An ectopic pregnancy is a phenomenon in which the implantation of a fertilized egg occurs outside the uterine cavity. In other words, a fertilized egg, passing through the uterine tube towards the uterus, does not reach it, but is attached along the path in any part of the fallopian tube, more rarely in the ovary or in the abdominal cavity. The causes of ectopic pregnancy can be inflammatory phenomena in the fallopian tubes, as well as endocrine disorders.
Ectopic pregnancy can result in either a tubal miscarriage or a rupture of the tube. During a tubal miscarriage, a fetal egg is pushed into the peritoneum through the ampullar end of the fallopian tube. The rupture of the tube is due to the division and growth of the fertilized egg and the germination of the chorionic villi. In both cases, intra-abdominal bleeding occurs.
Tubal miscarriage in this case must be differentiated from uterine miscarriage, as well as inflammation of the uterine appendages, with adnexal tumors, their torsion, and appendicitis. It is very difficult to make an accurate diagnosis - especially in the early stages of pregnancy. Both in uterine and in tubal miscarriage, there is a prolonged delay in menstruation, but with a tubal miscarriage, the termination of pregnancy usually occurs in the early periods - between the fourth and sixth weeks, while the uterine miscarriage happens, as a rule, later.
Symptoms of uterine and truncal miscarriage
With uterine miscarriage, pain increases, gaining a cramping character, and are felt mainly in the lower abdomen or in the lower back. Bleeding is abundant, with blood clots, blood of scarlet color.
With ectopic miscarriage, acute pains in the lower abdomen come suddenly and are localized on the side of the involved tube. Simultaneously with pain with an ectopic miscarriage, there may be dizziness, fainting, nausea, vomiting. Bleeding with an ectopic miscarriage is small, the smearing secretions have a dark color. They are accompanied by the departure of scraps of tissue or an impression of the mucous membrane of the uterine cavity.
What to do if a tubal miscarriage occurs
If the ectopic pregnancy is interrupted by the type of tubal miscarriage, surgery is needed, since the tube will not be able to perform its functions in the future. In the walls of the tube, in such cases, an active trophoblast remains, under the influence of which new hemorrhages are quite possible. The technique of the operation is practically no different from the operation when the pipe is broken. However, the patient does not have a serious condition, so the operation proceeds more calmly. The most sparing surgery for ectopic pregnancy is laparoscopy.