Patient's question:
Hello doctor, I used a pregnancy test and it came back positive, but I'm not very reassured because I always have lower abdominal pain. What could be the reason? I had a miscarriage a year ago. Could I have contracted any disease? Can ectopic pregnancy also show positive?Follow-up question: Hello doctor, I took a urine test today and it came back positive. The doctor confirmed that I'm pregnant and told me to have an ultrasound this week to check for the possibility of ectopic pregnancy. I'm very scared. Could you please tell me under what circumstances ectopic pregnancy is more likely to occur? Does my history of miscarriage have anything to do with it? I had a miscarriage without anyone knowing. Will this test reveal it?
Doctor's answer:
Hello, ectopic pregnancy, also known as tubal pregnancy, refers to a pregnancy that occurs outside the uterine cavity, with 98% of cases occurring in the fallopian tubes. Ectopic pregnancy poses a significant threat to a woman's physical and mental health, as well as her life safety. So, which women are most likely to experience ectopic pregnancy?Women with chronic tubal inflammation The fallopian tubes are the channels that transport the fertilized egg to the uterine cavity. They have folds inside, and these folds are lined with cilia. Under normal circumstances, the movement of the cilia and the peristalsis of the smooth muscle in the fallopian tubes move the fertilized egg to the uterine cavity. In women with chronic tubal inflammation, the mucosal folds inside the tube wall become adhered, narrowing the lumen. At the same time, due to inflammation and lesions, the cilia of the fallopian tube mucosa are damaged, and the peristalsis of the tube wall smooth muscle is weakened, making it difficult for the fertilized egg to reach the uterine cavity.
Women with fallopian tube developmental abnormalities or malformations Poor development of the muscular layer of the fallopian tubes, a lack of cilia in the endometrium, and other lesions reduce the function of the fallopian tubes in transporting the fertilized egg. Fallopian tube abnormalities such as bending, spiral shapes, double fallopian tube openings, or other underdeveloped fallopian tube malformations also make it difficult for the fertilized egg to reach the uterine cavity smoothly.
Women with endometriosis This is because the endometrium is ectopic in the interstitial part of the fallopian tube. On one hand, due to the thickening of the interstitial tissue, the lumen may become narrowed or blocked, making it difficult for the fertilized egg to pass through. On the other hand, when the fertilized egg reaches the interstitial tissue and comes into contact with the ectopic endometrium, the syncytiotrophoblast, like a normal pregnancy egg when it implants into the endometrium, allows the fertilized egg to implant and develop.
Women with masses in the pelvic cavity Due to the compression and traction of the mass, the position and shape of the uterus or fallopian tubes may shift, and it may even lead to