流产、异位妊娠(英文)-Abortian-and-EctopicPregnancy-尧良清PPT课件

➢ Environmental factors
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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
➢ Early Abortion：pregnancy loss before 12 gestational weeks
➢ Late Abortion: pregnancy loss during 12～28 gestational weeks
➢ Spontaneous Abortion ➢ Artificial Abortion
threatened abortion continue pregnancy
inevitable abortion
incomplete abortion
complete abortion
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Diagnosis
History
Physical Examination
Laboratory Assessment:
➢ Missed Abortion ➢ Habitual Abortion ➢ Septic Abortion
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Clinical Presentations
Threatened Abortion ➢ light vaginal bleeding with mild abdominal
pain ➢ cervical os closed, fetal membranes unbroken ➢ treatment might work , continue pregnancy
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Incomplete Abortion
➢ heavy vaginal bleeding
➢ pregnancy tissue protruding from the cervical os
➢ uterus small for the presumed gestational week
Complete Abortion
➢ ultrasound
➢ pregnancy test
➢ hormone level: serum progesterone
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History
Pelvic Examination
Bleeding
Threatened Light Abortion
Abdominal Pain
None/light
Tissue Expulsion
None
Cervical Os Uterus
Closed
Normal
Inevitable Mild to heavy Intensified None Abortion
Dilated
Normal or slightly small
Incomplete Light to Abortion heavy
Relieved
After 12 weeks: placenta fully formed.
➢ Uterine contraction→ expulsion of all the products of conception，light bleeding
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Symptoms
Amenorrhea, vaginal bleeding , and abdominal pain
➢ Early abortion：vaginal
bleeding preceding
abdominal pain
➢ Late abortion：abdominal
pain preceding vaginal
bleeding
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Types ofຫໍສະໝຸດ BaiduAbortion
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
➢ vaginal bleeding decreasing, abdominal pain alleviating
➢ cervical os closed
➢ uterus normal for the presumed gestational week
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Different Stages of Abortion
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Etiology
➢ Genetic defect
➢ Maternal factors:
systematic disease; genital organ anomalies; endocrine anomalies; irritation; bad habit
➢ Immune anomalies
Partial
Dilated or Small obstructed
Complete Light to none None Abortion
Abortion and Ectopic Pregnancy
Liang-Qing Yao
Obstetrics and Gynecology Hospital of Fudan University
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1
Abortion
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2
Concept
A pregnancy loss before 28 weeks of gestation while fetal weight under 1000 grams