Intrauterine Pregnancy | mombabykids.com

Intrauterine pregnancy

    Intrauterine Pregnancy: What This Term Means and Why It's So Important

    This term is generally used by the medical profession at the very beginning of pregnancy. It is the opposite of ectopic pregnancy. We explain what it means and why it's important to ensure that the pregnancy is indeed intrauterine.

It's a term that's good to know, otherwise it can be surprising or unnecessarily worrying during an ultrasound report or medical appointment. We explain what it is.

    Intrauterine Pregnancy or IUGR: The Definition

    In gynecological and obstetrical jargon, an intrauterine pregnancy is a pregnancy located in the uterus. It is therefore a "normal" pregnancy, at least in terms of location. The gestational sac, also called the embryonic or ovular sac, containing the embryo is visible in the uterus from 3 to 4 weeks of amenorrhea, or 3 to 4 weeks after the start of the last period. This is approximately two weeks of pregnancy.

    The term intrauterine pregnancy is the opposite of ectopic pregnancy, which is a medical emergency that must be terminated and cannot lead to the birth of a viable baby (see below).

    An intrauterine pregnancy causes various symptoms, commonly referred to as pregnancy symptoms: morning sickness (or even vomiting), fatigue, food cravings, swollen and/or painful breasts, and, most importantly, missed periods.

    The subtlety is that a pregnancy can be intrauterine without necessarily being viable: it can be in the uterus, but for example, in the uterine isthmus (the narrowing of the lower part of the uterus, between the uterine body and the cervix, editor's note), or in the cervix, or on a cesarean scar. These are tricky locations, since they are located in the uterus, but not in the uterine body, and therefore not conducive to a healthy pregnancy. In such cases, the pregnancy will have to be terminated.

    In the uterus and evolving: two major elements to check on ultrasound

    A positive urine pregnancy test, demonstrating the presence of the pregnancy hormone beta-HCG, or even a blood test showing the HCG level, does not indicate whether the pregnancy is intrauterine. It simply indicates that a pregnancy is underway, since the pregnancy hormone (with some exceptions) is produced first by the embryo, then by the placenta. However, the presence of this hormone says nothing about the location of the pregnancy.

    It is during the dating ultrasound or even during the mandatory first-trimester ultrasound (in the absence of worrying symptoms) that the location of the pregnancy is discovered. The obstetrician-gynecologist or midwife then ensures that the pregnancy is indeed intrauterine, in other words, that the gestational sac (and the embryo, depending on how far along the pregnancy is) is indeed within the uterus. The other key piece of information to look for to ensure that the pregnancy is progressing is the embryo's cardiac activity, which can be recorded around 6 weeks of amenorrhea, or 4 weeks of pregnancy. Without this cardiac activity, it is not possible to confirm that the pregnancy is progressing.

    So let's remember that the term intrauterine pregnancy, when located in the uterine body, is reassuring, even if, as we shall see, it in no way presumes that the pregnancy will progress well. Let's just say it's a good start!

    What is an ectopic pregnancy, an ectopic pregnancy, or even a heterotopic pregnancy?

    An ectopic pregnancy is called an ectopic pregnancy when, as the name suggests, the pregnancy is not located in the uterus. The terms ectopic and heterotopic pregnancy are synonyms: they also refer to a pregnancy in an inappropriate location, outside the uterine cavity. In short, a fertilized egg (future embryo) has implanted in a place where it should not have: in a fallopian tube (connecting the uterus and ovary, in which case it is called a tubal pregnancy), in an ovary, or even in the abdominal cavity. The embryo will not be able to develop properly there, and the pregnancy will not progress favorably. Emergency medical intervention is necessary as soon as an ectopic pregnancy is diagnosed, whether during a first-trimester ultrasound or due to suggestive symptoms.

    How can you tell if you have an ectopic pregnancy? What are the signs and symptoms?

    HCG hormone measurements taken several days apart can partially assess the progress of the pregnancy, as the level is expected to at least double every 48 hours in early pregnancy (up to the 10th week of amenorrhea). In cases of an ectopic pregnancy, the beta-HCG level is generally lower and does not double every 48 hours.

    Aside from this biological data, an ectopic pregnancy is primarily suspected due to the symptoms it causes, with varying degrees of intensity:

• A late period, as with an intrauterine pregnancy;
• Feelings of discomfort;
• Dark, brown, sepia-toned, or even blackish vaginal bleeding, which is light but lasts for several days;
• Lateralized pelvic (lower abdominal) pain, most often in one of the two iliac fossae (lower left or right abdominal area), but not necessarily on the side where the embryo implanted.

    Such symptoms, alone or in combination, should prompt a consultation to confirm or rule out an ectopic pregnancy, which constitutes a medical emergency.

    When does an ectopic pregnancy cause pain?

    It's difficult to say precisely when an ectopic pregnancy, located outside the uterine cavity, causes pelvic pain. Sometimes, an ectopic pregnancy is even asymptomatic for days or even weeks. Sometimes, an ectopic pregnancy causes bleeding, but not severe pain. It's important to note that an ectopic pregnancy often causes unilateral pain, meaning it's on one side only, but this isn't always the case. Therefore, even in the absence of pain, unusual bleeding associated with a positive pregnancy test should prompt immediate medical attention.