妇产科学教学课件：9-3Ectopic Pregnancy.ppt

Case presentation A woman, 32y, G2P1, menstruation: regular menstrual intervals30d X 3-4 LMP:2016-9-1Chief complaint: 45 days of menopause, sudden left lower abdominal pain for 3 hours with vaginal spotting Pregnancy test (Urine HCG (human chorionic gonadotropin))：positive What is happening? What’s the managements? Take history - Physical examination - Assistant detection Diagnosis - Differential diagnosis - Treatment 1 Ectopic Pregnancy 2 3Ectopic pregnancy fallopian tube blastocyst cervix amenorrhea culdocentesis New words Normal/Abnormal PregnancyNormal Pregnancy：normal duration normal location Abnormal Pregnancy: abnormal duration abnormal location 4If pregnancy terminate before 28 weeks, we call it abortion.…… Abortion is one kind of abnormal duration. 5 DefinitionThe blastocyst normally implants in the endometrial lining of the uterine cavity. Implantation anywhere else is an ectopic pregnancy. Ectopic PregnancyEctopic Pregnancy： implantation of the blastocyst (fertilized ovum) outside the uterine cavity As the embryo grows, eventually leading to fallopian tube rupture, which caused intraabdominal hemorrhage, and even life threatening6 Different Location of Ectopic Pregnancytubal pregnancy 95% broad ligament pregnancy cervical pregnancyperitoneal pregnancy ovarian pregnancy cesarean scar pregnancyCornual pregnancy 7 tubal pregnancy 8Interstitial portion EP(2-4%) Fimbria EP(17%)Ampulla EP(55-60%) Isthmus EP(20-25%) Etiology any reason that impede the passage of fertilized ovum along the tube toward the uterine cavity EtiologyTubal Factorschronic salpingitis (The commonest cause) inflammation destroy the epithelium, adhesion o