How Does an Ectopic Tubal Pregnancy Manifest Itself

Ectopic tubal pregnancy can be divided into progressive and disturbed. In the presence of a disturbed tubal pregnancy, a rupture of the fallopian tube is observed, or an ectopic pregnancy provokes a tubal abortion.

How Does an Ectopic Tubal Pregnancy Manifest Itself, and Is It Possible to Detect an Ectopic Tubal Pregnancy?

The symptoms of an ectopic tubal pregnancy are generally similar to those of a uterine pregnancy: changes in taste, breast engorgement, nausea, menstrual delay, and colostrum.

Tubal Pregnancy Progressive

The gynecologist notes cyanosis of the vaginal vestibule, its mucous, and uterine cervix. The uterus becomes softer, and its size increases significantly. The uterine mucosa is transformed into a falling-off membrane. There is a formation of a corpus luteum in the ovary, a positive immunological reaction to pregnancy is noted.

Tubal Pregnancy Interstitial

This type of tubal pregnancy is challenging to diagnose and is usually terminated in the third or fourth month. In this case, severe bleeding is observed. An accurate diagnosis can be made by a doctor only during the operation, in which a deformed uterus with a protruding angle and a protrusion of the ligamentous apparatus from the affected side is detected. The perforation can vary in size, but it does not communicate with the uterine cavity. Chorionic tissue may be visible from the wound. Emergency assistance from an anesthesiologist and gynecologist is necessary with a significant blood loss. In no case is it recommended to use any self-treatment methods, as this can lead to disastrous consequences.

Fallopian Tube Rupture

The patient experiences acute pain in the lower abdomen with this pathology, which radiates to the rectum. Blood pressure decreases, the skin turns pale, the patient may lose consciousness for a short time. The peritoneum begins to become irritated if the volume of blood in it reaches 500 ml. Body temperature can be both normal and elevated.

There is bloating and muscle tension in the anterior part of the peritoneum. On the side of the tube rupture, the patient experiences pain. Gynecological diagnostics, which should be carried out with the utmost care (to prevent increased bleeding and the occurrence of repeated pain shock in the patient), allows you to determine the increase in the uterus and the patient’s pain during palpation. Education in the form of tumor plasticity is diagnosed through the lateral fornix of the vagina in the region of the appendages.

There is a pain in the posterior vaginal fornix, which, in turn, is strongly protruded or flattened. A woman may see dark spotting from the cervical canal, but they may not be immediately after the attack. After a few hours after a painful episode, a woman can observe the rejection of outgoing tissue from the uterus. It is vital that the patient’s condition may return to normal or even improve, but as the intensity of bleeding increases, it can flow into a state of severe pain, shock, or collapse. It should be noted that the condition of the patient depends on her ability to endure blood loss.

Such a diagnostic measure as culdocentesis makes it possible to detect the presence of free fluid in the peritoneum. The blood obtained by puncture is dark in color, does not clot, and contains soft clots. If blood is not diagnosed during a stab through the posterior vaginal fornix, this does not mean that an ectopic pregnancy can be excluded entirely. The puncture may not be performed correctly, or due to the presence of adhesions in the pelvis, there may be no blood in the recess behind the uterus.

Emergency surgery is performed with hemoperitoneum. Pipe rupture is considered to be a relative indication for an operation involving the preservation of female reproductive organs. The second or third degree of hemorrhagic shock indicates that a laparotomy is necessary. This means that the choice of the type of operation is carried out individually in each case and depends on the patient’s current condition.

Tubal Abortion

The symptoms of a tubal abortion are a synthesis of the symptoms of an interrupted pregnancy and various signs of a normal pregnancy, which is why an ectopic pregnancy like a tubal abortion is very similar to other problems. A woman observes a delay in menstruation, after which there are paroxysmal pains in the lower abdomen, often on one side. Dark discharge of blood comes from the vagina, which is a rejection of the outgoing uterine membrane. An ectopic pregnancy like a tubal miscarriage can take a very long time and not be diagnosed by specialists. At the beginning of the development of pathology, the blood that is formed as a result of the detachment of the fetal egg enters the peritoneum. The clinical picture at this stage is expressed by the lability of the pulse and blood pressure when changing the position of the body. Further, anemia and uterine hematoma are observed. The peritoneum is irritated, the uterus increases in size. Pain is observed on palpation of the posterior fornix and cervix.

Tubal Ectopic Pregnancy Diagnosis:

In the early stages, an ectopic pregnancy interrupted by the type of tubal abortion is complicated to diagnose. The patient’s condition during the development of her progressing tubal pregnancy can be regarded as satisfactory. However, ectopic tubal pregnancy has characteristic signs and symptoms that can be used to classify an ectopic pregnancy (that is, distinguishing it from a uterine one):

  • The uterus increases in an uncharacteristic way for this period of gestation;
  • The level of HCG is lower than during a normal pregnancy at the same time;
  • A tumor-like formation is observed in the region of the appendages; when it is palpated, the woman experiences pain.

Today, the diagnosis of progressive tubal pregnancy becomes possible due to the availability of modern research technologies. Mainly, these are ultrasound and HCG monitoring. A fetal egg in the fallopian tube can be detected using ultrasound, as well as using laparoscopy, which is recognized as the most delicate operation for the female body, but it is difficult to guess the causes of ectopic tubal pregnancy. It can be a consequence of inflammation and other pathologies.

A patient with suspicion of this pathology should be observed exclusively in a hospital because a tubal-angular ectopic pregnancy can behave as you like, and therefore it is imperative that there is an operating room nearby. This is necessary due to the fact that a tubal miscarriage during an ectopic pregnancy occurs unexpectedly, and profuse bleeding into the abdominal cavity poses a significant threat to the patient’s life.

In order to collect an anamnesis, it is necessary to clarify information about the patient’s menstrual cycle, the number, and outcomes of previous pregnancies, if any, as well as the methods of contraception used by the woman. Based on this information, it is possible to assess the risks of ectopic pregnancy and be sure to study all the information about how an ectopic tubal pregnancy proceeded. The medical history will tell about all this.

If the estimated gestational age is three to four weeks, the uterine pregnancy is not diagnosed by ultrasound, and the analysis for HCG is positive, the patient is shown a diagnostic laparoscopy. If the reaction to HCG is adverse, it must be repeated. The most modern method of eliminating progressing tubal pregnancy has become organ-preserving surgery using endoscopic access.

The size of the surgical intervention is represented by excision of the uterine angle and the imposition of two rows of sutures: serous-muscular and muscular-muscular. Peritonization is carried out by attracting the uterine ligament (round).

 

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