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Ultrasound Diagnosis Of Ectopic Pregnancy

Ectopic pregnancy

The term "ectopic pregnancy" or "extrauterine" is defined as the pathological condition in which the implantation of the fertilized egg takes place in locations other than the uterine cavity. The recognition by pregnancy ultrasound and early treatment of this condition can help preserve the possibility of future pregnancies.

ectopic-pregnancy

What is ectopic pregnancy?

When the nesting takes place outside the uterus we talk about an extrauterine pregnancy (tubal pregnancy, ovarian pregnancy, abdominal pregnancy); instead, "ectopic intrauterine pregnancy" is defined when the implantation takes place inside the uterus but in an improper place, as in the case of the implant in the cervical canal (cervical pregnancy) or at the level of the tubal ostium (corneal pregnancy).

What are the causes of ectopic pregnancy?

Tubar pregnancies - the most common type of ectopic pregnancy, equal to about 95% of the total - take place when

The descent of the fertilized egg towards the uterus is delayed or deviated (due to anatomical lesions, inflammatory lesions, congenital tubal alterations, endometriosis or alterations of the pelvic anatomy due to previous surgical operations).

The development of the fertilized egg is accelerated so that it reaches the degree of maturity necessary for the implant when it is still in the tuba.

The underlying causes of other forms of extrauterine pregnancy can mostly be traced to the same factors as tubal pregnancy. Sometimes the cause is unknown.

What are the symptoms of ectopic pregnancy?

If the pregnancy is initial (4 ^ -6 ^ week), the patient is often asymptomatic. The suspicion of the presence of an ectopic pregnancy is therefore given by the presence of a positive pregnancy test without the visualization of the gestational chamber inside the uterine cavity. Blood losses are almost constantly present in cases of ectopic pregnancy. In cases of more advanced pregnancy, which involves the progressive erosion of the tube up to the rupture, to vaginal bleeding, it is accompanied by important pelvic and / or abdominal pain. In the most serious cases, that is when the tuba breaks, the consistent blood loss in the abdomen (hemoperitoneum) can lead to dizziness and fainting up to a real state of shock.

How to prevent ectopic pregnancy?

An ectopic pregnancy cannot be prevented, but some risk factors can be reduced. Among the virtuous behaviors that it is good to adopt, limit the number of sexual partners and use condoms during sexual intercourse, in order to prevent sexually transmitted infections and reduce the risk of developing conditions such as pelvic inflammatory disease.

The ultrasound test of suspected ectopic pregnancy is essentially carried out by:

Analysis of the blood value and changes of the HCG hormone (pregnancy hormone).

Transvaginal and trans-abdominal ultrasonography, which make it possible to exclude the presence of a gestational chamber in the uterine cavity and to visualize pregnancy in an ectopic location. Ultrasound also allows the recognition of blood effusions in the pelvic and / or abdominal area.

Treatments

Ectopic pregnancy can be treated:

In early cases, without any therapy (spontaneous resolution) or through a medical therapy based on methotrexate (a chemotherapy that prevents the cellular growth of pregnancy).

In the most advanced or symptomatic cases, or when drug therapy has failed, through laparoscopic surgery. Depending on the case, the affected tube (salpingectomy) is removed or only the ectopic pregnancy is removed.

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