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Ectopic pregnancy: symptoms, causes and course

In a normal pregnancy, the egg migrates up to the uterus and nests there. If the If the fertilized egg does not lodge in the uterus, but in the abdomen, it is an ectopic pregnancy. Like ectopic pregnancy, it is one of the extrauterine pregnancies.

How common an ectopic pregnancy is, what symptoms suggest it, and what causes are responsible, find out here.

Table of Contents

1. In an ectopic pregnancy, the egg is outside the uterus

There are different forms of ectopic pregnancy.

The ectopic pregnancy counts just like the ectopic pregnancy to the Pregnancies in which the egg is implanted outside the uterus. These are also known as extrauterine pregnancy (EUG) in Latin terminology. In the case of an ectopic pregnancy, the egg cell enters the abdomen via the fallopian tubes.

Usually the egg is expelled from the ovary, after which it is fertilized by a sperm in the fallopian tube. The egg then moves into the uterus, where it matures into an embryo.

In an ectopic pregnancy, complications occur in this way, so that the egg does not make it into the uterus and attach itself to the peritoneum, for example. Since no uterus is necessary, an extrauterine pregnancy can occur even after the uterus has been removed or sterilized.

Fortunately, this type of pregnancy is very rare. Overall, the probability of an ectopic pregnancy is around 0.01%. According to surveys, a rate of 20 extrauterine pregnancies per 1,000 live births is assumed in Germany. About 95% of pregnancies in which the egg is implanted outside the uterus is an ectopic pregnancy.

2. In most cases, anatomical causes are responsible

Previous artificial insemination can increase the risk of an ectopic pregnancy.

The fact that the egg does not reach the uterus via the fallopian tubes as usual can have various reasonsall of which, however, have not yet been fully scientifically clarified.

The Egg transport can be disrupted by the following aspects:

  • performed abdominal or pelvic operations
  • anatomical features (such as secondary tubes or sagging in the fallopian tube)
  • previous fallopian or ectopic pregnancies
  • artificial fertilization
  • IUD contraception
  • Fertility disorders
  • Endometriosis foci
  • after a hysterectomy

Also one Inflammation of the fallopian tubes, which in many cases is caused by chlamydia, can trigger an ectopic pregnancy. Smoking is also seen as an additional risk factor.

3. Some ectopic pregnancies are asymptomatic

hCG levels
In a normal pregnancy, the hCG level increases significantly and doubles at least every two days for the first few weeks. In an ectopic pregnancy, however, it is comparatively low.

A Extrauterine pregnancy is usually undetectable without an ultrasound. As with a normal early pregnancy, many affected women can suffer from symptoms such as morning sickness, tight breasts and a missed period. The pregnancy test is also positive.

Otherwise, in most cases, the ectopic pregnancy proceeds without any discomfort and therefore goes unnoticed. The main reason that no symptoms appear in the further course is that there is sufficient space in the abdomen. The In many cases, the embryo dies on its own because there is an insufficient supply of nutrients.

Diagnosis is usually only made through examinations. Most women who had a positive test at home then go to a gynecologist between the 9th and 12th week of gestation for an ultrasound examination to confirm the pregnancy.

During this examination, the doctor can determine whether a fertilized egg has implanted itself in the uterus. If this is not the case despite signs of pregnancy, more detailed ultrasound examinations can help to find the nested egg.

Danger: An ectopic pregnancy is very dangerous and can be life threatening. It is therefore imperative that you call a doctor or ambulance service if you have severe symptoms.

4. Ectopic pregnancy - when to have surgery

The embryo must be removed in order not to endanger the mother's life.

Since an embryo cannot be adequately supplied with nutrients in the abdominal cavity, In half of the cases, the body terminates the pregnancy by itself after a short time. The embryo dies and the tissue is reabsorbed.

If this is not the case, urgent treatment is required, as otherwise there could be considerable consequences for the mother. The risk of serious complications such as adhesions with other organs is very high.

If the egg is still very small, the doctor will give medication intravenously or intramuscularly to stop the pregnancy. If the egg is already firmly embedded in the abdominal cavity, a laparoscopy or surgical opening of the abdominal cavity is unavoidable. The latter can cause great problems, as the placenta and parts of the intestine usually have to be removed as well.

If the ectopic pregnancy is already advanced, this is life-threatening for the mother. Bleeding to death is the greatest danger.

It happens very rarely, however there have also been cases in which the child was carried to term in an ectopic pregnancy. If a mother insists on keeping and carrying the baby at her own risk, it must be brought by caesarean section in the 32nd to 34th week of pregnancy. Natural birth is not possible. According to researchers, the chances of mother and child surviving this birth are one in a million.

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Ectopic pregnancy: symptoms, causes and course
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