Case patient xxx, female, 35 years old Symptom: amenorrhea for 47 days i spot vaginal bleeding for 3 days; sudden abdominal pain for 2 hours Signs: Bp 12/ 8Kpa, P 120 times/min, abdominal tenderness and rebound tenderness(+); sharp pain on motion of the cervix sonography: a 4X5 cm irregular mass, 3 cm-depth fluid in cul-de-sac culdocentesis: 2 ml bloody fluid did not clot) urine HCG(+
Case patient xxx, female, 35 years old Symptom: amenorrhea for 47 days ; spot vaginal bleeding for 3 days; sudden abdominal pain for 2 hours. Signs: Bp 12/8Kpa, P 120 times/min, abdominal tenderness and rebound tenderness (+); sharp pain on motion of the cervix. sonography: a 4X5 cm irregular mass, 3 cm-depth fluid in cul-de- sac culdocentesis: 2 ml bloody fluid (did not clot) urine HCG (+)
If you were the doctor 1. What diagnosis would you thin水 of first? 2. How would you treat the patient
If you were the doctor, 1. what diagnosis would you think of first ? 2. How would you treat the patient ? ?
Ectopic pregnancy 异位妊娠
异位妊娠 ! Ectopic pregnancy
New words Ectopic pregnancy异位妊娠 fallopian tube 输卵管 a blastocyst 囊胚 ■cer|X 宫颈 a amenorrhea 停经 ■ culdocentesis 后穹隆穿刺
New words ◼ Ectopic pregnancy 异位妊娠 ◼ fallopian tube 输卵管 ◼ blastocyst 囊胚 ◼ cervix 宫颈 ◼ amenorrhea 停经 ◼ culdocentesis 后穹隆穿刺
I. Definition The blastcyst normally implants in the endometrial lining of the uterine cavity Implantation anywhere else is an ectopic pregnancy t is one in which the fertilized ovum is implanted and developed outside of the uterine cavity
Ⅰ.Definition ◼ The blastcyst normally implants in the endometrial lining of the uterine cavity. Implantation anywhere else is an ectopic pregnancy. ◼ It is one in which the fertilized ovum is implanted and developed outside of the uterine cavity
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iNcidence more than 1 in every 100 pregnancy Il. Types of ectopic pregnancy Tubal 95 7 O varian 0.5-1% cervical Abdominal Broad ligament
II.Incidence more than 1 in every 100 pregnancy III . Types of ectopic pregnancy Tubal 95% Ovarian 0.5-1% Cervical Abdominal Broad ligament
IV Tubal pregnancy a It is one of abdominal emergency a Interabdominal hemorrhage sevel hemorrhge shock died a 1 site ※(1) Ampullar60% (2)isthmic 25% (3)fimbrial 17% (4)Interstitial 2%-4%
Ⅳ.Tubal pregnancy ◼ It is one of abdominal emergency. ◼ Interabdominal hemorrhage sever hemorrhge shock died ◼ 1.site ※(1)Ampullar 60% (2)isthmic 25% (3)fimbrial 17% (4)Interstitial 2%~4%
Etiology (1)pelvic infection chronic salpingitis: 30%-50% PID(pulvic inflammatory disease) -(2 ) previous tubal surgery ■(③3) developmental and functional tubal abnormality
Etiology ◼ (1)pelvic infection chronic salpingitis : 30%~50% PID(pulvic inflammatory disease) ◼ (2) previous tubal surgery ◼ (3)developmental and functional tubal abnormality
-(5)Increased use of assisted reproductive technique a (6)Popularity of contraception that prevent intrauterine but not extrauterine pregnancy a(endometriosis etc
◼ (5)Increased use of assisted reproductive technique ◼ (6)Popularity of contraception that prevent intrauterine but not extrauterine pregnancy ◼ (6)endometriosis etc
