Ectopic pregnancy – this diagnosis usually sounds like a terrible sentence for a woman, because it carries not only the risk of infertility, but also a direct threat to the patient's life.
Over the past twenty years, according to statistics, the number of gynecological patients with such a diagnosis has increased significantly (3-5 times!).
Just 20 years ago, an ectopic pregnancy often became a de facto guarantee of deprivation of the opportunity to have children.
After all, the only possible surgical intervention was the complete removal of the tube with the fetal egg. This increased the risk of recurrent ectopic pregnancy. And if a woman lost the second fallopian tube, then she could no longer conceive a child.
Fortunately, in gynecology, laparoscopic surgery has been successfully used for a long time, which preserves women's health and fertility as much as possible.
1. Threats of ectopic pregnancy – indications for laparoscopic surgery
2. Features of laparoscopic surgery for ectopic pregnancy
3. Features of rehabilitation after laparoscopic surgery
Threats of ectopic pregnancy – indications for laparoscopic surgery
Ectopic (ectopic) pregnancy occurs for various reasons: inflammatory processes (especially often due to genital infections), which lead to adhesions and obstruction of the fallopian tubes, endometriosis, neoplasms, previous tubal surgeries (as we wrote above) and congenital pathologies.
The most common (in 98% of all cases) is an ectopic pregnancy in one of the tubes.
However, occasionally a gestational sac may attach and develop in one of the ovaries or the abdomen.
Ectopic pregnancy is extremely dangerous because it is difficult to detect in a timely manner. Indeed, for many women, unfortunately, pain in the lower abdomen is not a sign that they need to urgently consult a gynecologist (especially if they do not suspect pregnancy).
And at the 5-6th week of pregnancy, the fetal egg grows to such a size that it stretches and breaks the wall of the organ to which it is attached. This causes profuse internal bleeding in the abdominal cavity and can lead not only to infertility, but even to death if treatment is not provided in time.
But even if help is provided in time, the severely damaged pipe cannot be saved.
It is impossible not to pay attention to the symptoms of bleeding in the abdominal cavity: very severe pain in the lower abdomen, which suddenly appears, pallor, general weakness, dizziness, loss of consciousness.
Ideally, it is better to monitor the onset of pregnancy, and at the slightest suspicion of pregnancy, immediately contact a gynecologist.
The doctor will refer the woman for an ultrasound, which will show the absence of a gestational sac in the uterine cavity, which will serve as the basis for establishing a diagnosis.
Then the patient is recommended laparoscopic surgery - the most sparing surgical method to date, which will allow you to simultaneously visually assess the condition of the organs and remove the ovum, while maintaining in most cases a workable pipe.
Peculiarities of laparoscopic surgery for ectopic pregnancy
Laparoscopic surgery is performed using three punctures in the abdominal wall, through which the surgeon works with microscopic instruments with optical magnification.
Laparoscopy for ectopic pregnancy is two main types:
- Tubotomy (the tube is opened, the elements of the fetus are completely removed or the damaged part of the tube with the egg is removed - the organ completely retains its fertile functions).
- Tubectomy (if the ectopic pregnancy has left irreversible changes, depriving the tube of functionality, it is more reasonable to remove it completely). Tubectomy is an extreme method if the wall of the tube is irreversibly damaged by a large fetal egg or has undergone pathological changes.
In each case, the decision is made individually, taking into account the patient's history and preoperative examinations.
On the evening before the operation, fasting and an enema are prescribed. The operation takes about 1 hour. The intervention is performed under general anesthesia (less often - under combined local anesthesia).
Through the trocars in the punctures, the doctor penetrates into the problematic organ, makes all the necessary excisions and manipulations.
The cut-off areas are coagulated (bleeding stops), which makes it possible to do without even suturing the operated organ. Sterile pads are then placed over the puncture sites.
If the wounds are larger than 5 mm – absorbable sutures are required.
By the way, laparoscopic surgery allows you to simultaneously not only remove the fetal egg from one tube, but also to prevent the second tube, assessing its condition. If necessary, reconstruction can be performed immediately, restoring patency and removing adhesions.
Peculiarities of rehabilitation after laparoscopic surgery
Usually, after laparoscopic surgery, patients are kept in the hospital for 1-2 days under observation.
If the operation went without complications, then the woman is quickly allowed to go home, subject to certain conditions for postoperative recovery.
Already on the second day after laparoscopy the patient can get out of bed, walk and eat.
For the first 2-3 weeks, it is recommended to wash in the shower (in no case in the bath) followed by the obligatory treatment of the seams with iodine or another antiseptic. Sexual life, of course, should be abstained at this time.
After a couple of weeks the woman is considered to be fully functional, although, as practice shows, many patients return to work and normal life earlier if they feel well.
Over the next few months the woman should visit her gynecologist regularly for follow-up. At this time, you need to refuse to visit the sauna, bath, hot baths, intense physical exertion (especially strength).
Thus, laparoscopy for ectopic pregnancy is the most gentle solution to the problem and the most likely opportunity to conceive a child in the future, while maintaining healthy fallopian tubes.
A huge plus of laparoscopy - preservation of a woman's fertility due to the fact that the risk of further formation of adhesions in the operated tubes is minimized (as happens after traditional gynecological operations ) thanks to minimally invasive intervention.
If you suspect you have an ectopic pregnancy, contact your doctor immediately, because time is not in your favor.
Be healthy!
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