妇产科学-流产(中英文).ppt

* * * * * * DELIA.LIN DELIA.LIN ABORTION 流 产 * Case presentation A woman, 26y, G2P0, menstruation: 5-6/28d Chief complaint: 6 weeks of menopause, vaginal spotting for 3 days with slight lower abdominal pain 停经6周，少量阴道流血3天，伴轻微下腹疼痛 Pregnancy test (Urine HCG)：positive 尿妊娠试验: 阳性 What is happening? Managements? Take history - Physical examination - Assistant detection Diagnosis - Differential diagnosis - Treatment * Normal/Abnormal Pregnancy Normal Pregnancy：normal duration normal location 正常妊娠：正常时限，正常位置 Abnormal Pregnancy: abnormal duration abnormal location 异常妊娠：异常时限，异常位置 * Definition 定义 Abortion：spontaneous termination of pregnancy before the 28th week of gestation, the weight of fetus less than 1000g 流产：妊娠不足28周、胎儿体重不足1000g 而终止者 early abortion (before 12th week) 早期流产 late abortion (12th ~ 28th week) 晚期流产 * Incidence 发生率 frequency of spontaneous abortion is about 30% 自然流产占全部妊娠的30%左右 Approximately 80% is occurring during the first 12 weeks of pregnancy，in which 2/3 are clinically silent miscarriages 80%以上为早期流产；其中2/3 为隐性流产 * Etiology 病因 * hysteroscope 宫腔镜 * 正常宫腔 子宫纵隔 宫腔粘连 子宫粘膜下肌瘤 Etiology 病因 * PATHOLOGY 病理 The process of abortion is the separation and expulsion of pregnancy tissue from uterus 流产是妊娠物从子宫壁剥离、然后排 出子宫的过程 death of the embryo 胚胎死亡 hemorrhage in the decidua basalis 底蜕膜出血 c. uterine contraction & cervical dilatation 子宫收缩、宫颈扩张 pregnancy tissue detach & exclude 妊娠物剥离、排出 * clinical presentations 临床表现 amenorrhea 停经 vaginal bleeding 阴道流血 lower abdominal pain 腹痛 * Clinical categories 临床类型 threatened abortion 先兆流产 inevitable abortion 难免流产 incomplete abortion 不全流产 complete abortio