流产、异位妊娠(英文)-Abortian_and_EctopicPregnancy-尧良清.ppt

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
Artificial Abortion
ic defect
Maternal factors:
systematic disease; an 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
plete plete 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
plete 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
Different Stages of Abortion
threatened abortion continue pregnancy
inevitable abortion plete abortion