Ectopic pregnancy: Complications from inflammation of the fallopian tubes

The article is professionally consulted by Master, Doctor Trinh Thi Thanh Huyen - Department of Obstetrics and Gynecology - Vinmec Hai Phong International General Hospital.

One of the most feared complications of tubal inflammation is an ectopic pregnancy. This is a condition that can seriously affect the health of pregnant women if not detected and intervened in time.

From fertilization to delivery, pregnancy entails many changes in a woman's anatomy and physiology. One of the important steps is to have a smooth route for the fertilized egg to travel to the uterus for implantation. Any situation in which the fertilized egg does not adhere to the endometrium is called an ectopic pregnancy. At this time, the implantation site can be anywhere in the female reproductive organs such as attaching to the fallopian tubes, the cervix or even falling into the abdominal cavity.
As soon as a woman discovers that she has missed her period and is diagnosed with an ectopic pregnancy (about 1 in 50 normal pregnancies), early intervention is necessary before complications occur. complications, because it can be life-threatening to the mother.
Therefore, an untreated ectopic pregnancy is always considered an obstetric emergency. Only with timely treatment can dangerous risks be reduced, increasing the chance of a new, healthy pregnancy in the future.

The cause of ectopic pregnancy is still really unclear until now. In some cases, the following conditions are associated with an ectopic pregnancy or an ectopic pregnancy that is a complication of certain general gynecological conditions. In which, it should be especially noted are the conditions of inflammation of the ovaries, inflammation of the fallopian tubes, abscesses of the appendages ... These are diseases belonging to the group of inflammatory diseases of the appendages. Inflammation causes the body to react, excreting chemicals that kill bacteria but also destroy tissues. Then, inflammation will create conditions to cause bad scarring, permanent adhesions.
For the case of tubal inflammation in particular, scar tissue blocks the fallopian tubes, sperm can still go downstream to meet the egg, but the zygote after fertilization cannot move into the uterus, must implant right in the fallopian tube, causing an ectopic pregnancy.
Regarding the causes of tubal inflammation, ovarian inflammation, the factors are similar to those of adnexal inflammatory diseases. These are bacteria that are transmitted through unsafe sex, including syphilis and gonorrhea. In addition, the cause may be due to sexual activities with many partners or bad hygiene habits, disorder of resident organisms. A small number of cases of tubal inflammation are caused by medical interventions, are complications after previous procedures, surgery on the appendage.
In addition, the possibility of ectopic pregnancy is increased if there are abnormalities in endocrine factors, genetic abnormalities or congenital anomalies of the genitourinary system, both existing and newly discovered.
Accordingly, many observations suggest that all sexually active women may be at risk of ectopic pregnancy. Risk is increased with any of the following:
Pregnancy age 35 or older History of pelvic surgery, abdominal surgery or repeated abortions History of pelvic inflammatory disease, including fallopian tube inflammation , ovary inflammation and adnexal abscess History of endometriosis Spontaneous conception occurring despite tubal ligation or IUD insertion Conception with medication or assisted procedure artificial reproduction History of ectopic pregnancy , sexually transmitted diseases , such as gonorrhea or chlamydia Having structural abnormalities in the fallopian tubes that make it difficult for eggs to move Smoking habits

Nausea, abdominal pain, and vaginal bleeding are all symptoms that can occur in both ectopic and intrauterine pregnancies. However, the specificity of the symptoms and their severity will help to suspect an ectopic pregnancy and indicate when it is a medical emergency:
New-onset severe abdominal pain Pain occurring on one side of the abdomen Light to heavy vaginal bleeding Pale cold skin Low blood pressure Dizziness, fainting

Ectopic pregnancies are generally benign if detected early. The principle of treatment is to actively remove the embryo from the body as soon as possible. However, the way in which treatment is selected varies depending on the location of the ectopic pregnancy and its growth.
In terms of internal medicine, the doctor will use drugs to prevent the growth of the embryo, most commonly methotrexate. This is a medication that stops the growth of rapidly dividing cells and will cause symptoms similar to a miscarriage, including cramping abdominal pain and bleeding of tissue from the vagina. . The advantage of methotrexate so far is that no risk of fallopian tube damage has been found, you can get pregnant naturally again a few months later.
If the uterus is too large or has complications of ectopic pregnancy, it cannot be eliminated by medical treatment, the role of surgery will be set. The doctor will intervene with minimally invasive level through laparoscopy, both removing the fetus and preserving the fallopian tubes in the most complete way.
Regarding the ways to prevent ectopic pregnancy, nothing is more effective than always ensuring the integrity of the reproductive system. Any injury here, such as inflammation of the fallopian tubes, will scar the adhesions and cause obstruction, increasing the risk of ectopic zygote implantation. To achieve this, the main measures are to reduce the risk of pelvic inflammatory disease, practice safe sex with condoms and limit the number of sexual partners. At the same time, each woman also needs to build good genital hygiene habits, maintain a regular gynecological examination schedule, and take measures to improve personal health in general, such as quitting smoke, avoid alcohol and follow a scientific and healthy diet and lifestyle.
In summary, an ectopic pregnancy is an ectopic pregnancy, the most common consequence of tubal inflammation. Furthermore, tubal interventions, including surgical removal of an ectopic pregnancy, increase the risk of recurrent ectopic pregnancy. Therefore, prevention of tubal inflammation is an effective measure to protect reproductive health to carry out pregnancy and childbirth.
Master. Trinh Thi Thanh Huyen is highly trained in obstetric ultrasound, laparoscopic surgery and hysteroscopy at the National Hospital of Obstetrics and Gynecology and has more than 13 years of experience working at Hai Phong Obstetrics and Gynecology Hospital.
Currently, the doctor is an Obstetrician and Gynecologist at Vinmec Hai Phong International General Hospital