异位妊成：钟刚.ppt

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1、EctopicPregnancyZhongGangDepartmentofGynecologyandObstetricTongjiHospitalIntroductionPregnancyinanylocationotherthanthebodyofuterus,namelyimplantationoutsideoftheuterinecavityisconsideredectopic.Thevastmajorityofectopicpregnanciesoccurintheoviduct95%.Ectopicpregnancy

2、appearstohavebecomemorecommoninthelastyears.CauseofectopicpregnancyEctopicpregnancymaybecausedbyanyfactorthatretardsthepassageofthefertilizedeggcommonovarytoendometrium.Theprimaryriskfactorforectopicpregnancyisapriorhistoryofsalpingitis.Womenwithahistoryofsalpingitis

3、havea6-foldincreaseintheirriskofectopicpregnancy.Operationontheoviducthavebecomeincreasinglyimportantetiologicfactors.CauseofectopicpregnancyIntrauterinecontraceptiondevices(IUP)preventalltypesofpregnancies,althoughectopicpregnanciesmaybereducedrelativelylessthanfals

4、eimpressionthattheyareariskfactor.Ageisanimportantriskfactor,women35to44yearsoldhavethreefoldincreaseintherateofectopicpregnancycomparedwithwomen15to24yearsold.OtherfactorsPathologyTheterminationofthegestationdependslargelyonthelocation.Pregnanciesintheampulla,partic

5、ularlythedistalportion,frequentlyabortwithminimalsigns.Pregnancyintheisthmususuallyruptureintotheperitonealcavityorruptureapregnancyintheinterstitialportionofthetubemayberapidlyfollowedbyshock.Secondaryabdominalpregnancy,whichismorecommon,involvesreimplantationsomewh

6、ereintheabdominalcavityafterthepregnancyhasbeenseparatedfromitsprimarysiteofimplantationsuchasintubalabortion.PathologyThechangeofuterus:theuterususuallygrowsatanormalrateforaboutsixtoeightweeks,anddecidualreaction(withouttrophoblastictissue)iscommonlyfoundintheendom

7、etrium.Thearias-stellareactionisnotpathogenomicofoviductalpregnancy,butmaybefoundwhenthereisfunctioningtrophoblastictissueanywhereinthebody.Hereisectopicpregnancyinafallopiantubethatwasexcised.Thisisamedicalemergencybecauseofthesuddenrupturewithhemoperitoneum.Clinica

8、levaluationofpossibleectopicpregnancyTheclassicpresentationofapatientwithanectopicpregnancyincludesabdominalpain,amenorrhea,andvagi