Ectopic pregnancy is called, whichdevelops not in the uterine cavity. Most often this pregnancy develops in the fallopian tubes (in most cases in the right tube), the abdominal, ovarian and developed in the rudimentary horn of the uterus is much less common. The total frequency of such pathologies among all gynecological diseases is up to 4.4%.
The fertilized egg (trophoblast) secretesEnzymes that promote its introduction into the uterine mucosa. Usually this moment coincides with the time of trophoblast entering the uterine cavity. The fact that a fetal egg is introduced into the mucosa is not in the uterine cavity, two reasons may contribute. The first is the early onset of enzyme isolation. The second and most common cause is the retention of the fetal egg due to a decrease in peristalsis of the tubes, the presence of mechanical obstacles (adhesive process, deformation of the fallopian tubes, etc.).
Fat egg with tubal pathology is immersed inmucous tube and directly in contact with the muscle shell, which although hypertrophied, but completely all the needs of the fetus can not provide. Such a pregnancy is sooner or later interrupted. Interruption can occur by the type of rupture of a pipe or tubal miscarriage.
With its progression, signs of an ectopicpregnancy do not differ from the uterine: nausea, vomiting, changes in appetite, bluish color of the vaginal mucosa, enlargement and softening of the uterus, engorgement of the mammary glands and with pressure on the nipples discharge of colostrum, cessation of menstruation. Also, signs of ectopic pregnancy include mismatch of the size of the uterus to the expected duration of pregnancy, the preservation of the usual pear-shaped shape of the uterus, the presence in the region of the appendages of tumor-like formation of the testic consistency. In very rare cases, an ectopic pregnancy can reach a longer period, in such cases it is possible to determine the parts of the fetus, its movements, listen to the heartbeat, and the first signs of an ectopic pregnancy are not determined.
It is very important not to miss the main signs of ectopic pregnancy, because spontaneous interruption of it - a rupture of the pipe or a tubal miscarriage, represents a real danger to a woman's life.
The rupture of the tube is acute with a bright clinicalsymptomatology: vomiting, weakness, fainting, dizziness, sharp cramping pain, which is detected in one of the ileal regions and can be given to the shoulder or shoulder blade. As a rule, after pains there is a feeling of pressure on the rectum. An objective examination determines the patient's serious condition, cyanosis of the lips, pallor of the skin, cold sweat, frequent and weak filling of the pulse, blood pressure is lowered and continues to fall. Pain in the lower abdomen is not as pronounced when lying down. The abdomen will subjugate, painful on palpation, usually from the side of the ruptured tube. Body temperature does not usually change.
Interruption of ectopic pregnancy bytubal miscarriage is not so violent and it is characterized by a blurred clinical picture. Some women show signs of acute intra-abdominal bleeding, in others, on the contrary, the symptoms are so meager that it is not easy to identify the disease. Tubal miscarriage occurs quite long, with a weakly pronounced clinic. The condition of the woman remains satisfactory. In 70% of cases, menstruation is delayed (usually up to 7-8 days). There are pains of cramping in the lower parts of the abdomen, more often from the side of the pregnant tube, which gradually increase, and sometimes are accompanied by a fainting condition. The appearance of pain is often associated with physical overstrain, an act of defecation, and sexual intercourse. After a while there appear dark tar-like smearing character bloody discharge from the genital tract, which can last up to three weeks. In some women, the mucous membrane of the uterus can be rejected completely in the form of a so-called "impression". Often women consider such bloody dark discharge as prolonged menstruation, if they coincide in time.
Despite the high prevalenceof this disease, the correct diagnosis can be difficult, because the signs of an ectopic pregnancy are often blurred. However, one should always remember about early signs of ectopic pregnancy: a weak positive or positive pregnancy test, a violation of menstrual function, absence of pregnancy in the uterus according to ultrasound, subjective feelings of a woman's pregnancy, mismatch of the size of the uterus to the probable period of pregnancy, the presence of education or pastoznosti in the appendages, stomach.