Variants of tubal pregnancy

Ectopic pregnancy is a formidable gynecological diseases. Surgeons like to say that appendicitis - a monkey all diseases. If a little pereinachit surgical expression, we can say, "Ectopic pregnancy - a monkey all diseases." This is due to the fact that rarely suspected, and to diagnose ectopic pregnancy in the early stages, and it flows, often atypical, without the characteristic of classical features.

An ectopic (ectopic) pregnancy - a pregnancy that develops outside the uterus. Normally, the fusion of sperm and egg occurs in the fallopian tube, then the fertilized egg moves into the uterus, where it is implanted (attached). In the presence of certain factors, this process is disrupted, and the egg is implanted in the mother (usually) pipe.

Tubal (ectopic) pregnancy may occur in three forms:

• progressing ectopic pregnancy;
• ectopic pregnancy and stopped by type of tubal abortion Abortion - is always a risk ;
• ectopic pregnancy and stopped on the type of pipe rupture.

The progressive tubal pregnancy

Progressive tubal pregnancy is very difficult to suspect. Signs of it a little different than the normal uterine pregnancy. There is a delay in menstruation, usually no more than four - five weeks, breast engorgement, are present early signs of toxicity Toxicosis: expectant mothers as interesting   (nausea, vomiting, lack of appetite), and vaginal study determined cyanosis cervix and vagina, softening and a slight increase in the size of the uterus. May include the small nagging pains in the abdomen, the doctor usually suggests an incorrect idea of ​​threatened abortion. But, sooner or later, an ectopic pregnancy is terminated on the type of tubal abortion or a rupture of the pipe.

Ectopic pregnancy and stopped by type of tubal abortion

Since the fallopian tube is not designed for the carrying of a pregnancy, the development and growth of the ovum fallopian tube trying to push him off .  It may continue long enough for two - four weeks, manifesting bouts of pain and alternated with periods of full health .  The attack tubal abortion is accompanied by pulling or sharp pain in the abdomen, often on the affected side, aching pain in the lower back, and possibly mild or spotting .  The pain may radiate to the supraclavicular region, in the lower limb, in the rectum, and upper quadrant .  After stopping the attack a woman may feel quite healthy .  The general analysis of blood marked increase in anemia (due to the internal, and, rarely, external bleeding) .  There may be signs of intra-abdominal bleeding: weakness, dizziness, shortness of breath and heart rate, lower blood pressure .  In some cases joins subfebrile temperature (not more than 38 degrees) .

Ectopic pregnancy is interrupted for the type of pipe rupture

Rupture of the pipe - this is the most difficult and dangerous state of ectopic pregnancy. Usually fallopian tube breaks due to its distension, for up to ten weeks. The longer the pregnancy, the more massive and dangerous internal bleeding at rupture of the pipe. The patient noted a sharp cutting pain in the abdomen, pain in the upper quadrant gives clear, over-and subclavian area, rectum and a leg. Increasing signs of hemorrhagic shock due to internal bleeding intraperitoneal (dyspnea, tachycardia, pale skin, a sharp drop in blood pressure, loss of consciousness up to the darkening of the eyes, increased sweating). In the peripheral blood revealed a significant decrease in hemoglobin and red blood cells. Also present external spotting or moderate bleeding as a result of the rejection of endometrial decidua.

Diagnostics

The diagnosis of ectopic pregnancy is placed on the basis of complaints, anamnesis (inflammatory diseases of appendages, hormonal disorders Hormonal disorders: causes and the most frequent disease , Sexual infantilism) and pelvic exam. When vaginal examination revealed signs of pregnancy (cyanosis cervix), enlarged uterus and soft, but its size does not correspond to the expected term of the pregnancy, from the appendages is determined by soft, painful education, rear vaginal vault flattened or bulges (pozadimatochnaya hematoma). When ultrasound is determined by the absence of the ovum in the uterus, increasing the appendages, or even the presence of gestational sac, blood clots behind the uterus. In difficult cases, resorting to puncture the posterior fornix of the vagina, through which a dark clotted blood.

Anna Sozinova

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