1、Ectopic pregnancyAbortionZhao aimin M.D., Ph.D., Professor Department Of Obstetrics & GynecologyRenji Hospital Affiliated to SJTU School of Medicine * 1Abortion and Ectopic pregnancyEctopic pregnancyDefinitionImplantation outside of the uterine cavity is termed ectopic pregnancyIt is a condition tha
2、t significantly jeopardizes the mother because catastrophic bleeding may occur when the implanting pregnancy erodes blood vessels or ruptures of the tubal wallDate 2Abortion and Ectopic pregnancyImplant locationsTubal 95% (80% ampullary portion)Ovarian 1%Abdominal 1-2%Cervical 0.15%Cornual 2%Date 3A
3、bortion and Ectopic pregnancyEtiologySalpingitis have 6-fold increase the risk of ectopic pregnancyOperation of tubalIUD(intrauterine device)Dysfunction of tubalOrther: endometriosisDate 4Abortion and Ectopic pregnancyOutcomes of ectopic pregnancyTubal abortion 8-12 Weeks ampullary portionRupture of
4、 tubal pregnancy 5 weeks isthmic portionTubal abortion with subsequent implantation on an intraperitoneal structure for example liver pregnancyDate 5Abortion and Ectopic pregnancyClinical manifestation of ectopic pregnancyAmenorrhea 70-80% 6-8 weeksAbdominal and pelvic pain the most common symptom,w
5、hich is present in nealy all patients. Pain is a result of distented of tubal and irritation of peritoneum by bloodIrregular vaginal bleeding results from the sloughing of the deciduaShock result from amount of blood loss Abdominal massDate 6Abortion and Ectopic pregnancyPhysical findings in tubal p
6、regnancyGeneral findings: Anemic or pale face pulse increased BP decreased T 38 degreeDate 7Abortion and Ectopic pregnancyAbdominal examinationdistention and tenderness with or without reboundDecreased bowel soundShifting dullness positivemassDate 8Abortion and Ectopic pregnancyPelvic examinationSli
7、ghtly open cervix with bleedingCervical motion tenderness Adnexal tendernessAdnexal massThe uterus size may be normal or enlargedDate 9Abortion and Ectopic pregnancyDiagnostic proceduresTypical cases can be determined easyEarly ectopic pregnancy or unrupture type difficultyIt is nessesary to need assistant examinationDate 10Abortion and Ectopic pregnancy
