Restoration of the menstrual cycle after treatment of ectopic (tubal, ectopic) pregnancy

Ectopic pregnancy: causes and risks

During a normal pregnancy, the fetus develops in the uterus. But sometimes a fertilized egg takes root in places where bearing a child is impossible, and the mother’s health is at risk.

Even in pathological cases, menstruation in the literal sense of the word occurs extremely rarely. But there will almost always be bloody discharge of varying degrees of intensity reminiscent of it. They appear as a result of the attachment of the embryo in an unnatural place: in the tubes, abdominal cavity, cervix, ovaries, which stretch, become inflamed and bleed. And then breaks happen.

The reasons for the illogical course of pregnancy are different: weakness of male sperm, gynecological diseases of the expectant mother, hereditary predisposition to pathology, structural features of the reproductive system, consequences of abortion and excessive contraception, hormonal imbalances, and finally, this may be a complication after irrational use of medications that relax smooth muscles.

Do you have periods during an ectopic pregnancy?

According to various sources, from one and a half to five percent of pregnancies occur with similar pathologies. Identifying them is difficult, but possible. At first there may be no symptoms at all, then the signs are very similar to a normal pregnancy, even two test strips are detected during express analysis. True, the second one is pale.

Sometimes women believe that they are menstruating, but this is self-deception: they are mistaken for dark clots of blood secreted by the female genitals already in the first weeks after conception. These scanty discharges are combined with pain localized in the lower abdomen. At first it is tugging, but if the moment for early diagnosis is missed, the tube ruptures (up to 99% of atypical embryos are located in it). And then the pain worsens and the bleeding intensifies.

At 4-5 weeks, you can have surgery to remove part of the tube, but even if the tube or ovary is completely removed, this is not a death sentence. Pregnancy and normal childbirth are possible with one tube.

How is an ectopic pregnancy determined?

An ectopic pregnancy develops as usual: nausea, vomiting, delay and a positive test result.
There are all signs of fertilization. An abnormal course of pregnancy is determined only in the gynecology department, where the doctor examines the patient and prescribes an ultrasound. A woman cannot independently determine the pathology.

Drug treatment of ectopic pregnancy is today considered an ineffective method. The most common procedure to remove a fetus outside the uterus is surgery. It can be carried out in several ways; the choice of one method or another depends on the professionalism of the doctor and the woman’s condition.

The operation to remove an ectopic fetus is traumatic for the body.

Against the background of emotional stress, a woman often develops negative symptoms, the consequences of which can be unpleasant.

The vast majority of operations for this pathology are performed along with removal of the fallopian tube. If the fetus is sufficiently developed and the place of its attachment is deformed, then during the operation there is a risk of rupture. The doctor will not take risks, and therefore a decision is made to remove the entire tube along with the fetus.

The development of a zygote outside the body of the uterus entails similar changes in a woman’s hormonal background, as during simple pregnancy. Therefore, when the situation changes dramatically, a hormonal imbalance is observed. Treatment of such a complication is carried out only under the supervision of a gynecologist, in the presence of laboratory blood tests for testosterone and prolactin levels.

The consequences of removal also include controversial factors such as partial or complete infertility.

If one tube is removed, the second takes on the function of carrying the mature egg into the body of the uterus. It is also worth considering the following features:

• permeability;
• reserve of immature eggs;
• absence of inflammatory process of the reproductive organ;
• general psycho-emotional state of a woman.

Each woman experiences the consequences of an ectopic pregnancy individually. But it is clear that for everyone it is a stress that still needs to be overcome.

The worst thing that can happen is the excision of a tube (or two). Without such an important part of the reproductive system, it will be more difficult for the female body to perform the function of fertilization.

When a doctor is faced with a choice between the safety of an organ and the life of the patient, he will always choose the second. Reasons why the pipe is removed:

• re-attachment of the egg (recurrence of ectopic pregnancy);
• inflammation;
• the presence of a scar that prevents fluid from leaving the ovary;
• violation of the reproductive function of the organ;
• pipe deformation or rupture.

Removal is most often carried out:

• in women who have previously had several ectopic pregnancies;
• pregnant women who discovered pathology in the later stages (after the 7th week);
• with inflammation of the fallopian tube;
• in the presence of adhesions on the organ.

The most dangerous and negative consequence of such an operation is infertility. A woman who has experienced several pathological fertilizations risks being left without the entire reproductive organ. The result is the inability to conceive and bear a child on your own.

Rehabilitation after surgery takes about 9 months. During this time, hormonal levels are completely normalized and the menstrual cycle is adjusted.

The psycho-emotional recovery of a woman who is grieving a loss can be much more difficult.

After removing one tube, the chance of getting pregnant is 80%. The presence of the following factors reduces the likelihood of pregnancy:

• inflammation;
• endometritis;
• adhesions;
• low muscle activity of the uterus;
• infantile cilia in the uterus (poor movement);
• hormonal imbalance;
• stress;
• active physical activity in the first 6 months;
• non-compliance with recovery recommendations.

If you follow the rules of rehabilitation, then even after an ectopic pregnancy the probability of conceiving a child is high, since the egg will be released by a healthy organ during ovulation.

The consequences of removing an ectopic pregnancy partly depend on the woman herself, who understands the importance of such a process as rehabilitation and complies with all recovery requirements. If a pathology of fetal development is detected in the early stages, the zygote can be evacuated without removing part of the reproductive organ.

Based on materials from formama.online

An ectopic pregnancy does not always entail negative consequences. A woman’s future is influenced by a huge number of factors: features of surgical intervention (if any), concomitant diseases, lifestyle, etc. So, let’s look at several possible situations.

Unfortunately, not all women still plan their pregnancy and do not even monitor their menstrual cycle. Gynecologists will easily confirm that not every patient remembers when her last period began, which means they may also be unaware of their possibly interesting situation. Meanwhile, how an attentive attitude towards yourself can save you from tragedy. After all, the consequences of an ectopic pregnancy can be fatal, or they may not have much effect on the woman’s reproductive system. It all depends on the actions of the lady herself and on the speed of making the correct diagnosis.

If an ectopic pregnancy is not recognized early and the fetus continues to develop, tissue rupture may occur in the organ into which the fertilized egg was implanted, be it the fallopian tube, ovary or abdominal cavity. A woman may die from severe bleeding and painful shock if urgent surgery is not performed.

Of course, there are cases when an ectopic pregnancy stops developing on its own, but such situations are quite rare.

If one fallopian tube was removed during surgery

Yes, this comes as a shock to many women, because such consequences of an ectopic pregnancy can lead to infertility. But this is not always the case. Healthy young women (up to 28-30 years old) get pregnant quite easily and with one fallopian tube. The main thing is that her ovary functions well. For older women, especially after 35 years, it is much more difficult to get pregnant; they ovulate less frequently, and on the contrary, they have more chronic diseases. But in any case, there is always a way out of the situation - to do IVF. In this way, even those women who do not have a single fallopian tube get a chance at motherhood. Their eggs are taken directly from the ovaries using a mini-surgery, and before this, special hormonal therapy is carried out in order to induce the formation of several eggs that have every chance of conception. These eggs are fertilized under artificial conditions with the sperm of the husband (or donor). Already fertilized eggs are implanted directly into the uterus. So, the fallopian tubes are not involved in the process at all. If anything, you can do without them! Again, the healthier and younger the woman and the more accurately she follows all the doctor’s recommendations, the higher the chances of success.

Now there are techniques that allow, in the presence of other favorable conditions, not to remove the fallopian tube. In this case, the consequences of an ectopic pregnancy, such as difficulties conceiving a child, are less likely to occur. However, there is still a disadvantage to preserving the operated fallopian tube - the risk of developing an ectopic tube again and again in this tube increases. Any, even diagnostic, surgical intervention in the delicate reproductive world of a woman can have the most dire consequences. However, doctors believe that one should try to preserve the fallopian tube during VD if possible (if there is no significant damage) and the woman subsequently plans to become a mother. The risk of recurrence of the situation is lower than the risk of infertility. Doctors can remove the fallopian tube and ligate the second one if a patient who is over 35 years old and has 2 or more children so desires. This is called female sterilization.

You can save the fallopian tube if you do laparoscopic surgery. That is, remove the fetus and its membranes using special instruments inserted through small punctures in the abdominal wall. But, unfortunately, not all clinics in our country have the necessary equipment and qualified specialists to perform such operations, and it is not in all cases possible to remove the fetus in this way, without incisions. Too large a fetus or its inconvenient location may be the reason for a classic operation - laparotomy, that is, through incisions.

An ectopic pregnancy can have even smaller consequences if it can be terminated not surgically, but conservatively. This can be done with the help of a drug that was originally intended only for the treatment of cancer. It's called Methotrexate. The drug is quite harmful to the body, and before using it, the doctor must make sure that the woman is not pregnant. If everything goes well, the drug stops the growth of the fetus, it dies and dissolves. During 1-2 menstrual cycles it is necessary to carefully protect yourself, since the effect of the drug is to block folic acid - a substance, the lack of which causes children to be born with severe congenital pathologies, if not die while still in utero.

But, be that as it may, the consequences of an ectopic in this case are not as serious as with surgical intervention. However, when using Methotrexate, dangerous complications in the form of bleeding may occur. Therefore, an experienced specialist should prescribe this drug and then monitor the woman’s condition. The effectiveness of conservative treatment largely depends on the level of hCG at the time of drug administration; the lower it is, the greater the chance of success. Possible consequences of taking Methotrexate: severe pain, bleeding. The operation is performed if hCG does not fall, but rather increases after taking Methotrexate according to the protocol.

The first thing is to find out why this happened to you. Most often, the cause of tubal pregnancy is obstruction or adhesions. This means that the next pregnancy must be planned. And before that, be sure to undergo treatment and check the tubes (or the remaining tube, depending on what the consequences of the previous ectopic pregnancy were). Often the adhesive process is activated under the negative influence of various sexually transmitted infections - which means you need to take all the necessary tests and, if anything is found, get treatment. You should not overcool, as this provokes inflammatory processes.

According to statistics, repeated ectopic pregnancy occurs in approximately 5-20% of women, and after 2 cases, in 32%. You have the opportunity not to be included in the statistics.

Doctors, knowing that the patient has had cases of VD, monitor the course of pregnancy more closely, and planning is also more thorough. For example, the first ultrasound is performed not, as is customary, at 12 weeks, but almost immediately after the first signs of an interesting situation appear. After all, the woman is in the risk category according to the World Bank. Fortunately, numerous representatives of the fair sex calmly carry and give birth after experiencing a nightmare.

So, ectopic pregnancy does not always have significant health consequences. Much depends on preventive actions after experiencing VD, the attentiveness of women and doctors.

Based on materials from www.missfit.ru

Other signs of anomaly

The pain increases every week, or even every day, especially if the egg is localized in a narrow section of the tube. Bleeding is most intense when the fetus is in the richly vascular cervix. In isolated cases, it can pose a threat to a woman’s life.

Sometimes the blood is profuse due to spontaneous abortion, then it is also very important to seek medical help in time. Then the symptoms are supplemented by dizziness, sweating, weakness, sometimes to the point of fainting; the skin becomes pale or bluish. Inflammation can manifest itself as a rise in temperature, but the pressure, on the contrary, drops sharply, which is also extremely dangerous.

If you have an ectopic pregnancy, you have your period: what to do?

When the symptoms have been tracked in time and the diagnosis has been confirmed using ultrasound or laparoscopy, you can try to achieve a so-called tubal abortion, that is, a miscarriage organized with the help of medications. For example, with the use of the drug “Methotrexate”: it slows down cell growth, their division, and can provoke termination of pregnancy.

But more often it is necessary to resort to surgery, precisely because of the difficulties of diagnosis in general and the differentiation of normal and ectopic pregnancy, in particular. The best that a doctor can do is to limit himself to partial, gentle intervention, that is, to remove the very site of fetal development. In this case (and this is about half of the outcomes of the pathological development of the situation), the woman will have a solid chance of becoming a mother within a year.

But if the period is long, both the damaged organ and the uterus will have to be removed, then we are no longer talking about a favorable prognosis. Even worse is the prospect of a ruptured tube or ovary, when the likelihood of peritonitis is high, and it is fraught with great dangers, even death.

Symptoms of a pipe rupture

In the event of a tube rupture by a developing egg, the clinical picture develops quickly. Usually this is preceded by an act of defecation or some kind of physical activity. A woman suddenly experiences a severe attack of pain in the lower abdomen, which can radiate to the rectum. The skin also becomes pale and cold sweat appears. Loss of consciousness due to painful shock is possible. Symptoms of a ruptured fallopian tube include:

• Severe pain in the lower abdomen.
• A sharp decrease in blood pressure.
• Reducing heart rate.
• Headaches and general malaise.
• Bleeding.

In the absence of immediate medical assistance, bleeding occurs in the abdominal cavity, which is accompanied by severe pain.

Also, when a woman ruptures, you may notice pale and cold extremities, weak and rapid breathing. On palpation, severe pain occurs in the abdomen; the abdomen itself remains soft and slightly swollen. With active hemorrhage, signs of irritation of the peritoneum and muffled percussion tone appear.

Tubal abortion

Tubal abortion is a phenomenon in which a fertilized egg is released from the fallopian tube into the abdominal cavity. It can occur spontaneously and always develops against the background of an ectopic pregnancy. Signs of a tubal abortion develop within a few days. Typically, women begin to sound the alarm after the appearance of pain in the abdominal area. This is explained by contraction of the fallopian tube, which causes detachment of the fertilized egg. Also, due to a tubal abortion, bleeding opens into the abdominal cavity. The degree of pain is mainly determined by the volume and speed of blood flow.

Attacks of pain in the lower abdomen may be accompanied by nausea, dizziness, and upset bowel movements. Also, due to a sharp change in hormonal levels, vaginal bleeding occurs. Diagnosing tubal abortion is difficult, since there are no symptoms that indicate this phenomenon. Typically, this pathology can only be recognized by the results of laparoscopy or ultrasound.

The choice of surgical intervention method depends on the amount of blood loss, the general condition of the woman, the size and location of the fertilized egg, and the severity of the adhesive process in the pelvis. A ruptured fallopian tube requires emergency surgical intervention, which can not only relieve a woman of pain, but also preserve reproductive function.

Features of sexual life after surgery

After the operation, for obvious reasons, your sex life will change somewhat. Complete abstinence is required for about a month, otherwise infection and further complications are possible. Then sexual life should increase, but very carefully, gradually, with mandatory contraception.

It will be very helpful to get pregnant after rehabilitation by being examined for chlamydia, gonorrhea, other infections, and the condition of the genital organs: are there any adhesions, inflammatory foci, cysts, tumor formations. If any are detected, the diseases are treated with laser, physiotherapy, and other modern methods.

Menstruation after ectopic pregnancy and rehabilitation

After surgery, recovery progresses differently, but in any case, the onset of a new pregnancy should be postponed for at least 3-4 months, and ideally for a year. After an ectopic pregnancy, some people's periods return almost immediately, others - after a month or a month and a half. A longer period is a signal of trouble, then you need to see a gynecologist.

Rehabilitation includes painkillers, a strict daily routine, compliance with hygienic requirements, and restorative therapy. This complex, combined with examination and treatment of concomitant ailments, will preserve the possibility of motherhood and a happy family life.

Discharge

The procedure for laparoscopic removal of an ectopic pregnancy involves complete or partial resection of the fallopian tube. This operation has a much more negative impact on the woman’s body than interruption by taking medications.

Depending on how the intervention was performed, discharge from the genital tract may be of a different nature. Accordingly, in different patients they can be scanty or abundant, short or long, and are clearly accompanied by characteristic symptoms.

Menstruation after removal of the tube during an ectopic pregnancy always passes along with painful sensations in the peritoneal area. This is due to the fact that the uterus contracts in the body, and the injured tissues have not yet fully recovered. The degree of their severity directly depends on the woman’s pain threshold and the scope of the intervention performed.

Also, many patients complain that after the procedure they experience general weakness and increased drowsiness. The occurrence of this condition is associated with the fact that a hormonal imbalance has occurred in the body, and immunity has also decreased. It is very important to distinguish uterine bleeding from menstrual bleeding; the first appears approximately 25 days after surgery.

If such a situation occurs, then the woman needs to go to a leading gynecologist as soon as possible. Bleeding is often accompanied by increased body temperature, severe pain in the abdominal area, and an unpleasant odor of discharge. In this case, there is a possibility that the body has become infected, so urgent medical intervention is necessary.