How does ectopic pregnancy evolve?
Ectopic pregnancy It is a pathology that needs timely diagnosis and treatment to prevent the woman's life from putting herself at risk. If we take into account all pregnancies that happen in the world, approximately 1-2% of them are ectopic.
That is, of every 100 pregnant women, 1 or 2 suffer from the extrauterine form of pregnancy. In the group of women who have ectopic pregnancy, 99% develop in the fallopian tubes, being the most frequent place of pathological nesting of pregnancy.
What is ectopic pregnancy?
Basically An ectopic pregnancy is any pregnancy that develops outside the woman's uterus. It can also be called extrauterine pregnancy. Ectopic is a word that derives from the Greek, and is composed of two parts: ektos, which means outside, and moles, which means place.
Unfortunately, the frequency of pathology has been increasing in the world for a few decades. The factors that influence this are not clear. It is mainly suspected of increased sexually transmitted infections which, as we will see later, constitute a risk factor.
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Causes of ectopic pregnancy
Ectopic pregnancy can have anatomical and functional causes. However, there are other risk factors involved in its development.
Broadly speaking, we can separate the causes of ectopic pregnancy into two groups: by anatomical causes and by functional causes.
1. Anatomical causes
Between these, the biggest problem is the passability of the fallopian tubes. This anatomical structure of women must be able to let the fertilized egg formed by the ovule and sperm freely pass through.
The fallopian tubes can be blocked by polyps or adhesions that are formed due to previous infections. Sexually transmitted diseases are a common origin of adhesions.
2. Functional causes
Instead of altering the anatomy of the fallopian tubes, What can be altered is their mobility. This mobility of which we speak is a function that accompanies the path of the fertilized egg to reach the uterus.
The fallopian tubes may have muscle weakness, or more commonly, a cilia deficit. Cilia are small structures of the organ that move microscopically to drag the fertilized egg. If there are fewer cilia, there is less mobility.
There are groups of women who are more likely to have an ectopic pregnancy than others. These groups have some risk factor, that is, some previous condition that makes them more susceptible to reaching the situation where pregnancy develops outside the uterus.
The most important risk factors are:
- Pelvic inflammatory disease (PID): This is the biggest risk factor according to scientific studies on ectopic pregnancy. Women who have had PID and have a positive pregnancy test should consult the doctor as soon as possible so that an ultrasound determines the location of the pregnancy.
- Previous ectopic pregnancies: The woman who has already had an extra-uterine pregnancy is more likely to have it again.
- Having had abortions.
- Use IUD as a contraceptive method
- Have undergone surgical procedures in the abdomen or pelvis.
- Have a history of diseases such as endometriosis or tuberculosis.
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How ectopic pregnancy evolves
Because of its complexity, ectopic pregnancy puts a woman's life at risk. Therefore, it is important to detect it in a timely manner.
All pregnancies begin outside the uterus, when a sperm fertilizes an egg. This fertilization occurs in the fallopian tubes, specifically in the infundibular area, which is the most distant region of the uterus and closest to the ovary.
The first days of the fertilized egg occur there, and then migrate through the tubes in search of implantation or nesting, which is the process by which the fertilized egg adheres to the uterus. Normally, between 7-8 days after fertilization, the egg should start implantation. That is to say that, a week after being formed, the egg should enter the uterus to remain there.
In ectopic pregnancy, nesting or implantation happens outside the uterus. The most frequent location is the fallopian tube, but it can also develop in an ovary or in the woman's abdominal cavity.
The vast majority of ectopic pregnancies are not viable, because only the uterus is conditioned to receive the egg and protect the embryo by feeding it. The usual outcome of extrauterine pregnancies is spontaneous abortion, which can manifest without symptoms, and the woman may never know; or become apparent with vaginal bleeding and low abdominal pain.
In a low percentage of cases, it does not resolve itself. Gestation grows outside the uterus, sometimes completing up to a full trimester. This is the most dangerous variant. Ectopic pregnancies located in the fallopian tube, growing, can rupture the tubes causing internal abdominal bleeding that will require immediate surgical intervention.
Detected in time, the ectopic pregnancy is intervened before serious complications appear. Because Medical consultation is essential during the first trimester of pregnancy, and performing an obstetric ultrasound that determines the location of the embryo within the woman's body. In the same way, before any vaginal bleeding or persistent low abdominal pain, timely medical consultation also becomes essential.