Pregnancy in the tubes, also known as tubal pregnancy, is a type of ectopic pregnancy in which the embryo is implanted outside the uterus, in this case, in the fallopian tubes. When this happens, the development of pregnancy can be impaired, because the embryo cannot move into the uterus and the tubes are not able to distend, and can disrupt and endanger the woman’s life.
Some factors may favor the development of tubal pregnancy, such as sexually transmitted infections, endometriosis or have already made a tubal ligation, for example. Usually, this type of pregnancy is identified up to 10 weeks of gestation on an ultrasound, but can also be discovered later.
However, if the problem is not detected, the tube may rupture, being called an ectopic pregnancy route, which can cause internal bleeding, which can be fatal.
The main causes
The occurrence of tubal pregnancy can be favored by several factors, the main ones being:
- Use the IUD;
- Scarring of a pelvic surgery;
- pelvic inflammation;
- Endometriosis, which is the growth of the endometrium tissue outside the womb;
- previous ectopic pregnancy;
- Salpingitis, which is characterized by inflammation or deformation of the fallopian tubes;
- The complications of chlamydia;
- Previous surgery in the fallopian tubes;
- Malformation of the fallopian tubes;
- In case of infertility;
- Have performed tubal ligation.
In addition, age over 35 years, IVF and the fact that several sexual partners may also favor the development of an ectopic pregnancy.
Signs and symptoms of tubal pregnancy
Some signs and symptoms that may indicate pregnancy outside the uterus include pain of just one side of the belly, which is getting worse each day, always localized and similar to colic, and vaginal bleeding, which can start with a few drops of blood, but which in a short time becomes stronger. Also see other causes of colic in pregnancy.
The pharmacy pregnancy test can detect that the woman is pregnant, but it is not possible to know if it is an ectopic pregnancy, and it is necessary to perform an ultrasound examination to check exactly where the baby is located. Since ectopic pregnancy can become route before the 12th week of gestation, it does not give the belly time to start growing, enough to be noticed by other people. Learn how to identify the signs and symptoms of ectopic pregnancy.
Treatments for ectopic pregnancy
Treatment for ectopic pregnancy can be done through the use of the drug methotrexate, which induces abortion, or through surgery for removal of the embryo and reconstruction of the tube.
When the surgery is indicated
Surgery to remove the embryo, can be done by laparostomy or open surgery, and is indicated when the embryo is more than 4 cm in diameter, the Beta HCG test has more than 5000 mIU/ml or when there is evidence of rupture of the fallopian tube, which puts the woman’s life at risk.
In any case, the baby cannot survive and the embryo must be completely removed and cannot be implanted inside the uterus.
When the remedies are indicated
The doctor can decide to use drugs such as methotrexate 50 mg, in injection form when ectopic pregnancy is discovered before 8 weeks of gestation, the woman has no rupture of the tube, the gestational sac has less than 5 cm, the Beta HCG test is less than 2,000 mU/ml and the heart of the embryo is not beating.
In this case the woman takes 1 dose of this medicine and after 7 days should perform a new Beta HCG, until it is undetectable. If the doctor finds it safer, you may indicate 1 more dose of this same medicine to make sure the problem is solved. Beta HCG should be repeated in 24 hours and then every 48 hours to check if it is gradually downloading.
During this treatment that can last up to 3 weeks is recommended:
- Do not do the vaginal touch test because it can cause tissue disruption;
- not having intimate contact;
- Avoid exposure to the sun because the remedy can stain the skin;
- Do not take anti-inflammatories due to the risk of anemia and gastrointestinal problems related to the remedy.
Ultrasound can be performed once a week to see if the mass has disappeared because even if the HCG beta values are decreasing there is still the possibility of rupture of the horn.
Is it possible to get pregnant after surgery?
If the tubes were not damaged by the ectopic pregnancy, the woman has new chances of getting pregnant again, but if one of the tubes ruptured or was injured, the chances of getting pregnant again are much lower, and if the two tubes ruptured or are affected, the most viable solution will be in vitro fertilization. See how to become pregnant after a tubal pregnancy.
A medical mastologist and gynecologist graduated from the Federal University of Pernambuco, in 2008 with professional registration in CAB 17459-PE.
