It is rare, but it happens that the egg (fertilized egg) implants in the peritoneum instead of implanting itself in the uterine wall. This is called peritoneal pregnancy or abdominal pregnancy: different treatments may be considered depending on the case.
Implantation in the peritoneum: how to explain it?
- In France, ectopic pregnancies are relatively uncommon: they concern about 2% of pregnancies. In most cases, instead of implanting in the uterine lining, the egg begins to develop in a fallopian tube. More rarely, it can also attach to the peritoneum, a membrane lining the inside of the abdominal cavity. Alas, this place is not at all suitable for the development of a baby: very often, the egg does not evolve even to the fetal stage and when a fetus is formed, the chances of carrying the pregnancy to term are almost zero ...
- The exact causes of abdominal pregnancy - and more widely of all ectopic pregnancies - are still poorly understood, but several risk factors have been identified. These include mainly fallopian tube lesions such as salpingitis (tubal inflammation usually caused by sexually transmitted infections) or a history of surgery in the fallopian tubes. Endometriosis and smoking may also promote these extra-uterine pregnancies.
Peritoneal pregnancy: symptoms and diagnosis
- After implantation of the egg in the peritoneum, the first symptoms of abdominal pregnancy can resemble those of a "classic" pregnancy: tense breasts, nausea, late menstruation ... In addition, the result of the first pregnancy tests is positive.
- In the end, in most cases, it is the examinations performed during pregnancy monitoring that distinguish between an abdominal pregnancy and a uterine pregnancy. In the first place, the control ultrasound reveals that the volume of the uterus does not increase. In addition, the blood tests indicate that the hormone chorionic gonadotropin (HCG) level does not change as regularly as during a normal pregnancy.
- To know : a more advanced peritoneal pregnancy can lead to complications such as severe haemorrhage. Consult urgently in case of significant blood loss, severe pelvic pain, discomfort or loss of consciousness.
Peritoneum: what are the treatments for abdominal pregnancy?
- In many cases, the egg does not develop after implantation in the peritoneum: the abdominal pregnancy then ceases on its own. However, if the egg begins to develop, it is best to stop the ectopic pregnancy at the earliest.
- If detected early enough, medications can be used to stop cell division. Otherwise, surgery is needed to aspirate the embryo and prevent complications. Most often, it is a laparoscopy, also called laparoscopy: this technique minimally invasive surgery can intervene in the abdominal cavity via tiny incisions.
- Good to know : having an abdominal pregnancy will not prevent you from later carrying a pregnancy to term.