After everyone calms down from the joy of early pregnancy, the biggest worry is: whether the pregnancy is in the womb.
In early pregnancy, this is a difficult question to answer, and no one can give you a clear answerall at once. As a result, many sisters are in dangerous situations because they did not take timely measures.
I always believe that women of childbearing age should have some basic common sense. With this basic knowledge, it will help to a great extent. You make a preliminary judgment.
◎ Causes of ectopic pregnancy
Ectopic pregnancy is a sword hanging over the head of pregnant sisters. Everyone is afraid that it will fall. on his own head. According to estimates, its incidence rate is between 5 and 10 per thousand. In the past 20 years, the birth rate of ectopic pregnancies has been increasing, and the number of deaths due to ectopic pregnancies has also increased.
Most ectopic pregnancies occur in the fallopian tube, accounting for 97.7%; 1.4% occur in the abdomen; less than 1% occur in the ovary and cervix. The vast majority of fallopian tube pregnancies occur in the ampulla of the fallopian tube, 12% in the isthmus, and 5% in the fimbria. It can also occur in the contralateral fallopian tube, but this is rare.
Ectopic pregnancy does not happen for no reason. The main cause is salpingitis. Histological examination shows fallopian tube inflammation in 40% of patients. %; followed by abnormality or dysplasia of the fallopian tube. The fallopian tube is slender, curved, or compression and traction by tumors on the ovary and uterus will cause the fallopian tube to shift or deform. , and even affect the pregnancy and egg pass; other reasons include fallopian tube surgery, smoking during pregnancy, infertilityTubal ligation failed as a contraceptive method, and diethylstilbestrol (DES) has been used.
Therefore, as long as you do not have the above conditions, you do not need to worry about ectopic pregnancy. Even women who have had an ectopic pregnancy, The risk of recurrence is only 7% to 15%.
However, in addition to patients with a history of salpingitis, women who have long-term use of oral hormones for contraception and use intrauterine devices, The probabilities of ectopic pregnancy are 1% and 5% respectively. Therefore, sisters who take long-term contraceptive pillsyou must be fully aware of this danger!
◎ How to judge ectopic pregnancy
The sooner ectopic pregnancy is eliminated, the better! In the beginning, you can only rely on your own feelings. Abdominal pain is almost the most common symptom of patients with ectopic pregnancy. Before the fallopian tube ruptures, although there are no obvious symptoms, there are someThe patient will have a dull pain on one side of the lower abdomen; when the fallopian tube pregnancy miscarriages or ruptures, he will suddenly feel a tearing feeling on one side of the lower abdomen or paroxysmal pain. As the villi separate from the fallopian tube wall, or the fallopian tube wall ruptures, intra-abdominal bleeding may occur, and the blood may stimulate the peritoneum, causing abdominal pain.
According to statistics, more than 90% of patients with ectopic pregnancy have abdominal pain. Along with abdominal pain, 25% of patients experienceshoulder pain. This is because the abdominal diaphragm is stimulated by blood, which can cause radiating pain to the shoulder. In addition, when bloodfluid accumulates in the uterus and rectum, it can manifest as anal distension and a feeling of defecation. This symptom is pelvicThe unique manifestation of hemorrhage is of great significance to the judgment of ectopic pregnancy. Therefore, everyone must remember that ifif you have abdominal pain, shoulder pain, or a lingering feeling of defecation, then youYou should go to the hospital for examination as soon as possible.
Ectopic pregnancy also has another characteristic, that is, abdominal pain is often accompanied by irregular vaginal spotting and bleeding. The amount is less than the menstrual amount and the blood color is dark red. This is because the endometrium lacks the support of secretion and falls off. The other reason is that bleeding in the fallopian tube passes through the uterus. Caused by discharge from the cavity to the vagina.
It should be reminded that vaginal bleeding caused by ectopic pregnancy is obviously different from the \”off-duty phenomenon\” mentioned above. Distinguishes should be made when making self-judgments, and do not mistake the \”off-duty phenomenon\” for ectopic pregnancy.
Although self-feeling can make you more vigilant in a timely manner, it is not a reliable method. The samesame pain feels very different in different people. Some people have a strong tolerance for pain, while otherscannot tolerate it at all. When the former thinks it is not too painful, the latter Already yelling.
Therefore, the judgment of ectopic pregnancy should still rely on scientific means. You can go to the hospital to have your blood testedHCG. 90% of pregnant women with normal pregnancies have plasma HCG values every 48 hours in the first 6 to 7 weeks of pregnancyDoubles. When the growth of HCG is less than 66%, it indicates that it may be abnormal.
In early pregnancy, measuring blood HCG is indeed a quantitative method. When you take the test for the first time, you get a data. After 48 hours, you draw blood again and get another data. Compare the two data Once. When the second data is twice as large as the first data, ectopic pregnancy is basically ruled out. This is aA practice that everyone is already familiar with. The disadvantage is that you have to draw blood twice, go to the hospital twice, and have to wait a relatively long time before you know the results.
Now I will tell you a simple method, that is, when you go to the hospital to test your blood HCG, take another test at the same time. Progesterone, because progesterone can also correctly reflect the implantation status: 98% of patients with ectopic pregnancy without ovulation induction have plasma progesterone lower than 20ng/ml . This means that as long as you conceive naturallyand in the early stages of pregnancy, the measured progesterone level is higher than 20ng/ml, then ectopic pregnancy can be ruled out is possible.
If progesterone exceeds 20ng/ml, ectopic pregnancy is largely ruled out; if it is less than 20ng/mlit must be ectopic pregnancy ? Neither. When progesterone is lower than 20ng/ml or even lower than 15ng/mlthe situation is more complicated. It may be due to insufficient luteal function or ectopic pregnancy. Therefore Further differential diagnosis must be made. To confirm the diagnosis, the most commonly used method in the hospital is B-ultrasound examination. Here, I would like to remind everyone: when vaginal B-ultrasound is used to detect the position of pregnancy, it is more Abdominal B-ultrasound can be performed one week earlier. At the same time, B-ultrasound must be combined with HCG measurement. There is no point in doing B-ultrasound too early!
When blood HCG reaches 6500mIU/ml, abdominal B-ultrasound can diagnose intrauterine pregnancy; when blood HCG reaches 2000mIU/ml , vaginal B-ultrasound can diagnose intrauterine pregnancy.
Of course, correct judgment also requires high-quality medical personnel and high-quality ultrasound equipment, so Therefore, I suggest that sisters must find a more trustworthy hospital and an experienced doctor.
Ultrasound examination can find: 68% of fallopian tube pregnancy, the fallopian tube has a hypoechoic area of 1 to 3 cm, surrounded by 2 to 4 cm Concentric edge rings produced by millimeter ultrasound. Almost every hospital has its own standards for ultrasound and HCG parameter values forevaluation of ectopic pregnancy. In addition to the above methods, the hospital will also use posterior fornix puncture and laparoscopy to directly examine the fallopian tubes.
Posterior fornix puncture is rarely used now, and laparoscopy is often used as the last step in diagnosing ectopic pregnancy! The accuracy rate is quite high, but there is still an error of 4%.
Ectopic pregnancy is the second largest killer of pregnant women, with the death toll accounting for about 40%of the total number of ectopic pregnancies. Therefore, Early elimination after pregnancy is the first priority. Time is very important hereThe key is: if it is discovered early, conservative treatment can be adopted, and the embryonic heart can be stopped with drugs; if it is discoveredIf it is too late, the fallopian tube must be removed; once the fallopian tube ruptures, causing massive abdominal bleeding, it is only one step away from deathFar away!
Everyone must note that the time of fallopian tube rupture is related to the size of the lumen where the pregnant egg implants and the thickness of the tube wall. For example, in the isthmus, rupture occurs earlier, often within a week after implantation; interstitial pregnancy occurs because the muscle tissue of the uterine corners is thicker , often ruptures only in the 3rd to 4th month of pregnancy. Because there are extremely rich blood vessels, once it ruptures, the bleeding will be very serious.
The safety of pregnant women is the first priority, so ectopic pregnancy must be ruled out as early as possible in early pregnancy. Time is indeed very important, however, The correct diagnosis is more important, the uterusMisdiagnosing an internal pregnancy as an ectopic pregnancy, or diagnosing an ectopicpregnancy as an intrauterine pregnancy will have serious consequences.
Experienced doctors can diagnose ectopic pregnancy using simple methods; inexperienced doctors can diagnose ectopic pregnancy even with advanced instruments Misdiagnosis occurs. Instead of completely relying on others, it is better to try to rely on yourself. Extrauterinepregnancy has feelings. It is always more direct to feel it yourself than to let the doctor feel it for you. You should keep in mind the various methods listed in the article. Some methods are very scientific and simple and can help you eliminate them in the first timeectopic pregnancy.
This article is provided by Baidu Reading and is excerpted from \”Pregnancy Can Be Simple\” Author: Feifei Mom