Pregnancy tubal: causes, symptoms, diagnosis and treatment features

One of the most beautiful periods in a woman's life is pregnancy. It is good, if the embryo develops according to the terms in the place established by physiology. But it also happens that the attachment of the fetal egg does not occur where it is prescribed. Then there is a suspicion that the patient had an ectopic pregnancy (tubal, ovarian, abdominal, cervical). One of these types will be presented to you by the article. You will learn what a tube pregnancy is. Causes and symptoms, methods of diagnosis and treatment will be described later.

Mechanism of occurrence and classification of ectopic pregnancy

After the fusion of the male and female gametes (sperm and egg), active division of the formed mass begins. Slowly, but surely the zygote is moving into the uterus. This is where the fetal egg should be fixed, according to the rules of physiology. But this is not always the case.

For certain reasons, the fertilized egg does not enter the uterus, but remains in the fallopian canal. In this case, a tubal pregnancy develops. If the zygote is pushed back, the embryo can attach to the ovary or abdominal cavity. Less often it happens that a fetal egg passes the genital organ and is fixed in the cervical canal (cervical pregnancy).

Pipe pregnancy: causes

In general, ectopic attachment of the fetal egg occurs in two percent of all cases. In this case, a tubal pregnancy occurs in 97% of them. In half the situations, the reasons for this outcome remain unknown. But gynecologists identify risk factors that can lead to the described pathology. Consider them.

• Operations performed on the organs of the abdominal cavity. If a woman has had a surgical intervention earlier, this can lead to the formation of adhesions. These films, in turn, prevent the normal movement of the fertilized cell.
• Incorrectly selected contraception. If you use oral hormonal drugs in an inappropriate dose, then conception can take place, but the embryo will develop incorrectly. Also, a tubal pregnancy can occur when using intrauterine spirals.
• Infectious diseases and inflammation of the pelvis. These pathologies (even in the anamnesis) lead to deformation of reproductive organs, hormonal failure and the formation of adhesions. The fallopian tubes are thinned, the inner villi cease to function correctly.
• Neoplasms. If the uterus is fibroids, polyps or there are cysts of the ovaries, the entire process of conception is violated. Therefore, the probability of attaching the fetal egg outside the cavity of the genital organ is high.
• Anomalies of the genital organs. Often an ectopic (tubal) pregnancy occurs with congenital or acquired pathologies of the pelvic organs (the presence of a septum, adhesions, a bicornic uterus and so on).

Signs of pathology

What are the tubal pregnancy symptoms? This question is of interest to many women. Clinical manifestations are divided into primary and secondary. At first, the symptoms are no different from those that appear in normal pregnancy. But later signs that signal a pathological process are added.

Up to 5-7 weeks, a woman can feel nausea, sometimes it is accompanied by vomiting. There is increased fatigue, drowsiness. There is a delay in menstruation, and a pregnancy test shows a positive result.

With the onset of 4-8 weeks, additional symptoms are added. They must warn the woman and become a reason to call a doctor. Among such manifestations are:

• Pain (pulling sensations in the lower part, giving in the back or leg, surrounding the lumbago);
• Bleeding from the genital tract (most often the secretion is of a smearing nature, they are associated with a decrease in the level of progesterone).

Interrupted tubal pregnancy

Violation of the viability of the embryo can be considered an interruption of pregnancy. In this case, it can have two types:

• Interrupted tubal pregnancy as a tubal abortion;
• Cessation of development of the embryo by the type of rupture of the fallopian tube.

Both conditions are manifested by increased bleeding, pain in the lower abdomen. It should be noted that the rupture of the uterine tube is characterized by acute pain in the abdominal cavity, a decrease in pressure and pulse, pallor of the skin, respiratory distress and fainting. Such a picture is dangerous for life, therefore it requires immediate medical intervention.

Methods for diagnosing ectopic pregnancy

How is the ectopic pregnancy determined by the doctors, tubal abortion? Specialists for a correct diagnosis conduct a number of studies. Among them are the following:

• Gynecological examination. When the patient addresses the described gutters, the doctor first performs palpation on the chair. In this case, the size of the genital organ is noted, the ovaries are probed. In some cases, the doctor can determine the presence of a neoplasm (fetal egg) between the uterus and the ovaries. After such a survey, only a preliminary diagnosis is made, since it is not yet possible to say exactly whether the tube is a pregnancy or other pathology.
• The next stage of diagnosis will be ultrasound. After him, the picture clears up. During the procedure the specialist measures the uterus and ovaries, compares the obtained data with the set day of the cycle. With ectopic pregnancy the genital organ does not correspond to the term of pregnancy. Also, the fetus does not determine the fetal egg. At a period of 7-10 weeks, the doctor can clearly see the location of the embryo.

Diagnosis of tubal abortion is more complicated, it requires careful collection of anamnesis, examination of the patient (objective and vaginal examination, bimanual examination, serum chorionic gonadotropin, ultrasound, laparoscopy). Diagnosis is often required.

Laboratory research

Confirm tubal pregnancy can and with the help of laboratory diagnosis. For this, the patient must donate blood to determine the level of two substances: progesterone and chorionic gonadotropin. In normal pregnancy, these values are constantly increasing, corresponding to the term. If you get values that are less, there is a possibility that the embryo is attached outside the uterine cavity.

To make a reliable diagnosis, you need to re-take the analysis in a few days. Positive dynamics or lack of it will allow us to correctly interpret the situation.

Treatment: is it possible to medication correction?

If tubal pregnancy is confirmed, treatment should begin immediately. It should immediately be said that it is impossible to eliminate pathologies with pills and preparations. Even the means for drug or tablet abortion here will not help. Interruption and elimination of pathologically located fetal eggs is possible only by surgical means. Correction is always under general anesthesia. Currently, doctors use two methods of treating tubal pregnancy: laparotomy and laparoscopy.

Laparotomy surgery

Such intervention is quite difficult to tolerate by patients. The recovery period lasts from two weeks to several months. During the manipulation, the abdominal cavity is cut by layer. After this, ectopic pregnancy is corrected.

During a laparotomy, a tubectomy is often performed. In other words, the affected fallopian tube is completely excised along with the embryo. After this, the peritoneum toilet is performed, and the wound is sutured in the reverse order.

Gentle method: laparoscopy

The most popular in recent years is laparoscopic surgery. It involves two to four punctures in the abdominal cavity. Laparoscopy allows you to not completely remove the fallopian tube, but only to excise its damaged area. This operation is called pantotomy.

This method is chosen taking into account the age, condition and desires of the patient. Preservation of the uterine tube allows to preserve the childbearing function in the future. However, when repeating an ectopic pregnancy, a complete removal of the fallopian canal is indicated.

Heterotopic pregnancy and its features

It is rare enough, but nevertheless there are cases when a pregnancy tube coincides with normal. In this case, one fetal egg is located as indicated above, and the second - in the uterus.

Possibilities of modern medicine and high qualification of surgeons allow to eliminate pathologically attached embryo with preservation of viability of a normal embryo. Note that the earlier the problem is detected, the greater the chance of a positive outcome.

Consequences of pregnancy developing in the fallopian tube

If you have removed the tubal pregnancy, then it is necessary to conduct drug therapy. It provides for physiotherapy, acupuncture, selection of the right contraceptive methods. Also, a woman needs antibacterial, anti-inflammatory and restorative therapy.

The consequences of pathology can be different: it all depends on the time and method of ending the tubal pregnancy. The probability of normal conception and subsequent delivery is 50%. In 30% of cases, infertility occurs (usually with the repetition of pathology and complete removal of fallopian tubes). The frequency of recurrence of ectopic pregnancy is determined in 20%.

The consequences of pathology include a process of adhesion in the small pelvis, pain, irregular menstrual cycle, hormonal failure, psychological deviations. When re-conception, a woman should be under the close attention of specialists from the very first days of the delay. This will help in time to detect and correct or refute relapse.

Let's sum up the results

If you suspect a tubal pregnancy, you need to contact the gynecologist as soon as possible. The doctor will be able to dispel or confirm your doubts and, if necessary, prescribe a treatment. Remember that during the period of bearing the baby is unacceptably nervous. Therefore, better once again consult with a gynecologist.

If both the fallopian tubes were removed during the treatment (operation), you should not lose hope. Modern medicine allows conceiving a child even in this case. To find out more information about this, you need to visit a gynecologist. All the best to you!