Ectopic pregnancy refers to the abnormal pregnancy process in which the fertilized egg implants and develops outside the uterine cavity. If not detected in a timely manner, it can cause very serious consequences. Many women are not aware of the specific hazards and diagnosis and treatment methods of ectopic pregnancy. I hope this article can be helpful.
The hazards of ectopic pregnancy:
1. Miscarriage
Complete miscarriage results in less bleeding, while incomplete miscarriage results in some villi remaining in the fallopian tube. Over a period of time, nourishing cells can continue to invade the fallopian tube wall, causing recurrent bleeding.
2. The occurrence of ectopic pregnancy again
According to surveys, 10% to 15% of women who have experienced ectopic pregnancy before will have another ectopic pregnancy. This means that after removing one fallopian tube, there is still a possibility of ectopic pregnancy occurring in the opposite fallopian tube.
3. Life threatening
About one-third of ectopic pregnancy patients are in a pre shock or shock state upon admission, and the severity of their shock depends on the amount and speed of internal bleeding, which is not proportional to the amount of vaginal bleeding. Once ruptured, a large amount of intra-abdominal bleeding occurs in a very short period of time, and failure to rescue in a timely manner can be life-threatening.
4. Infertility
Ectopic pregnancy can cause infertility, but most women do not directly cause infertility, but rather indirectly. For example, blocked fallopian tubes can lead to ectopic pregnancy, which can cause infertility. Over time, this can cause menstrual disorders in women.
5. rupture
The villi of the fertilized egg erode the muscular layer and serosa of the fallopian tube wall, causing rupture of the fallopian tube, which can damage small arteries and cause acute bleeding.
Diagnosis of ectopic pregnancy: 1. Transvaginal ultrasound examination is the preferred diagnostic method for patients with suspected ectopic pregnancy. Vaginal ultrasound indicates the presence of yolk sac and/or embryo in the accessory area of ectopic pregnancy, which can clearly diagnose ectopic pregnancy.
2. Atypical patients: Continuous transvaginal ultrasound examination and/or serum HCG value measurement can assist in diagnosis.
3. Diagnostic curettage can also be used to distinguish between early intrauterine pregnancy miscarriage and ectopic pregnancy, especially in patients with abnormal uterine manifestations indicated by ultrasound.
The treatment methods for ectopic pregnancy: Surgery is often the main treatment method for ectopic pregnancy, followed by medication.
（1） Surgical treatment: The surgical procedure should be based on the patient's age, fertility status, and the condition of the affected fallopian tube, and conservative surgery such as salpingectomy or preservation of the fallopian tube should be selected.
1. Tubectomy: It is commonly used for older women who do not require fertility preservation or for patients with large fallopian tube ruptures, acute internal bleeding, and concurrent shock. We should actively correct shock and at the same time, operate as soon as possible, stop bleeding quickly, transfuse blood when necessary, correct shock, and perform salpingectomy.
2. Conservative surgery: suitable for young women with fertility requirements. Select the surgical method based on the implantation site of the fertilized egg and the condition of the fallopian tube lesions. However, for those who require conservative surgery before surgery, if it is found to be in the interstitial or isthmus of the fallopian tubes during surgery, it may not be suitable for conservative surgery.
In addition, some cases of ectopic pregnancy are caused by adhesions in the fallopian tubes or pelvic cavity, making it difficult to undergo conservative surgery or tubal resection.
（2） Non surgical treatment: Drug therapy is mainly suitable for patients with early ectopic pregnancy who require fertility preservation. The following conditions should be met: 1. The fallopian tube pregnancy has not ruptured or miscarried. 2. The diameter of the fallopian tube mass is less than 3cm. 3. There is no obvious internal bleeding or bleeding volume less than 100ml, and the blood HCG is less than 2000U/L. 4. There are no abnormalities in liver and kidney function and blood routine.
Systemic or local medication can be used, and currently the commonly used medication is methotrexate, which is a chemotherapy drug. During the drug treatment process, some patients may fail, so B-mode ultrasound and blood HCG should be closely monitored during the treatment period. If the blood HCG decreases and remains negative for 3 consecutive times after 2 weeks of medication, abdominal pain is relieved or disappears, and vaginal bleeding is reduced or stopped, it is considered effective. If the condition worsens or is ineffective, immediate cessation and surgical treatment should be performed.
Ectopic pregnancy is a common gynecological acute abdomen and one of the causes of maternal mortality. Early detection and treatment are key. Once pregnant, if menstruation expires for about 2 weeks or vaginal bleeding or lower abdominal pain occurs, it is necessary to go to the hospital for B-ultrasound in a timely manner. The examination shows ectopic pregnancy, which provides an opportunity for early detection and treatment to avoid shock and death caused by heavy bleeding.