How is ectopic pregnancy caused
Release time : 01/18/2025 18:13:27
Ectopic pregnancy is a highly dangerous gynecological condition that greatly concerns many women of childbearing age. So, what causes ectopic pregnancies? What are the symptoms of ectopic pregnancies? Is pelvic inflammatory disease responsible for ectopic pregnancies? Understanding the symptoms of ectopic pregnancies helps in preventing them.
To conceive a healthy baby, ladies, come and learn more.
What causes an ectopic pregnancy? 1. Chronic pelvic inflammatory disease (PID) is a common and major cause of ectopic pregnancies.
Inflammation causes adhesion, narrowing, and irregularity in the fallopian tube mucosal tissue. These pathological changes lead to weakened muscular contractions of the fallopian tube wall, thereby affecting the transportation of fertilized eggs.
When a pregnancy ovum is blocked in the fallopian tubes, that is to say, it may develop locally and give rise to an ectopic pregnancy.
2. Fallopian tube surgery - Post-surgical fallopian tube sterilization, if recanalization or fistula formation occurs, there is a potential for ectopic pregnancy, especially with laparoscopic electrocoagulation of the fallopian tube and silicone ring occlusion.
Following infertility treatment with tubal lysis and anastomosis, such as tubal anastomosis, tubal opening, etc., the incidence rate of recurrent tubal pregnancy is 10% to 20%.
3. Ovarian Developmental Abnormalities or Functional Impairments Ovarian developmental abnormalities often manifest as an excessively long fallopian tube, poor muscle layer development, and the absence of mucosal cilia.
Other causes include a double uterus, diverticula, or accessory sacs.
If the secretion of estradiol hormone is abnormal, it may affect the normal operation of the fertilized egg.
Furthermore, psychological factors can also cause uterine spasms and abnormal motility of the tubes, interfering with the transportation of fertilized eggs.
4. Eggs that have fertilized are migrated to one of the fallopian tubes, and the fertilized eggs travel through the uterine cavity or abdominal cavity into the opposite fallopian tube, known as egg migration.
If the time of migration is prolonged, the fertilized egg will grow and develop, which can then implant in the opposite uterine tube to form an ectopic pregnancy.
5. From the earliest artificial insemination to the current application of ovulation induction drugs and intra-uterine insemination (IUI) or gamete intrafallopian transfer (GIFT), there has been an incidence of ectopic pregnancy, with a rate of approximately 5%, which is higher than that of spontaneous ectopic pregnancies.
The factors associated with increased risk include preoperative pelvic inflammation, a history of pelvic surgery, technical factors in embryo transfer, the number and quality of transferred embryos, endocrine environment, and excessively high levels of transfer medium.
6. Other pelvic structures, such as tumors around the uterus or ovaries, particularly endometriosis, can also impede the flow of the fallopian tubes and ovaries by causing adhesions between the surrounding tissues. This can affect the patency of the fallopian tubes and hinder the passage of fertilized eggs.
Research also suggests that embryonic defects, artificial abortion, smoking, and other factors are associated with the occurrence of ectopic pregnancy.
Symptoms of Ectopic Pregnancy: Clinical Manifestations and Pathogenesis of Uterine Pregnancies are related to the site of implantation, whether there is rupture or abortion, the amount of blood in the peritoneal cavity, and the timing of onset.
In the pre-rupture or pre-explosion stage of tubal pregnancy, there are no symptoms and signs. In addition to amenorrhea and pregnancy manifestations for short periods, sometimes lower abdominal pain is present, and when examined, the fallopian tubes are normal or enlarged.
Following an ectopic pregnancy or rupture, the condition is generally classified into acute and chronic types based on the severity of the condition.
1. Acute ectopic pregnancy symptoms include: (1) missed menstruation, except for interstitial pregnancy where the missed period is longer, the majority of patients experience a missed period lasting 6-8 weeks, followed by abdominal pain and vaginal bleeding, but about 20% of patients do not report any history of missed periods.
(2) Abdominal pain is the most significant symptom for patients seeking medical attention. The abdominal pain is caused by factors such as ovarian cyst enlargement, rupture, and stimulation of the peritoneum by blood. Rupture occurs suddenly with a tearing pain in one side, often accompanied by nausea and vomiting. If the blood is confined to the affected area, localized abdominal pain occurs.
When blood accumulates in the pelvic cavity, a sensation of heaviness and distension in the anus occurs.
Excessive hemorrhage results in blood flowing from the pelvis to the abdomen, with pain spreading from the lower abdomen to the entire abdomen.
When blood stimulates the diaphragm, it can cause radiating pain in the shoulder area.
(3) After abortus death, there is usually irregular vaginal bleeding. The color is dark brown, the amount is small, generally less than menstrual flow, but not clean.
(4) Hemorrhage and shock are caused by acute hemorrhage in the abdominal cavity, leading to a decrease in blood volume and severe abdominal pain. Mild cases often experience syncope, while more serious cases present with shock. The severity of symptoms is directly proportional to the speed and amount of hemorrhage from the abdominal cavity, i.e., the greater the amount of hemorrhage, the faster it occurs, and the more severe the symptoms will be. However, this does not correlate with the amount of bleeding from the vagina.
Physical signs (1) When intra-abdominal hemorrhage is extensive, the patient presents with an acute anemia appearance. Severe hemorrhage may lead to pallor, cold limbs, rapid and weak pulse, and a decrease in blood pressure, symptoms of shock. The body temperature generally remains normal, but may be slightly lower during shock, and when the blood in the abdominal cavity is absorbed, it may rise slightly, but not exceed 38°C.
(2) Abdominal examination reveals significant tenderness and rebound tenderness in the lower abdomen, especially on the affected side, but the muscular tension is lighter than that seen in peritonitis. When there is significant bleeding, percussion over the area may reveal a mobile fluid collection. Over time, this can lead to the formation of a blood clot, and a soft-tissue mass may be palpable in the lower abdomen. Recurrent bleeding can cause the mass to enlarge and harden over time.
(3) Pelvic examination reveals the cervix is significantly tender and the posterior fornix of the vagina is full. Stiffness in the cervix, when gently lifted or rotated to the left or right side, can cause severe pain. The uterus appears slightly enlarged and soft. When there is significant hemorrhage, the uterus may float. A mass can be palpated on one side or behind the uterus, resembling a wet flour paste ball with unclear boundaries and pronounced tenderness. The diagnosis of an ectopic pregnancy differs from that of other locations within the fallopian tubes; the size of the uterus is generally consistent with the month of menstruation but is disproportionate to the uterine contour. The protruding part of the uterine angle on the affected side is characteristically prominent, resembling the appearance of a ruptured pregnancy uterus.
2. Chronic ectopic pregnancy refers to the condition in which after a tubal gestation has resulted in abortion or rupture, the duration of illness is long, with repeated hemorrhagic episodes gradually leading to stabilization. At this stage, the embryo has died, the chorionic villi have regressed, and the internal hemorrhage ceases. The abdominal pain decreases, but the formed hematoma gradually undergoes ossification and hardening, and it becomes adherent to surrounding tissues and organs. Patients with chronic ectopic pregnancies may report a history of recurrent episodes of intrauterine hemorrhage post-menstrual, with clinical manifestations including irregular vaginal bleeding, episodic abdominal pain, adnexal masses, and low fever. Low fever is due to the process of blood absorption within the peritoneum. If secondary infection occurs, it presents as high fever.
Signs of an Ectopic Pregnancy: 1. Early signs of a threatened miscarriage in early pregnancy, the pain associated with threatened miscarriage is generally mild, and the size of the uterus matches the gestational period, with minimal vaginal bleeding. There is no sign of internal bleeding.
B-mode ultrasound can differentiate.
2. Ovarian luteal rupture and bleeding, which often occurs during the luteal phase or menstrual period.
However, it is sometimes difficult to differentiate from ectopic pregnancy, especially in patients without a history of amenorrhea and with irregular vaginal bleeding. It is often necessary to combine β-HCG for diagnosis.
3. Patients with ovarian cyst torsion present normal menstrual cycles without signs of intraperitoneal hemorrhage, typically have a history of an adnexal mass, and the cyst base may exhibit significant tenderness upon palpation.
The diagnosis can be confirmed through gynecological examinations combined with ultrasound.
4. Patients with ovarian cyst rupture and bleeding who have a history of endometriosis often experience this condition before or during menstruation, accompanied by severe pain and noticeable rectal tenesmus.
Transvaginal posterior fornix puncture can yield chocolate-like fluid, which is diagnostic; if the rupture site injures blood vessels, signs of internal bleeding may occur.
5. Acute pelvic inflammatory disease (PID): In cases of acute or subacute inflammation, there is generally no history of missed periods. Abdominal pain is often accompanied by fever, and blood tests typically show elevated white blood cell count and erythrocyte sedimentation rate (ESR). Ultrasound may reveal adnexal masses or pelvic fluid. Urine HCG testing can assist in diagnosis. Notably, after anti-inflammatory treatment, symptoms such as abdominal pain and fever usually gradually improve or disappear.
Surgical Condition: Acute appendicitis is often characterized by significant migratory pain in the right lower abdomen, usually accompanied by fever, nausea, vomiting, and an elevated white blood cell count.
Urinary tract stone, lower abdominal pain often presents as colicky pain, accompanied by flank pain on the same side, and often accompanied by hematuria.
A combination of ultrasonography and X-ray examination can confirm the diagnosis.
How to Prevent Ectopic Pregnancy: 1. Choose a time when both partners are in good physical and emotional condition to conceive.
If you're not planning to become a mother, you should be prepared for birth control.
Good contraception fundamentally eliminates the occurrence of ectopic pregnancy.
2. Timely treatment of reproductive system diseases is essential. Inflammation is the primary cause of cervical strictures, and artificial abortion or other uterine manipulation procedures further increase the chances of inflammation and endometrial tissue entering into the fallopian tubes, leading to adhesions and narrowing. This increases the likelihood of ectopic pregnancy.
Malignant 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 all reduce the occurrence of ectopic pregnancy.
3. Experimenting with in vitro fertilization (IVF) could lead to another ectopic pregnancy, which is enough to shatter a woman's confidence in having a child.
You can have an in vitro fertilization.
After sperm and egg successfully "marry" in vitro, the fertilized egg can be transferred back to the mother's uterus for safe gestation.
Pay attention to personal hygiene, and take care of hygiene during menstruation, childbirth, and the postpartum period to prevent infections in the reproductive system.
After a missed period, it is important to confirm the location of the pregnancy as early as possible to promptly detect an ectopic pregnancy.
If symptoms have already appeared, it is crucial to seek immediate medical attention for intravenous fluids, blood transfusion, and to undergo an exploratory laparotomy without delay.
Can salpingitis cause an ectopic pregnancy? Ectopic pregnancy is a highly dangerous gynecological condition for women, and many women of childbearing age are extremely wary of it. There are many causes of ectopic pregnancy, such as repeated abortions, improper contraceptive methods, and more.
So, can salpingitis cause an ectopic pregnancy? 1. Salpingitis can indeed lead to an ectopic pregnancy. When a woman develops salpingitis, the inflammation can cause blockages, fluid accumulation, or adhesions in the fallopian tubes, which hinder the movement of sperm, eggs, or fertilized eggs. As a result, the fertilized egg cannot reach the uterine cavity and instead implants outside the uterus, leading to an ectopic pregnancy.
2. Ectopic pregnancies mostly occur in the fallopian tubes, with approximately 98% of these occurring in the fallopian tubes. The fertilized egg cannot persist naturally within the fallopian tubes. Within 1 to 2 months after menstruation ceases, the fertilized egg gradually grows and ultimately bursts through the fallopian tube, leading to significant hemorrhage and potentially life-threatening shock.
3. Ovulation is the process by which an egg is released from the ovary and fertilized. The tubes that carry the sperm to the uterus are called fallopian tubes. 4. Fallopian tubes are a pair of long, thin tubes that connect the ovaries to the uterus. They are lined with mucus and have tiny openings called ampullae. 5. Ampullae are small openings on the outside of the fallopian tubes that allow sperm to enter them. 6. Sperm can swim through the mucus in the fallopian tubes and reach the ovaries. 7. Once a sperm has fertilized an egg, it travels down the fallopian tubes to the uterus. 8. If the fallopian tubes become blocked or damaged, it can cause infertility. 9. In some cases, inflammation or infection in the fallopian tubes can also lead to scarring and blockage, which can further impede fertilization and pregnancy. 10. Therefore, it is important for women to maintain good health and avoid infections that may affect their fallopian tubes.
Ovulatory infertility is a significant cause of uterine tube dysfunction. Uterine tube inflammation, which is common among infertile women, is primarily caused by pathogenic infection, with the majority occurring after childbirth, miscarriage, or menstruation. Therefore, women who have undergone uterine surgery should pay attention to the prevention of uterine tube inflammation.
The medical information provided in this text is for reference only and should not be used as a substitute for professional medical advice.
In case of discomfort, it is advised to seek immediate medical attention for accurate diagnosis and treatment.