Will repeated abortions lead to ectopic pregnancy? TCM syndrome differentiation is effective in treating ectopic pregnancy

Ectopic pregnancy is a common disease in modern gynecology. For some reasons, the fertilized egg goes wrong during the migration process and does not reach the uterus, but stays somewhere else, which becomes an ectopic pregnancy. So what are the reasons for women's ectopic pregnancy?

There are two reasons for ectopic pregnancy

Repeated abortion: With the continuous change of traditional concepts, premarital sex has led to abortion, which is becoming more and more common. Repeated abortion can easily lead to ectopic pregnancy. The incidence of ectopic pregnancy has increased 5 to 6 times compared with the 1980s. The more abortions you have, the greater the chance of ectopic pregnancy. Therefore, whether you have children or not, women should take good contraceptive measures to prevent ectopic pregnancy.

Chronic pelvic inflammatory disease: Chronic pelvic inflammatory disease, especially salpingitis, is another important factor in the development of ectopic pregnancy. Women must not ignore this common gynecological disease. Because salpingitis can narrow the lumen of the tube, it is difficult for the fertilized egg to enter the uterine cavity, so it has to "set up camp" in the fallopian tube or ovary.

TCM Syndrome Differentiation and Treatment of Two Types of Ectopic Pregnancy

Undamaged

It refers to tubal pregnancy that has not yet resulted in abortion or rupture. There is a history of amenorrhea, early pregnancy reactions, or vaginal bleeding, dull pain on one side of the lower abdomen, and a soft mass on one side of the adnexa during pelvic examination, which is tender; urine pregnancy tests are mostly positive, and B-ultrasound examination shows cystic masses in the adnexa, or no gestational sac in the uterus but a gestational sac outside the uterus; the pulse is stringy and slippery.

Treatment principles: Promote blood circulation, remove blood stasis, eliminate lumps and kill embryos.

Prescription: Prescription No. 2 for ectopic pregnancy. Main ingredients: Danshen, red peony root, peach kernel, three-edged sword, and curcuma.

Massive

The tubal pregnancy has been ruptured for a long time, and the blood in the abdominal cavity has formed a hematoma, which is a chronic ectopic pregnancy. The tubal pregnancy has been ruptured for a long time, and a hematoma has formed in the pelvic cavity. The abdominal pain is relieved or gradually disappears; there may be a feeling of heaviness in the lower abdomen or the urge to defecate, and the vaginal bleeding gradually stops. Pelvic examination can touch an irregular mass that is adhered to the surrounding tissues; the pulse is thin and wiry.

Treatment principles: Promote blood circulation, remove blood stasis, eliminate symptoms and disperse nodules.

Prescription: Prescription II for ectopic pregnancy. If the lump is hard, add pangolin and Achyranthes bidentata to strengthen the function of eliminating symptoms and dispersing nodules; if the body is weak, add Astragalus and Codonopsis pilosula to strengthen the body and eliminate evil; if blood stasis and heat are transformed into low fever, add Peony Root, Tortoise Shell, and Lycium bark to dissolve blood stasis and clear heat.

Other conservative treatments

1. Drug treatment

Chemotherapy is generally administered systemically, but can also be administered locally. Methotrexate (MTX) is commonly used for systemic administration. The therapeutic mechanism is to inhibit the proliferation of trophoblasts, destroy villi, and cause embryonic tissue necrosis, shedding, and absorption, thus avoiding surgery. The usual dose is 0.4 mg/kg.d, injected intramuscularly, and a course of treatment is 5 days. The application of chemotherapy may not be successful in every case.

2. Traditional Chinese medicine treatment

At present, non-surgical treatment mainly includes conservative treatment with traditional Chinese medicine, but it takes a long time for traditional Chinese medicine to kill the embryo, and during the conservative treatment, there is a possibility that the embryo will continue to develop and cause fallopian tube rupture. In addition, sometimes surgical treatment is required because the treatment is not thorough, which is easy to waste the patient's time, physical strength and money.

3. Salpingectomy

For patients who have already given birth, if the fallopian tube rupture is too severe to undergo a fenestration surgery, a unilateral salpingectomy can be performed. For most women who want to have children, a fenestration surgery at the fallopian tube rupture can be performed, which can retain a 25% chance of fertility for the patient.

4. Conservative surgery for ectopic pregnancy

The treatment principle of ectopic pregnancy is mainly surgical treatment. There are two types of surgical methods for open abdominal surgery of ectopic pregnancy. One is to remove the affected fallopian tube; the other is to retain the affected fallopian tube, which is conservative surgery.

Applicable population: Conservative surgery is suitable for young women who want to have children, especially those whose contralateral fallopian tube has been removed or has obvious lesions. In recent years, due to the improvement of diagnostic technology, more and more fallopian tube pregnancies have been diagnosed before miscarriage or rupture, so the use of conservative surgery has increased significantly compared with the past.