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Tubal pregnancy, also known as tubal pregnancy, is a type of ectopic pregnancy in which the embryo is implanted outside the uterus, in this case, in the fallopian tubes. When this happens, the development of pregnancy can be impaired, this is because the embryo is unable to move into the uterus and the tubes are not able to stretch, which can rupture and endanger the woman's life.
Some factors can favor the development of tubal pregnancy, such as sexually transmitted infections, endometriosis or having already had a tubal ligation, for example. Usually, this type of pregnancy is identified until 10 weeks of gestation on an ultrasound, but it can also be discovered later.
However, if the problem is not detected, the tube may rupture and is called a ruptured ectopic pregnancy, which can cause internal bleeding, which can be fatal.
Main causes
The occurrence of tubal pregnancy can be favored by several factors, the main ones being:
- Use an IUD;
- Scar from pelvic surgery;
- Pelvic inflammation;
- Endometriosis, which is the growth of endometrial tissue outside the uterus;
- Previous ectopic pregnancy;
- Salpingitis, which is characterized by inflammation or deformation of the fallopian tubes;
- Chlamydia complications;
- Previous surgery in the fallopian tubes;
- Malformation of the fallopian tubes;
- In case of infertility;
- Having sterilized the tubes.
In addition, age over 35 years, in vitro fertilization and the fact of having several sexual partners can also favor the development of an ectopic pregnancy.
Signs and symptoms of tubal pregnancy
Some signs and symptoms that may indicate pregnancy outside the womb include pain on only one side of the belly, which gets worse every day, always in a localized and colic-like manner, and vaginal bleeding, which can start with a few drops of blood, but that soon becomes stronger. See also other causes of colic in pregnancy.
The pharmacy pregnancy test can detect that the woman is pregnant, but it is not possible to know if it is an ectopic pregnancy, being necessary to perform an ultrasound exam to check exactly where the baby is located. As an ectopic pregnancy can become broken before the 12th week of gestation, there is not enough time for the belly to start to grow, enough to be noticed by other people. Learn how to identify the signs and symptoms of ectopic pregnancy.
Treatments for ectopic pregnancy
Treatment for ectopic pregnancy can be done through the use of the drug methotrexate, which induces abortion, or through surgery to remove the embryo and reconstruct the tube.
When surgery is indicated
Surgery to remove the embryo can be done by laparostomy or open surgery, and is indicated when the embryo is more than 4 cm in diameter, the Beta HCG test has more than 5000 mUI / ml or when there is evidence of rupture of the tube, which puts the woman's life at risk.
In either case, the baby cannot survive and the embryo must be completely removed and cannot be implanted inside the uterus.
When remedies are indicated
The doctor may decide to use medicines such as methotrexate 50 mg, in the form of an injection when an ectopic pregnancy is discovered before 8 weeks of gestation, the woman does not present rupture of the tube, the gestational sac is less than 5 cm, the Beta exam HCG is less than 2,000 mUI / ml and the embryo's heart is not beating.
In this case, the woman takes 1 dose of this medication and after 7 days she must undergo a new Beta HCG, until it is undetectable. If the doctor finds it safer, he can indicate 1 more dose of this same medicine to make sure the problem is solved. Beta HCG should be repeated in 24 hours and then every 48 hours to see if it is gradually decreasing.
During this treatment, which can last up to 3 weeks, it is recommended:
- Do not do the vaginal touch exam as it can cause tissue rupture;
- Not having intimate contact;
- Avoid exposure to the sun because the medicine can stain the skin;
- Do not take anti-inflammatory drugs due to the risk of anemia and gastrointestinal problems related to the drug.
Ultrasound can be performed once a week to check if the mass has disappeared because even though the beta HCG values are decreasing, there is still the possibility of rupture of the tube.
Is it possible to get pregnant after surgery?
If the tubes were not damaged by ectopic pregnancy, the woman has new chances of getting pregnant again, but if one of the tubes broke or was injured, the chances of getting pregnant again are much lower, and if both tubes have broken or are affected, the most viable solution will be in vitro fertilization. See how to get pregnant after a tubal pregnancy.