A fertilized egg that lays outside the normal uterine cavity is called an ectopic pregnancy, also called an ectopic pregnancy, and about 95% are tubal pregnancies. Rupture of ectopic pregnancy may lead to massive intra-abdominal bleeding and life-threatening consequences. If ectopic pregnancy is detected and effective measures are taken in time before it ruptures, the risk is minimized.
Key points for early diagnosis.
1. Ultrasound examination.
The time when the gestational sac can be seen on ultrasonography after pregnancy: regular menstruation delayed for more than 10 days; 4 weeks after ovulation; blood HCG greater than 2000 IU/L; if no gestational sac is seen in the uterine cavity on ultrasonography at this time, ectopic pregnancy is highly suspected.
2.Blood HCG and progesterone determination:
(1) Blood HCG determination.
The HCG (chorionic gonadotropin) secreted by the normally developing embryonic villi rises rapidly after early pregnancy, often increasing 1-fold every 2-3 days, and if the doubling time is longer than 7 days or the increase is less than 66% every 2 days, ectopic pregnancy is very likely.
(2) Progesterone measurement.
Progesterone is low in ectopic pregnancy tests, mostly between 10-25ng/ml, or even less than 5ng/ml.
In special cases of ectopic pregnancy after ovulation with ovulation-promoting drugs leading to multiple follicles ovulation or IVF embryo transfer, in a few cases, there may be simultaneous pregnancy in the uterus and ectopic, or even simultaneous pregnancy in multiple parts of the uterus, which requires doctors to be alert and may be detected early after meticulous ultrasound examination 4-5 weeks after ovulation or 4-5 weeks after embryo transfer.
Treatment methods.
1, drug treatment indications: gestational sac less than 3-4 cm, blood HCG less than 2000 IU/L , no obvious intra-abdominal bleeding, ectopic pregnancy without fetal heartbeat.
Drugs: methotrexate (MTX), mifepristone, Chinese herbal prescriptions, can be used alone or in combination, success rate 60-90%.
2. Indications for surgical treatment: Applicable to those who have failed in drug treatment, intra-abdominal bleeding, and those whose diagnosis is unclear.
Surgical modalities.
1. Preservation of the affected fallopian tube.
If the contralateral fallopian tube has been removed or the lesion is severe, the pregnancy tissue can be removed and the fallopian tube can be preserved after repair in order to preserve the patient’s reproductive function, but ectopic pregnancy may occur again after surgery.
2. Removal of the diseased fallopian tube.
This is suitable for patients with severe tubal lesions or severe internal bleeding and shock. The operation can be performed openly or laparoscopically, which has become the main surgical method because of its minimally invasive, aesthetic and fast recovery.
Before announcing the happy news, it is better to go to the hospital for ultrasound examination and blood HCG and progesterone measurement to exclude the possibility of ectopic pregnancy and to have a healthy baby successfully and safely.