Pregnancy Questions

Ectopic fetation, extrauterine development of the human fetus.
Depending on the insertion (implantation) site of the ovum, pregnancy could be tubal, ovarian or abdominal.  The most common form (99%) of extrauterine pregnancy is tubal pregnancy. In such a case the ovum is fertilized by spermatozoid in the uterine tube. Extrauterine pregnancy occurs when the ovum navigation through the tube to the uterine is disturbed. Such a disturbance is caused by the damage of epithelial tissue of tubal mucous membrane occurred in the result of inflammatory diseases of female internal sex organ (the cause of 1/3 of all extrauterine pregnancies), abortions and consequences of gonorrhea. Other causes of extrauterine pregnancy may include presence of gland masses (adenomyosis) in the muscular layer of the tubes or hypogenitalism (genital infantilism) caused by anhormonia. In some cases extrauterine pregnancy may occur in the result of so called external movement of the ovum, it is when the fertilized egg gets from ovary on one side to the tube on the opposite side; by the time the ovum gets into tube, trophoblast would have developed and the ovum acquires property to implant into the mucous membrane.
Extrauterine pregnancy is usually interrupted in the 4-6th week in the result of tubal wall break by the ovum villi (tubal rupture) or expulsion of the egg by tubal contraction into abdominal cavity (tubal abortion). Extrauterine pregnancy interruption in the result of tubal rapture is accompanied by internal bleeding and shock because of acute pain at the bottom of stomach.Tubal abortion causes less bleeding. It is characterized by cramp-like pain accompanied by short-term fainting.These symptoms usually pass away in a few hours and the patient`s condition improves.However, the danger of severe internal rebleeding is still pending, that is why additional examination is needed for detection of extrauterine pregnancy (pregnancy reaction test, puncture of posterior vaginal fornix, etc.) and supervision during 2-3 weeks.In rare cases after tubal abortion the fertilized ovum gets implanted in the abdominal cavity (abdominal secondary pregnancy) and may develop until late pregnancy; in such cases laparotomy sometimes may help to give birth to a live full-term newborn.The treatment consists in surgical removal of the damaged uterine tube. Every woman who underwent an operation for extrauterine pregnancy should undergo a long-term course of therapy to prevent consecutive extrauterine pregnancy in the second tube.