The implantation of the embryo in the cervix, ovary, abdomen, fallopian tubes or interstitium is an abnormal situation. Hence, ectopic pregnancy is considered a health problem, which requires medical intervention, avoiding putting the woman’s life at risk. Above all, because some complications can arise that lead to internal bleeding that is difficult to treat.1
In fact, hormonal imbalance, alteration in the development of the ovaries, recurrent infections and having had a previous history of the same phenomenon, are considered among the possible culprits of this anomaly. Likewise, they are risk factors, undergoing fertility treatments, tubal surgery or the use of intrauterine devices as a contraceptive method.1
This is how we see that the positioning of the fertilized egg as it passes through the tubes remains trapped, with tubal pregnancy being the most frequent. Making, that a possible state of pregnancy with suggestive symptoms is presumed. But, as abnormal growth progresses, abdominal pain and dark-colored bleeding appear, indicating difficulties that must be corrected in the shortest possible time.
Ectopic pregnancy demands solutions
Hence, the GP and OB / GYN play a very important role in diagnosis and treatment. Since, in your hands, it is to establish an adjusted clinical picture, with the help of the results of the vaginal ultrasound and the quantitative measurement of human chorionic gonadotropin, hCG.2
Above all, because to establish the appropriate procedure, several aspects must be taken into account. Among which we have the size of the dough; gestational age; the amount of hCG; progesterone levels; peritoneal fluid and fallopian tube conditions. Because these indicators bring the doctor closer to the real scenario of ectopic pregnancy.2
What can be done?
Opt for expectant medical or surgical treatment. Where the former is used, in mild cases, when the mass is less than 30 mm in diameter. Hence, the same body is expected to progressively lower hCG levels. And, to verify this, intensive monitoring is carried out, until verifying that everything returns to normal.2
Similarly, when the ectopic pregnancy is less than 4cm, there is no cardiac activity and there is no rupture, medical treatment with drugs is chosen. Where the use of a folic acid antagonist called Methotrexate is included, which prevents the growth of active proliferative cells. What it does, that the growth of the ovule stops, later helping to eliminate the fetal cells more easily.3
In addition, in situations in which the size of the fertilized ovum is greater than 5cm, there is cardiac activity, there is rupture or the woman has unstable hemodynamics, it is mandatory to resort to surgery. Above all, because the fetus is unlikely to develop outside the uterus, the mother is also at risk of hemorrhage and life-threatening infections. 3
In this way, we understand that ectopic pregnancy requires specialized care, but also speed on the part of the patient. Above all, because when suspected of being pregnant, professional guidance should be sought. To implement prenatal controls and perform diagnostic tests that reveal if the blastocyst is implanted correctly and does not put the mother’s health at risk.
References:
1.Espinoza Garita S, Garnier Fernández JC, Pizarro Alvarado G. Generalities of ectopic pregnancy. Rev. medic. synerg. [Internet]. May 1, 2021 [citado 22 de julio de 2021]; 6 (5): e670. Available in:
https://revistamedicasinergia.com/index.php/rms/article/view/670.
2.Altunaga Palacio Margarita, Rodríguez Morales Yordanka, Lugones Botell Miguel. Management of ectopic pregnancy. Rev. Cubana Obstet Ginecol [Internet]. Dec 2011 [citado 2021 Jul 22]; 37 (4): 513-523. Available in:
http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-600X2011000400008&lng=es..
3.Huixian Hu Liang Jairo Sandoval Vargas Ana Gabriela Hernández Sánchez Josué Vargas Mora. Ectopic pregnancy: a biographical review with a focus on medical management. Rev. Clin. Esc. Med. [internet] 2018 [consultado 22 jul 2021]; 19 (1): 28-36. Available in:
https://www.medigraphic.com/pdfs/revcliescmed/ucr-2019/ucr191d.pdf.