An ectopic pregnancy is an abnormal pregnancy that poses a serious threat to a woman's health and requires emergency medical attention. In this case, the fertilized egg develops outside the uterus. Most often it is fixed in the fallopian tube, but there are cases of its localization in the ovaries or in the abdominal cavity.

According to statistics, 1-2% of all pregnancies, including those resulting from artificial insemination, are ectopic. The risk of this pathology increases in more mature women over 35 years of age. In view of this, representatives of the fair sex who are of reproductive age are often interested in whether an ectopic pregnancy is visible on an ultrasound?

Options for ectopic pregnancy

According to the location of the fertilized egg, ectopic pregnancy can be divided into the following types:

• Pipe arrangement. The sperm reaches the egg in the fallopian tubes, but due to the obstruction of the tubes, the embryo cannot penetrate the uterus. As a result, tubal rupture may occur or urgent termination of pregnancy may be indicated.
• Location in the ovary. Fertilization occurs before the egg leaves the follicle or the sperm reaches the newly ejected female reproductive cell, which immediately attaches to the ovary. As a result, ovarian apoplexy may occur or the embryo may be removed in a timely manner.
• Cervical attachment is a rare pathology that is very easily diagnosed. When examined, the uterus is shaped like an hourglass. The fetus can be found in the lumen. The prognosis is unfavorable - sometimes, to save the patient’s life, they resort to hysterectomy.
• Location of the embryo in the peritoneum. This pathology occurs even less frequently, when a fertilized egg accidentally enters the abdominal cavity, implants and begins to develop. Or it may break off from the fallopian tube and travel into the peritoneal cavity.

Heterotopic pregnancy is extremely rarely diagnosed. It represents the coexistence of intrauterine and ectopic pregnancy.

When should you sound the alarm?

Signs of an ectopic pregnancy are important information for any woman. Among the primary ones we can highlight the following:

• delayed menstruation;
• first signs of toxicosis;
• painful mammary glands;
• basal temperature is slightly increased.

These signs will not help much, since they are one to one, just like in intrauterine pregnancy. But there is something that should alert a woman closer to the 4th week of her expected pregnancy:

• The concentration of chronic gonadotropin (hCG) is below the norm typical for this period.
• Standard tests to determine pregnancy do not show a positive result.
• There is copious discharge mixed with blood from the vagina.
• Painful sensations in the area of ​​the uterus and appendages.
• Reduced blood pressure and dizziness.
• Significant increase in body temperature.

A woman who is worried about her health and the future of her baby should certainly go to an antenatal clinic. Already there, the gynecologist may suspect the presence of an ectopic pregnancy in the following cases:

• The size of the uterus is somewhat smaller than it should be at this stage.
• An ultrasound examination did not show the presence of a fertilized egg in the uterus.
• Low hCG levels.
• Painful sensations.

Moreover, if the uterus is smaller than it should be, then the gynecologist may recommend a follow-up examination after 7 days. If then everything remains unchanged, then the woman is sent for an ultrasound and blood donation for hCG. Such symptoms do not always indicate an ectopic pregnancy. We can talk about a complete absence of pregnancy or a frozen pregnancy.

In more than half of the cases, focusing on bleeding or pain, women turn to a specialist before serious complications can arise

Diagnostics

Ultrasound using a transvaginal sensor is the best way to determine the location of the embryo. If the pregnancy test persistently shows 2 stripes, and no fertilized egg is found in the uterus, then they begin to suspect that the embryo is in the ovary or peritoneum.

The question remains relevant: at what stage can an ectopic pregnancy be detected by ultrasound? Some experts claim that this diagnostic method makes it possible to detect the place of attachment of the fertilized egg already on the 20th day of gestation. But still, a more common opinion is that objective information can only be obtained after 30 days.

It happens that a woman comes in very early and it is impossible to physically examine the fertilized egg in the uterus. If there are serious reasons to suspect a pathological pregnancy, then the procedure is repeated after 5-7 days. And it is even more correct in this case to immediately hospitalize the woman and conduct a full medical examination.

During intrauterine pregnancy, an ultrasound examination with a vaginal sensor can show the embryo in the uterine cavity 5 weeks after the onset of a delay in the menstrual cycle. Whereas the fertilized egg can be seen after 14 days.

The ultrasound technique through the anterior abdominal wall is less sensitive. This ultrasound shows an ectopic pregnancy only at 7-8 weeks.

Signs that can be seen on ultrasound

The discovery of a living embryo outside the uterus is an undeniable sign of a pathological pregnancy.

In addition, there are a number of additional signs that help identify such pathology:

• In the area of ​​the fallopian tubes and ovaries, a pathological formation of various shapes and sizes is visualized.
• Despite the presence of the first signs of pregnancy, an embryo is not detected in the uterus.
• The body of the uterus has an increased size or other changes in the muscle layer of this organ, but the picture of a healthy pregnancy is completely absent.
• Enhanced reflection of ultrasound by the inner mucous membrane of the uterus, against the background of the effect of human chorionic gonadotropin on it.
• A false embryo is found in the uterine cavity.
• An accumulation of fluid is detected in the recess of the parietal peritoneum.
• A cyst is discovered, which occurs due to the accumulation of fluid at the site of the burst follicle and can sometimes contain blood.

The ultrasound picture of an ectopic pregnancy may differ in each specific case. Its formation can be influenced by various factors:

• organic changes in the fallopian tubes (obstruction, salpingitis, dropsy);
• formation of cysts at the site of a burst ovary;
• extensive hemorrhages in the abdominal cavity and pelvis;
• close arrangement of loops in the small intestine;
• accumulation of benign uterine tumors.

On the monitor of an ultrasound machine or a photo taken for the patient, you can see a false fertilized egg (there is no embryo inside). To save a woman’s life, an urgent operation is required to remove a fertilized egg from the fallopian tube or other organ.

In this case, there can be no talk of home treatment; timely hospitalization is the key to saving a woman’s life

Inaccuracies and complications

And yet, concerned women are interested in whether an ultrasound will show an ectopic pregnancy in the early stages in all cases? Or are there errors? No one can give a 100% guarantee due to the following reasons:

• Too short a pregnancy does not physically allow one to determine whether there is an embryo in the uterine cavity or not.
• Limited range of ultrasound machine capabilities.
• Imperfection of the equipment used and its possible malfunction.
• The specialist performing the diagnostic procedure did not have sufficient qualifications and experience.

Sometimes an accumulation of fluid or a blood clot in the uterus looks like a fertilized egg and the specialist mistakenly determines intrauterine pregnancy. The woman calms down accordingly, and if the internal bleeding is insignificant, then a pathological pregnancy can proceed hidden for a long time and at the same time not have pronounced symptoms.

A frequent option for further developments is rupture of the fallopian tube. This happens suddenly and is accompanied by the following symptoms:

• A sharp pain is felt in the lower abdomen, mainly on the side where the fertilized egg was attached to the tube. The pain radiates to the rectum area, as well as the right collarbone.
• Often there is a false urge to defecate or loose stools appear. The abdomen is swollen and painful on palpation.
• Decreased blood pressure, severe weakness, even fainting. With severe bleeding, hemorrhagic shock develops.
• Pale skin and mucous membranes, shortness of breath, cold sweat.
• Apathy, lethargy, rapid, weak pulse.

Treatment in this case involves immediate surgery. The damaged fallopian tube is removed laparoscopically, and if hemorrhagic shock occurs, then by performing a laparotomy (open access to the abdominal cavity).

Ultrasound with the introduction of a vaginal sensor is considered the most accurate diagnostic method in determining ectopic pregnancy. But you shouldn’t expect a 100% guarantee from him either. Not in all cases this pathology will be visible and the correct diagnosis will be made. It is advisable to combine ultrasound diagnostics with other methods for greater accuracy.

Is it possible and how to determine an ectopic pregnancy? Doctors often hear this question when seeing patients - according to medical statistics, this pathology occurs with a frequency of 2% of overall indicators.

We’ll talk about pathologies such as ectopic or ectopic pregnancy further.

When an ectopic pregnancy develops, the fertilized egg does not reach the uterine cavity and is implanted on the walls of the fallopian tubes. It is at the attachment site that the future embryo develops.

But such development of the embryo carries a great danger for the patient - tubal abortion or rupture of the fallopian tubes, heavy bleeding and, in the absence of timely intervention from doctors, leads to death.

How to determine an ectopic pregnancy?

How to detect an ectopic pregnancy in the early stages? Doctors note that it can be determined both at home, taking into account certain symptoms, and in a medical facility, after undergoing a series of examinations.

At home

Quite often, in the early stages, even ectopic fetal development will show itself as signs of a normal pregnancy:

1. Increased basal temperature and delayed menstruation.
2. Sensation of swelling of the mammary glands.
3. Attacks of nausea and vomiting, loss of appetite.

When to see a doctor?

When the first symptoms appear, you should not postpone your visit to the clinic, especially when the woman knows about her pregnancy and the slightest deviation from the norm can cause a miscarriage or death for the pregnant woman herself.

Symptoms indicating the need to immediately call an ambulance or see a doctor:

• An attack of acute and piercing pain localized in the lower abdomen, radiating to the leg or lumbar back.
• Heavy bleeding from the vagina.
• Attacks of general weakness and loss of consciousness.

If these symptoms appear, do not wait - seek medical help immediately.

Treating an ectopic pregnancy or trying to save it will not work. The only way out is to terminate the pregnancy and, in the future, to take measures aimed at restoring the woman’s reproductive function.

To prevent ectopic pregnancy, doctors give the following recommendations and advice:

• It is worth practicing only protected sex, with reliable means of contraception, as well as promptly treating all inflammatory diseases and STDs.
• If you are planning a pregnancy, you should undergo a full routine examination with a gynecologist and other specialized doctors, if required.
• If you are planning an abortion, choose low-traumatic methods, in the optimal time frame - up to 8 weeks.

After termination of an ectopic pregnancy, a woman should strictly follow all the doctor’s recommendations:

• Avoid any physical activity and injury, bruises and concussions.
• You should not lift heavy weights, so as not to provoke heavy bleeding.
• For the abdominal type of operation, wear a special bandage or belt for 2-3 weeks.
• A special diet is required - it should be easily digestible food, nutritious and rich in vitamins. But products that provoke fermentation or violent peristalsis in the gastrointestinal tract should be kept to a minimum.
• Hypothermia and drafts should not be allowed during the postoperative period either - this is why it is so important to wear warm underwear in winter.

Often women who have undergone termination of an ectopic pregnancy are interested in planning the next conception and carrying the fetus. The doctor can answer this question after the patient undergoes a course of therapy and a full examination.

In the absence of contraindications or any pathologies, fertilization and gestation can be planned no earlier than a year later.

During this period of time, the woman’s body is completely restored. If during the process of removing the fetus, the tubes themselves were removed from the fallopian tubes, normal conception in this case is impossible, so you can use the help of reproductive medicine and its methods. But again, even in this case, not earlier than in a year.

An ectopic pregnancy is a dangerous condition, and it cannot be saved. But even in the case of diagnosis and its interruption, there is no need to despair. With proper treatment and rehabilitation, a woman has every chance of becoming a mother in the future.

An ectopic pregnancy is an abnormal condition that poses a serious threat to a woman’s life. The normal location of a fertilized egg is the uterus. If fixation occurs in any other place, this is a pathology and requires immediate intervention from doctors. The first signs of an ectopic pregnancy, if known about them, should alert a woman and encourage her to make an appointment with a specialist.

During ovulation, a mature and fully formed egg leaves the ovary. It enters the tube, where the process of direct fertilization occurs. After conception occurs, the zygote migrates into the uterine cavity. This phenomenon is facilitated by measured peristaltic contractions of the fallopian tubes and wave-like swaying of the villi of the mucous membrane.

The journey is long, migration lasts about 3 days. This time is enough for the embryo to form special cells responsible for the secretion of a number of enzymes. With their help, the process of attachment of the formed zygote to the mucous membranes occurs.

If at one of the stages listed above the zygote encounters mechanical or hormonal obstacles, the fertilization algorithm will be disrupted. The main reasons for the development of ectopic pregnancy in the early stages are discussed in the table below.

The development of an ectopic pregnancy can be caused by local tuberculosis or external endometriosis. Moreover, long-term treatment of infertility with hormonal drugs can also cause this specific problem.

Classification of ectopic conditions

Ectopic pregnancy, given its signs and symptoms, is divided into several categories. The classification is conditional, but quite complex.

Types of pathological conditions according to the location of the ovum:

• pipe;
• ovarian (intrafollicular and developing on the surface of the glandular organ);
• abdominal (primary and secondary);
• interligamentous;
• cervical;
• implantation in the rudimentary uterine horn;
• interstitial pregnancy.

According to the stages of the course and how exactly an ectopic pregnancy manifests itself:

• progressive pregnancy;
• interrupted pregnancy;
• interrupted pregnancy.

Signs of an ectopic pregnancy

The early period (5-6th week) does not allow a woman to independently determine whether the pregnancy is ectopic.

Primary signs are typical for everyone:

• delayed pregnancy;
• enlargement of the mammary glands, soreness;
• toxicosis of the first trimester (nausea accompanied by vomiting).

Most often, the diagnosis of ectopic pregnancy is made when the symptoms already indicate the development of a tubal abortion or other termination scenarios. A progressive ectopic pregnancy, in which the fetus develops relatively normally in the initial stages, is established during an ultrasound examination.

At the same time, the diagnostician’s task was not always to search for “traces of pregnancy.” The abnormal location of the ovum is most often discovered during diagnostic measures to identify completely different pathological conditions.

If the pregnancy did not occur in the uterus and was unexpectedly interrupted, the symptoms will be as follows.

1. - the first dangerous sign by which it is possible to recognize various forms of ectopic pregnancy. If the pain is dull and constant, a progressive tubal pregnancy may be suspected. The fetus is growing, and over time it will become too crowded. Every day the risk of pipe rupture will increase. Constant cramping pain radiating to the lower back indicates that a rupture has occurred.
2. The first signs of a progressive ectopic pregnancy, which has already been interrupted, is often associated with specific pain or discomfort in the anus. Women experience unusual pressure, as at the beginning of contractions or before defecation;
3. Bloody issues appear at the moment when the blood from the pipe finds its way out. Small spotting of scarlet, brown, beige color, which cannot be described as menstruation, is a formidable symptom. The woman should consult a doctor immediately;
4. Signs indicating rapid progression internal bleeding, – pallor of the skin, hypotension up to the development of collapse, severe weakness, severe dizziness. There is no time to determine the exact cause of this condition - you must immediately call an ambulance.

If, among other things, the patient develops hyperthermia, which is prone to progression, there is every reason to believe that an inflammatory process has begun in the body. This is a particularly difficult case that requires immediate treatment and long-term rehabilitation.

What will the test show?

When considering the question of what symptoms an ectopic pregnancy gives, what signs in the early stages are characteristic of this condition, it is worth separately considering the nuances associated with the use of the test. This type of fertilization causes a delay in menstruation. In the first expected cycle, there may still be discharge. As a rule, they are scanty and of a specific color. “Pseudo-mentruation” occurs at the wrong time and lasts only a couple of days.

This alarms the woman, since a normal cycle, in any case, cannot look like this. Wary, patients often purchase a pregnancy test.

The test will be positive. However, with ectopic localization of the fetal egg, the second stripe is usually indistinct and blurry. Experts attribute this to the fact that the level is lower if the zygote is attached to the tissues of the tube.

However, there are tests that help to recognize an abnormal pregnancy, as well as assess the risk of pipe rupture. However, in order to purchase and conduct such a specific test, a woman needs to be on alert, distinguishing between normal and abnormal variants of the course of pregnancy.

Sad consequences

The consequences of an ectopic pregnancy include:

• rupture of the tube with subsequent migration of the fertilized egg into the peritoneal cavity;
• termination of an abnormal pregnancy by any other means;
• massive bleeding due to detachment of the fetus from the walls of the appendage;
• bleeding due to actual damage to the pipe, which can be fatal for the woman;
• the development of peritonitis if blood enters the abdominal cavity with the subsequent development of inflammatory processes.

Treatment of patients

Treatment of interrupted abnormal pregnancy is carried out exclusively by salpingectomy. The deformed tube is removed if the gestation period is relatively early. There are two reasons for this:

• stop massive bleeding that cannot be controlled in any other way;
• get rid of an organ that has completely lost its functional potential.

There are laparoscopic and laparotomic surgical procedures. The intervention itself is quite traumatic and requires appropriate qualifications of a doctor.

If the tube has retained its integrity, treatment of an ectopic progressive pregnancy is carried out in other ways. A chemical substance is injected into the fertilized egg for the purpose of subsequent medical sclerosis of the tissue. Then the walls of the tube are excised, followed by removal of the fetus.

The fabrics are carefully sewn up. No specialist can guarantee that the pipe will ultimately retain at least minimal permeability. As for scars and fibrous bands, they form as a natural reaction of the body to surgical interventions.

Rehabilitation and subsequent preparation for pregnancy

All rehabilitation measures are presented below.

1. Immediately after the operation, intensive infusion therapy is prescribed in order to correct the water and electrolyte balance.
2. Antibiotic therapy to prevent a number of postoperative complications.
3. Stabilization of hormonal levels.
4. Contraception from 6 to 12 months after surgery.
5. Prevention of adhesions using enzyme preparations.
6. Physiotherapeutic procedures for general health.

Provided that a woman has at least one tube left with optimal patency, the likelihood of becoming pregnant in the future is quite high. The optimal period for reconception is 1 year after surgery. In general, the prognosis is favorable, but provided that the disease is identified fairly quickly and truly professional assistance is provided.