流产、异位妊娠－赵爱民.ppt

Abortion and Ectopic pregnancy abortion and ectopic pregnancy Ectopic pregnancyAbortion Abortion Definition Abortion is the termination of a pregnancy before 28 weeks from the first day of the last menstrual period and the fetus weight 1000g Clinical manifestation Haemorrhage is usually the first sign and may be significantly if placental separation is incomplete. Pain is usually intermittent, ‘like a small labrur’. It ceases when the abortion is complete. * * Zhao aimin M.D., Ph.D., Professor Department Of Obstetrics Gynecology Renji Hospital Affiliated to SJTU School of Medicine Ectopic pregnancy Definition Implantation outside of the uterine cavity is termed ectopic pregnancy It is a condition that significantly jeopardizes the mother because catastrophic bleeding may occur when the implanting pregnancy erodes blood vessels or ruptures of the tubal wall Implant locations Tubal 95% (80% ampullary portion) Ovarian 1% Abdominal 1-2% Cervical 0.15% Cornual 2% Etiology Salpingitis have 6-fold increase the risk of ectopic pregnancy Operation of tubal IUD(intrauterine device) Dysfunction of tubal Orther: endometriosis Outcomes of ectopic pregnancy Tubal abortion 8-12 Weeks ampullary portion Rupture of tubal pregnancy 5 weeks isthmic portion Tubal abortion with subsequent implantation on an intraperitoneal structure for example liver pregnancy Clinical manifestation of ectopic pregnancy Amenorrhea 70-80% 6-8 weeks Abdominal and pelvic pain the most common symptom,which is present in nealy all patients. Pain is a result of distented of tubal and irritation of peritoneum by blood Irregular vaginal bleeding results from the sloughing of the decidua Shock result from amount of blood loss Abdominal mass Physical findings in tubal pregnancy General fin