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Ectopic pregnancy- The term ectopic pregnancy is used when the fertilized egg does not implant in the lining of the uterus, but in the fallopian tube, for example. About 1-2% of all pregnant women have this risk. Often, the fertilized egg also gets lost in the muscles or entrance of the uterus, in the ovary, or even in the abdominal cavity of the mom.
As soon as it is determined that it is an ectopic pregnancy, not only does the risk increase for the woman to have another ectopic pregnancy, but she is also very likely to lose her baby and must be treated surgically. Since the female body behaves in an ectopic pregnancy as in an ordinary pregnancy, typical symptoms are good detection signs to rule out an ectopic pregnancy. Above all, the usual signs of pregnancy can reveal an ectopic pregnancy and prevent the worst.
How An Ectopic Pregnancy Occurs
If ovulation occurs, the mature egg moves through the fallopian tube. This consists of small hairs, called cilia, which move in favor of the egg and facilitate its journey to the uterus. Since the fallopian tube also performs movements, also called tubal peristalsis, the movements of the cilia are supported. However, if the path is disturbed by various impacts, the fertilized egg can also implant in the fallopian tube instead of in the uterus, as it should.
The reason for this can be a narrowing or displacement of the fallopian tube so that the path to the uterus is not possible for the egg. These disorders can be caused, for example, by inflammation of the fallopian tube. Adhesions caused by appendicitis, for example, can also contribute to narrowing of the abdominal cavity or the fallopian tube. The organs may be kinked or damaged from previous surgery. Tumors on the fallopian tube or uterus can also block the way, and they don’t even have to be malignant, pressing on the fallopian tube and uterus from the outside.
Thus, an ectopic pregnancy can result from this disorder. If the tubal peristalsis, movement of the fallopian tube, is altered by the secretion of the corpus luteum hormone, the egg can get lost and implant in the fallopian tube. If a woman, despite successful fertilization, takes the mini-pill, or even the morning-after pill, it can lead to dysfunctions that promote an ectopic pregnancy.
Women who cannot get pregnant and want to promote pregnancy through hormonal treatments are often affected by an ectopic pregnancy. It can also be seen that women over the age of 30 are more prone to extrauterine pregnancy than younger women. The reason for this is hormones. If a woman has had an ectopic pregnancy, the risk increases to 15 to 20 percent of having another one. After the second, the risk rises to as much as 70 percent.
Possible Ectopic Pregnancy
Because the fallopian tube is made up of several parts, there can be different courses. The narrower part of the fallopian tube is also called the isthmus, and about 25% of ectopic pregnancies occur here. About 65% occur in the ampulla and the rest in other zones of the fallopian tube. The fertilized egg can implant in the fallopian tube, mostly in the ampulla, and also stay there for up to eight weeks. In most cases, it cannot grow any further and abortion occurs.
This is called a tubal abortion. This is also the most common variant, whereby the fertilized egg settles in the ampulla and is rejected and excreted after some time due to the lack of space. Since other complications can also occur in an ectopic pregnancy, an ectopic pregnancy is treated in any case. If the fertilized egg nests in the narrower part of the fallopian tube, the isthmus, the fallopian tube could rupture and tubal rupture would occur.
Life-threatening bleeding is the result in most cases. It is very rare for a baby to develop in the fallopian tube and for actual delivery to occur. In most cases, the mother or the baby dies at birth. If at the beginning of the 20th century many women still died as a result of an ectopic pregnancy, treatment is possible in our time and prevents the worst because of good early medical diagnosis.
Symptoms Of Ectopic Pregnancy
Since the female body also reacts in ectopic pregnancy, as in usual pregnancy, the same symptoms often appear. The menstrual period may be absent, there may be a pain in the abdomen or even bleeding. However, these are not uncommon even in a pregnancy that progresses normally.
The pregnancy is first detected by a beta-hCG test (urine or blood). Subsequently, a major screening examination is carried out at an early stage of the pregnancy, which also includes an ultrasound. This takes place from the 8th SSW to the 12th SSW.
Alternatively, a diagnosis is also made via curettage. Since most women suspect a pregnancy quite early, the gynecologist can detect an ectopic pregnancy very early. For example, if he sees no signs in the uterus of pregnancy despite a high beta-hCG level, he can determine ectopic pregnancy by means of further tests.
Signs Of Ectopic Pregnancy
If an ectopic pregnancy abortion occurs, various signs appear. In most cases, there is no menstruation for a longer break, as the body reacts as it does in an ordinary pregnancy. As the space in the fallopian tube then becomes too small for the embryo, it is rejected. This results in bleeding. Severe abdominal pain, due to the distension caused by the accumulated blood around fallopian tubes, is another sign that it is an ectopic pregnancy.
Once the embryo moves into the abdomen for expulsion, many women experience cramping pain, which can also be like contractions. About 5% of all ectopic pregnancies can be fatal, as women can bleed to death within minutes. Often, mothers arrive at the hospital too late, their circulation is unstable and they are already in shock due to anemia. If there are clear signs that it is an ectopic pregnancy, the woman is monitored in a hospital to prevent the worst. In most cases, it is enough to treat it with medication. Operations are very rare in our time.