妇产科——流产.pptVIP

流产 上海交通大学附属第六人民医院 陶敏芳 2010-11-11 结束 * * 流产 1、妊娠不足28w 2、胎儿体重不足1000g而终止者 定义 Definition Abortion: The pregnancy terminates at the gestational age less than 28 weeks, the weight of fetal is less than 1000g 分类 Types 1. 时间分类 早期流产 Early Abortion: 12weeks 晚期流产 Late Abortion: 12- 28weeks 2 流产方式分类 自然流产 Spontaneous Abortion （incidence rate 10%-15%） most of cases occur in early pregnancy 人工流产 Artificial Abortion 流产Abortion 病因 Etiology 1．遗传基因缺陷Genitic gene defect 染色体异常50%-60% 发生早期流产 Chromosomal abnormities cause at least half of these early abortion ?数目异常 三体、 X单体、三倍体及四倍体 ?结构异常 断裂、倒置、缺失和易位 病因 Etiology 2.母体因素 Maternal factors ?全身性疾病 Physical diseases such as infections,anemia, Heart Failure, chronic nephritis, hypertension ?生殖器官异常 Reproductive organs such as malformation of uterus, myoma of uterus, incompetent cervix ?内分泌异常 Endocrine abnormalities such as hypothyroidism, severe ?diabetes mellitus, luteal insufficiency ?不良习惯 Bad habits such as excessive smoking, alcoholism, excessive coffee, drug ?创伤刺激 Trauma stimulation such as severe shock, uterine trauma, stess, anxiety , fear, sadness 病因 Etiology 3. 免疫功能异常Immunological factors Much attention has focused on the immune system as important in recurrent pregnancy loss 4. 环境因素Enviroment conditions chemical pollute, x-ray, noising and so on 早期流产 Early Abortion Embryo die first, hemorrhea in deciduas occurs then, uterine contraction follows, and the content is discharged. ? 8w Complete, less bleeding ? 8-12w Incomplete, more bleeding 晚期流产 Late Abortion Abdominal pain occurs, accompanied with vaginal bleeding, then discharge the fetal and placenta. 病理 Pathology 临床表现 Clinical Presentations 主要症状?Symptoms 停经后阴道流血、腹痛。阴道排出组织物 Menolipsis, Vaginal bleeding and abdomen ache. ? 早期流产 Early Abortion: 12weeks vaginal bleeding abdomen