妊娠时限异常及Ectopic Pregnancy 课件.ppt

Abnormal Pregnancy Time Limit and Ectopic Pregnancy Xin Wu Obstetric and Gynecology Hospital sky_xin1980@ Abortion Early abortion Late abortion Spontaneous abortion Artificial abortion Case 1 27, female, menopause 51 days, a small amount of vaginal bleeding 1 day, no obvious abdominal pain Menstrual history: 12 3/30，menstrual rules G3P0 2008, 2010 spontaneous abortion Miscarriage requirements Ultrasound: uterus 7×5×4cm，embryo sac 12×8×5，no obvious germ 尿HCG（+） Routine blood and urine: normal Gynecological examination Vulva: married type Vagina: smooth, a small amount of dark red blood stains Cervix: closed, blood-stained, no obvious lifting pain Palace: front-bit, 6w of pregnancy size, no tenderness Annex: soft QUESTIONS Current diagnosis Further examination Treatment Prognosis QUESTIONS Current diagnosis: missed abortion？Threatened abortion? Further examination: review ultrasound and serum HCG 3 days later，coagulation, observe vaginal bleeding and abdominal pain Treatment: bed rest，progesterone miscarriage Prognosis: endocrine factors and immune factors should be checked Case 2 22, female, menopause 36w，Small amount of vaginal bleeding with paroxysmal abdominal pain 3 hours, half an hour of the vaginal fluid Menstrual history: 12 3/30, menstrual rules G1P0 Check-ups during pregnancy normal Ultrasound: intrauterine single fetus, BPD 85mm, HC 298mm ,AC 312mm, FL 63mm, AFI 60mm Vagina liquid PH test: blue Routine blood and urine normal, blood pressure and body temperature normal Abdominal examination Top of Palace at 3cm under xiphoid Regular contractions 20”/5-6’，moderate Vaginal examination Cervical completely receptivity Cervix can accommodate 2 fingers No obvious amniotic sac Diameters within the pelvic normal QUESTIONS Current diagnosis Further observation Further treatment QUESTIONS Current diagnosis: G1P0 36 weeks pregnant，premature birth labor Further observation: CST, contractions,, anomalies Further treatment: review cervical dilation and fetal he