Ectopic pregnancy treatment
Release time : 01/18/2025 18:13:27
Women who are trying to conceive are most afraid of an ectopic pregnancy.
An ectopic pregnancy is a condition where the fertilized egg fails to reach the uterus and implants elsewhere in the fallopian tube.
The majority of ectopic pregnancies occur within the fallopian tubes, but they can also occur in the ovaries, abdominal cavity, or myometrium.
Considering that the fertilized egg continues to grow and enlarge, the narrow fallopian tube cannot accommodate such a large mass. Eventually, it will burst, causing severe bleeding and even leading to sterility! Abnormal pregnancy should not be overlooked.
Aside from good preventive measures, there are several treatment options for ectopic pregnancy. The treatment of ectopic pregnancy currently has multiple choices, which depend on the reproductive requirements, size and location of the ectopic pregnancy, and the patient's physical condition.
For unmarried individuals, the principle should be to preserve their fertility as much as possible under the premise of saving the patient's life and avoid performing sterilization surgery.
1. Medical treatment for ectopic pregnancy involves the use of medications to kill the embryo, allowing it to be absorbed by the body and eliminating the need for surgery.
If it is definitely a ectopic pregnancy and the embryo is relatively small, hCG is not very high, the doctor may give the pregnant woman methotrexate (MTX) and other anticancer drugs to kill the embryo.
Methotrexate is administered by intramuscular injection, reaching the embryo via blood circulation and inhibiting cell and placental growth to terminate an ectopic pregnancy.
After a period of time, such very small embryos can be absorbed by the body.
The medication may start to take effect at some time during pregnancy, and this may cause some abdominal cramping or bloating, along with possible nausea, vomiting, or diarrhea.
During the medication period, there are many precautions to take: pregnant women should avoid drinking alcohol and having sexual intercourse, and also avoid taking multivitamins or supplements containing folic acid because these substances can affect the effect of amethopterin.
A blood test for human chorionic gonadotropin is still required to determine whether the embryo of an ectopic pregnancy has ultimately died.
Due to the inherent limitations of pharmacological treatment, one potential drawback is that if the medication fails to eradicate the embryo, it could cause the embryo to grow larger and potentially lead to rupture of the fallopian tubes with significant hemorrhage.
Secondly, if a portion of the embryo is killed while another part remains alive, an old embryo will be formed, leading to female infertility.
2. Surgical treatment for ectopic pregnancy may not be suitable if methotrexate is contraindicated in certain situations, such as during lactation, abdominal diseases, or when the gestation has developed to a larger size. In these cases, surgical intervention is necessary to manage ectopic pregnancies.
If the pregnant woman's condition is stable and the embryo is sufficiently small, it can be removed through laparoscopic surgery.
Through this surgery, a miniature camera is inserted through a small incision made near the navel to observe the fallopian tubes. Typically, the fetus or any remaining tissue can be removed while preserving the fallopian tubes.
However, if the damage to the fallopian tubes is severe or there is too much bleeding, it may also involve the removal of the fallopian tubes.
Laparoscopic surgery requires general anesthesia, special equipment, and skilled surgeons to operate these devices. Post-laparotomy, the patient may need approximately one week to recover.
Laparoscopic surgery should not be used in cases where there is a large scar or significant bleeding in the abdominal cavity, and thus an open-abdomen operation is required.
Under anesthesia, the uterus is opened, and the fetus is removed.
Like laparoscopic surgery, the fallopian tubes may be preserved or removed depending on the specific circumstances during the operation.
After about 6 weeks, the recovery can be expected.
During recovery, pregnant women may experience some swelling, abdominal pain, or other discomfort.
How does an ectopic pregnancy occur? After intercourse, sperm and egg meet in the fallopian tubes to form a fertilized egg.
The fertilized egg travels for 7 days before entering the endometrial cavity, known as "implantation," and then develops into a fetus within the uterine cavity.
However, once the fallopian tube becomes inflamed or congested due to certain inflammations or lesions, leading to a narrowing of its "channel" for fertilized eggs, this can cause the fertilized egg to become lodged within the fallopian tube, resulting in pregnancy at an abnormal location.
Some women may also develop a tubal pregnancy due to the delay in the arrival of fertilized eggs to the uterine cavity due to an excessively long or tortuous fallopian tubes, resulting in the embryonic tissue "implanting" within the fallopian tube.
Having undergone tubal ligature surgery can also narrow the fallopian tubes, leading to an ectopic pregnancy.
An ectopic pregnancy can also occur in other areas of a woman's body.
According to clinical statistics, about 90% of all ectopic pregnancies occur in the fallopian tubes, with the remaining symptoms including cervical pregnancy or adnexal pregnancy, myometrial pregnancy, broad ligament pregnancy, abdominal pregnancy, ovarian pregnancy, retroperitoneal pregnancy, and so on.
Therefore, it is referred to as an ectopic pregnancy.
The fertilized egg grows outside the uterus, in organs that are not elastic like the uterus and eventually burst because of the expanding size of the fertilized egg.
Abortion in the early stages is often asymptomatic, making it difficult to detect.
Many patients experience early pregnancy symptoms after cessation of menstruation, such as loss of appetite, nausea, and aversion to food. Some also experience slight vaginal bleeding accompanied by subfertility or an acidic distension in the lower abdomen. This is due to the embryonic growth within the fallopian tubes gradually expanding, causing the tubes to become overly distended.
Some patients experience pain that is not very significant, with a uterus slightly enlarged and soft upon gynecological examination. A mass or softened and thickened area can be palpated, with slight tenderness.
Following an ectopic pregnancy that results in rupture, the disease undergoes a qualitative change.
Patients suddenly feel tearing pain in lower abdomen, which gradually increases in intensity and is accompanied by nausea. This mainly results from the blood flowing into the abdominal cavity after an ectopic pregnancy rupture, stimulating nerves in that area.
Initial hematoma accumulation in the lower abdomen may present with localized abdominal pain accompanied by defecatory sensation. As blood flow increases, the hematoma can fill the abdominal cavity, resulting in generalized abdominal pain. If blood irritates the diaphragm, it can also radiate to the shoulder area, causing pain there. If bleeding continues, syncope and shock may occur.
According to clinical statistics, about 1/3 patients may suffer from hemorrhage due to ectopic pregnancy and collapse, which can lead to shock or pre-shock state when admitted. If not treated in time, it may endanger life. If delayed treatment is also affected by shock, it may affect the brain.
The six major causes of ectopic pregnancy, in recent years, the incidence rate of ectopic pregnancy among women has been rising.
An ectopic pregnancy doubles the risk of pregnancy, a moment could be life-threatening for expectant mothers, and it also leads to the death of the fetus inside.
There are many causes of ectopic pregnancy, six of which are most typical.
Female friends should pay extra attention to their daily lives in order to avoid ectopic pregnancy.
1. I have a history of ectopic pregnancy.
Having an ectopic pregnancy once increases the risk of having another one.
Patients who undergo treatment for an ectopic pregnancy and preserve the fallopian tubes are at a higher risk of recurrent ectopic pregnancies, although these often occur in the contralateral fallopian tube. This suggests that both fallopian tubes may possess a similar underlying functional defect. Patients who have undergone frequent abortions.
Frequent abortions can lead to internal injuries in the uterus, making it difficult for the embryo to implant properly within the uterine cavity and instead may move elsewhere to establish a new home.
Artificial abortion and ectopic pregnancy are definitely related, and the risk of complications is doubled.
The more times an abortion is performed, the greater the risk of ectopic pregnancy.
3. Smoking, drinking alcohol.
The incidence of ectopic pregnancy in married women who smoked and those who did not was investigated. It was found that the incidence of ectopic pregnancy was 1.5 to 4 times higher in smokers than in nonsmokers.
Both tobacco and alcohol can have certain harmful effects on women's health.
Nicotine in tobacco can change the cilia movement of the fallopian tubes.
Additionally, it was discovered that women who consume alcohol over a long period or suddenly consume large amounts of alcohol are more likely to experience stenosis in the fallopian tubes, impaired ciliary movement, and reduced peristalsis within the fallopian tube walls, all of which are detrimental to the successful migration of fertilized egg into the uterus.
4. Fallopian tract issues.
Individuals with acute and chronic salpingitis may experience congestion and edema of the fallopian tube mucosa, resulting in adhesions between folds, narrowing of the lumen, and diminished contractility of the smooth muscle wall. These conditions are unfavorable for the movement of fertilized eggs, potentially leading to ectopic pregnancies.
Individuals with naturally narrow or deformed fallopian tubes are also susceptible to ectopic pregnancy.
5. Ovarian cyst.
Women with uterine fibroids or ovarian cysts may experience displacement of the uterus and fallopian tubes due to the compression of the masses, resulting in morphological changes. These changes can obstruct the normal pathway for fertilized eggs, thus hindering their implantation and causing ectopic pregnancies.
6. Patient with endometriosis.
Endometriosis caused by various reasons, such as retrograde menstruation, is a high-risk factor for ectopic pregnancy.
Especially when the endometriosis is located in the uterine tube interstitium, there is a high likelihood that the fertilized egg will settle here.
Four symptoms of ectopic pregnancy, although not a normal pregnancy, are still part of the fertilization process.
An ectopic pregnancy can also present with early pregnancy symptoms and may be accompanied by some abnormal phenomena.
Pregnant women should accurately understand these symptoms and take early measures.
1. Abnormal menstruation and early pregnancy symptoms can be caused by an ectopic pregnancy obstructing the fallopian tubes, resulting in amenorrhea.
The majority of patients have a brief history of amenorrhea prior to the onset of symptoms, which is usually around 6 weeks.
However, some individuals may confuse pathological bleeding with menstruation due to insufficient luteinizing hormone-releasing hormone (LH) from the villi tissue, or because the condition is diagnosed earlier, they may mistakenly attribute the pathological bleeding to a menstrual cycle.
Pregnant women may experience early pregnancy symptoms such as nausea and vomiting, and a positive pregnancy test can be obtained.
2. Abdominal pain is the most common symptom of an ectopic pregnancy, which is caused by fertilization in the fallopian tubes leading to implantation. Therefore, abdominal pain is a typical sign of an ectopic pregnancy, with an incidence rate of approximately 95%.
Abdominal pain is caused by various factors including ovarian cyst expansion, rupture and blood stimulation to the peritoneum. It often presents as sudden, tearing-type or intermittent pain on one side of the lower abdomen accompanied by nausea and vomiting.
Stimulation of the diaphragm causes radiating pain in the shoulder area. When there is fluid in the pelvis and a sensation of heaviness in the anus with defecation, it can be helpful in diagnosing an ectopic pregnancy.
Patients with ectopic pregnancy can also experience diarrhea symptoms. Without careful analysis of the condition, it is easy to be mistaken for indigestion or intestinal emergency.
3. Following an ectopic pregnancy where the implanted embryo does not develop normally and aborts, irregular vaginal bleeding is often observed.
Most commonly present as small, dark brown spots, with a volume generally less than that of menstruation, and persisting indefinitely.
Vaginal bleeding is caused by the shedding of endometrial tissue or the expulsion of blood from the fallopian tubes through the uterine cavity.
Abdominal pain accompanied by vaginal bleeding often indicates that the embryo is compromised.
Abdominal pain without vaginal bleeding is often due to the continued viability of the embryo or ectopic pregnancy, and should raise suspicion.
4. Nausea and shock occur when fertilized eggs grow and burst the fallopian tubes, causing acute intraperitoneal hemorrhage and intense pain, leading to syncope and shock.
The more the bleeding, the quicker it occurs and the symptoms appear.
This can lead to dizziness, pallor, a thin pulse, hypotension, and sweating, thereby causing syncope and shock.
Tips: 1. Women who have had an ectopic pregnancy once cannot be taken lightly in the event of a subsequent ectopic pregnancy, so they must not be negligent.
2. An ectopic pregnancy that breaks open can have serious consequences.
Therefore, if a woman of childbearing age has a history of early pregnancy loss and exhibits positive urinary pregnancy test results, along with symptoms of lower abdominal pain accompanied by irregular vaginal bleeding, she should be vigilant and alert to the possibility of ectopic pregnancy. It is crucial to seek medical attention promptly without any delay.
Emergency measures for ruptured ectopic pregnancy: Once ruptured, patients of ectopic pregnancy may experience syncope and shock, accompanied by bleeding in the lower body.
Before the ambulance arrives, one should lower their head and elevate their feet to prevent bleeding which can lead to shock.
It's also important to keep things warm with blankets, etc.
Prevention plan of ectopic pregnancy, also called ectopic pregnancy, refers to the implantation and development of fertilized eggs in non-uterine body parts.
Aside from the uterus, a fertilized egg can never develop normally if it implants anywhere else.
When the fertilized egg grows to a certain size, the zona pellucida will spontaneously rupture or burst under the force of external forces, and the blood vessels within the zona pellucida will also bleed.
At this time, the patient often presents with sudden, severe pain in one side of the lower abdomen, and may also experience generalized abdominal pain, even leading to reflexive shoulder pain.
Individuals who have lost a significant amount of blood are often characterized by pallor, tachycardia, and profuse sweating, as well as a drop in blood pressure.
Early symptoms of ectopic pregnancy are often concealed, and most patients only become aware of the condition when sudden severe abdominal pain occurs. However, by this time, the zona pellucida has often already broken or ruptured, necessitating immediate hospital treatment.
In clinical practice, some patients may lose the opportunity for surgery due to a long distance from the hospital or other reasons because of too much intra-abdominal hemorrhage, or severe shock caused by severe pain.
Ectopic pregnancies are indeed a serious condition. How can we prevent them? 1. When pregnant and choosing the right contraceptive method, choose the time when both partners' mood and physical conditions are optimal, to ensure a safe pregnancy.
If you're not planning to get pregnant, it's important to practice contraception.
Good contraception fundamentally eliminates the occurrence of ectopic pregnancies.
2. Timely treatment of gynecological diseases is crucial in preventing ectopic pregnancy, as abnormalities in the fallopian tubes are the primary causes. Inflammation is the primary culprit behind the narrowing of the fallopian tubes. Artificial abortion and other uterine manipulation procedures also increase the likelihood of inflammation and endometrial tissue entering the fallopian tubes, leading to adhesions and strictures within the tubes, thereby increasing the risk of ectopic pregnancies.
Uterine fibroids, endometriosis, and other reproductive system diseases may also alter the morphology and function of the fallopian tubes.
Timely treatment of these diseases can help reduce the occurrence of ectopic pregnancy.
3. If the expectant mother is at a higher risk of ectopic pregnancies, in vitro fertilization may be considered.
After the sperm and egg are successfully fertilized in vitro, the fertilized egg can be safely transported back to the mother's uterus for safe gestation.
4. Health and Infection Prevention: Female patients need to ensure the cleanliness and health of their reproductive system.
Pay attention to hygiene during menstruation, childbirth, and the postpartum period to prevent infections of the reproductive system. If an infection has occurred, it should be treated promptly by hospitalization for intravenous fluids and transfusions, and at the same time, immediate laparotomy is recommended.
Maintaining a healthy lifestyle, avoiding smoking and alcohol consumption. Nicotine and alcohol can have adverse effects on pregnant women and their fetuses, potentially leading to uterine abnormalities.
6. Timely treatment of salpingitis is crucial as it is the critical pathway for fertilized eggs to reach the uterus. Any abnormalities can lead to the failure of fertilized eggs to implant properly.
The inner wall of the fallopian tube generally has cilia. Under normal circumstances, fertilization occurs through the movement of these cilia and the contraction of the smooth muscles in the fallopian tube, which transports the spermatozoa to the uterine cavity.
However, if the fallopian tube is inflamed, the mucosal folds of the female fallopian tube will be adhered together, leading to narrowing of the lumen. At the same time, cilia will be damaged, smooth muscle contraction in the wall will weaken, so fertilized eggs can not reach the uterus smoothly and fall out of the fallopian tube, resulting in a pregnancy in the fallopian tube and causing an ectopic pregnancy.
Ectopic pregnancy is not an unwarranted occurrence, and it has close relationships with various lifestyle habits and some diseases.
If you could conduct a thorough physical examination before pregnancy and make adjustments to your lifestyle according to the doctor's advice, it could greatly improve the environment of the reproductive system and reduce the incidence of ectopic pregnancies.
Following an ectopic pregnancy, one can still conceive again. After a single episode of ectopic pregnancy, one is generally able to conceive again.
The earlier the embryonic sac is removed, the sooner the ectopic pregnancy ends, and the less damage to the fallopian tubes, the greater the chance of a successful re-conception after full term.
Even if one fallopian tube is removed, as long as the other remains normal, pregnancy and childbirth can still occur.
If you have a tubal pregnancy, you can still conceive normally.
Should the affected fallopian tube be surgically removed, and the other fallopian tube remains normal and undamaged, there is still a chance for conception and childbirth.
Only when both fallopian tubes are diseased and fail to function will a woman lose the ability to conceive naturally.
Under normal circumstances, after the treatment of an ectopic pregnancy, a woman can then become pregnant. However, it is necessary to undergo relevant examinations such as tubal sclerosis and other tests to confirm whether the fallopian tubes are patent and whether there are inflammatory conditions like pyelonephritis or peritonitis.
If the fallopian tubes are blocked, a hysterosalpingogram should be performed first.
If there is inflammation such as pelvic inflammatory disease, it should first be treated with anti-infection.
If the inflammation is not completely eliminated and you become pregnant again, it may occur again due to another inflammatory process in the fallopian tubes, resulting in an ectopic pregnancy.
Therefore, once a woman of childbearing age suspects she might be pregnant, it is advisable for her to seek medical examination at an early stage and closely monitor her physical condition to rule out the possibility of ectopic pregnancy.
*The medical information provided in this text is for reference only.
If you feel discomfort, it is recommended to seek medical attention immediately. The diagnosis and treatment should be based on a face-to-face consultation with a medical professional.