Definition: What is implantation?
the implantation correspond egg implantation into the uterine cavity a few days after fertilization.
The stages of fertilization
“It all starts with the fertilization, recalls Dr. Odile Bagot. At a intercoursepart of sperm travels to the uterus then towards the fallopian tubes where the encounter with the ovum. The two cells fuse and form the baby’s first cell. This is then divided into two cells, then four, then sixteen, etc. This is how it is formed the egg consists embryonic appendages – the amnion and chorion, which give rise to the amniotic membrane as well as the trophoblast at the origin of the placenta – and the embryo who will take the name fetus At the end of first trimester, as soon as its organs are constituted. In the 5 to 6 days after fertilization, the morula – or small bramble – which corresponds to the first stage of the embryo blastocyst. this blastocyst then takes its time – between 4 to 8 days – to descend from the fallopian tube into the uterus, where the implantation.
When does it take place?
the implantation takes place second week of pregnancy (4th week of amenorrhea). Under the influence of hormones – estrogen then progesterone – endometrium thickens to accommodate the embryo. This then adheres to the wall of the uterus and gradually nests in the thickness of the mucous membrane.
This moment, called implantation, occurs a week after fertilization and a week before the delay in menstruation, specifies Dr. bagot.
How long does it take?
After fertilizationthe egg moves thanks to the through the tube vibrant lashes and reaches the uterus in three to four days. “After two or three days in the water, it nests the endometriumthe mucous membrane that covers the inside of the uterus, explains Pr Hédon, co-author of the Big book of my pregnancy. It is here implantation : The egg develops extensions that cling to the uterine lining and become future placenta which serve as the lungs and digestive tract of the fetus”. The future placenta releases pregnancy hormones, the rate of which then doubles every 24 hours. For the record, these are Beta HCG hormones which are sought and dosed when a pregnancy test (blood test).
What are the symptoms of successful fertilization?
There are very few signs of this implantation. “Most of the time, the implantation passes unnoticed, confirms Dr. bagot. We can possibly have a slight one bleeding if there is no late period yet. Nothing can be seen on the ultrasound. You must be at least a week late for your period for you to start seeing a small spot on the uterus.
Ectopic pregnancy: when the implantation takes place outside the uterus
If the implantation Mostly done in the uterus, unfortunately it happens that the egg cell is implanted in one of the two fallopian tubes : we will then talk about it ectopic pregnancy (GEU). Ectopic pregnancies account for 0.5% of pregnancies. “It is important diagnose early to be able to carry out a medical or surgical treatment before the fallopian tubes rupture, which would require an emergency intervention”, specifies Professor Hédon, co-author of the Big book of my pregnancy.
What is an ectopic pregnancy?
Normally, after fertilizationthe egg progresses through the fallopian tubes during the first seven days of pregnancy, then it implants itself in the uterus. Sometimes, however, it does not implant itself in the lining of the womb. the pregnancy is not then not viable and the development of the egg can be dangerous for the expectant mother. The fallopian tube containing the embryo grows and may rupture.
What causes an ectopic pregnancy?
Ectopic pregnancy (EPG) is one implantation failure of the embryo in the uterus, which is mainly explained by a migration disorder.
The Migration Disorder is essentially associated with an anomaly of the fallopian tubes and a reduction in their mobility. “The fallopian tubes may be narrowed or blocked, especially after a salpingitean infection caused by bacteria Chlamydiae trachomatis or after a first ectopic pregnancy,” says Dr. bagot.
What are the signs of an ectopic pregnancy?
If at first the signs of an ectopic pregnancy are the same as with a normal pregnancy – the patient has her period and she no longer has it pregnancy test is positive – Very quickly, the following symptoms should alert the patient and prompt her to see her doctor. For example :
- pain in the lower abdomen,
- Classically sepia (brown), but sometimes bleeding red after a late period.
“If not diagnosed in time, an ectopic pregnancy can result tubal tear and a internal bleeding “Warn Dr. Odile Bagot.
How to diagnose it?
the ectopic pregnancy can be diagnosed accidentally if first ultrasound pregnancy monitoring or when symptoms lead the patient to see a doctor. The diagnosis of GEU A blood test is then used to measure it pregnancy hormone (beta-HCG) and in particular its evolution over time.
“The ultrasound will come validate the diagnosis so you can confirm the absence of pregnancy in the uterus or in the mold to visualize from a lump in a trunk often accompanied by an effusion of fluid in the abdomen, evidence of pelvic hemorrhage ectopic pregnancy says dr bagot.
What is the treatment?
A ectopic pregnancy rarely leads to spontaneous expulsion. If she quits early, sometimes she can develop naturally. If she does not stop spontaneously and the egg continues to grow, it can become dangerous for the expectant mother.
“In case of stagnation at an early stage and without signs of complications, treatment consists of injection of a drug called methotrexate which stops the development of the ovum and leads to resorption of the amniotic sac, explains Dr. bagot. When the patient presents with me complications or that the pregnancy is too advanced and progressive, a surgical interventionunder laparoscopy will be carried out”. Depending on the condition of the fallopian tube, it can be decided a salpingotomy (i.e. to keep the fallopian tube) or, on the contrary, to remove it (salpingectomy).
Ectopic pregnancy and recurrence
If the patient already had an ectopic pregnancy, the risk of recurrence is around 10 to 20%. Pregnancies occurring after EP should also be monitored at an early stage. “It is important not to start a new pregnancy too quickly and therefore to use an appropriate method of contraception, specifies the National College of French Obstetricians and Gynecologists. Contraception is often offered by estrogen progestin pill to regenerate the lining of the uterus (the progestin pill is avoided because it alters the lining of the uterus)”.