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Ectopic pregnancy
How is an ectopic pregnancy caused?
Ectopic pregnancy refers to the implantation of a fertilized egg outside the uterine cavity. A pregnancy located outside the uterine cavity is commonly known as an ectopic pregnancy. The most common type of ectopic pregnancy is a tubal pregnancy, though less common types include abdominal, ovarian, and cervical pregnancies. How does an ectopic pregnancy occur? Inflammation is the most common cause, as it can lead to adhesions in the fallopian tubes or pelvic area, causing abnormal transport in the fallopian tubes. Additionally, ectopic pregnancies can result from scarring after surgeries, such as pregnancies in cesarean section scars, and from anomalies of the uterus, like pregnancies in a remaining part of the uterus.
Symptoms of ectopic pregnancy
The symptoms of an ectopic pregnancy depend on the location of the implantation of the fertilized egg, whether there has been a rupture or miscarriage, and the amount and duration of bleeding if there has been a rupture or miscarriage. Generally, there may be no symptoms in the early stages. If a miscarriage or rupture occurs, symptoms similar to those of threatened miscarriage or early pregnancy might appear. Typically, the manifestations of ectopic pregnancy include missed periods, usually about six to eight weeks of amenorrhea. The second is abdominal pain, which is the most common symptom in patients with tubal pregnancies, accounting for about 95%. Third, there is a small amount of vaginal bleeding, which does not correlate proportionally with internal bleeding and is generally less than a normal menstrual period. Fourth, fainting and shock can occur if there is significant internal bleeding. Fifth, a mass may be palpable in the abdomen.
Ectopic pregnancy medical conservative treatment
Under normal circumstances, the treatment of ectopic pregnancy is generally divided into conservative treatment and surgical treatment. Conservative treatment is usually applied when the ectopic pregnancy has not ruptured, using medication for about a week. After one week, a follow-up examination is done to check blood HCG levels and an ultrasound scan. If blood HCG levels have dropped significantly, the ultrasound shows that the mass has not grown, and the symptoms of abdominal pain have decreased, it indicates that the conservative treatment was successful. The threat is only considered resolved when blood HCG returns to normal levels. Otherwise, the conservative treatment for ectopic pregnancy may fail, and surgery will be necessary to treat the ectopic pregnancy symptomatically. If there is a particularly large amount of bleeding or a rupture has occurred, surgical treatment is the only option.
What are the symptoms of an ectopic pregnancy?
Ectopic pregnancy initially presents with a lack of menstruation, specifically in women of childbearing age who miss their expected period and then discover they are pregnant. A few days later, they might experience light vaginal bleeding, which is usually scanty and in drips. Additionally, about 95% of affected individuals will feel pain in the lower abdomen, which typically presents as a faint cramping pain before the ectopic pregnancy ruptures. If a rupture occurs, it can lead to very severe, tearing-like intense pain. If the pain leads to internal bleeding, severe cases may result in symptoms of shock.
Can an ectopic pregnancy be carried to term?
Ectopic pregnancy refers to the implantation of a fertilized egg outside the uterine cavity, commonly known as ectopic pregnancy. An ectopic pregnancy is when the pregnancy sac implants outside the uterine cavity. Because the muscle layer outside the uterine cavity is very thin, it restricts the growth of the pregnancy sac during its development. Furthermore, the trophoblast invades the local blood vessels, causing the vessels to rupture and miscarriage to occur very early in the pregnancy, potentially endangering the patient's life. Therefore, an ectopic pregnancy is an abnormal pregnancy that cannot be sustained. If an ectopic pregnancy is detected, it should be treated as early as possible.
Ectopic pregnancy characteristics
Lower unilateral abdominal pain, irregular vaginal bleeding, and even after 50 days of pregnancy, the ultrasound still does not show the gestational sac implanted in the uterine cavity. An ultrasound can be used to understand the size and location of the gestational sac. The symptoms of an ectopic pregnancy are often atypical. Some patients may experience shock due to heavy bleeding, with pale complexion and a drop in blood pressure. It is important to hospitalize timely for the treatment of ectopic pregnancy to prevent life-threatening severe bleeding. In cases of ectopic pregnancy, blood hCG levels may not increase.
How many days can an ectopic pregnancy be detected?
Generally around six weeks after a missed period, an ectopic pregnancy can be detected through an ultrasound examination. For women with regular menstrual cycles, if menstruation is delayed by a week and a pregnancy test shows a positive result, it indicates pregnancy. At this time, it is necessary to visit the hospital for an ultrasound to ascertain the implantation site of the gestational sac. In the case of an ectopic pregnancy, it is normal that no gestational sac is visible within the uterine cavity during an ultrasound. The ultrasound might reveal irregular echo areas in the adnexal area, which includes the fallopian tubes or ovaries, possibly indicating thickened fallopian tubes or enlarged ovaries. At this point, one should be vigilant about the possibility of an ectopic pregnancy and seek timely treatment.
What is the best treatment for ectopic pregnancy?
In cases where an ectopic pregnancy is diagnosed, timely treatment is necessary. Generally, around 50 days into the pregnancy, there is a possibility of the ectopic pregnancy rupturing, so early treatment is crucial. If it is discovered before rupture, conservative treatment can be an option. However, if an ectopic rupture has already occurred, surgical treatment is required. The type of surgery depends on the specific situation; women who wish to preserve their fertility may undergo a salpingostomy, whereas those without fertility needs may undergo salpingectomy.
Ectopic pregnancy signs
Normally, if menstruation does not occur at the expected time and there is irregular, light bleeding, the first step is to go to the hospital for an early pregnancy test. If the test shows two lines, this indicates pregnancy. Pregnancy includes intrauterine pregnancy and ectopic pregnancy. In cases of ectopic pregnancy, there is generally also irregular bleeding and abdominal pain. Therefore, if the early pregnancy test is positive with two lines and there is irregular bleeding and abdominal pain, one must be alert for the occurrence of an ectopic pregnancy. At this time, you can go to the hospital for blood tests to check the HCG levels and progesterone, along with an ultrasound to comprehensively determine the situation. If there is no gestational sac within the uterine cavity and an abnormal mass is found outside the uterus, then hospitalization and appropriate treatment for the ectopic pregnancy are needed.
How is an ectopic pregnancy treated?
The treatment methods for ectopic pregnancy include surgical treatment, medical treatment, and expectant management. Surgical treatment involves surgical intervention, which can be either conservative or radical surgery. Generally, surgery is indicated when blood HCG levels are relatively high, exceeding 3000 units per liter, or when there is a continuous increase. An ultrasound may show ectopic cardiac activity, a large mass, or it may be used when medical treatment is contraindicated, ineffective, or when vital signs are unstable and there is significant internal bleeding. These are indications for surgical treatment of an ectopic pregnancy. Additionally, there are conservative treatments and expectant management. Expectant management involves no medication, just regular monitoring of HCG levels and ultrasound examinations.