妇产科学流产.ppt

Abortion HuWenSheng（胡文胜） Women’s Hospital School of Medicine Zhejiang University Definition Abortion:Pregnancy terminated before 28 weeks gestation with fetal weight 1000 gram. Early abortion：pregnancy terminated before 12 weeks gestation Late abortion：pregnancy terminated between 12 and 28 weeks gestation Etiology Embryo factor Chromosomal anomaly is the chief agent. More than 80 percent of abortions occur in the first 12 weeks of pregnancy At least half result from chromosomal anomalies After the first trimester, both the abortion rate the incidence of chromosomal anomalies decrease Inheritance Infection Drug F9-1 Etiology Mother factors Systemic disease Endocrine abnormalities Anomaly of immunity Disease of reproduction organ---Uterine defects Stimulus of trauma Maternal factors Nutrition Dietary deficiency of any one nutrients → not important cause Drug use and environmental factor Tobacco Alcohol Caffeine Chemical agent(benzene,lead,et al) X-ray Radiation Environmental toxins Pathology Dead of embryo or fetus Bleeding of decidua basalis Embryo or fetus out of uterus Clinical symtoms Suppressed menstruation Abdominal pain Vaginal bleeding Embryo discharge Shock infection Categories of spontaneous abortion Threatened abortion Threatened abortion Threatened abortion Inevitable abortion Complete or incomplete abortion Missed abortion Recurrent abortion Clinical groups and identification Management Diagnose in time patient history clinical symptoms Lab test and image：Bus,HCG，E,P，HPL Manage according to the type of abortion Threatened abortion general management：Lying in bed，forbidding coition，relaxation Etiologic managementTreatment Progesterone (IM) or synthetic progestational agent (PO or IM) Lack of evidence of effectiveness Often results in no more than a missed abortion Adjustment according to patient’s condition I