最新 流产、异位妊娠(英文)

Examination Assessment:
Laboratory
ultrasound pregnancy test hormone level: serum progesterone
History
Bleeding Threatened Abortion Inevitable Abortion Light Mild to heavy Abdominal Pain None/light Intensified

Different Stages of Abortion
threatened abortion continue pregnancy
inevitable abortion
incomplete abortion
complete abortion
Diagnosis
History Physical


After 12 weeks: placenta fully formed.
Uterine contraction→ expulsion of all the products of conception，light bleeding
Symptoms

Amenorrhea, vaginal bleeding , and abdominal pain
Incomplete Abortion heavy vaginal bleeding pregnancy tissue protruding from the cervical os uterus small for the presumed gestational week Complete Abortion vaginal bleeding decreasing, abdominal pain alleviating cervical os closed uterus normal for the presumed gestational week




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
Partial
Dilated or obstructed
Small
Complete Abortion
Light to none
None
Complete
Closed
Normal or slightly large
Management


Abortion and Ectopic Pregnancy
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 Artificial Abortion


Etiology

Genetic defect
Maternal factors: systematic disease; genital organ anomalies; endocrine anomalies; irritation; bad habit


Immune anomalies


During 8～12 weeks：with firm
attachment to the basal decidua Partial expulsion of the products of conception→ non-ideal uterine contraction, severe bleeding
Early abortion：vaginal bleeding preceding abdominal pain Late abortion：abdominal pain preceding vHale Waihona Puke Baiduginal bleeding


Types of Abortion
Threatened Abortion Inevitable Abortion Incomplete Abortion Complete Abortion
Inevitable Abortion bleeding heavier, abdominal pain more severe, or fluid passed cervical os open， pregnancy tissue visible abortion is inevitable

Pelvic Examination
Tissue Expulsion None None Cervical Os Closed Dilated Uterus Normal Normal or slightly small
Incomplete Abortion
Light to heavy
Relieved
Environmental factors

Pathology


Before 8 weeks: chorionic villi
immature
Fetal death→basal decidual bleeding →uterine contraction→expulsion of all the products of conception, light bleeding