Gravidanza, Gravidanza a rischio

Gravidanza ectopica: sintomi, diagnosi e cura

Gravidanza ectopica

Gravidanza ectopica, ne avete mai sentito parlare? Sapete che non è un’eventualità così rara come potrebbe sembrare?
La gravidanza ectopica è una patologia nella quale l’impianto dell’embrione avviene in sedi diverse dalla cavità uterina.
La gravidanza ectopica si distingue in:

  • gravidanza intrauterina, con impianto in sede impropria, cioè inadeguata al suo sviluppo. L’ovulo può posizionarsi nell’ostio tubarico, a livello della cervice uterina, nell’interstizio uterino, ecc.
  • gravidanza extrauterina, quando l’annidamento avviene al di fuori dell’utero.

A seconda delle sue sedi, la gravidanza extrauterina viene definita: tubarica, la più frequente; tubo-ovarica; ovarica; addominale.
La gravidanza extrauterina è il caso più frequente di gravidanza ectopica.

L’incidenza della gravidanza ectopica è piuttosto alta. Circa 1,6 delle gravidanze sono di natura ectopica. Il rischio di insorgenza è maggiore per le donne primipare giovanissime e per quelle di età avanzata. Ma anche le nullipare con anamnesi di poliabortività sono molto esposte. Più gravidanze extrauterine simultanee sono un’evenienza rara. Tuttavia l’esposizione a tecniche di fecondazione assistita favorisce questo tipo di gestazione anomala.

Gravidanza ectopica cause

La gravidanza ectopica può essere ricondotta a diverse cause.
Una delle motivazioni principali può essere l’ostruzione del passaggio nelle tube di Falloppio. Come sappiamo, tutte le gravidanze in fase iniziale sono extrauterine. Nei primi giorni l’embrione rimane nella tuba, raggiungendo solo in seguito la cavità uterina. Un’infezione o infiammazione nelle tube può bloccare il passaggio e rendere impossibile l’attraversamento dell’ovulo. Tra le ragioni che provocano l’ostruzione delle tube c’è la presenza di una malattia infiammatoria pelvica. Altre cause di queste gravidanza anomala possono essere: endometriosi, fibromi, aderenze pelviche, appendicite, squilibri ormonali o conformazione del sistema riproduttivo materno.

gravidanza ectopica

Gravidanza ectopica sintomi

I sintomi sono diversi per ogni donna e spesso sono confusi con altri disturbi dell’apparato genitale.
Tra i sintomi più frequenti ci sono comunque:

  • crampi addominali,
  • salpingiti,
  • emorragie uterine,
  • amenorrea,
  • nausea,
  • vomito,
  • mal di schiena,
  • vertigini,
  • febbre,
  • tensione a livello pelvico
  • ipotensione.

Test gravidanza precoce

L’esame dell’hcg fornisce informazioni sulla presenza di una gravidanza. Livelli bassi o in lento aumento di questo ormone possono rappresentare un indizio di gravidanza ectopica.
Una diagnosi precoce di questa patologia permette modalità di intervento meno invasive. In alcuni casi, infatti, viene prescritta una terapia farmacologica oppure una salpingotomia.
La salpingotomia laparoscopica prevede l’apertura della tuba e la rimozione del tessuto formatosi con la gravidanza.
Se invece questa gravidanza anomala non viene diagnosticata in tempo si può incorrere nel rischio di emorragie gravi. Tali emorragie possono portare alla morte non solo del feto ma anche della madre.

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