A positive pregnancy test triggers a feeling of happiness in many women. Closely associated with this is usually the need to arrange a gynecologist appointment, on the one hand, to confirm the pregnancy. If there is a pregnancy and the fertilized egg is not in the uterus during the ultrasound examination, doctors speak of extrauterine pregnancy.
A few statistical data
An ectopic pregnancy is one of the serious complications of pregnancy. About two percent of pregnant women are affected. Ectopic pregnancy is present in 95% of pregnancies outside the uterus. That is, the fertilized egg did not manage to nest in the uterus due to certain circumstances.
This happens during an ectopic pregnancy in the body
The nature of the woman allows one or more oocytes to mature in one or both ovaries in an approximately four-week cycle. These are released from the ovary into the connected fallopian tube when they are ripe. In this approximately 14-centimeter-long funnel the egg moves towards the uterus. The egg cells are usually fertilized in the fallopian tube.
If a fertilized egg does not nest in the uterine lining, but in the lining of a fallopian tube, this is called ectopic pregnancy. If the fertilized egg cell reaches the abdomen, attaches to the peritoneum, for example, and continues to grow there, medics speak of an abdominal cavity pregnancy.
The exact causes of extrauterine pregnancies are not fully understood scientifically. Researchers assume that the following aspects favor the disturbed egg transport to the uterus:
- anatomical, congenital peculiarities, such as Nebeneileiter or sagging in the fallopian tube, in which the fertilized egg can settle,
- Bonding of fallopian tubes due to bacterial infections (such as chlamydia),
- Presence of so-called endometriosis foci (in this physical peculiarity the uterine lining is not located in the uterus, but outside),
- previous ectopic pregnancies or earlier operations on the lower abdomen, which left scars on the fallopian tubes,
- artificial fertilization.
Recognize a fallopian tube or peritoneal pregnancy
In the early stages of pregnancy, a pregnancy outside the uterus without appropriate ultrasound can hardly be distinguished from a regular course of pregnancy. From the sixth to the ninth week of pregnancy, severe pain often occurs when the fertilized egg grows in one of the two fallopian tubes.
Fever and a very sensitive abdominal wall can also be symptoms of ectopic pregnancy. In an abdominal cavity pregnancy, the physical symptoms can show later, since the fertilized egg has more space to grow, as in the narrow fallopian tube.
After about 12 weeks of gestation, vomiting, abdominal pain, nausea and, in some cases, very noticeable, painful child movements often occur during an abdominal cavity pregnancy.
An advanced, painful ectopic pregnancy can usually palpate the gynecologist. Ultrasound examinations usually show precisely where the fertilized egg has settled and grown. If this is not clear, a laparoscopy is necessary.
The treatment of fallopian tubes and peritoneal pregnancies
The type of treatment of a fallopian tube and abdominal cavity pregnancy depends heavily on the time of pregnancy and the mental and physical condition of those affected. At an early, pain-free stage, drug therapy is often possible that inhibits the further growth of pregnancy and results in rejection of fertilized ice.
After such drug therapy, women should wait six to 12 months for pre-pregnancy, as the drugs used may cause malformations in later pregnancies.
In a very early stage of pregnancy, a wait-and-see behavior can be useful, since nature often regulates such “errors” in itself and there is a delayed withdrawal bleeding. However, this is only possible if the ectopic pregnancy still causes no pain.
If the pregnancy is already advanced, an operation takes place. In an ectopic pregnancy, it is usually made so that the fallopian tube remains as possible. There is a risk of scarring of the fallopian tube. These may promote the development of another ectopic pregnancy in a subsequent pregnancy, as they may be an obstacle to the fertilized egg on the way to the uterus.
In sporadic cases, a fertilized egg will nest in the ovary or cervix. If medication is not administered or is delayed, removal of the ovary or uterus may be necessary. If an ectopic pregnancy is detected too late, the growth of the egg can lead to the rupture of the fallopian tube and life-threatening bleeding.
Implantation of a fertilized ice outside the uterus can hardly be influenced. However, it may be helpful to treat inflammation in the fallopian tubes as early as possible to prevent possible scarring or adhesions that increase the risk of ectopic pregnancy.