Ectopic pregnancy
An ectopic pregnancy is a pathological condition in which a fertilized egg implants and develops outside the uterine cavity, most often in a fallopian tube. Embryo growth can lead to fallopian tube rupture, internal bleeding, and other dangerous complications. The earlier an ectopic pregnancy is detected, the greater the chance of preserving reproductive health. After surgical removal of the fertilized egg, it is important to diagnose and determine the cause of the condition to prevent similar problems in the future.
specialists
equipment
treatment
What is an ectopic pregnancy?
An ectopic tubal pregnancy occurs when a fertilized egg implants outside the uterus. This most commonly occurs in the fallopian tubes, and less commonly in the ovaries, cervix, or abdominal cavity. This condition occurs in 2% of cases and poses a serious threat due to the high risk of internal bleeding.
In rare cases (less than 2%), the embryo can implant in atypical locations, posing a particular risk to the woman's health. An ovarian ectopic pregnancy occurs when fertilization occurs directly within the follicle and is characterized by early bleeding as early as 4-6 weeks. Cervical pregnancies, often associated with previous IVF or cesarean section, are dangerous due to massive bleeding and in most cases require emergency hysterectomy. Abdominal pregnancies are the most difficult to diagnose and can progress to late pregnancy.
Classification of ectopic pregnancy
Ectopic pregnancies are classified into several types, depending on the location of implantation of the fertilized egg outside the cervix. Tubal pregnancies are the most common in our clinic, accounting for approximately 98% of all cases. They are classified by the section of the fallopian tube: ampullary, isthmic, and interstitial. Each type of tubal pregnancy has characteristic clinical manifestations and risk factors.
Less common are atypical forms: cervical, abdominal, and ovarian pregnancies. These variants are particularly severe and carry a high risk of massive bleeding.
Symptoms of an ectopic pregnancy
The following symptoms are typical of an early ectopic pregnancy:
- Delayed menstruation
- Brown vaginal discharge
- Dragging or sharp pain in the lower abdomen
- General signs of pregnancy include nausea, breast swelling, and loss of appetite.
If you notice any unpleasant symptoms, consult a doctor for a comprehensive examination.
Early ectopic pregnancies may present with nonspecific signs similar to those of a normal pregnancy, making diagnosis difficult. However, as the pathological process progresses, the clinical picture becomes more pronounced.
Signs of progressive tubal pregnancy
As the embryo develops in the fallopian tube, the following symptoms appear:
- Constant, intense pain
- Heavy bloody discharge
- Symptoms of internal bleeding: paleness, tachycardia, drop in blood pressure
In cases of progressive tubal pregnancy, a gynecological examination at the clinic may reveal sharp pain when the cervix moves.
Signs of a ruptured fallopian tube
If the tube ruptures (usually between 6-8 weeks), the following symptoms appear:
- Sudden, sharp abdominal pain that can irradiate to the rectum and shoulder
- Massive bleeding into the abdominal cavity
- Symptoms of hemorrhagic shock: cold sweat, loss of consciousness, thready pulse
- Tension of the anterior abdominal wall muscles
Types of ectopic pregnancy
There are 3 types of ectopic pregnancy:
- Abdominal. The egg attaches to the omentum, liver, uterosacral ligaments, or the area between the uterus and rectum. This type of pregnancy increases the risk of severe bleeding and damage to internal organs. The fetus often develops serious birth defects.
- Tubal. The most common form of ectopic pregnancy, in which the egg attaches to the wall of the fallopian tube. Complications include arrest of embryonic development and rupture of the tube with severe bleeding.
- Ovarian. It is detected in less than 1% of all ectopic pathologies. It is accompanied by the attachment of the egg to the ovary, an inflammatory process, and damage to the ovary. There is a high probability of developing peritonitis
In rare cases, cervical pregnancy occurs. It is characterized by the attachment of the egg in the cervix, a high probability of sudden bleeding due to the proximity of large vessels.
The table presents the types of ectopic pregnancy with a description of the features and possible risks.
| Type of pathology | Where the egg is attached | Features | Possible risks |
|---|---|---|---|
| Abdominal |
Organs of the abdominal cavity:
|
|
|
| Tubal | Falling tube |
|
|
| Ovarian |
|
|
|
| Cervical | Cervical canal (cervical canal) | Can be caused by abortions, cesarean sections, or fibroids |
|
General information
Treatment of ectopic pregnancy
If pathology is suspected, the woman must be urgently taken to the hospital. Rupture of the tube and other complications usually occur unexpectedly. Treatment is performed surgically. The method is chosen depending on the patient's condition and the stage of the disease.
- Tubectomy. It is performed when the tube ruptures or is severely stretched. The doctor completely removes the damaged tube along with the fertilized egg
- Tubotomy. If pathology is detected early and the tube is slightly stretched, an incision is made and the embryo is removed. The tube can be preserved
- Laparoscopy. It is performed through small punctures in the abdominal wall, which helps to minimize injuries. During the operation, the fertilized egg and the damaged part of the tube are removed
- Laparotomy. If laparoscopy is not possible due to adhesions, heavy bleeding or obesity, the operation is performed through an incision in the abdominal wall
Laparoscopy reduces the risk of recurrent ectopic pregnancy, speeds up recovery and minimizes trauma after surgery. Women return to their normal lives in 5-7 days.
At the K+31 clinic in Moscow, you can receive qualified assistance with an ectopic pregnancy. Experienced gynecologists accompany patients at all stages of treatment. Call our medical center or make an appointment on the website.
FAQ
How does an ectopic pregnancy affect a woman's ability to have children?
When can you return to training after treatment for an ectopic pregnancy?
What are the main risks for uterine pregnancy?
Does a woman's age affect the likelihood of an ectopic pregnancy?
Yes, it does. Women under 25 have a lower risk of abnormal pregnancy. Between the ages of 30 and 40, the risk increases approximately 2-3 times. After 40, the risk becomes even greater, especially in the presence of pelvic diseases or fallopian tube surgery.
Women over 35 who are planning a pregnancy are recommended to undergo a comprehensive examination, including a tubal patency check, hormonal status assessment, and a consultation with a reproductive specialist.
Our doctors
This award is given to clinics with the highest ratings according to user ratings, a large number of requests from this site, and in the absence of critical violations.
This award is given to clinics with the highest ratings according to user ratings. It means that the place is known, loved, and definitely worth visiting.
The ProDoctors portal collected 500 thousand reviews, compiled a rating of doctors based on them and awarded the best. We are proud that our doctors are among those awarded.
Make an appointment at a convenient time on the nearest date
Price
Other services
Reviews
Appointment to the doctor
Our clinics
Application “Personal Account K+31”
Causes and risk factors of ectopic pregnancy
The main cause is a malfunction of the fallopian tubes. These hollow organs are lined with microscopic villi that help the egg enter the uterus. If their function is impaired, the egg attaches in the wrong place.
The egg's passage into the uterus occurs through the coordinated work of several systems. The villi of the fallopian tube capture the egg after ovulation, while microscopic cilia on the inner surface of the tube create a directed flow of fluid. Simultaneously, muscular contractions of the tube walls gently propel the egg forward.
The above processes are under hormonal control: estrogen increases ciliary activity and tubal contractility, while progesterone has the opposite effect. When this delicate mechanism is disrupted, the egg may become retained in the tube.
Factors that increase the risk:
The risk of ectopic pregnancy is also high in women who have previously had an ectopic pregnancy and in those who use intrauterine contraceptive devices.
Pathogenesis and mechanisms of occurrence
The pathogenesis of ectopic pregnancy is based on a complex disruption of the fallopian tube's transport mechanism. The fertilized egg is retained in the lumen of the tube, where the implantation process into the mucosa begins. The embryonic trophoblast actively penetrates the tube wall, producing proteolytic enzymes that destroy its layers—the mucous, muscular, and serous. As the fertilized egg begins to grow and develop, the tube stretches and thins, which can ultimately lead to rupture with massive bleeding.