ECTOPIC PEGNANCY课件.ppt

Welcome to my lecture! CaseHuang Ying, femal,35years oldHaving no child !  amenorrhea for 50 days ; spot vaginal bleeding for three days;sudden abdominal pain for 2 hours.  Her face pale, blood pressure 80/40 mmHg, the pulse is weak and rapid. Tenderness and rebound tenderness on abdominal palpation, sharp pain on motion of the cervix;tender mass on the left side of the uterus.culdocentesis: bloody fluid(did not clot)Bloodβ-HCG(2000) ECTOPIC PREGNANCY Department of OBGYN of CMU Feng Jin Definition In an ectopic pregnancy, the fertilized ovum implants at any site other than the endometrial cavity. The fallopian tube is the most common site, accounting for more than 95% of ectopic pregnancies, but other implantation sites include the cervix, abdominal cavity including broad ligament, and the ovary. What will happen in tubal gestation? Incidence Currently, approximately 1.4% of reported pregnancies are Ectopic. Ectopic pregnancy is the leading cause of first-trimester maternal death. Etiology Conditions preventing or retarding the passage of the fertilized ovum into the uterine cavity, such as salpingitis, developmental abnormalities, peritubal adhesions, tumors, tubal surgery, the use of intrauterine device and hormonal effects. Conditions that increase the receptiveness of foreign tissue. Transmigration Conditions associated with multiple embryos, in vitro fertilization with transfer of multiple fertilized ova is associated with a greater risk of ectopic gestation, particularly heterotopic pregnancies. Pathogenesis Ampulla. Eighty percent of ectopic pregnancies occur in this portion of the fallopian tube, where more growth of the embryo can occur prior to disruption. Isthmus. Approximately 13% of ectopic pregnancies occur in the isthmus the tube. Erosion and rupture in this narrow portion take place early. Interstitium. Pregnancy in this location accounts for approximately 2% of tubal gestations. Because of the greater distensibility