatomical changes in the wall of the fallopian tube or in nearby tissues cause the transferred abortions, surgical interventions on the organs of the small pelvis. Ectopic pregnancy often occurs in women with genital infantilism (squirming and thin tubes slow the progress of the egg), endometriosis, tumors of the uterus and appendages. Increases the risk of ectopic pregnancy using intrauterine contraceptives.
Course of ectopic pregnancy.
After the implantation of the fetal egg in the woman's body, changes begin in normal pregnancy: the yellow body of pregnancy develops in the ovary, a decidual membrane forms in the uterus, under the influence of hormones that produce the ovary, the uterus softens and grows in size, pregnancy. Chorionic gonadotropin is produced, which can be determined by appropriate studies, a positive pregnancy test. The woman has all the signs of pregnancy: nausea, changes in appetite, lack of menstruation.
As the fetal egg grows, the walls of the tube stretch. Vorsic chorion, growing deeper and deeper, cause its destruction. The wall of the fallopian tube can not create favorable conditions for the development of the fetal egg, therefore at 4-7 weeks there is an interruption of the ectopic pregnancy.
Pipe pregnancy is interrupted by the type of rupture of the fallopian tube or by the type of tubal abortion, depending on how the fertilized egg enters the abdominal cavity. When the fallopian tube breaks, its destruction does not occur through its mechanical stretching and rupture, but rather through erosion of the chorionic villi. When interrupting by the type of tubal abortion, detachment of the fetal egg from the walls of the tube occurs and its expulsion into the abdominal cavity through the ampullar end.
Before the appearance of signs of interruption, ectopic pregnancy is diagnosed relatively rarely. The complexity of diagnosis is due to the fact that there are no symptoms that would distinguish it from uterine pregnancy. Sometimes women are concerned about the pain in the lower abdomen.
Difficulties in diagnosis, arise due to the fact that due to the development of the decidual membrane and hypertrophy of the muscle fibers, the uterus continues to increase for some time, although it lags behind the expected pregnancy period.
In some cases, it is possible to diagnose a progressive ectopic pregnancy with ultrasound - there is no embryo in the uterine cavity. Confirm the diagnosis with laparoscopy.
If there is a suspicion of a progressive ectopic pregnancy, an urgent hospitalization of a woman is required for comprehensive examination and follow-up.