Under normal conditions, the fertilized egg cell meets the sperm cell in the Fallopian tubes or tubes and comes to the endometrium, the inner layer of the uterus, and begins to grow inside the uterus. If the product of conception settles somewhere other than the endometrium, it is called an ectopic pregnancy.
Ectopic pregnancy Where can it be seen?
1-It is most commonly located in the tubes.
2-In the abdominal cavity
3-In the ovaries
4-In the cervix
5 -Inside the broad ligament of the uterus
Why does ectopic pregnancy occur?
Disruption in the discharge of the egg cell from the ovary, infection of the fimbriae of the tassel-like structures at the end of the tubes, even if ovulation is normal, As a result of the delay in catching the egg cell due to hormonal disorders and intra-abdominal masses, and the slowdown in the migration of the egg cell into the uterus due to narrowing and blockages in the tubes for the same reasons, the product of pregnancy cannot reach the uterus at the appropriate time. Thus, it begins to grow wherever it attaches, most often in the widest part of the tubes.
Ectopic pregnancy Who is more common in it?
1-It is most common between the ages of 35-44.
2-The risk of ectopic pregnancy again in those who have had an ectopic pregnancy is 10-25.
3- The risk increases in those with tubal diseases due to reasons such as tubal inflammation, salpingitis, endometriosis and tumors, which are seen together with previous genital infections.
The microorganism called chlamydia is the most important factor that causes tubal damage and subsequent tubal pregnancy.
4-Surgical interventions on the tubes, such as tying the tubes, opening the tubes, and previous ectopic pregnancy surgery, also increase the risk.
5-Congenital defects in the uterus and tubes
6-Intrauterine devices (IUD) There is no certainty that it increases ectopic pregnancy. However, ectopic pregnancy is 5 times more common in intrauterine device users compared to normal pregnancy. 4 of the pregnancies with copper IUDs and 17 of the pregnancies with hormonal IUDs are tubal ectopic pregnancies.
7-If the pregnant woman used birth control pills containing low dose progesterone or estrogen after intercourse,ectopic pregnancy risk increases.
8-Infertile or The risk increases in those who use assisted reproductive techniques.
9-Smoking increases the risk.
10-The risk increases 2-4 times in recurrent miscarriages. The risk is 10 times higher in places where illegal abortions are common.
Incidence
1-2 of the pregnancies are ectopic pregnancies.
Symptoms of Ectopic Pregnancy
In the early period, menstrual delay occurs, which is also the case in normal pregnancies. However, in the short term, the tube begins to stretch due to the product of pregnancy growing inside it, and pain due to stretching is the most common complaint. Abnormal vaginal bleeding may also occur at this time. If the patient applies during this period, it will be treated most successfully.
The pregnancy product, the embryo, which begins to grow in the tube, disrupts the nutrition of the surrounding tissue, causing rupture and serious internal bleeding. The most common cause of death from the disease is this internal bleeding. If the tube ruptures and bleeding occurs, the patient is admitted to the hospital with complaints of severe stabbing pain, dizziness and fainting due to internal bleeding. Some women may experience diarrhea, nausea and vomiting along with pain. Since such a picture is very similar to gastroenteritis, incorrect diagnosis can unfortunately lead to death from ectopic pregnancy.
Diagnosis
1- Gynecological examination
2-betaHCG test
3-Transvaginal ultrasound
After the above, if necessary, vaginal color Doppler ultrasound, progesterone measurement, Dilatation Curettage, Laparoscopy are performed.
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