流产异位妊娠-Abortian-and-EctopicPregnancy-尧良清.pptVIP

Surgical Treatment ? Radical operation ： hemodynamically unstable ; interstitial pregnancy; tubal rupture ? Conservative operation ： with wishes to retain potential for fertility － milking or linear salpingostomy ＋ MTX Abortion and Ectopic Pregnancy Liang-Qing Yao Obstetrics and Gynecology Hospital of Fudan University Abortion Concept ? A pregnancy loss before 28 weeks of gestation while fetal weight under 1000 grams ? Early Abortion ： pregnancy loss before 12 gestational weeks ? Late Abortion: pregnancy loss during 12 ～ 28 gestational weeks ? Spontaneous Abortion ? Artificia l Abortion ? Genetic defect ? Maternal factors: systematic disease; genital organ anomalies; endocrine anomalies; irritation; bad habit ? Immune anomalies ? Environmental factors Etiology Pathology ? Before 8 weeks: chorionic villi immature ? Fetal death → basal decidual bleeding → uterine contraction → expulsion of all the products of conception, light bleeding ? During 8 ～ 12 weeks ： with firm attachment to the basal decidua ? Partial expulsion of the products of conception → non-ideal uterine contraction, severe bleeding ? After 12 weeks: placenta fully formed. ? Uterine contraction → expulsion of all the products of conception ， light bleeding Symptoms ? Amenorrhea, vaginal bleeding , and abdominal pain ? Early abortion ： vaginal bleeding preceding abdominal pain ? Late abortion ： abdominal pain preceding vaginal bleeding Types of Abortion ? Threatened Abortion ? Inevitable Abortion ? Incomplete Abortion ? Complete Abortion ? Missed Abortion ? Habitual Abortion ? Septic Abortion Clinical Presentations ? Threatened Abortion ? light vaginal bleeding with mild abdominal pain ? cervical os closed, fetal membranes unbroken ? treatment might work , continue pregnancy ? Inevitable Abortion ? bleeding heavier, abdominal pain more severe, or fluid passed ? cervical os open ， pregnancy tissue visible ? abortion is inevitable ? Incomplete Abor