Symptoms after successful conservative treatment of ectopic pregnancy

Ectopic pregnancy is a condition that can only be detected after women undergo a comprehensive examination after becoming pregnant. If this disease occurs, it may cause a series of symptoms. The most common is vaginal bleeding. If the patient's condition is more acute, it may also cause fainting or shock. Therefore, the specific situation should be judged based on one's physical condition. Usually, it cannot be recovered through conservative treatment.

1. Menopause

Except for pregnancy in the fallopian tube interstitial region, which lasts for a longer period of time, most cases last for 6 to 8 weeks. 20% to 30% of patients have no obvious history of amenorrhea, or their menstruation is only delayed by two or three days.

2. Vaginal bleeding

After the death of the embryo, there is often irregular vaginal bleeding, which is dark red in color and small in amount, generally not exceeding the amount of menstruation. A small number of patients have heavy vaginal bleeding, similar to menstruation, and may be accompanied by the discharge of decidual fragments.

3. Syncope and shock

Due to acute intra-abdominal bleeding and severe abdominal pain, mild cases may experience fainting, while severe cases may suffer from hemorrhagic shock. The more and faster the bleeding, the quicker and more severe the symptoms appear, but they are not proportional to the amount of vaginal bleeding.

1. HCG determination

It is currently an important method for early diagnosis of ectopic pregnancy.

2. Progesterone determination

The serum P level in ectopic pregnancy is low, but it is relatively stable at 5 to 10 weeks of gestation, and a single measurement has a great diagnostic value. Although there is overlap between normal and abnormal pregnancy serum P levels, making it difficult to determine the absolute critical value between them, a serum P level lower than 10 ng/m1 (radioimmunoassay) often indicates abnormal pregnancy, with an accuracy rate of about 90%.

3. Ultrasound diagnosis

Type B ultrasound examination is particularly commonly used for the diagnosis of ectopic pregnancy, and vaginal ultrasound examination is more accurate than abdominal B-type examination.

4. Diagnostic curettage

When ectopic pregnancy cannot be ruled out, a diagnostic curettage can be performed to obtain the endometrium for pathological examination. However, the endometrial changes in ectopic pregnancy are not characteristic and may be manifested as decidual tissue, highly secretory phase with or without A-S reaction, and various secretory and proliferative phases. Changes in the endometrium are related to whether the patient has vaginal bleeding and the duration of vaginal bleeding. Therefore, the diagnosis of ectopic pregnancy based solely on diagnostic curettage has great limitations.

5. Posterior fornix puncture

Posterior uterine fornix puncture is widely used to assist in the diagnosis of ectopic pregnancy. Blood can often be drawn out and does not coagulate after being placed, and contains small blood clots. If no fluid is removed, the diagnosis of ectopic pregnancy cannot be ruled out.

6. Laparoscopy

In most cases, early ectopic pregnancy can be diagnosed after medical history, gynecological examination, blood β-HCG measurement, and B-ultrasound examination. However, for some cases that are more difficult to diagnose, examination under direct laparoscopy can provide a clear diagnosis in a timely manner and surgical treatment can be performed at the same time.