Dr. Zhang of the Obstetrics and Gynecology Department of Xiehe once shared such a story:
One of her college roommates went to the university hospital with stomach pain, but when the doctor consulted, she firmly refused to admit that she had sex, thinking that she had acute gastroenteritis, and finally the fallopian tube ruptured and hemorrhaged, and died in the cold bed of the school hospital.
This story let many women know that there is a "fatal" pregnancy called "ectopic pregnancy", and so far, there are many women who "escape from death" from its clutches.
(Source: Network)
We know that normal embryos should grow in the uterine cavity, and "ectopic pregnancy", as the name suggests, is not grown in the uterus, grown outside the uterus.
In medicine, it has a broader definition called "ectopic pregnancy", as long as the fertilized egg implants outside the proper position of the uterine cavity and can continue the pregnancy, it is an ectopic pregnancy, such as cervical pregnancy, although in the womb, but not the appropriate part of the uterine cavity, so it is ectopic pregnancy, and the risk is very large.
Image source: Stand Cool Helo
Its incidence is about 2% to 3% [1], which means that for every 100 pregnancies, 2-3 ectopic pregnancies will occur.
Among all fatal gynecological diseases, the incidence of ectopic pregnancy is relatively high. Especially more than a month after the holiday (especially Valentine's Day), the hospital will treat many ectopic pregnancy patients.
The most common is tubal pregnancy, accounting for 95%, and others include ovarian pregnancy, intra-abdominal pregnancy, cervical pregnancy, etc. [1].
Because the fallopian tubes are narrow and small, the surrounding blood vessels are abundant, once the embryos of ectopic pregnancy grow up, they "break" the fallopian tubes, which are prone to heavy bleeding and will be fatal when severe.
(Bleeding from rupture of fallopian tubes, source: utah.edu)
After the sperm and egg are combined in the fallopian tubes, they will enter the uterus for 4-5 days by the peristalsis of the fallopian tubes.
If the fallopian tubes are narrowed, blocked, or underpowered, the fertilized egg remains in the fallopian tubes and implants, develops, or falls through the umbel end of the fallopian tubes and is implanted in the ovaries or abdominal cavity, resulting in a more rare and severe "ectopic pregnancy".
Especially these 4 types of women, the risk is higher:
1. Inflammation in or around the lumen of the fallopian tubes (most common)
Having an unclean sex life (such as not wearing a condom) or multiple sexual partners, it is easy to be infected with gonorrhea, Chlamydia trachomatis and other pathogens, and such people are more likely to have abortions, and repeated abortions are prone to uplink infection of the genital tract, resulting in salpingitis. Infections can also occur after childbirth.
2. History of tubal pregnancy or surgery
If you have had a single tubal pregnancy and your fallopian tubes are still present, there is a 10 percent chance of ectopic pregnancy occurring again, and the risk of recurrence rises to more than 25 percent after more than two ectopic pregnancies [2].
Other tubal surgeries, such as sterilization, also increase the risk of ectopic pregnancy.
3. Tubal dysplasia or dysfunction
Long fallopian tubes may prevent the fertilized egg from reaching the uterus within 4 to 5 days. Endocrine disorders or psychiatric factors (anxiety, stress) can cause abnormalities in the "transport function" of the fallopian tubes [1].
4. Miscellaneous
Such as IVF, smoking, endometriosis, emergency contraception failure.
Among the above factors, the first one we can control and master the most is to do a good job in contraception and sexual hygiene, and avoid tubal inflammation caused by infection.
The most typical triple signs of ectopic pregnancy are menopause, abdominal pain, and vaginal bleeding [1].
But in most cases, there are only 1 to 2 of these manifestations, or even no symptoms, such as many people are prone to abnormal vaginal bleeding as menstruation, not realizing that they are pregnant.
Abdominal pain is even more difficult to judge because it is easily confused with acute gastroenteritis, pelvic inflammatory disease, appendicitis, luteal rupture, ovarian cyst twist, etc.
Image source: Stand Cool Helo
Therefore, women who have sex, with or without contraception, as long as they have:
1. The great aunt is late;
2. Bleeding that is different from normal menstruation, such as small amount, different color and previous, long duration, etc.;
3. Abdominal pain: especially lower abdominal pain, with or without nausea, vomiting, strong stool intentions, lower abdomen or bloating sensation.
Any of these 3 symptoms should first determine whether there is pregnancy, because once pregnancy is ruled out, ectopic pregnancy is also excluded, and other diseases are generally not life-threatening.
Don't trust the pregnancy test stick!
During ectopic pregnancy, the blood index of pregnancy is often not high, and the test strip/pregnancy test stick may appear false negative, so the results of the blood test in the hospital are accurate. If pregnancy is confirmed, a ultrasound examination is done next to see if the gestational sac is in the womb or out of the womb. And you must do vaginal ultrasound.
(Source: Network)
Time is key to treating ectopic pregnancies!
If it is found early that the B ultrasound detects that the mass is not large, the blood hCG of pregnancy indicators is not high, you can choose drug embryo killing treatment, and you can also perform fallopian tube windowing embryo removal through laparoscopy (punching a hole of about 1 cm on each side of the umbilical eye and abdomen, and performing minimally invasive surgery).
But if it is found too late and the gestational sac bursts the fallopian tube, the unfortunate fallopian tube can only be removed.
Rarely, uterine damage is severe and there is a possibility of removal of the uterus.
In general, the later the rupture is detected, the more severe the bleeding, and the higher the risk of death. But if effective treatment is obtained before rupture, women rarely die as a result.
Therefore, early detection is really a life recovered!
Finally, Zhimei wants to say that ectopic pregnancy as a major killer of women's health, the incidence is not low, but the risk is extremely high, I hope that Jimei, including everyone's girlfriends, can improve their awareness of medical treatment, seek truth from facts about sexual life history, and do not hide and deceive doctors.
Only in this way can doctors help everyone find and treat early, save lives, and avoid major regrets in life.
Image source: Stand Cool Helo
Review expert: Liu Haifang | deputy chief physician of the Department of Obstetrics and Gynecology of Huashan Hospital affiliated to Fudan University
bibliography
Xie Xing,Kong Beihua,Duan Tao. Journal of Obstetrics and Gynecology (9th Edition).Beijing:People's Medical Publishing House,2018.]
[2] "Chinese Expert Consensus on the Diagnosis and Treatment of Tubal Pregnancy", Cancer Reproduction Branch of Chinese Society of Eugenics, Chinese Journal of Practical Gynecology and Obstetrics, Vol. 35, No. 7, July 2019.
*The content of this article is a popularization of health knowledge and cannot be used as a specific diagnosis and treatment recommendation, nor is it a substitute for face-to-face consultation by a practicing physician, for reference only.
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