妊娠时限异常及ectopic pregnancy课件

AbnormalPregnancyTimeLimitandEctopicPregnancy XinWuObstetricandGynecologyHospitalsky xin1980 Abortion EarlyabortionLateabortionSpontaneousabortionArtificialabortion Case1 27 female menopause51days asmallamountofvaginalbleeding1day noobviousabdominalpainMenstrualhistory 123 30 menstrualrulesG3P02008 2010spontaneousabortionMiscarriagerequirements Ultrasound uterus7 5 4cm embryosac12 8 5 noobviousgerm尿HCG Routinebloodandurine normal Gynecologicalexamination Vulva marriedtypeVagina smooth asmallamountofdarkredbloodstainsCervix closed blood stained noobviousliftingpainPalace front bit 6wofpregnancysize notendernessAnnex soft QUESTIONS CurrentdiagnosisFurtherexaminationTreatmentPrognosis QUESTIONS Currentdiagnosis missedabortion Threatenedabortion Furtherexamination reviewultrasoundandserumHCG3dayslater coagulation observevaginalbleedingandabdominalpainTreatment bedrest progesteronemiscarriagePrognosis endocrinefactorsandimmunefactorsshouldbechecked Case2 22 female menopause36w Smallamountofvaginalbleedingwithparoxysmalabdominalpain3hours halfanhourofthevaginalfluidMenstrualhistory 123 30 menstrualrulesG1P0Check upsduringpregnancynormal Ultrasound intrauterinesinglefetus BPD85mm HC298mm AC312mm FL63mm AFI60mmVaginaliquidPHtest blueRoutinebloodandurinenormal bloodpressureandbodytemperaturenormal Abdominalexamination TopofPalaceat3cmunderxiphoidRegularcontractions20 5 6 moderate Vaginalexamination CervicalcompletelyreceptivityCervixcanaccommodate2fingersNoobviousamnioticsacDiameterswithinthepelvicnormal QUESTIONS CurrentdiagnosisFurtherobservationFurthertreatment QUESTIONS Currentdiagnosis G1P036weekspregnant prematurebirthlaborFurtherobservation CST contractions anomaliesFurthertreatment reviewcervicaldilationandfetalheaddown4hourslater Case3 29 female menopause42days asmallamountofvaginalbleeding3days suddenrightlowerabdominalpain1hourMenstrual 145 7 28 ruleG2P0medicalabortion1timein2010 Ultrasound Uterussize6 5 4cm endometrial7mm noobviousgestationalsac amixedechoarea25 18 7mminsidetherightovatyUrinaryHCG RoutinebloodHb98g LBp95 65mmHg GynecologicalExamination Vulva marrigedtypeVagina smooth asmallamountofdarkbloodCervix closed blood staining givepain Palace median normalsize withouttendernessAnnex a3cmblockontherightside tenderness QUESTIONS CurrentdiagnosisFurtherexaminationTreatmentmethod QUESTIONS Currentdiagnosis Ectopicpregnancy Furtherexamination preoperativeexaminationandbloodHCGTreatmentmethod Laparoscopy Points TypesofabortionDe