Ectopic pregnancy poses a great threat to women's health. If not detected in a timely manner, as the embryo develops, there may be symptoms of massive bleeding. In severe cases, it may endanger life. Generally, how to rule out ectopic pregnancy in the early stages of pregnancy, and what are the methods for diagnosing ectopic pregnancy? Next, the editor will explain it specifically to female friends.
How to exclude ectopic pregnancy in the early stages of pregnancy
1. Stop menstruation. Most patients have a brief history of amenorrhea before onset, usually around 6 weeks. However, some patients may mistake pathological bleeding for menstruation and believe that there is no history of amenorrhea due to insufficient production of chorionic gonadotropin by the chorionic gonadotropin produced by the trophoblast tissue to maintain the endometrium, or due to early onset of the disease.
2. Abdominal pain. The main symptom of tubal pregnancy destruction, with an incidence rate of 95%, is often sudden tearing or intermittent pain on one side of the lower abdomen, accompanied by nausea and vomiting. Stimulating the diaphragm can cause radiating pain in the scapula, and when there is fluid accumulation in the pelvic cavity, there may be a feeling of heaviness and defecation in the anus, which is very helpful for diagnosing ectopic pregnancy.
3. Irregular vaginal bleeding. Mostly in the form of droplets, dark brown in color, with a small amount that does not exceed menstrual flow. Vaginal bleeding is caused by the shedding of the endometrium or the outward discharge of fallopian tube bleeding through the uterine cavity. Abdominal pain accompanied by vaginal bleeding is often a sign of embryonic damage. Patients with only abdominal pain and no vaginal bleeding are mostly due to embryo survival or abdominal pregnancy, and should be vigilant.
4. Fainting and shock. It is caused by acute intra-abdominal bleeding and severe pain. The more bleeding, the faster the symptoms appear. It can cause dizziness, pale complexion, thin pulse, decreased blood pressure, cold sweat, leading to crises such as fainting and shock.
Methods for diagnosing ectopic pregnancy
1. HCG testing: Urine or blood hCG is crucial for early diagnosis of ectopic pregnancy. During ectopic pregnancy, the level of hCG in the patient's body is lower than during intrauterine pregnancy. Continuous measurement of blood hCG, if the doubling time is greater than 7 days, there is a higher possibility of ectopic pregnancy.
2. Progesterone measurement: The measurement of serum progesterone is helpful in determining the development of normal pregnancy embryos. During ectopic pregnancy, serum progesterone levels are generally low, mostly between 10-25ng/ml. If the serum progesterone level is 25ng/ml, the probability of ectopic pregnancy is less than 1.5%; If its value is 5ng/ml, intrauterine pregnancy miscarriage or ectopic pregnancy should be considered.
3. B-ultrasound diagnosis: No gestational sac is detected in the uterine cavity. If an abnormal hypoechoic area is detected near the uterus and embryonic and primitive heartbeats are seen, ectopic pregnancy can be diagnosed. If a mixed echo area is detected near the uterus and there is a free dark area in the uterorectal fossa, although no embryo or fetal heartbeat is seen, ectopic pregnancy should be highly suspected. The combination of blood hCG measurement and ultrasound examination is of great help in the diagnosis of ectopic pregnancy. When the blood hCG2000IU/L and vaginal ultrasound show no intrauterine gestational sac, the diagnosis of ectopic pregnancy is basically established.
4. Laparoscopic examination: The gold standard for the diagnosis of ectopic pregnancy during laparoscopic examination, and can be performed with endoscopic surgical treatment at the same time as diagnosis. However, about 3% -4% of patients are missed due to a small gestational sac, and may also be misdiagnosed as a pregnancy due to fallopian tube dilation and color changes, which should be taken seriously.
5. Vaginal posterior fornix puncture: suitable for patients suspected of having intra-abdominal bleeding. Abdominal bleeding is most likely to accumulate in the rectovaginal cavity, and even if the amount of bleeding is not significant, blood can be extracted through vaginal puncture of the posterior fornix. When there is an old ectopic pregnancy, small or non coagulating old blood can be extracted. When there is no internal bleeding, the amount of internal bleeding is minimal, the hematoma location is high, or there is adhesion in the rectovaginal cavity, blood may not be able to be drawn out. Therefore, a negative vaginal puncture of the posterior fornix cannot rule out tubal pregnancy.
If female friends experience the above symptoms after pregnancy, it is recommended to go to the hospital for examination in a timely manner to rule out whether they have ectopic pregnancy. Once diagnosed with ectopic pregnancy, the pregnancy should be terminated in a timely manner and an artificial abortion surgery should be performed to avoid delaying the condition and causing secondary harm to the body. After the surgery, it is necessary to wait for the body to fully recover before considering another pregnancy.
