How does an ectopic pregnancy arise, what is it, its first signs
In the normal course of pregnancy, the egg afterof its fertilization comes from the fallopian (uterine) tubes and is attached to the uterus, where it continues to develop until the time of delivery. In case of pathological development of pregnancy, due to certain circumstances, a fertilized egg (fetal egg) does not enter the uterus, but is fixed in the fallopian tube, and in rare cases in the ovaries or abdominal cavity, where, with medical intervention, doctors have to remove the incorrectly attached egg with the fetus . Ectopic pregnancy as a pathology is well known and sufficiently studied. The most common form of this anomaly is tubal extrauterine pregnancy. The delay in the ovule in the fallopian tubes is indicative of their inadequate and reduced permeability. Fertilized egg is almost a month after its attachment to the wall of the tube, increasing in size and size, can lead to rupture of the pipe. In this case, the probability of severe bleeding is very high with the ingress of blood to the abdominal cavity. Not only health, but the very life of a woman at a time when ectopic pregnancy is developing, is under great threat. Therefore, it is very important when planning pregnancy to know the first signs of ectopic pregnancy, undergo a full medical examination and eliminate all possible violations from the normal functioning of the body to avoid the occurrence of complications afterwards. 
Causes of an ectopic pregnancy
So why does an ectopicpregnancy and becomes possible its occurrence? Because of what the fertilized egg gets lost from the correct course and suddenly turns out to be in a place not intended for its further development? Ectopic pregnancy and related problems are the poor functioning of the fallopian tubes, whose patency can be violated due to any factors and destabilizing causes. As a rule, this is preceded by difficult complicated births or abortions, as well as current or previously transmitted inflammatory diseases of the genitals and various infections. The mucous membrane of the uterus is swollen due to illness and, being in this condition, it sticks together in some places, because of which the tubes themselves lose their ability to contract. In addition, ectopic pregnancy may also occur in the case of inadequate development of fallopian tubes (infantilism). Infantile (immature, undeveloped) pipes in their structure and form are narrow, long and sinuous, with sufficiently narrow lumens. They are deprived of the ability to contract and the ability to push the fetal egg forward to the uterus (the first ectopic pregnancy symptom). At a certain stage of ontogenesis, villi begin to develop in the fetal egg, due to which it has the ability and ability to attach for further development to the walls of the uterus and to obtain through this constant blood supply. If, at a certain time, the fetal egg does not come to the uterus, then it is attached to the place where it is now (the second ectopic pregnancy symptom). Thin and delicate walls of the fallopian tubes can not stretch like uterine tissues, because of which their rupture soon comes. This occurs approximately between the fourth and sixth weeks after the fertilization of the egg. As a result of the rupture of the walls of the tubes, blood rushes straight into the abdominal cavity. As a consequence, nausea and severe acute pains appear in the lower abdomen, reminiscent of prenatal fights. Quite often, there is a loss of consciousness, there may be convulsions. The rupture of large blood vessels with the inability to provide qualified medical care can end tragically and lead to death. True, in a number of cases the scheme of the development of actions occurs in a different direction, when a fetal egg bursts and flows into the abdominal cavity, and along with it a certain amount of blood also flows. These circumstances are also accompanied by nausea and bloody discharge from the genitals. Tubal abortion is accompanied by severe pain, gradually subsiding after a while. Most of the women who have experienced this on themselves, after a recession of painful attacks, relax morally, suggesting that everything is already behind. However, it's not time to rejoice here. It will be necessary to urgently seek help and advice to medical specialists in order to avoid and exclude any possible variants of development of pathological painful symptoms, for example, peritonitis - a purulent inflammation of the abdominal cavity, accompanied by a general severe condition of the body. In most cases, peritonitis poses a direct threat not only to health, but also to the life of the patient, which requires urgent medical attention. Forecasts in cases of untimely or unqualified treatment of peritonitis are very unfavorable, and the consequences are very dangerous. 
Signs and symptoms of ectopic pregnancy
Practice shows that a simple test forthe definition of pregnancy reflects and fixes the signs of an ectopic pregnancy, as in the case of normal conception. Detect and identify the difference will be possible only as a result of ultrasound examination. In this case, medical specialists conducting an ultrasound examination will not detect the presence of a fertilized egg in the uterus and will conduct additional checks, as a result of which, they will be able to diagnose the probable pathology already at the earliest stages of its development. Deviation from normal fetal development can be diagnosed already in the second week of pregnancy. To do this, you only need to enter into the cavity of the vagina the ultrasound device for the study. After that, as a rule, diagnostic laparoscopy is assigned, which gives the most accurate results of the analysis. Another way to check is to take a blood sample to carry out its hormonal analysis. The first and main signs of ectopic pregnancy in the early stages should be attributed spotting from the vagina (at first they may not be very significant). After that, there are painful sensations in the lower abdomen. These pains begin to acquire a growing character as the pathology itself develops. At this point, the pain can become very strong, sometimes have a kind of cramping pain. It's quite difficult to make an accurate diagnosis to yourself, but it's quite possible to suspect an ectopic pregnancy in the early stages, based on the signs listed above. If the usual symptoms of pregnancy (whether delayed menstruation, toxicosis, psycho-emotional irritability, a violation of taste and addictions, etc.) are added, and not very strong aching pain in the lower abdomen, spotting, it is necessary immediately and without any hesitation go to a medical institution for a gynecological examination in order to exclude any pathology in the development of the fetus. Often in such cases, there is an ectopic pregnancy. 
What to do with an ectopic pregnancy: treatment and rehabilitation
For the treatment of an ectopic pregnancyThere are several ways that are applied at different stages of its development. If the slightest signs indicate that the patient may have an ectopic pregnancy, medical specialists will suggest monitoring in the hospital. Do not categorically reject this, because all the examinations necessary to determine the exact location of embryo implantation, it will be much easier to conduct it in a hospital. In the early detection of an ectopic pregnancy the doctor will be able to interrupt it in much more gentle ways. One of these low-trauma methods of medical treatment is laparoscopy. This is a type of diagnostic medical examination of the abdominal cavity and its organs, as well as the method of modern surgery, in which investigations, analysis and operations on internal organs are performed through a small hole or puncture (0.5 to 1.5 cm in size) of the abdominal wall using a special optical device - laparoscope. Through a very small incision on the skin of the abdomen, a special laparoscope is inserted into the abdominal cavity. This device has an optical system like a device for gastroscopy. Therefore, all the manipulations of the doctor, the operating field itself and the entire operation process are displayed and monitored on the monitor of the device. With the help of a laparoscope, the doctor removes the fetal egg, acting by the type of mini-abortion. By itself, this is a relatively safe and relatively painless procedure. The surrounding tissues and internal organs during operation are not affected or injured. There is no danger of formation of postoperative adhesions and scars. The risk of fatal outcomes in such operations in medical practice is extremely minimal. The greatest comfort for a woman in this case will be the circumstance that this operation prevents injury to the fallopian tubes, and after going through the necessary course of treatment and rehabilitation after a while she may well become pregnant again and take out a healthy, full-fledged child.
Ectopic pregnancy and tube rupture
With more severe consequences of developmentEctopic pregnancy, when there was a rupture of the uterine tube, there is an acute question: to save or remove it? To keep a fallopian tube, of course, it is possible, but only if its gap has not yet occurred or was insignificant. When the tube is ruptured, a closed organ-preserving surgical operation called salpingotomy (or tubotomy) is usually prescribed. This is an operation to remove the affected fallopian tube. This procedure is less painful, the loss of blood during surgery is significantly less. After it is carried out much faster is the process of recovery of the body, and the patient spends much less time in the hospital. Thanks to salpingophotomy, the risk of repeated pathological abnormalities significantly decreases with the subsequent conception and bearing of the child.
Ectopic pregnancy and postoperative treatment
A certain number of women (from 4 to 8%) inThe cavity of the fallopian tubes remains the so-called pregnancy tissue. Therefore, the attending physician can prescribe the introduction of a special drug that stops the growth and development of tissues. This drug is called methotrexate, a specialized antitumor agent. It is sometimes used as an alternative to a surgical procedure. It is used at the earliest stages of pregnancy, when pregnancy hormones have not yet increased in the body of a woman to a large extent. This drug has a certain narcotic effect of exposure. It causes the body to absorb tissues of pregnancy. When treating such a drug should be extremely accurate, you only need to enter a few injections. After that, within a few weeks there will be bleeding from the genitals and the so-called purification of the body from the remnants of the tissues of pregnancy. With a sufficiently early diagnosis of the presence of the disease and the necessary operation to remove the embryo in the early stages of the use of this drug may not be needed. But the decision about the best and optimal treatment for each individual patient is still made by the doctor, and everything depends on his qualification and experience in this matter.
