Ectopic pregnancy

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Written by Liu Qin
Obstetrics and Gynecology
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Causes of ectopic pregnancy

Ectopic pregnancy refers to the implantation of a fertilized egg outside the uterine cavity, among which tubal pregnancy is the most common type, accounting for about 95% of ectopic pregnancies. There are many causes of ectopic pregnancy, with the main cause being inflammation of the fallopian tubes. The inflammation can cause the mucous membrane of the fallopian tube to become sticky, narrowing the lumen of the tube, or impairing the function of the cilia inside the tube, leading to obstruction of the fertilized egg's movement within the tube and resulting in implantation at that location. Other causes include surgery on the fallopian tubes, poor development or abnormal function of the fallopian tubes, further development of assisted reproductive technologies, and the use of emergency contraceptive pills, also known as contraceptive failure, among others. (The use of medications should be under the guidance of a doctor.)

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Written by Du Rui Xia
Obstetrics
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ectopic pregnancy rate

The probability of an ectopic pregnancy occurring is generally quite low, with an incidence rate of about 2%-3%. An ectopic pregnancy refers to a fertilized egg that does not implant within the uterine cavity, and occurs outside the uterine cavity; the most common site for an ectopic pregnancy is the fallopian tube, followed by the ovaries and the abdominal cavity. These are the common sites for ectopic pregnancies. The main causes of ectopic pregnancies are chronic inflammation or congenital diseases, which lead to adhesions and blockages in the fallopian tubes, affecting the migration of the fertilized egg.

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Written by Du Rui Xia
Obstetrics
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Does an ectopic pregnancy hurt?

Ectopic pregnancy is an abnormal pregnancy state where the fertilized egg implants outside the uterine cavity. As the pregnancy sac grows, there is a possibility of rupture and bleeding at the implantation site, which can lead to abdominal pain. In the early stages of an ectopic pregnancy, women generally do not exhibit any specific symptoms and are unaware of the condition. Symptoms are only felt when rupture occurs, causing pain in the lower abdomen. If rupture occurs, the pain often feels like tearing in the lower abdomen and is frequently accompanied by nausea and vomiting. It is recommended to promptly visit a hospital for an ultrasound and actively pursue surgical treatment.

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Written by Liu Qin
Obstetrics and Gynecology
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What causes an ectopic pregnancy?

Ectopic pregnancy refers to the implantation of a fertilized egg outside the uterine cavity, with tubal pregnancy being the most common type, accounting for up to 95% of cases. There are many causes of ectopic pregnancy, with the main reasons including the following: First, inflammation of the fallopian tubes is a major cause of ectopic pregnancy because the inflammation can cause the mucous membranes of the tubes to adhere, narrowing of the lumen, or impairment of the cilia function, leading to obstruction of the fertilized egg's movement within the tube, preventing it from reaching the uterine cavity, thus, it implants in the tube. Second, the patient has a history of fallopian tube surgery or a previous ectopic pregnancy. Third, poor development or abnormal function of the fallopian tubes. Fourth, the implementation of assisted reproductive technology. Fifth, the intake of emergency contraceptive pills by individuals who experienced contraceptive failure. (The use of medications should be done under the guidance of Doctor Yan.)

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Written by Zhang Lu
Obstetrics
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Does an ectopic pregnancy hurt in the early stages?

Ectopic pregnancy refers to the implantation of the gestational sac outside the uterine cavity, with common implantation sites including the fallopian tubes, ovaries, and pelvic cavity. Early ectopic pregnancy can also cause some pain, with common reasons for the pain including the following: First, the main reason is the enlargement of the uterus under the stimulation of estrogen and progesterone in the body, which pulls on the surrounding tissues and ligaments, such as the round ligament of the uterus, uterosacral ligaments, or bilateral adnexa, causing lower abdominal traction pain. This presents as a feeling of heaviness or menstrual-like sensation. This pain is a normal physiological manifestation during early pregnancy and is present in both intrauterine and ectopic pregnancies. Second, in early ectopic pregnancy, sometimes the gestational sac can cause mild irritation and pressure on local tissues, leading to mild localized pain, which is often not very noticeable.

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Written by Su Wen
Obstetrics and Gynecology
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Early symptoms of ectopic pregnancy

Ectopic pregnancy, also known as extrauterine pregnancy, refers to the implantation of the gestational sac outside the uterine cavity. For example, in the fallopian tubes, ovaries, or the cornual region, etc., leading to a series of symptoms known as ectopic pregnancy. Typically, symptoms of an ectopic pregnancy include a history of amenorrhea, where most individuals have a long or short history of missed periods. The second symptom is bleeding, which can be irregular, minor vaginal bleeding or significant bleeding, as well as bleeding within the abdominal cavity, which can lead to hemorrhagic shock in severe cases. Additionally, abdominal pain may occur, manifesting as sudden, tearing-like lower abdominal pain, or irregular referred pain.

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Written by Zhang Lu
Obstetrics
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ectopic pregnancy symptoms

Ectopic pregnancy is not a normal state of pregnancy. Normally, the gestational sac should be located in the middle of the uterine cavity. An ectopic pregnancy refers to the implantation of the gestational sac outside the uterine cavity. Common types of ectopic pregnancy include tubal pregnancy, ovarian pregnancy, and abdominal pregnancy, with over 99% of ectopic pregnancies being tubal pregnancies. The symptoms of an ectopic pregnancy include the following aspects: 1. In the early stages of an ectopic pregnancy, there are no clinical symptoms because the early gestational sac is relatively small and does not stimulate the fallopian tube or the local area, thus causing no symptoms. 2. When the gestational sac grows to a certain size, it compresses the tube cavity, causing mild abdominal pain. This pain intensifies as the gestational sac grows and can lead to tearing pain, indicating a ruptured tubal pregnancy. 3. During an ectopic pregnancy, because the gestational sac cannot develop normally, the levels of estrogen and progesterone in the body are relatively low, leading to endometrial withdrawal bleeding, which manifests as a small amount of bright red vaginal bleeding.

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Written by Tang Mei Xiang
Obstetrics and Gynecology
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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.

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Written by Tang Mei Xiang
Obstetrics and Gynecology
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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.

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Written by Zhang Xiu Rong
Obstetrics and Gynecology
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Ectopic pregnancy medical conservative treatment

Under normal circumstances, the treatment of ectopic pregnancy is generally divided into conservative treatment and surgical treatment. Conservative treatment is usually applied when the ectopic pregnancy has not ruptured, using medication for about a week. After one week, a follow-up examination is done to check blood HCG levels and an ultrasound scan. If blood HCG levels have dropped significantly, the ultrasound shows that the mass has not grown, and the symptoms of abdominal pain have decreased, it indicates that the conservative treatment was successful. The threat is only considered resolved when blood HCG returns to normal levels. Otherwise, the conservative treatment for ectopic pregnancy may fail, and surgery will be necessary to treat the ectopic pregnancy symptomatically. If there is a particularly large amount of bleeding or a rupture has occurred, surgical treatment is the only option.