流产异位妊娠英文AbortianandEctopicPregnancy ppt完美版课件.pptx

1、Habitual Abortionvaginal bleeding decreasing, abdominal pain alleviatingHabitual AbortionHabitual Abortionrupture：1216 weeksperform suction curettage promptlyComplete AbortionMissed abortion, cervical pregnancy?Incomplete AbortionConcept：implantation of the developing conceptus in the cervical canal

2、Pelvic examination：cervical motion tenderness，sensation of a floating uterus ，adnexal mass, etc.A pregnancy loss before 28 weeks of gestation while fetal weight under 1000 gramsVaginal bleedingadnexal cardiac activity or ultrasonographic lucency ; presence of cul-de-sac fluidLaboratory AssessmentMis

3、sed abortion, cervical pregnancy?Pain mild，bleeding light；IntensifiedPregnancy mass3cm or undetected；Complete AbortionDescribe the clinical presentations of different stages of abortion？No intraabdominal bleeding；Light to noneConcept：implantation of the developing conceptus in the cervical canalultr

4、asound：the empty uterus sign；Before 8 weeks: chorionic villi immatureBefore 8 weeks: chorionic villi immaturevaginal bleeding decreasing, abdominal pain alleviatingBefore 8 weeks: chorionic villi immatureone of the main causes of acute abdomen and deathMissed abortion, cervical pregnancy?abortion：81

5、2 weeksprevious tubal surgery：for infertility, tubal pregnancy, etc.Summarize the treatment for tubal pregnancy and its choice？Abdomen examinationThe occurrence of 3 or more consecutive spontaneous abortionsMild to heavyPain mild，bleeding light；culdocentesis：nonclotting bloodmonitoring：ultrasound；Pa

6、rtial expulsion of the products of conception non-ideal uterine contraction, severe bleedingBleedingAbdominal PainTissue ExpulsionCervical OsUterusThreatened AbortionInevitable AbortionIncomplete AbortionComplete AbortionLightMild to heavyLight to heavyLight to noneNone/lightIntensifiedRelievedNoneN

7、oneNonePartialCompleteClosedDilatedDilated or obstructedClosedNormalNormal or slightly smallSmallNormal or slightly large History Pelvic ExaminationConcept：implantation of the developing conceptus in the cervical canalLate Abortion: pregnancy loss during 1228 gestational weeksWhat conditions should

8、be differentiated from tubal pregnancy their respective differential points？Treatment principle：transfusion preparation; curretage or suction curretage ; MTX and/or uterine curretageHabitual AbortionPelvic examinatioonabortion：812 weeksComplete AbortionNo intraabdominal bleeding；Septic AbortionSpont

9、aneous Abortioncorrecting coagulation defects：heparin, fibrinogen, etc.Ovarian PregnancyBefore 8 weeks: chorionic villi immatureIncidence：1：18000Inevitable AbortionGenetic defectClinical PresentationsProtocol：MTX150 mg，give a second dose on day 7 if necessaryTypes of AbortionPartial expulsion of the

10、 products of conception non-ideal uterine contraction, severe bleedingInevitable AbortionThreatened AbortionGenetic defectHabitual Abortionpregnancy testInevitable AbortionNo intraabdominal bleeding；Clinical presentations：amenorrhea, abdominal pain and vaginal bleeding；no demonstration of cardiac ac

11、tivity or embryonic budHabitual Abortionbefore 12 weeks: suction curettageTissue Expulsionpreventive antibiotic useExtrauterine PregnancyInevitable Abortioncervical os closed, fetal membranes unbrokentubal pregnancyGenetic defectAbdominal pain：time, characteristicsserum HCG whether to continue pregn

12、ancyFollow-up reliableFaint/shockabortion：812 weekssensitizing the uterus： diethylstilbestrolpregnancy tissue protruding from the cervical osPelvic examination：cervical motion tenderness，sensation of a floating uterus ，adnexal mass, etc.Differential DiagnosisHabitual AbortionPregnancy mass3cm or und

13、etected；Incidence：1：18000What does laboratory assessment for Ectopic pregnancy include？Late abortion：congenital uterine anomalies，cervical incompetence，uterine fibroids, etc.abortion：812 weeksNo evidence of tubal rupture；Pain mild，bleeding light；curretage of the endometrial cavity is nonproductive o

14、f pregnancy tissueExpectant treatmentSpontaneous AbortionLaboratory AssessmentSeptic Abortionculdocentesis：nonclotting bloodpreventive antibiotic useabortion：812 weeksInevitable AbortionGenetic defectmonitoring：ultrasound；abortion：812 weeksDifferential DiagnosisInevitable AbortionHabitual AbortionEc

15、topic pregnancyHabitual AbortionSeptic AbortionDescribe the clinical presentations of different stages of abortion？Complete AbortionPain mild，bleeding light；Threatened Abortionone of the main causes of acute abdomen and deathFollow-up reliableManagementlaparoscopy：gold standard，diagnosistreatmentFet

16、al deathbasal decidual bleeding uterine contractionexpulsion of all the products of conception, light bleedingSpontaneous AbortionConcept：implantation of the developing conceptus in the cervical canalpregnancy tissue protruding from the cervical osWhat does laboratory assessment for Ectopic pregnanc

17、y include？Ovarian PregnancyClinical presentations：amenorrhea, abdominal pain and vaginal bleeding；What conditions should be differentiated from tubal pregnancy their respective differential points？No evidence of tubal rupture；What does laboratory assessment for Ectopic pregnancy include？enlargement

18、and softeningIntensifiedindication：no contraindication to chemotherapy ；Light to nonePhysical Examinationtubal inflammation, pelvic inflammationSummarize the treatment for tubal pregnancy and its choice？Nontubal Ectopic Pregnancythe fetal sac must occupy the position of the ovary；cervical os closed,

19、 fetal membranes unbrokenThreatened Abortionno retained products of conception confirmed by ultrasound；Management15% or symptoms worsening or internal bleeding occurring; 2 weeks until negativecurretage of the endometrial cavity is nonproductive of pregnancy tissuebefore 12 weeks: suction curettaget

20、ubal inflammation, pelvic inflammationPhysical ExaminationEnvironmental factorsEctopic Pregnancypreventive antibiotic useafter 12 weeks：induction of laborWhat conditions should be differentiated from tubal pregnancy their respective differential points？Follow-up reliableGeneral conditionClinical Man

21、ifestation:Pelvic examinatioonHabitual AbortionPelvic examinatioonIncidence：1：18000pregnancy tissue protruding from the cervical oswith severe bleeding：management of infection while applying forceps, with secondary suction and curettagerupture：1216 weeksinevitable abortion incomplete abortionLaborat

22、ory Assessment:before 12 weeks: suction curettagecurretage of the endometrial cavity is nonproductive of pregnancy tissueinevitable abortion incomplete abortionPartial expulsion of the products of conception non-ideal uterine contraction, severe bleedingDescribe the clinical presentations of differe

23、nt stages of abortion？Ovarian PregnancyIncidence：1：18000Fetal deathbasal decidual bleeding uterine contractionexpulsion of all the products of conception, light bleedingCervical OsLaboratory Assessment:Threatened AbortionEarly abortion：chromosomal abnormalities，immunologic factors，luteal-phase insuf

24、ficiency, hypothyroidismabortion：812 weeksConcept：implantation of the developing conceptus in the cervical canalHabitual AbortionSeptic AbortionNormal or slightly largeMissed AbortionAdnexal inflammationMissed AbortionSummarize the treatment for tubal pregnancy and its choice？vaginal bleeding decreasing, abdominal pain alleviatingWhat conditions should be differentiated from tubal pregnancy their respective differential points？IntensifiedWhat does laboratory assessment for Ectopic pregnancy include？pregnancy tissue protruding from the cervical osHabitual Abortion