Ectopic pregnancy is one of the most common fears for a girl who has just become pregnant and whose pregnancy is desired. After all, you can’t find out reliably whether the fertilized egg has attached correctly right away, but only during a routine ultrasound.

Therefore, many people use home diagnostic methods, for example, measuring BT. Basal temperature during early ectopic pregnancy has its own specifics.

For many women, it is an effective way to determine the period of ovulation. This is useful to know for planned conception. Or, on the contrary, in order to avoid unwanted fertilization. The method of measuring it is quite delicate and requires strict adherence to the regime.

The process of measuring basal temperature itself is recommended to be carried out rectally, without getting out of bed after waking up in the morning and, if possible, without moving. Before the procedure, it is desirable that you sleep for at least 5 hours. The BT schedule is formed throughout the cycle. Ideally, you need to draw several such graphs, that is, measure the temperature over 3-4 months.

The indicators will change with the changing phases of the female cycle. On days 12-17 of the cycle, the temperature normally jumps to 37 degrees and above. This means that the egg is ready for conception. If fertilization occurs, BT will be slightly elevated until the delay and throughout the first trimester.

Ectopic pregnancy

Ectopic pregnancy is a pathology that, according to statistics, is observed in 2% of cases. During a normal pregnancy, the fertilized egg implants into the wall of the uterus. When pathological, it is attached to the fallopian tube, ovary, abdominal cavity or cervix.

Alas, such a conception cannot end in the successful development of the baby and childbirth. After all, the fetus is viable only in the uterus. If the fertilized egg attaches somewhere else, the rapid growth of its cells can lead to dire consequences. The larger it is, the less space it has. And when the critical size of the fetus is reached, the organ in which it is located awaits rupture. For a woman, this is fraught with a threat to life.

This phenomenon can have many reasons:

• age. The older the woman, the higher the risk;
• inflammatory processes, adhesions of the fallopian tubes;
• congenital pathologies of the structure of the genital organs;
• previous operations on the fallopian tubes;
• abortions;
• hormonal imbalances.

There is a version that ectopic pregnancy is a hereditary pathology that was observed in mothers and female relatives of a pregnant woman.

Main symptoms

It is not easy to identify an “incorrect” pregnancy at home. In the first weeks, the symptoms of ectopic fetal development are the same as during normal pregnancy:

• absence of menstruation;
• engorged mammary glands;
• a pulling sensation in the lower abdomen due to an enlarged uterus;
• toxicosis;
• change in taste preferences and increased appetite.

However, there may also be warning signs. Even in the first days, a dark, bloody “spot” may appear, similar to scanty menstruation. A pulling sensation in the lower abdomen painfully radiates to the anus. If you experience pulling pain in the lower abdomen, you need to pay attention to which side it is happening on, since that is where the fetus may be located.

Heavy, prolonged bleeding may also begin if conception occurs in the cervix, as there are many blood vessels located there. An increase in body temperature and basal temperature may be observed during early ectopic pregnancy. These symptoms do not always appear; sometimes an ectopic pregnancy occurs without obvious signs.

BT for ectopic

For those who regularly measure their basal temperature and create a chart, it will be easier to track the moment of pregnancy. When ovulation occurs, the production of a hormone for the normal development of the egg, progesterone, increases. An increase in basal temperature in the second half of the cycle is an indicator of hormone growth. Normally, before the next menstruation, BT decreases slightly. If conception has occurred, the temperature will be consistently high before and after the delay - 37 and above.

The average increase in basal temperature during pregnancy is 37.2-37.3. This happens regardless of its type. The production of progesterone in any case increases during fertilization, so the basal temperature during an ectopic pregnancy will not differ from Bt with normal intrauterine localization of the fetus.

When, during an ectopic pregnancy, the fetus increases in size and stretches the fallopian tube, this may be accompanied by pain and a rise in temperature - both general and basal to 37.5-38 degrees and above. This is a situation where you can’t hesitate - you need to call an ambulance.

What to do?

If you suspect that you will soon become a mother, and the test confirms this, you need to go to the doctor. If, based on the symptoms, he suspects an incorrect localization of the ovum, an ultrasound may be required, which will remove all doubts.

Ectopic pregnancy is a common pathology. It is not difficult for doctors to diagnose it and take measures to prevent irreversible consequences. Therefore, the sooner this diagnosis is made, the easier it is to resolve the situation.

If it was not possible to determine an ectopic pregnancy in a timely manner, and alarming symptoms appear (pain, bleeding), it is necessary to urgently perform surgery.

So, it is impossible to consider basal temperature indicators as a reliable sign of the presence or absence of pathologies in the location of the ovum. Therefore, a conclusion based on this indicator alone can be a fatal mistake for any woman. An ectopic pregnancy is not a death sentence. If you diagnose it as early as possible, the reproductive system will not be affected, and you will still become the mother of a healthy baby.

The BT chart is the lowest temperature readings recorded in a state of maximum rest.

The measurement technique is the easiest and free way to diagnose an ectopic pregnancy. It is associated with hormonal changes in the female body during the menstrual cycle (MC).

Sometimes the basal temperature of a girl with an ectopic pregnancy differs in the early stages from normal conception, which usually indicates the development of pathology.

Measure your temperature

During an ectopic pregnancy, not everyone knows what basal temperature is normal or a sign of serious changes. From the article you will learn what indicators confirm the onset of conception and the values ​​that are classified as threatening symptoms. And also how to react correctly and what to do when pathological changes are detected, for example, ectopic pregnancy.

Why measure BT?

Basal body temperature is a valuable source of information that allows you to determine the state of the reproductive system at different periods of the menstrual cycle.

Why are BBT measurements taken during the early stages of pregnancy?

1. When undergoing IVF, it is mandatory to confirm the onset of ovulation.
2. Indicators are important in intensive therapy for infertility.
3. For the purpose of planning conception, determining the arrival of ovulation is one of the ways to successfully become pregnant.
4. To identify the threat of spontaneous abortion (miscarriage) or frozen pregnancy.
5. To diagnose hormonal imbalance, change indicators when progesterone production decreases during the period of MC or during pregnancy.
6. Determination of inflammation of the abdominal and pelvic organs.
7. To confirm the normal or pathological development of the embryo, during an ectopic pregnancy, depending on the trimester, temperature values ​​may fluctuate.

Ectopic fertilization is an anomaly in which implantation of the egg occurs outside the uterus. There are several types of ectopic pregnancy:

• pipe;
• abdominal ectopic pregnancy;
• ovarian;
• cervical

Early diagnosis of ectopic pregnancy depends on the location, that is, the organ on which the fertilized egg is attached.

For example, there is conception in the cervix, which is detected very quickly. The first signs of an ectopic pregnancy appear literally at 1-2 weeks, since this is the narrowest area not suitable for embryo development.

However, in 97% of cases, abnormal implantation is recorded in the fallopian tubes. In many patients, ectopic pregnancy is asymptomatic for a long time, until the organ ruptures.

This condition is a direct threat to the life and health of a woman. According to statistics, in 80% of cases, organ rupture during ectopic pregnancy ends in death. Therefore, it is extremely important to diagnose the development of pathology as early as possible by any known means.

In order for basal temperature indicators to be considered reliable and the detection of ectopic pregnancy to be timely, it is necessary to observe the specifics of the method for several months.

Measurement rules.

1. The procedure must be performed without getting out of bed immediately after sleep, which should be at least 3 to 4 hours.
2. Measurements are taken over 5 minutes at the same time.
3. You cannot change the measurement location and thermometer throughout the entire graph. The rectal method is preferred, but vaginal or oral is acceptable, taking into account the nuances.
4. The results of the indicators are noted immediately, accompanied by comments about the slightest changes in the schedule or condition. For example, drinking alcohol the day before, fatigue, heavy workload, anxiety, taking medications, climate change.

Record and schedule

Periodic or one-time measurement of basal temperature is not accepted by doctors as one of the influencing factors when diagnosing ectopic pregnancy.

Only regular adherence to temperature rules over a long period of time can reveal a trend in changing indicators. This allows you to monitor planned conception, the normal course of early pregnancy or the development of pathology.

How to recognize an ectopic pregnancy by basal temperature?

The highest rates are observed on the days of ovulation. If conception has occurred, then a slightly elevated temperature should remain until your period is expected.

After a delay, as the embryo begins to develop and throughout the entire gestation period, the device will show approximately similar values.

The basal temperature during ectopic conception can be 37.2 degrees in the early stages, which corresponds to the average value during normal pregnancy.

Depending on the state of hormonal levels, the type of fertilization, the occurrence of a disease or infection, the numbers may vary.

A change in indicators is an indicator indicating the development of complications. After pregnancy is established, a decrease in basal temperature indicates a threat of miscarriage or fading, that is, the death of the embryo.

If BT begins to increase sharply, this is often due to an inflammatory process in the appendages. A similar condition is characteristic of ectopic fertilization. You should see a specialist immediately.

Why deviations occur

To understand what changes can be observed during an ectopic pregnancy, you should know the dynamics of basal temperature indicators during a normal cycle:

• when estrogen production increases, the average values ​​are considered to be fluctuations in the range of 36.7-36.9 degrees;
• at the beginning of the menstrual cycle, the basal temperature rises by 0.2-0.3°;
• before the next menstruation there is a slight decrease in BT;
• upon the onset of ovulation, the indicators increase by 0.4-0.6°, that is, with an increase in progesterone levels, BT within 37.2-37.4° is considered normal;
• if on the eve of the next menstruation the basal temperature is stably fixed at 37° and above, and a delay is detected, then this condition is a sign of successful conception.

From the moment pregnancy is established and up to the 16th week, basal temperature indicators of 37.1-37.4° are considered characteristic for the normal course of bearing a baby.

It is worth paying attention to the individual characteristics of the body. For some women, elevated values ​​within the range of 37.5-38° are normal and do not indicate an ectopic pregnancy.

Normal indicator

A borderline state in which we can talk about abnormal development of the embryo is recognized as a lower level of basal temperature of 37°. A value above 37.7° is often a sign of complications during pregnancy, ectopic pregnancy.

The following factors may be the causes of pathological deviations from the norm of basal temperature:

• above 38° – infection, development of inflammation in the reproductive system, ectopic conception;
• below 37° – threat of arbitrary termination (miscarriage), risk of frozen fetus, insufficient production of progesterone, ectopic pregnancy.

Episodic changes in parameters depend on the sensitivity of basal temperature to any external factor. For example, acclimatization, active sex life, taking medications, lack of sleep, stress, movement after waking up, and others.

Pathological changes in basal temperature during ectopic pregnancy are usually permanent. If a decrease or increase in rectal indicators persists for several days, then the situation requires an immediate visit to the gynecologist.

Examples of basal temperature measurements

For clarity and a complete understanding of the picture, let’s consider possible BT indicators at different stages of pregnancy:

After 12-16 weeks, the basal temperature level usually remains within 36.6-36.8°. If deviations in the direction of decline or increase are observed, then we are talking about hormonal imbalances or other pathologies, for example, ectopic pregnancy.

Immediately before childbirth, a fairly high temperature may be observed, which is considered normal for this period.

Example of BT indicators:

Correct schedule

What BT for ectopic pregnancy

With ectopic conception, the growing embryo gradually begins to put pressure on the walls of the organ. This causes severe pain on the affected side and an increase in BT to 37.5-38° (or more).

During an ectopic pregnancy, a woman may develop a fever due to an inflammatory process in the reproductive system.

Measuring BT is not considered a highly accurate diagnostic method that allows differentiating pathological fertilization from physiological conception.

An exception is a sharp drop in basal temperature below 37° when pregnancy is diagnosed, warning of the possibility of tubal abortion or embryo death. As well as a high temperature above 38° at 6–12 weeks during ectopic fertilization, which is accompanied by the following clinical picture:

• severe pain in the lower abdomen;
• dark bloody discharge;
• lowering blood pressure;
• apathy, lethargy;
• cold sweat appears, hyperhidrosis (increased sweating) is noted;
• Bleeding may occur, which usually results in hemorrhagic shock;
• loss of consciousness.

Acute symptoms of ectopic pregnancy are a direct threat to a woman’s life. Therefore, at the first sign of fever or pain, you should immediately consult a doctor.

Pain below the abdomen - a symptom

What to do?

Body temperature 37.2 in the early stages of pregnancy, its increase or decrease is a sign of pathology. Changes in basal temperature do not allow one to determine the type of pregnancy, for example, its ectopic development, but it does give the doctor a reason to conduct an additional detailed examination.

Therefore, in case of any violations of the BT schedule, it is better to play it safe by notifying the gynecologist about them. This is especially true for cases that are accompanied by suspicious symptoms in the form of discharge or nagging pain in the lower abdomen. This could be an ectopic pregnancy.

Early diagnosis of ectopic fertilization greatly increases the chances of preventing irreversible serious consequences with death or a disappointing diagnosis of infertility.

Timely operation using laparoscopy allows you to preserve the damaged organ and reproductive functions after an ectopic pregnancy. And most importantly, the life and health of a woman.

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Attention!

The information published on the website is for informational purposes only and is intended for informational purposes only. Site visitors should not use them as medical advice! The site editors do not recommend self-medication. Determining the diagnosis and choosing a treatment method remains the exclusive prerogative of your attending physician! Remember that only complete diagnosis and therapy under the supervision of a doctor will help you completely get rid of the disease!

Ectopic pregnancy is the second most common cause of death in pregnant women. I think this is a compelling argument not to delay registration when signs of pregnancy appear. Expectant tactics here also threaten the loss of the ability to become pregnant again. Our article will help you recognize the “enemy in person.”

Concept and localization of ectopic pregnancy

An ectopic pregnancy is a pregnancy in which the egg was fertilized, but was finally implanted in a place other than the uterus. It is pathological in that the growing fertilized egg stretches and tears the place of the fetal receptacle, and the chorionic villi destroy the tissues and blood vessels of the attachment site.

Depending on where it was implanted or the location of the fertilized egg - zygote, ectopic pregnancy is given its name:

• pipe The egg, maturing in the ovary, enters the fallopian tube and is fertilized there by a sperm. And then it attaches to the wall of the tube and begins to grow, tearing it apart as the fertilized egg grows. Tubal pregnancy can be: isthmic - when developing in the isthmus of the fallopian tube, ampullary - in the widest section of the tube, fimbrial - in the villi at the exit from the tube, interstitial - at the junction of the tube and uterus;

  

  Since there are no normal conditions for embryo development outside the uterus, chorionic villi penetrate into the tissue of the organ and damage it, causing bleeding into the abdominal cavity

• ovarian - can develop on the surface of the ovary or inside the ovulated follicle. Quite a rare species, occurring in 0.2 to 1.3% of cases;
• abdominal or abdominal - with a probability of occurrence from 0.1 to 1.4% of all cases. When the fertilized egg develops initially in the abdominal cavity - the primary form or gets there after a tubal abortion - the secondary form. In this case, the fertilized egg first secured itself in the fallopian tube, grew so much in 4–8 weeks that the tube ruptured, and from there it entered the abdominal region, but did not die, but settled there and continued to develop;

  

  If the fertilized egg gets into the abdominal region due to a rupture of the tube, then it can become fixed there in the spleen, liver, perimeter (outer layer of the uterus), omentum, intestinal flexures or pouch of Douglas (between the uterus and rectum)

• in the rudimentary uterine horn - a pathology similar to duplication, division of the uterine cavity into two parts, occurs in 0.1–0.9% of cases of all ectopic pregnancies. In this case, one tube and ovary are connected to the uterine cavity, and the second pair of tube and ovary are connected only to the horn, separated by a muscular septum from the uterine cavity;

  

  You can suspect the presence of a rudimentary horn that does not communicate with the uterus by a sharp deterioration in the condition during menstruation - dysmenorrhea: “cotton legs”, vomiting, bloating, severe pain in the lower abdomen, even fainting, increased temperature

• heterotopic pregnancy, in which there are two fertilized eggs, one of them is located in the uterus, and the other is outside it. This is an option for the development of intrauterine and ectopic pregnancies at the same time, the most possible after IVF fertilization in multiple pregnancies (with a probability of 1:00 to 1:30,0000 cases);
• cervical - the zygote was unable to gain a foothold in the uterus due to the characteristics of the tissue lining it and slid down to the narrowed area of ​​​​the transition to the vagina. The probability of such a situation occurring is from 0.1 to 0.4% of cases;

  

  The danger of this pathology is that there are no signs characteristic of an ectopic pregnancy, and this condition is often confused with the lower insertion of the child’s place

• intraligamentous or intraligamentous - in 0.1% of all cases (or 1 case in 300 cases of ectopic pregnancy) develops in the thickness of the broad ligaments of the uterus, often secondary to a rupture of the fallopian tube towards the mesentery, also possible with a fistula connecting the uterus and tissue around the cervix - parametrium. In this case, it can become attached to the bladder, uterus or pelvic walls;

  

• combined multiple pregnancy. It is distinguished by a large number of possible combinations of places for fixation of 2.3 fertilized eggs at the same time. The most common combinations are: ampullary + isthmic tubal twin pregnancy or ovarian + interstitial tubal + abdominal triple pregnancy. Due to the widespread use of IVF technologies, the probability of such a pathology is from 1 case in 100 to 1 case in 620 ectopic forms of pregnancy.

In order to assess the likelihood of such a pregnancy occurring in a particular woman, it is better to familiarize yourself with this list of risk groups and consistently mentally cross out the items if they are not relevant to you:

Since I myself, with a bicornuate uterus and frequent inflammations in the vagina, was at risk of developing an ectopic pregnancy, a wave of panic covered me with any delay. I dropped everything and rushed to the ultrasound diagnostic room. The gynecologist found me good contraceptives and treated me for inflammatory diseases. On her advice, every six months, before each visit to the gynecologist, I undergo foliculometry to be sure of the proper functioning of the reproductive system.

Video: doctor S. Agapkin on predisposing factors that increase the risk of developing an ectopic pregnancy

Causes of ectopic pregnancy

In addition to risk groups, predisposing conditions for the development of ectopic pregnancy include:

• the presence of a chronic sexually transmitted infection;
• violation of the mechanisms of fertilization and movement of eggs through the fallopian tubes, caused by:
  
• using incorrectly selected contraception:
  • installation of a fallopian device or wearing it for longer than the prescribed five-year period without replacement. It is worth considering that the spiral only protects against the implantation of an egg into the walls of the uterus, and in case of an ectopic pregnancy, the egg may stop in the oviducts and not reach the uterus;
  • the use of estrogen-free “mini-pills” or medroxyprogesterone injections without indications for them instead of combined contraceptives that completely block ovulation. Such weak drugs do not provide a 100% guarantee of protection against unwanted pregnancy and are prescribed only to breastfeeding women for 6 months after childbirth, to persons over 35 with a long history of smoking, that is, to those whose ability to conceive is maximally reduced;
  • protection against conception in the form of douching, which disrupts the natural microflora of the vagina and inflames its sensitive tissues. A study ten years ago in the USA found that constant douching increases the development of inflammatory diseases of the pelvic organs by 73%.
• inflammation of the fallopian tube with salpingitis due to infection;

  

  The disease develops when pathogenic microflora spreads from the uterine cavity or from other organs through the hematogenous route.

• chromosomal pathologies of the fetus, in particular blastopathy, which occurs in the first 15 days after conception. It is expressed in a violation of the implantation mechanism in the form of attachment in an organ unsuitable for gestation or too superficial or excessively deep implantation depth.

Symptoms of ectopic pregnancy

An early ectopic pregnancy does not always manifest itself with clinical symptoms or may not differ in any way from the symptoms of a normal intrauterine pregnancy in the form of breast swelling, vomiting, increased fatigue and drowsiness.

Even if the second line on the pregnancy test is barely noticeable, blurred and does not change color intensity for two or three days, then it is worth continuing to monitor the hCG level over time. To do this, you will need to do several tests or donate blood several times to check the hCG level, which will increase with a normally developing pregnancy or “tread water” with an ectopic form. With these incorrect tests, it is worth visiting a gynecologist.

With an ectopic pregnancy, the second stripe will not become brighter and clearer after a few days

Early diagnosis and treatment of non-uterine pregnancy will not only protect against removal of the organ housing the lost fetal cell, but will also prevent the woman from conceiving a child on her own in the future.

Knowing the accompanying signs, it will be easier to suspect an abnormal pregnancy, these are the distinctive points:

• cycle failure. “Pseudo-mentruation” occurs at the wrong time and lasts only a couple of days. Sometimes menstruation continues in the first month;
• brown discharge from the genital tract after the end of menstruation due to overstretching of the tube occupied by the fertilized egg and hemorrhages inside it;
• sharp, dagger-like or prolonged nagging attacks of pain in the lower abdomen, causing pain in the hypochondrium, anus, legs, sacrum for half an hour or several hours;
• signs of progressive internal bleeding:
  • a sharp decrease in blood pressure, acceleration of the pulse, weak filling, up to loss of consciousness;
  • pale skin with the appearance of beads of sweat on the forehead.

Based on a woman’s complaints, a gynecologist can suggest the location of improper attachment of the fertilized egg:

• if you experience pain on one side of the lower abdomen, which increases in intensity with fast walking, changing body position or physical activity, the fertilized egg is in the oviducts;
• if there is pain, the area of ​​which can be indicated with one finger, moving to the lower back or towards the intestines, the passage of feces is very painful, and the attacks themselves are accompanied by fainting - ovarian pregnancy;
• if you are worried about a frequent urge to urinate and heavy bleeding without attacks of pain in the abdominal area - cervical or cervical-isthmus;
• if digestion is difficult due to vomiting, nausea, and the feces are denser or, conversely, too watery, and the attacks of pain are unbearable, then an abdominal variation of an ectopic pregnancy is suspected.

Video: obstetrician-gynecologist M. Borets about the symptoms of ectopic pregnancy

Diagnosis of ectopic pregnancy

Of course, the diagnosis is not made only on the basis of the doctor’s complaints and assumptions. Instrumental and laboratory techniques are used for confirmation.

1. Self-diagnosis at home. To exclude ectopic pregnancy, from the fifth day of delay, it is recommended to repeat a pregnancy test over several days, which determines the level of hCG in the urine. Electronic types of tests are the most informative.

   

   Such electronic tests not only detect hCG in urine, but also compare its measured level with norms for different stages of pregnancy

2. Examination on the chair by a gynecologist. May reveal the following warning signs:
   • pain on palpation of the appendages;
   • the increased size of the appendages or pipes on one side is determined;
   • the size of the uterus does not correlate with the duration of the expected pregnancy;
   • the uterus is softer, but its size is smaller than expected.
3. Laboratory test:
   • analysis for the level of hCG or human chorionic gonadotropin, confirming the fact of pregnancy. It, as a rule, lags behind the normal level for several days or stops growing altogether in case of spontaneous miscarriage;
   • analysis of progesterone levels, which will also be significantly lower than normal;
   • a general blood test, which will determine inflammation in the organs by an increase in leukocytes and ESR, decreased levels of hemoglobin, red blood cells and hematocrit due to bleeding.
4. Ultrasound examination of the pelvic organs, which can confirm or refute ectopic attachment, which determines:
   
5. Minimally invasive diagnostic laparoscopy, which allows you to make a definitively correct diagnosis that does not raise doubts. With its help, the doctor examines the pelvic organs, determines the integrity of the tubes and the location of the development of the ectopic pregnancy.

   

   This method is not traumatic; it will leave only 3 small scars 0.5–1.5 cm wide on the abdomen as a “memento” through which the instrument for internal examination and manipulation was inserted - tubes and a laparoscope

Thanks to minimally invasive diagnostic laparoscopy alone, the accuracy of diagnosing ectopic attachment of the fetal unit increased to 100%, while the combination of ultrasound with checking the hCG level gave a maximum of 95% probability, and with ultrasound alone - no more than 78%.

Medical care in the form of surgery or drug therapy

If the diagnosis of ectopic implantation is confirmed, the fertilized egg will be removed. Here, several options for further actions are possible, depending on the woman’s condition; the choice of the desired method remains with the doctor, who has all the collected data about the pregnancy. The only effective means of eliminating an ectopic pregnancy are surgical methods.

Since among all ectopic pregnancies, more than 90% of cases are tubal variations of egg arrest, surgical methods of intervention in the area of ​​the fallopian tubes are the most studied and tested many times. In 40% of cases, after treatment of ectopic pregnancy, intrauterine pregnancy occurs.

Table: surgical methods for treating ectopic tubal pregnancy

After organ-conserving operations, after 2 days of postoperative recovery, it is necessary to monitor the level of hCG in the blood every 2 days, which ideally should be half the hCG value before surgery. If the hCG level has decreased by only 25%, then an additional intramuscular injection of methotrexate will be prescribed to stimulate the natural rejection of the trophoblast tissue remaining in the tube cavity after the operation.

Drug effects on ectopic pregnancy

It is possible to use a medical method of treating ectopic pregnancy without surgery if a number of conditions are met:

• Steadily developing ectopic pregnancy without bleeding;
• hCG level before treatment is less than 5000 mIU/ml;
• the size of the fertilized egg is no more than 2–3.5 cm;
• the embryo's heartbeat is not detected;
• The woman’s health condition allows the use of cytostatic drugs that block cell division and metabolism in them:
  • the liver and kidneys work without failures;
  • leukocytes in the blood are not reduced to 1.5 * 10 9 / l;
  • platelets greater than 150*10 9 /l;
• short period of pregnancy, no more than 42 days of the non-menstrual period.

Photo gallery: drugs for terminating ectopic pregnancy

Mifegin is used once in the amount of 600 mg under the supervision of a doctor for 2 hours after taking Mefepristone is used once in a volume of 600 mg, always under the supervision of a doctor, sometimes in combination with misoprostol 400 mg to enhance the effect, and followed by ultrasound control after 1.5–2 days The drug for embryo rejection is administered intramuscularly, 1 injection every 2 days, and when the hCG decreases by 15%, the administration is stopped

Prediction of pregnancy development at various locations of the embryo and possible complications

The vast majority of types of ectopic pregnancy require immediate surgical intervention to remove the embryo that is developing in the wrong place and its membranes. Possible complications from a late detected ectopic pregnancy include:

• the development of internal bleeding with large blood losses, which lead to the development of hemorrhagic shock with the need to replace blood loss;
• rupture of the fallopian tube with the formation of scars inside the organ;
• loss of reproductive function. When removing an embryo from a sheltering organ during surgery, it may be necessary to remove the fetal sac (uterus, ovary, tube on one side) due to its overstretching or massive bleeding;
• hormonal imbalances from an interrupted pregnancy;
• the risk of repeating such an abnormal pregnancy after recovery;
• a fatal outcome when a woman loses not only the embryo, but also her life because inflammation in the organ has spread through the blood.

Table: type of ectopic pregnancy and possible outcome

Prevention of non-occurrence of ectopic pregnancy

No one is immune from such an abnormal pregnancy, but it is possible not to create the conditions that contribute to it.

1. If a second fuzzy line is detected on the test, perform several home tests to confirm the increase in hCG levels.
2. Prepare for pregnancy:
   • take smears for infections transmitted from a sexual partner, especially for chlamydia and gonococci - the most ardent opponents of a normally developing pregnancy, causing an acute inflammatory process;
   • undergo an ultrasound of the pelvic organs in order to find out whether the woman’s uterus is of the correct shape and whether there are signs of endometriosis or inflammation of the tissues of the internal organs;
   • take blood tests to check the level of hormones, the lack or excess of which can direct the fertilized egg in the direction opposite to the uterus.
3. Carefully treat old inflammations of the genitourinary system to prevent transmission of infection to the uterus.
4. Use barrier contraception during pregnancy to prevent infection after conception;
5. If you do not want to become a mother in the near future, choose a method of contraception that is suitable for you. You cannot take contraceptive pills that your friend takes, you cannot install an IUD without consulting a gynecologist and without an examination. For example, if a woman has a bicornuate uterus, installing an IUD is not at all effective, and even with a normal uterus shape it will not protect against ectopic pregnancy if barrier protection methods are not used.
6. Be examined by a gynecologist as part of a medical examination at least once a year, if there are no complaints.
7. Maintain careful hygiene of the genitals, wash the vaginal area after sexual intercourse, and during menstruation - after each urination. Morning and evening toileting of the vulva is mandatory.
8. Quit smoking. Every year, the ability to bear children due to smoking decreases, and when the threshold of 10 years is reached, a woman is at risk with a high probability of developing an ectopic or ectopic pregnancy.

Video: gynecologist surgeon S. Novikov on the prevention of ectopic pregnancy

Doctors know what to do with such a pregnancy; each case has its own solution. But any delay in seeking medical help risks a woman losing her reproductive organs during surgery to remove an overgrown fertilized egg. To preserve fertility, it is worth monitoring the health of the pelvic organs and periodically visiting a gynecologist to undergo the necessary tests.

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Does basal temperature change during ectopic pregnancy? Yes, sure. Just like with normal, it increases to 37.3. However, unlike the latter, such indicators on the thermometer do not last long. By 5-7 weeks they change dramatically.

What is basal temperature?

This is the temperature of a body that has been at rest for more than 5-6 hours. It is used to determine:

• phase of the menstrual cycle;
• ovulation;
• occurrence or absence of pregnancy;
• problems in its course.

It should be measured not under the armpit, but in the rectum, that is, rectally. This should be done every morning after sleep, without getting out of bed. Measurements should begin on day 5 of the cycle.

What is the reason for its increase or decrease?

What basal temperature will be in different phases of the cycle depends on the woman’s age, her emotional state, and various other reasons. Typically its indicators are as follows:

1. Initially it stays within 36.5-36.7 degrees.
2. By the time of ovulation it rises to 37. It is during this time that a child is conceived.
3. Then, if it occurs, after 7-10 days it decreases slightly. At this time, the fertilized egg is consolidated.
4. After this it returns to 37 degrees, or to be more precise, to 37.3. If menstruation comes, it does not increase.
5. The temperature during an ectopic pregnancy in the early stages will be 37.3 degrees. At later times it will increase or decrease.

What can you find out using basal temperature?

It is impossible to say exactly where the fetus is attached and whether it is developing normally just by measuring it. A doctor can diagnose an ectopic or frozen one only after performing a pelvic ultrasound.

However, if a woman measures her basal temperature and sees that it does not correspond to the norm, then she needs to consult a gynecologist. This must be done as quickly as possible. Thanks to this, she will be able to terminate a pathological pregnancy earlier, thereby preserving the possibility of further childbearing.

How does it change at different times?

Body temperature during an ectopic pregnancy can remain within normal limits (37.3), increase (38 or more) and even decrease (36.7).

• If the degrees on the thermometer do not exceed 37.3, then this indicates that the embryo is still too small and does not have a negative effect on the organ to which it is attached.
• If it is lowered, it means that its development has stopped. He ceased to exist.
• There may be an elevated temperature during an ectopic pregnancy. This indicates that an inflammatory process is occurring in the woman’s body. It is associated with detachment of the fertilized egg or rupture of the organ to which it was attached.

From all of the above, we can conclude: body temperature may indicate a pathology of fetal development, however, based on it alone, one cannot say that something went wrong. In addition, one should not judge that an ectopic occurred due to the fact that on one day the indicators were higher or lower than normal. We can talk about pathology only when disturbances are observed for more than 3-4 days.

In the early stages, it is almost impossible to determine the attachment of the fertilized egg outside the uterus. Basal temperature indicators are usually the same as when it was attached to the uterus. Only after its detachment occurs will they change upward.

A pregnancy is called ectopic when a fertilized egg implants in the fallopian tube, ovary, abdomen, or cervix. In this case, it is impossible to carry and give birth to a child; in addition, the pathology poses a danger to the health and life of the woman herself. Therefore, it is important to detect symptoms of ectopic pregnancy, diagnose and treat them as early as possible.

The severity of symptoms may vary. Sometimes women already identify the manifestations of pathology in their early stages. But there are situations when ectopic implantation of the fertilized egg becomes known after a sharp deterioration in health and an ambulance is called.

But there are several signs that may indicate ectopic implantation of the embryo:

• Often the test works later than in a normal pregnancy. This is due to the fact that the concentration of hCG increases slowly. If the embryo is located ectopically, the timing of diagnosis is shifted by 2-3 days compared to normal.
• After the first day of delay, the second test strip appears. This is also explained by the slow rise in hCG levels in the urine.

If a specialist suspects the development of an ectopic pregnancy, the following studies are prescribed:

1. Laboratory blood test for hCG . Human chorionic gonadotropin increases more dynamically in the blood than in the urine. Therefore, pregnancy can be confirmed in this way at an earlier date: 5-6 days after fertilization. To find out whether it is ectopic, it is necessary to compare data from several studies. During normal pregnancy, the level of hCG doubles every 2 days; in pathological pregnancy, the changes are insignificant.
2. Transvaginal ultrasound . Using ultrasound, the position of the embryo can sometimes be determined from the 3rd week of pregnancy, but most often it is detected only by 4-5. If the doctor suspects an ectopic pregnancy, but the fertilized egg is not visible (its size is extremely small), then a repeat examination is prescribed or the woman is hospitalized so that she is under constant medical supervision. Transvaginal ultrasound is the most reliable method for diagnosing ectopic pregnancy, but in 10% of cases it also gives an error: the fertilized egg is considered as a blood or fluid clot. Therefore, the examination is always carried out in combination with a blood test for hCG.
3. . The procedure is carried out as a diagnostic procedure only according to indications: when there is a serious suspicion of an ectopic pregnancy (symptoms, hCG dynamics), but it cannot be confirmed using ultrasound. Laparoscopic surgery is performed under anesthesia; small punctures are made using special instruments, where a tube with a camera and light is inserted, and the doctor examines the organs through an image on a monitor. If an ectopic pregnancy is detected, then therapeutic measures are immediately taken (removal of the fertilized egg, etc.).

Symptoms

Since ectopic pregnancy occurs in different ways, specific symptoms may appear gradually, late or completely absent until an emergency condition develops (with bleeding, rupture of the fallopian tube, etc.). Therefore, you should not hope only for a deterioration in your health; it is necessary to carry out diagnostic procedures in parallel: determination of hCG, ultrasound.

The first symptoms of an ectopic pregnancy coincide with those of a normal pregnancy: general weakness, drowsiness appears, and the mammary glands swell. Pathological implantation does not manifest itself in any way at first. A woman may also experience: nausea, vomiting, dizziness.

At this stage, an ectopic pregnancy can sometimes be determined by testing the level of hCG in the urine. As noted above, in this case, its results may be delayed for several days, since the hormone is produced more slowly than usual. Therefore, if a woman notices signs of pregnancy, but the test gives a negative result, it is likely that the fertilized egg has settled outside the uterus.

An ectopic pregnancy in the early stages has the same symptoms as a normal one, but their nature is somewhat different:

• . Symptoms of an ectopic pregnancy before a missed period are spotting or slight bleeding. When the embryo is implanted into the wall of the uterus, they are short-lived, lasting several hours. But if it is established outside of it, this symptom will be more intense and lasting.
• . Often such sensations occur in the lower abdomen. During normal pregnancy, they are tugging and develop due to increased tone of the uterus. With ectopic, they accompany the process of implantation and development of the embryo and can be localized in different areas - where the fertilized egg is attached. Later the pain spreads to the entire abdomen. Its intensity constantly increases - from barely noticeable at first, to sharp, cramping after a few days.
• General malaise . Normal pregnancy in the early stages may be accompanied by decreased performance, increased drowsiness, and fatigue. With an ectopic, all these symptoms are more pronounced, in addition, dizziness and fainting develop.
• Toxicosis . Nausea and vomiting often accompany normal pregnancy. In a pathological condition, these manifestations are more pronounced and intensify every day.

At later stages, the symptoms of ectopic pregnancy increase faster, and in a critical situation - rapidly. A woman’s blood pressure drops sharply, she experiences frequent dizziness, and her body temperature rises. Sometimes there are signs of anemia due to decreased hemoglobin levels.

If the fallopian tube ruptures and internal bleeding develops, this is manifested by very severe pain, shock, and loss of consciousness. Urgent medical attention is required.

For each type of pathological fixation of the ovum, there are characteristic symptoms:

• Pipe An ectopic pregnancy is manifested by pain on the left or right side, depending on where the implantation of the fertilized egg occurred. If it is fixed in the wide ampulla part, then the symptom appears at 8 weeks, if in the narrow part (in the isthmus) - then at 5-6. The pain intensifies while walking, turning the body, or sudden movements.
• Ovarian An ectopic pregnancy does not show any pathological symptoms for a long time. This is explained by the fact that the follicle can stretch to fit the size of the embryo. But when the limit of elasticity is reached, severe point pain appears in the lower abdomen, gradually spreading to the lower back and large intestine area. Defecation becomes painful. The attack lasts from several minutes to hours and is accompanied by dizziness and faintness.
• Cervical and cervical-isthmus ectopic pregnancy occurs without pain. Bloody discharge comes to the fore - from spotting to copious, profuse, posing a threat to life. Due to the increase in the size of the cervix, urination disorders develop (for example, frequent urge).
• Ectopic pregnancy in the abdominal cavity in the early stages it has symptoms that are no different from those during normal pregnancy. But as the embryo grows, dysfunctions of the gastrointestinal tract appear (constipation, diarrhea, nausea, vomiting), signs of an “acute abdomen” (severe pain, bloating, fainting).

What is an ectopic pregnancy and what symptoms are typical for it? With this pathology, the fertilized egg is implanted outside the uterus: most often in the fallopian tube, less often in the ovary, abdominal cavity, and cervical region.

An ectopic pregnancy can be detected from 4-6 weeks using a blood test for hCG and ultrasound. Symptoms in the early stages are almost the same as during normal pregnancy, but gradually they become more pronounced and specific (localization and intensity of pain, bleeding, disturbances in the functioning of other organs).

Useful video about the symptoms of ectopic pregnancy