流产异位妊娠英文AbortianandEctopicPregnancy尧良清

severe, or fluid
➢ cervical os closed,
passed
fetal membranes ➢ cervical os open，
unbroken
pregnancy tissue
➢ treatment might
visible
work , continue
➢ abortion is inevitable
➢ 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
➢ Late Abortion: pregnancy loss during 12～28 gestational weeks
➢ Spontaneous Abortion ➢ Artificial Abortion
Etiology
➢ Genetic defect ➢ Maternal factors:
Abortion
Concept
A pregnancy loss before 28 weeks of gestation while fetal weight under 1000 grams
➢ Early Abortion：pregnancy loss before 12 gestational weeks
Types of Abortion
Threatened Abortion Inevitable Abortion Incomplete Abortion Complete Abortion
➢ Missed Abortion ➢ Habitual Abortion ➢ Septic Abortion
Clinical Presentations
Threatened Abortion Inevitable Abortion
➢ light vaginal bleeding ➢ bleeding heavier,
with mild abdominal abdominal pain more
pain
Partial
Dilated or Small obstructed
Complete Light to none None Abortion
Complete Closed
Normal or slightly large
Management
Threatened Abortion
➢ bed rest, sedation ➢ anti abortion：progesterone，HCG；
pregnancy
Incomplete Abortion ➢ heavy vaginal bleeding ➢ pregnancy tissue protruding
from the cervical os ➢ uterus small for the presumed
gestational week
systematic disease; genital organ anomalies; endocrine anomalies; irritation; bad habit
➢ Immune anomalies ➢ Environmental factors
Pathology
Before 8 weeks: chorionic villi immature
None
Cervical Os Uterus
Closed
Normal
Inevitable Mild to heavy Intensified None Abortion
Dilated
Normal or slightly small
Incomplete Light to Abortion heavy
Relieved
Symptoms
Amenorrhea, vaginal bleeding , and abdominal pain
➢ Early abortion：vaginal bleeding preceding abdominal pain
➢ Late abortion：abdominal pain preceding vaginal bleeding
➢ ultrasound ➢ pregnancy test ➢ hormone level: serum progesterone
History
Pelvic Examination
Bleeding
Threatened Light Abortion
Abdominal Pain
None/light
Tissue Expulsion
Complete Abortion ➢ vaginal bleeding decreasing,
abdominal pain alleviating ➢ cervical os closed ➢ uterus normal for the
presumed gestational week
Different Stages of Abortion
threatened abortion continue pregnancy
inevitable abortion
incomplete abortion
complete abortion
DiagnBiblioteka Baidusis
History
Physical Examination
Laboratory Assessment: