We speak of ectopic pregnancy when the fertilized egg implants itself outside the uterus. Ectopic pregnancies usually occur in a fallopian tube (hence referred to as tubal pregnancies). The egg may lodge itself in the ovary and, rarely, in the cervical canal or the abdominal or pelvic cavities. In general, the fertilized egg does not reach the form of an embryo and it can not be transplanted into the uterus.
In the case of a normal pregnancy, the egg is fertilized in the fallopian tube. Small hairs in the walls of the tube, propelling the egg into the uterus, where it can take hold. If the fallopian tube scar tissue or if for some other reason, it is blocked, the fetus will grow outside the uterus. An ectopic pregnancy must be terminated because the fetus can develop normally outside the uterus and this represents a danger to the health of women.
Although they're becoming more common in recent years, ectopic pregnancies are generally rare. Approximately 2% of pregnant women have an ectopic pregnancy.
Causes
If you had an infection in the pelvic region (eg. Pelvic inflammatory disease), so have had pelvic surgery or if you are born with a congenital condition that narrowed your fallopian tubes, the risks that you have a pregnancy Ectopic increased. A history of ectopic pregnancy can also increase the risk of a second pregnancy of this type. An unsuccessful tubal ligation - a sterilization technique by which the fallopian tubes are cut or blocked - can be risky for ectopic pregnancy.
The ectopic pregnancies were also associated with pills containing only progesterone and in the morning after pill. Women who use an intrauterine device (IUD, a kind of birth control), especially if it contains estrogen, more likely to have an ectopic pregnancy if they become pregnant despite using the IUD. Women who were exposed in utero to a drug called diethylstilbestrol (a synthetic estrogen) are also at greater risk of ectopic pregnancy.
The use of certain assisted reproduction techniques may also increase the risk of ectopic pregnancy, and having multiple sexual partners and smoking.
Symptoms and Complications
Irregular vaginal bleeding or a missed period can be a sign an ectopic pregnancy, although some women with an ectopic pregnancy continue to menstruate. Most ectopic pregnancies are diagnosed before the woman knows she is pregnant.
The developing fetus may damage or rupture the tissue around the reproductive organs, causing internal bleeding and severe pain. If the cell becomes too large in gestation, it may damage the walls of the fallopian tube. The bleeding that results can be painful and create a feeling of overflow in the abdomen. Severe bleeding can cause a voltage drop resulting in symptoms of shock, including paleness, sweating, weakness and fainting.
In general, the ectopic pregnancy ruptures the wall of the fallopian tube between the sixth and eighth weeks after last menstrual period. An ectopic pregnancy that implants partly in the fallopian tube and partly in the uterus usually in principle a break later, between the 12th and 16th weeks of pregnancy. A woman who suffered a rupture of the fallopian tube feels intense pain that comes on suddenly and most of the time, she fainted because of the significant internal bleeding triggered in the abdomen. A rupture that occurs later in pregnancy is extremely dangerous and can be fatal.
Diagnosis
The doctor will perform a pelvic examination, blood tests and an ultrasound to determine if it is an ectopic pregnancy. If your blood samples or urine indicates that you are pregnant but your uterus is not growing, you can suspect an ectopic pregnancy. Blood tests revealed low levels of human chorionic gonadotropin (CG), or increasing slower than normal, may foreshadow an ectopic pregnancy.
This is followed by an ultrasound to see if the uterus is empty. Ultrasound may also show blood in the abdominal and pelvic cavities. A fiber-optic tube, attached to a camera called laparoscope and (or laparoscope) is inserted into the abdomen to allow the doctor to look inside the uterus. In rare cases, a procedure called culdocentesis is performed to check for abnormal fluid in the back of the uterus.
Treatment and Prevention
If an ectopic pregnancy occurs, the physician must remove the fetus and placenta of the fallopian tube, or the area where it operates. The procedure is done by the administration of methotrexate or by laparoscopy (laparoscopic surgery).
Methotrexate is used to treat tubal pregnancy in its early stages, where the risk of rupture is considered low. He interrupts the subdivision of cells that are reabsorbed.
Laparoscopy is also used as treatment to stop an ectopic pregnancy, if the health of the woman is unstable, if there is a reason for not using methotrexate, or in the case of an ectopic pregnancy non-uterine tubal, pregnancy tubal eventually exceeded, or tubal pregnancy with a significant risk of rupture. During this procedure, the doctor inserts a thin tube into the abdominal cavity. This tube has a camera and surgical instruments are attached.
If the pregnancy develops in the fallopian tube, it will be cut and allowed to heal naturally to avoid scar tissue due to injury from blocking the fallopian tube. It will be harder for a woman to have a baby if the fallopian tube is blocked. In some rare cases, the fallopian tube should be removed because the ectopic pregnancy has deteriorated. A woman who no longer has one fallopian tube can still become pregnant. If the patient has bled a lot, a blood transfusion may be necessary.
Although it is impossible to prevent all forms of ectopic pregnancy, there are few ways to reduce the risk of tubal pregnancy (ectopic pregnancy that occurs in the fallopian tube), the most common type of pregnancy ectopic. Pelvic inflammatory disease (PID) and sexually transmitted infections (STIs) are common causes of tubal ectopic pregnancy. Both are preventable. Ask your doctor about ways to reduce the risk of SIP and STIs as condom use and prompt treatment of any genital infection it, stomach or bladder .