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Tang Mei Xiang
Obstetrics and Gynecology
About me
Graduated from South China University with a master's degree, chief physician, engaged in obstetrics and gynecology work for 25 years
Proficient in diseases
Pre-conception, pregnancy, postpartum guidance. Threatened miscarriage, fetal demise, diagnosis and treatment of fungal vaginitis during pregnancy, common gynecological diseases, management of recurrent diseases, vaginitis, cervicitis, pelvic inflammatory disease, uterine fibroids, endometriosis, infertility, family planning guidance, medication-induced abortion, surgical abortion, menstrual disorders.
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How is an ectopic pregnancy caused?
Ectopic pregnancy refers to the implantation of a fertilized egg outside the uterine cavity. A pregnancy located outside the uterine cavity is commonly known as an ectopic pregnancy. The most common type of ectopic pregnancy is a tubal pregnancy, though less common types include abdominal, ovarian, and cervical pregnancies. How does an ectopic pregnancy occur? Inflammation is the most common cause, as it can lead to adhesions in the fallopian tubes or pelvic area, causing abnormal transport in the fallopian tubes. Additionally, ectopic pregnancies can result from scarring after surgeries, such as pregnancies in cesarean section scars, and from anomalies of the uterus, like pregnancies in a remaining part of the uterus.
Symptoms of ectopic pregnancy
The symptoms of an ectopic pregnancy depend on the location of the implantation of the fertilized egg, whether there has been a rupture or miscarriage, and the amount and duration of bleeding if there has been a rupture or miscarriage. Generally, there may be no symptoms in the early stages. If a miscarriage or rupture occurs, symptoms similar to those of threatened miscarriage or early pregnancy might appear. Typically, the manifestations of ectopic pregnancy include missed periods, usually about six to eight weeks of amenorrhea. The second is abdominal pain, which is the most common symptom in patients with tubal pregnancies, accounting for about 95%. Third, there is a small amount of vaginal bleeding, which does not correlate proportionally with internal bleeding and is generally less than a normal menstrual period. Fourth, fainting and shock can occur if there is significant internal bleeding. Fifth, a mass may be palpable in the abdomen.
Can an ectopic pregnancy be carried to term?
Ectopic pregnancy refers to the implantation of a fertilized egg outside the uterine cavity, commonly known as ectopic pregnancy. An ectopic pregnancy is when the pregnancy sac implants outside the uterine cavity. Because the muscle layer outside the uterine cavity is very thin, it restricts the growth of the pregnancy sac during its development. Furthermore, the trophoblast invades the local blood vessels, causing the vessels to rupture and miscarriage to occur very early in the pregnancy, potentially endangering the patient's life. Therefore, an ectopic pregnancy is an abnormal pregnancy that cannot be sustained. If an ectopic pregnancy is detected, it should be treated as early as possible.
How is an ectopic pregnancy treated?
The treatment methods for ectopic pregnancy include surgical treatment, medical treatment, and expectant management. Surgical treatment involves surgical intervention, which can be either conservative or radical surgery. Generally, surgery is indicated when blood HCG levels are relatively high, exceeding 3000 units per liter, or when there is a continuous increase. An ultrasound may show ectopic cardiac activity, a large mass, or it may be used when medical treatment is contraindicated, ineffective, or when vital signs are unstable and there is significant internal bleeding. These are indications for surgical treatment of an ectopic pregnancy. Additionally, there are conservative treatments and expectant management. Expectant management involves no medication, just regular monitoring of HCG levels and ultrasound examinations.
Can an ectopic pregnancy cause a fever?
Ectopic pregnancy generally does not cause fever symptoms unless there is an infection. The typical signs of an ectopic pregnancy include a history of missed menstruation, minor vaginal bleeding, and abdominal pain. When the ectopic pregnancy in the fallopian tube has not ruptured, the pain is characterized by swelling pain in the lower abdomen. If the fallopian tube pregnancy ruptures, there will be tearing pain, followed by tenderness in the lower abdomen, rebound pain, and abdominal muscle tension, and then fainting and shock can occur. During a gynecological examination, it is possible to feel a mass in the abdomen. Ectopic pregnancies generally require surgical treatment. After surgery, there might be a temporary fever known as "absorption fever," but this type of fever is short-lived and the body temperature does not exceed 38 degrees Celsius. This is a normal physiological reaction after surgery and is not considered a pathological fever.
How is endometrial cancer diagnosed?
Endometrial cancer often manifests as vaginal bleeding after menopause, and in women who have not experienced menopause, it often presents as menstrual irregularities. The diagnostic methods for endometrial cancer include the following: 1. Fractional curettage is the most important method for diagnosing endometrial cancer. First, scrape the cervical canal, then sequentially scrape the endometrial tissue from each part of the uterine body, label the specimens separately, and send them for pathological examination together. 2. Cytological examination is a method for screening for endometrial cancer. A specially made uterine cavity suction tube or brush is inserted into the uterine cavity to collect secretions for cytological culture. 3. Hysteroscopic examination allows direct observation of the growth of endometrial lesions and can also obtain live tissue for pathological examination. It involves pelvic ultrasound examination to understand the size of the lesion, surrounding infiltration, etc. 5. Other methods, such as lymphangiography, CT, MRI, and serum CA125 testing.
The main causes of postpartum hemorrhage
There are four main causes of postpartum hemorrhage: one is uterine atony, two is due to trauma in the soft birth canal, three is due to placental factors, and four is coagulation dysfunction. Uterine atony is the most common cause of postpartum hemorrhage clinically. Various factors can lead to uterine atony, such as maternal exhaustion during labor due to not eating, leading to physical decay, which can also cause uterine atony. Additionally, an excessively large uterus, such as from excessive amniotic fluid, twins, or triplets, can lead to poor uterine contraction and retraction rates after childbirth. As for injuries in the soft birth canal, they mainly occur due to insufficient protection of the perineum during childbirth or inappropriate use of vacuum assistance during the second stage of labor, causing trauma in the soft birth canal. Placental factors include placental adhesion, placenta accreta, partial placental abruption, and retained placenta, all of which can lead to postpartum bleeding due to placental issues.
What are the symptoms of an ectopic pregnancy?
Ectopic pregnancy refers to the implantation of the fertilized egg outside the uterine cavity. Because it is not in the environment of the uterus, ectopic pregnancies often end in miscarriage or rupture. The symptoms of an ectopic pregnancy mainly depend on the location of the implantation of the fertilized egg, whether a miscarriage or rupture has occurred, the amount of bleeding, the duration of the bleeding, and whether there is a rupture or miscarriage in a tubal pregnancy. Generally, there are often no specific clinical manifestations in the early stages. If it reaches the middle to late stages, there might be symptoms such as abdominal pain and vaginal bleeding. If a tubal pregnancy ruptures, the abdominal pain follows a series of tearing pains, then progresses to generalized abdominal tenderness and rebound pain.
Can you have intercourse with an ectopic pregnancy?
Ectopic pregnancy and sexual intercourse often occur when the patient is unaware, specifically during the early stages when there is no bleeding, no abdominal pain, and only amenorrhea is present; intercourse might occur under these circumstances. However, if there is irregular vaginal bleeding or abdominal pain, suspecting an ectopic pregnancy, it is advised not to have intercourse. This is because intercourse can cause excitement, which might lead some ectopic pregnancy masses to rupture, potentially causing severe bleeding.
What are the early signs of ectopic pregnancy?
Ectopic pregnancy is a common term for what is known as a displaced pregnancy; that is, a condition where the fertilized egg implants outside of the uterine cavity. Therefore, ectopic pregnancy and intrauterine pregnancy are different. In the early stages of an ectopic pregnancy, if there is no splitting of the pregnancy sac or bleeding, there generally are no symptoms. However, the condition can be understood and assessed through some auxiliary examinations. For example, after the cessation of menstruation, an ectopic pregnancy might be accompanied by a small amount of vaginal bleeding, and blood tests for HCG might show that the HCG levels do not double as expected. Or, at a certain gestational week, such as six or seven weeks, an ultrasound might not reveal a pregnancy sac. These are all precursors to an ectopic pregnancy, and if these signs appear, the likelihood of an ectopic pregnancy is very high.