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Ectopic pregnancy

the term used to define implantation of the fetus anywhere outside the normal uterine location.

There are different types depending on where it is located:

  • In the tube (tubal), which is the most frequent form (98%) and, depending on the portion of the tube in which it occurs, we will have: ampullary location (60%), isthmic location (35%) or interstitial location ( 3%)
  • In the ovary (ovarian)
  • In the abdominal (abdominal) cavity
  • On the cervix (cervical)
  • In other locations that are much rarer

The frequency of ectopic pregnancy is 0.6-2% of the total number of deliveries.

Causes of ectopic pregnancy

The causes of ectopic pregnancy cannot be proven in half of the cases.

There are a series of factors that do favor its appearance, among them are:

  1. pelvic inflammatory disease, which is the most important.
  2. tubal surgery.
  3. the failure of some contraceptive techniques, such as tubal sterilization or IUDs.
  4. some treatments to correct infertility, such as ovulation induction using hormones or in vitro fertilization.

Under normal conditions, an egg is fertilized in one of the areas of the fallopian tube (called the ampullary portion), and from there it must be transported to its place of implantation in the uterus. This implantation process occurs on the 6th-7th day after fertilization of the ovum.

In ectopic pregnancy, there is a delay in the transport of the ovum, so it is implanted wherever it is, when those 6-7 days have passed.

Ectopic pregnancy symptoms

The symptoms of an ectopic pregnancy depend on how it progresses.

10% resolve spontaneously and may go unnoticed, but 90% lead to a tubal abortion or tubal rupture, which gives more obvious symptoms and is known as an accident ectopic pregnancy.

Evolving ectopic pregnancy

It is characterized by diffuse abdominal pain, lack of menstruation for 6-8 weeks, initial symptoms of a normal pregnancy (nausea, dizziness, breast tension …) and intermittent vaginal bleeding of little quantity and dark color.

Accident ectopic pregnancy

The most striking symptom is very severe abdominal pain that is accompanied by constant vaginal bleeding.

How is it diagnosed?

The main thing to diagnose an ectopic pregnancy is to suspect its existence due to the symptoms it produces and the presence of factors that favor its appearance (high-risk history). When it is suspected, a physical examination and a series of complementary tests will have to be carried out in order to confirm its existence.

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On physical examination, a vaginal examination is performed, in which the degree of pain is assessed; Sometimes a soft, rounded mass is palpable in the pelvic area, and the uterus is smaller than it would be at this point in pregnancy.

As for the complementary tests, the following should be carried out:

  • Pregnancy test: which shows that the patient is really pregnant, by studying the values ​​of a hormone (ß-HCG).
  • Ultrasound: used to visualize the presence of the fetus outside its usual place, although it can give doubtful images that will have to be confirmed with other tests.
  • Laparoscopy: it is used in doubtful cases since it is a very reliable test, since with it the EE is directly visualized.
  • Uterine curettage: with this test the interior of the uterus is studied under a microscope and very characteristic alterations are observed, known as the Arias-Stella sign.

Treatment of ectopic pregnancy

Routine treatment of EE is surgical and immediate.

Said treatment can be radical or conservative, depending on the patient’s desire to have more children or not and the evolutionary stage of the ectopic pregnancy:

Radical treatment

It consists of a surgical technique called salpingectomy, in which the affected tube is removed. This technique is indicated:

  • when the woman does not want to maintain her fertility
  • when the severity of the bleeding requires urgent intervention
  • when the trunk is badly injured

Conservative treatment

It can be performed using two different surgical techniques: salpingostomy and tubal expression. These techniques are indicated when the woman wishes to maintain her fertility.

In some cases, surgery can represent a risk for the woman, so medical treatment with methotrexate is indicated, which stops the growth of the EE, thus favoring its spontaneous resolution.

How can I avoid it?

As the causes that produce an ectopic pregnancy are not fully proven, the most important thing is to consult your gynecologist when you want to have a child and the woman presents some of the factors that favor its appearance.

Any woman who is pregnant should see her gynecologist as soon as she presents any type of vaginal bleeding or if a very intense abdominal pain appears, so that the doctor can assess it.

Likewise, if it is suspected that you may be pregnant and bleeding of characteristics other than normal menstruation appears, the gynecologist should also be consulted.

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Hello Readers, I am Nikki Bella a Psychology student. I have always been concerned about human behavior and the mental processes that lead us to act and think the way we do. My collaboration as an editor in the psychology area of ​​Well Being Pole has allowed me to investigate further and expand my knowledge in the field of mental health; I have also acquired great knowledge about physical health and well-being, two fundamental bases that are directly related and are part of all mental health.

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