扬州大学：《妇产科学》课程教学课件（PPT讲稿）06 异位妊娠与自然流产 Ectopic pregnancy Abortion

Ectopic pregnancyAbortion

Ectopic pregnancy Abortion

EctopicpregnancyDefinitionImplantation outside of theuterine cavityistermed ectopic pregnancyIt is a condition that significantly jeopardizes themother because catastrophic bleeding may occurwhen the implanting pregnancy erodes blood vesselsor ruptures of the tubal wall2025/10/21AbortionandEctopicpregnancy

2025/10/21 Abortion and Ectopic pregnancy 2 Ectopic pregnancy Definition Implantation outside of the uterine cavity is termed ectopic pregnancy It is a condition that significantly jeopardizes the mother because catastrophic bleeding may occur when the implanting pregnancy erodes blood vessels or ruptures of the tubal wall

Implant locations>Tubal95%(80%ampullaryportion)>0varianAbdominal1-2%>Cervical0.15%>Cornual2%2025/10/21AbortionandEctopicpregnancy

2025/10/21 Abortion and Ectopic pregnancy 3 Implant locations ➢Tubal 95% (80% ampullary portion) ➢Ovarian <1% ➢Abdominal 1-2% ➢Cervical 0.15% ➢Cornual 2%

EtiologySalpingitis have 6-fold increase the risk ofectopic pregnancyOperation of tubalIUD(intrauterinedevice)Dysfunction of tubalOrther: endometriosis2025/10/21AbortionandEctopicpregnancy

2025/10/21 Abortion and Ectopic pregnancy 4 Etiology Salpingitis have 6-fold increase the risk of ectopic pregnancy Operation of tubal IUD(intrauterine device) Dysfunction of tubal Orther: endometriosis

Outcomesof ectopic pregnancyTubalabortion8-12 Weeks ampullary portionRupture of tubalpregnancy5weeks isthmic portionTubal abortion with subsequentimplantationon an intraperitoneal structure for example liverpregnancy2025/10/21AbortionandEctopicpregnancy

2025/10/21 Abortion and Ectopic pregnancy 5 Outcomes of ectopic pregnancy Tubal abortion 8-12 Weeks ampullary portion Rupture of tubal pregnancy 5 weeks isthmic portion Tubal abortion with subsequent implantation on an intraperitoneal structure for example liver pregnancy

Clinicalmanifestation of ectopicpregnancyAmen0rrhea70-80%6-8weeksAbdominaland pelvic painthe most common symptom,which is present in nealy allpatients. Pain is a result of distented of tubal and irritation ofperitoneum by bloodIrregularvaginalbleedingresultsfromthesloughing ofthe deciduaShock result from amount of blood lossAbdominalmassAbAborionand Ectopicpregnancy

2025/10/21 Abortion and Ectopic pregnancy 6 Clinical manifestation of ectopic pregnancy Amenorrhea 70-80% 6-8 weeks Abdominal and pelvic pain the most common symptom,which is present in nealy all patients. Pain is a result of distented of tubal and irritation of peritoneum by blood Irregular vaginal bleeding results from the sloughing of the decidua Shock result from amount of blood loss Abdominal mass

Physical findings in tubal pregnancyGeneral findings:Anemicorpalefacepulse increasedBP decreasedT<38 degree2025/10/21AbortionandEctopicpregnancy

2025/10/21 Abortion and Ectopic pregnancy 7 Physical findings in tubal pregnancy General findings: ➢ Anemic or pale face ➢ pulse increased ➢ BP decreased ➢ T< 38 degree

Abdominalexaminationdistention and tenderness with or without reboundDecreased bowel sound>Shifting dullness positive>mass2025/10/21Abortionand Ectopicpregnancy

2025/10/21 Abortion and Ectopic pregnancy 8 Abdominal examination ➢distention and tenderness with or without rebound ➢Decreased bowel sound ➢Shifting dullness positive ➢mass

Pelvic examination>Slightly open cervix with bleeding>Cervical motiontendernessAdnexaltendernessAdnexalmass>The uterus size may be normal or enlarged2025/10/21AbortionandEctopicpregnancy

2025/10/21 Abortion and Ectopic pregnancy 9 Pelvic examination ➢Slightly open cervix with bleeding ➢Cervical motion tenderness ➢Adnexal tenderness ➢Adnexal mass ➢The uterus size may be normal or enlarged

DiagnosticproceduresTypical cases can be determined easyEarly ectopic pregnancy or unrupture type difficultyIt is nessesary to need assistant examination2025/10/2110AbortionandEctopicpregnancy

2025/10/21 Abortion and Ectopic pregnancy 10 Diagnostic procedures Typical cases can be determined easy Early ectopic pregnancy or unrupture type difficulty It is nessesary to need assistant examination