妇产科异位妊娠课件.pptVIP

异位妊娠

EctopicPregnancy(宫外孕extrauterinepregnancy)妇产科异位妊娠

IntroductionDefinitionEtiology(themostcommoncause)Pathology(threepathologicalterminations)ClinicalManifestation(theclassictriad)Diagnosis(fourancillarymethods)Treatment(theprimarytreatment)妇产科异位妊娠

Definition:Pregnancyinanylocationotherthanthebodyoftheuterusisconsideredectopic.Incidence:0.5~1%妇产科异位妊娠

图1异位妊娠的发生部位妇产科异位妊娠

TubalPregnancy壶腹部(Ampulla)55~60%峡部(Isthmus)20~25%伞部(Fimbria)少见间质部(Interstitialportion)少见妇产科异位妊娠

Chronicsalpingitispelvicinflammatorydisease(PID)盆腔炎sexuallytransmitteddisease(STD)性传播疾病Priortubalsurgerytubalsterilizationorsalpingectomy绝育输卵管切除术CurrentIUDuse:intrauterinedevice宫内节育器HistoryofinfertilityEtiology妇产科异位妊娠

Pathology一、Terminationsoftubalpregnancy21、输卵管腔2、输卵管内血肿3、绒毛侵犯管壁4、绒毛膜5、羊膜图2输卵管妊娠剖面示意图妇产科异位妊娠

图3输卵管妊娠时孕卵的着床部位1、着床于粘膜皱襞内常向管腔破裂2、着床于粘膜皱襞间常穿破管壁妇产科异位妊娠

（一）Tubalabortion图4输卵管妊娠流产妇产科异位妊娠

（二）Ruptureoftubalpregnancy图5输卵管妊娠破裂妇产科异位妊娠

ampullarypregnancy:8-12W(abortion,rupture)isthmicpregnancy:6W(rupture)interstitialportoion:4M(rupture)图6间质部妊娠妇产科异位妊娠

(三)Secondaryabdominalpregnancy图7腹腔妊娠示意图妇产科异位妊娠

二、Uterinechanges（一）Enlargementandsoft:sameasIUP(intrauterinepregnancy)宫内孕图8输卵管妊娠子宫剖面示意图妇产科异位妊娠

（二）Endometrium子宫内膜decidualreactiion蜕膜变Arias-StellareactionA-S反应proliferativephase增生期secretoryphase/menstrualperiod分泌期或月经期妇产科异位妊娠

ClinicalManifestation一、SymptomsAmenorrhea停经Abdominalpain腹痛Vaginalbleeding阴道出血Syncopeandshock晕厥与休克妇产科异位妊娠

SymptomsAmenorrhea(3/4)mistakeuterinebleedingfortruemenstruation(月经)lackofamenorrhead