What is ectopic pregnancy
Where a pregnant egg implants outside the uterine cavity, it is called ectopic pregnancy. According to the location, there are fallopian tube pregnancy, ovarian pregnancy, abdominal pregnancy, cervical pregnancy and so on. The most common sites are in the fallopian tubes, possibly in the cervix, and rarely in the abdominal cavity. Often leads to miscarriage, ruptured fallopian tubes, abdominal pain, vaginal bleeding, and even shock. The usual approach is to remove the fallopian tubes and embryos on the affected side.
Many women who have completed a test tube transplant are afraid that implantation will not be successful, after all, there are too many uncontrollable factors in this process. In fact, it is not only the case of ectopic pregnancy that occurs in natural pregnancy, but also when doing IVF.
Causes of ectopic pregnancy
1. Inflammation of the fallopian tubes
It can be divided into salpingal mucositis and periosalitis, both of which are common causes of tubal pregnancy. Severe tubal mucositis can cause luminal obstruction and lead to infertility, and mild tubal mucosal adhesions and cilia defects, affecting the operation of the fertilized egg and implantation there. Salpingitis caused by gonococcal and Chlamydia trachomatis often involves mucosa, while periosalitis is often caused by miscarriage or postpartum infection.
2. Tubal surgery
If tubal recanalization or fistula is formed after tubal sterilization, it may lead to tubal pregnancy, especially laparoscopic electrocoagulation tubal sterilization and silicone ring sleeve; due to infertility, the incidence of tubal pregnancy is 10% to 20%.
3. Tubal dysplasia or abnormal function
Tubal dysplasia often manifests as excessively long fallopian tubes, poor muscle development, and mucosal cilia deficiency. Others, such as double fallopian tubes, diverticulas, or parawips, can be the cause of tubal pregnancy. If the secretion of estrogen progesterone is abnormal, it can affect the normal operation of the fertilized egg. In addition, psychiatric factors can also cause tubal spasm and abnormal peristalsis, interfering with the transport of fertilized eggs;
4. The fertilized egg wanders
The egg is fertilized in one fallopian tube, and the fertilized egg enters the contralateral fallopian tube through the uterine cavity or abdominal cavity, which is called the fertilized egg wandering. If the migration time is too long, the fertilized egg develops more, and the implantation in the contralateral fallopian tube can form a fallopian pregnancy.
5. Assisted reproductive technology
From early artificial insemination to the current application of commonly used ovulation induction drugs, as well as in vitro fertilization - embryo transfer (1VF - ET) or gamete intrasalping transfer (GIFT), ectopic pregnancies have occurred, and the incidence rate is about 5%, which is higher than the incidence of ectopic pregnancies of general causes. The factors associated with it are preoperative fallopian tube lesions, history of pelvic surgery, technical factors for embryo transfer, the quantity and quality of implanted embryos, hormonal environment, and excessive transfer fluid during embryo transfer.
6. Miscellaneous
Tubal adhesion of the fallopian tubes and tissues around the ovaries due to compression of peripheral tumors, such as uterine fibroids or ovarian tumors, especially endometriosis, can also affect the patency of the fallopian tubes and hinder the operation of the fertilized egg. Some studies have also suggested that defects in the embryo itself, induced abortion, smoking, etc. are also related to the onset of ectopic pregnancy.
Ectopic pregnancy is a common acute abdomen in obstetrics and gynecology, with an incidence of 2% to 3%, and is the leading cause of maternal mortality in the first trimester of pregnancy. In recent years, with the development of medical technology, ectopic pregnancy patients can be diagnosed and treated earlier, and the survival rate and fertility retention ability of patients have been significantly improved.
Symptoms of ectopic pregnancy
There are many symptoms of ectopic pregnancy, typical of which are menopause, abdominal pain, and vaginal bleeding. Worsening symptoms may lead to serious complications such as shock, anemia, peritonitis, and so on.
Early pregnancy reaction: the history of the fallopian tube pregnancy is often a miscarriage or rupture, that is, abdominal pain and vaginal bleeding after menopause.
Vaginal bleeding: the most common symptom is vaginal bleeding around 6 to 8 weeks in the first trimester.
Abdominal pain: secondary infection, the formation of an abscess, may have symptoms of abdominal pain.
Syncope and shock: due to increased intra-abdominal bleeding and severe abdominal pain, fainting occurs in mild cases and hemorrhagic shock occurs in severe cases.
Pelvis and lower abdomen masses
When a fallopian tube pregnancy is miscarried or ruptured, the amount of internal bleeding is large, and a hematoma can form over a long period of time, and a pelvic mass is formed by adhesion with surrounding tissues or organs.
Treatment of ectopic pregnancy
The clinical treatment plan for ectopic pregnancy has been individualized treatment, but different treatment methods have their advantages and limitations, and clinical treatment needs to be formulated according to the patient's gestational weeks, bleeding degree and fertility status. The condition is urgent and requires surgery, and mild symptoms can be treated with medication as appropriate.
Treatment cycle: The treatment cycle of patients with ectopic pregnancy is about one week.
Emergency treatment: ectopic pregnancy rupture, patients with intra-abdominal hemorrhage, shock doctors will timely infuse, blood transfusion, correction of shock and preparation for emergency surgery.
Pharmacotherapy: for ectopic pregnant patients with low blood HCG and small ectopic pregnancy masses, conservative treatment with mifepristone or methotrexate may be an option.
How to avoid ectopic pregnancy?
1. Reduce alcohol consumption
How to avoid ectopic pregnancy? There are many reasons for ectopic pregnancy in women, and current scientific research shows that female alcoholism is an important cause of ectopic pregnancy. Therefore, those female friends who are actively trying to conceive must pay attention to not drinking alcohol or drinking a small amount of alcohol.
2. Do gynecological examinations frequently to avoid gynecological inflammation
The high incidence of gynecological diseases is also an important reason why ectopic pregnancies are common in life. Especially chronic gynecological inflammation, many symptoms are not very obvious, many female friends do not know that they have such diseases. Xiaobian reminds: Women of childbearing age must do gynecological examinations on time to avoid ectopic pregnancy in the future.
3. Women who have had fallopian tubes have been ligated, be wary of ectopic pregnancy
In addition to gynecological diseases, women who have had tubal ligation surgery are also prone to ectopic pregnancy. Because of this type of woman, although through scientific means to restore reproductive function. But the fallopian tubes are narrower than those of the average person. Fertilized eggs are not easy to implant into the uterus, which is easy to cause ectopic pregnancy.
4. Multiple miscarriages, be wary of ectopic pregnancy
We are now in a relatively open social climate, with seventy percent of people having premarital sex. Unintended pregnancies abound. Here Xiaobian reminds everyone that premarital sex must be carefully taken. Miscarriage can cause damage to a woman's body. If there is a history of multiple miscarriages, the probability of ectopic pregnancy is very high.
5. The fertilized egg wanders abnormally, and is treated scientifically
I believe that seeing this, many people will shout wrong, why do I not meet all the above reasons, or ectopic pregnancy? In fact, ectopic pregnancy refers to the situation that the fertilized egg does not fall correctly in the womb, even if it is a normal fertility environment, ectopic pregnancy will occur, but the probability is relatively small. Therefore, ectopic pregnancy must be treated scientifically, as long as you prepare for pregnancy, you can successfully get pregnant next time.
6. Discover ectopic pregnancy and intervene in time
If you have an ectopic pregnancy, it must be timely. Ectopic pregnancy is an abnormal pregnancy and it is impossible for the fetus to survive. In addition, the longer the ectopic pregnancy, the greater the damage to the mother. After finding yourself unfortunately ectopic, do not hesitate to operate immediately.
Precautions for ectopic pregnancy
Scientific contraception, pay attention to sexual health, it is recommended to use condoms.
When intrauterine procedures such as intrauterine devices and abortions are performed, routine procedures and measures to prevent infection should be strictly observed.
Pelvic soft tissue infections should be treated early and cured completely at once.
Aggressive treatment of endometriosis.
After the use of ovulation-inducing drugs, when early pregnancy is suspected, or after successful fertility, ectopic pregnancy and compound pregnancy should be ruled out.