Ectopic pregnancy

Ectopic pregnancyECTOPIC PREGNANCY - implantation and development of the fertilized egg occurs outside the uterus - usually in the fallopian tube (99% of cases). Ectopic pregnancy is found in 1-4% of the total number of gynecological patients. The most common cause of ectopic pregnancy are inflammatory changes of the fallopian tubes. Along with the greater role of infantilism and various endocrine disorders that alter motility pipes. The chorionic villi deeply grow the entire thickness of the uterine tube, and not coming on its way impact antiproteolytic enzyme decidual membrane, as in a pipe she expressed weakly. Ectopic pregnancy can be terminated or tubal abortion, when the fertilized egg is expelled through ampullary the end of the pipe or tube breakage of its germination of the chorionic villi. In this and in the other case occurs intraperitoneal bleeding, which formed the accumulation of blood in the tube, peritumoral or Samotechnaya hematoma. When you break the pipe bleeding is particularly strong. The symptoms for. Distinguish between progressive and interrupted ectopic pregnancy. Progressive ectopic pregnancy is accompanied by the same symptoms as uterine (delay menstruation, nausea and vomiting in the morning, cyanosis of the vagina and cervix, and increase the softening of the uterus and other). Usually at this stage of development an ectopic pregnancy is not diagnosed and taken for uterine. Changes in the uterine tube is insignificant. The interruption of tubal pregnancy in the pipe rupture most often occurs in 6-8 weeks. Suddenly appear sharp abdominal pain with irradiation up (phrenicus-symptom), or down in the region of the external genital organs or rectum; dizziness, fainting condition, the reduction of blood pressure, increased heart rate and increasing the symptoms of internal bleeding. Bleeding from the genital tract may be missing because of the decidual membrane is no time to pull away from the walls of the uterus. Violation by the type of tubal abortion may be long and have a diverse picture. Usually by the slight delay of menstruation, the patient experiencing cramping pain in the abdomen, feeling of General weakness, dizziness, lightheadedness. After a few days appear dark bloody smearing secretions from the genital tract. These symptoms are intermittent in nature. Body temperature is normal or subfebrile (rarely). With significant internal bleeding symptoms similar to those at break of the pipe. The correct diagnosis of progressive tubal pregnancy rarely put. The diagnosis of disturbed ectopic pregnancy set with the data of anamnesis (oophoritis, infantilism, hormonal disorders, the characteristic delay of menstruation, the clinical picture. When rupture of the fallopian tube with a clinical picture of disease is defined pain, internal bleeding and progressive anemia patient. Palpation of the abdomen painful, especially in the lower sections of the side location of the diseased tube. There are peritoneal symptoms. When significant bleeding find the dullness of percussion sound in the lateral abdomen. When moving the patient from side to side boundaries blunting correspondingly moved. At vaginal examination mark cyanosis of the mucous membranes, a small increase in the size of the uterus (it is less than it should be the estimated duration of pregnancy), her softening. Palpation of the uterus on the affected side causes a sharp pain and a protective reaction of the abdominal muscles, resulting in increased appendages to palpate often fails. The posterior vaginal vault will wybodaeth, painful on palpation. When puncture of posterior fornix get dark blood with small clots (not always). Disturbed ectopic pregnancy occurring on the type of tubal abortion, requires to recognize a longer time, as similar symptoms can be observed in other diseases: started uterine abortion, inflammation of the uterus, acute appendicitis, etc. So for the diagnosis along with the above symptoms known value gain additional tests (biological or immunological reactions to pregnancy, puncture of the posterior vaginal fornix, laparoscopy, a study using ultrasound, and others)..



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