Extra-uterine pregnancy of
About existence of such phenomenon as extra-uterine pregnancy, each woman knows, perhaps. And to keep health and ability to become mother further, each woman has to know about the reasons and symptoms of this dangerous state about which speech will go in this article. >
pregnancyApproximately in the middle of a menstrual cycle from one of ovaries in an abdominal cavity As usual begins
i the ovum is released. This moment is called an ovulation. An ovum - the surprising cage bearing in the structure a half of genes of future child and nutrients which amount is enough for life within several days. Possessing ability to move slowly but surely in the necessary direction, the ovum from an abdominal cavity moves to a uterine tube where usually it also meets spermatozoa (from within the pipe is covered by the cages having eyelashes which vibrating movements help an ovum to move towards a uterus.) . Spermatozoa are very mobile, immediately they by means of the zhgutik slide from a vagina in a uterus further on uterine tubes. In favorable conditions after such meeting the ovum is impregnated. Now, having found a full set of genetic information, it looks for the place for the further development. In most cases the uterus wall appears such place. Its loose inside coating, contains a large amount of water and nutrients, it easily collapses a germ which at implantation plunges into this layer. Besides, exactly there are cages which produce the substances stopping process of penetration of a germ. Vessels of a wall of a uterus are twirled by a spiral therefore they are easily pressed, and thus the bleeding caused by penetration of a germ into a uterus wall stops.
What is extra-uterine pregnancy
In some cases on the way of movement of an ovum obstacles arise, and then it is implanted, or implanted, not into a uterus cavity (the wall of a vessel contains muscle cells; they are reduced that leads to a vessel perezhimaniye.) . This state is also called extra-uterine pregnancy. Statistically, it makes about 1 of 100 developing pregnancies. In most cases (95%) extra-uterine pregnancy develops in a uterine tube, is more rare - in a neck of a uterus, an abdominal cavity or in an ovary, depending on where the ovum stopped and implanted. There are no chances to keep pipe and yaichnikovy pregnancy any. Very seldom, but there are situations when 2 ova are at the same time impregnated, and one of them begins to develop in uterus cavities, and another in other place. Such pregnancy is called geterotopny.What factors can lead
to development of extra-uterine pregnancy? The same which finally exert impact or on an anatomic structure of genitals, or on their normal functioning, or on a condition of the ovum (see the table).
| of |
the Facts promoting development of extra-uterine pregnancy
|Inflammatory processes in a uterus, uterine tubes, an abdominal cavity||Against an inflammation change properties of the mucous, covering a way of advance ovum. Often inflammations are complicated by formation of the solderings interfering normal advance of an ovum.|
|the Previous artificial interruptions of pregnancy||the Scraping of a mucous membrane of a uterus which is carried out at artificial interruption of pregnancy can cause change of its normal structure. Often after abortion inflammatory processes in a uterus and adjacent bodies develop.|
|of Anomaly of development of uterine tubesby||changed a natural way of advance of spermatozoa and an ovum.|
|Surgical interventions on uterine tubesby||changed a natural way of advance of spermatozoa and an ovum.|
|Use as a method of contraception of an intrauterine spiral||Preventing uterine pregnancy, spirals create conditions for development of extra-uterine. In certain cases existence of a foreign matter in a uterus can stimulate inflammatory process.||Is carried out by|
|to the women having various diseases of the gynecologic sphere, leading to the above described consequences.|
|Infertility||To infertility are led by the same reasons which cause extra-uterine pregnancy.|
|Medicamentous stimulation of conception||Changes the physical activity of uterine tubes in normal conditions helping an ovum to move towards a uterus.|
|the Age is more senior than 35 years||To this age, many women get “bunch“ of diseases of the gynecologic sphere. The ova which are formed in ovaries during this period when future mother herself still was in mother`s womb gradually over the years also “grow old“, some of their properties change.|
What extra-uterine pregnancyis dangerous by
Taking root into a wall of a uterine tube, horion a germ gradually destroys it. Besides, the growing fetal egg stretches a pipe more and more. These influences at some moment lead to a rupture of a pipe and severe bleeding. Such pipe will be removed further in the surgical way, and the probability of the subsequent pregnancy decreases. At implantation of the impregnated ovum in any other “not adapted“ for this place - a peritoneum, a uterus neck, - events are developed similarly. Bleeding at cervical pregnancy is especially dangerous: it can be stopped only in one way - removal of a uterus (without appendages). Any bleeding at extra-uterine pregnancy demands immediate surgical intervention.
Diagnostics of extra-uterine pregnancy
Diagnostics of extra-uterine pregnancy, especially at its early stages, is rather difficult. Existence of pregnancy per se can be defined with the help the test - strips, pregnancy, sensitive to hormone availability, in urine. Further it is necessary to be guided on:
- clinical symptoms which can be very different: a delay of periods, pain of different intensity in the bottom of a stomach (the pregnancy accruing in process of development), bloody allocations from a genital tract. Considering difficulties of diagnostics, at all women of childbearing age with uncertain pains in the bottom of a stomach and bloody allocations even without violation of a menstrual cycle it is necessary to exclude suspicion on extra-uterine pregnancy from a genital tract;
- of ultrasonography, especially vaginal. It is possible to suspect extra-uterine pregnancy if result of the research capable to reveal fetal egg in a uterus already on the term of 2,5 - 3 weeks, negative or if in the field of appendages of a uterus volume education is found;
- laboratory diagnostics. Level a beta - subjedinitsa of a horionichesky gonadotrophin in urine (HG) considerably differs at usual and extra-uterine pregnancy. Therefore if conception term is precisely known, it is possible to use this method - that is to make the test of urine on HG.
In critical situations it is often used kuldotsentez - a method at which by means of a special needle availability of blood in an abdominal cavity is defined.
“The gold standard“ of diagnostics in a critical situation is the laparoscopy at which the long thin tube supplied with optical devices by means of which the doctor has an opportunity to examine abdominal organs and, in particular, a condition of uterine tubes is entered into an abdominal cavity through a small opening.
Treatment of extra-uterine pregnancy
Treatment of patients with extra-uterine pregnancy generally surgical. Methods of treatment depend on the term of pregnancy and a stage of a disease. At diagnostics of extra-uterine pregnancy at early stages and in lack of signs of its interruption perhaps laparoscopic removal of fetal egg with preservation of a uterine tube and its function. Interruption of pregnancy is followed by massive bleeding and demands the emergency operation. In case of pipe pregnancy make removal of a uterine tube, in case of yaichnikovy pregnancy delete that part of an ovary (removal of all ovary is required seldom), into which fetal egg was implanted, the interrupted cervical pregnancy as it was already told, can demand removal of a uterus (without appendages), at belly pregnancy operation at which fetal egg is removed is also made.
in principle the method of conservative treatment of extra-uterine pregnancy also when the diagnosis is made early exists and there are no pregnancy interruption signs - a method at which appoint a preparation the methotrexate which is perniciously influencing fetal egg. However this method unsafe, in our country it is applied extremely seldom and only in a hospital under strict control of doctors.
of the Consequence of extra-uterine pregnancy
by results of the conducted researches, the probability of repetition of extra-uterine pregnancy after preservation of a pipe is slightly higher, than after its removal. However doctors prefer to leave the damaged pipe because the probability of repeated pregnancy at preservation of two pipes is much higher and therefore that after repeated extra-uterine pregnancies with removal of a pipe pregnancy can come only after extracorporal fertilization.
Emotional problems after interruption of pregnancy can pursue the woman much longer, than physical. Consult to the doctor how it is better to support and restore the physical and mental health.