Does ectopic pregnancy cause abdominal pain?

Ectopic pregnancy is an abnormal pregnancy. If a woman has an ectopic pregnancy and it is not treated in time, it can easily bring extremely adverse effects and even affect the woman's normal fertility and the health of her reproductive system. There are many symptoms of ectopic pregnancy, and many women experience abdominal pain. Next, I would like to introduce you to some relevant knowledge about ectopic pregnancy!

1. Symptoms of ectopic pregnancy

1. History of amenorrhea

Women who have always had regular menstruation experience amenorrhea. Generally, menopause lasts for 6-8 weeks. When irregular vaginal bleeding occurs a few days after the menstrual period, patients often mistake it for menstruation and neglect to go to the hospital for treatment. Especially women with irregular menstruation would not even think of going to the hospital for examination.

2. Abdominal pain

The abdominal pain caused by ectopic pregnancy occurs approximately within 6-8 weeks after pregnancy. The abdominal pain is caused by the rupture of the fallopian tube. It is often a tearing pain in one side of the lower abdomen, accompanied by nausea, vomiting, and a feeling of heaviness in the anus. If there is excessive bleeding, the pain will be unbearable. Not only will there be abdominal pain, but there will also be vaginal bleeding.

3. Vaginal bleeding

It often presents as irregular bleeding after a brief period of amenorrhea, with a small amount of bleeding, spot-like, dark red or brown color. Some patients have heavy bleeding, similar to menstrual flow.

4. Syncope and shock

It can cause dizziness, pale complexion, thin pulse, low blood pressure, cold sweat, syncope, shock, etc. Syncope resulting from an ectopic pregnancy can easily be mistaken for hypoglycemia.

5. Other symptoms

There may be nausea, vomiting, and frequent urination. The symptoms of ectopic pregnancy are often atypical. Some patients may go into shock due to heavy bleeding, become pale, and have low blood pressure.

2. Diagnosis of ectopic pregnancy

1. Pregnancy test

When the embryo is alive or the trophoblast cells are viable, the syncytial cells secrete hCG and the pregnancy test may be positive. Since the hCG level in patients with ectopic pregnancy is lower than that in normal pregnancy, the general hCG determination method has a low positive rate, and a more sensitive β-hCG radioimmunoassay or monoclonal antibody enzyme-labeled method must be used for detection.

2. Endometrial pathology examination

Diagnostic curettage is only suitable for patients with heavy vaginal bleeding and is intended to exclude intrauterine pregnancy. Uterine discharge should be routinely sent for pathological examination. If villi are seen in the section, intrauterine pregnancy can be diagnosed.

3. Ultrasound diagnosis

In early tubal pregnancy, B-ultrasound images show an enlarged uterus, but an empty uterine cavity and a low-echo area beside the uterus. This image is not the sonographic feature of tubal pregnancy, and the possibility of early intrauterine pregnancy with corpus luteum of pregnancy needs to be excluded. Ultrasound detection of the gestational sac and fetal heartbeat is very important for diagnosing ectopic pregnancy. If the pregnancy is located outside the uterus, it can be diagnosed as an ectopic pregnancy; if the gestational sac is located inside the uterus, ectopic pregnancy can usually be ruled out. B-ultrasound has important clinical significance for early diagnosis of interstitial pregnancy, as it can show protrusion of one uterine horn, local thickening of the muscle layer, and an obvious gestational sac inside.

4. Posterior fornix puncture

Since blood in the abdominal cavity is most likely to accumulate in the rectouterine pouch, even if the amount of blood is not large, it can be sucked out through posterior fornix puncture. Use an 18-gauge long needle to pierce the rectouterine pouch from the posterior fornix of the vagina. Aspirating dark red, non-coagulated blood is a positive result, indicating the presence of intra-abdominal blood.

5. Laparoscopy

Laparoscopic examination can be used if conditions permit and when necessary.

3. Emergency measures for ectopic pregnancy

After an ectopic pregnancy ruptures, the patient will feel severe abdominal pain and massive internal bleeding, and will experience shock symptoms such as pale complexion, rapid pulse, and decreased blood pressure. Generally, an ectopic pregnancy ruptures around the 6th to 8th week after pregnancy. An ectopic pregnancy rupture can penetrate the fallopian tube wall or miscarry from the fallopian tube fimbria into the abdominal cavity, threatening the life of the pregnant woman. Before the ambulance arrives, you should keep your head low, feet high, stay quiet and prevent bleeding. It is also important to keep warm with products such as blankets.

If ectopic pregnancy is handled properly, the patient's reproductive function and organs can be preserved without affecting the patient's quality of life and life safety. Therefore, early diagnosis is crucial. Women of childbearing age with regular menstruation who stop having menstruation or have irregular vaginal bleeding or lower abdominal pain should go to the hospital in time to prevent misdiagnosis and incorrect treatment, which may cause unnecessary losses to the patient or even cost her life.