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,#,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,Abortion,Abortion,1,Concept,A pregnancy loss before 28 weeks of gestation while fetal weight under 1000 grams,Early Abortion,：,pregnancy loss before 12,gestational weeks,Late Abortion:pregnancy loss,during 12,28,gestational weeks,Spontaneous,Abortion,Artificia,l Abortion,Concept A pregnancy loss befor,2,Genetic defect,Maternal factors:,systematic disease;genital organ anomalies;endocrine anomalies;irritation;bad,habit,Immune anomalies,Environmental factors,Etiology,Etiology,3,Pathology,Before 8 weeks:,chorionic villi immature,Fetal death,basal decidual bleeding,uterine contraction,expulsion of all the products of conception,light bleeding,During 8,12,weeks,：,with firm attachment to the basal decidua,Partial expulsion of the products of conception,non-ideal uterine contraction,severe bleeding,After 12,weeks:,placenta fully formed.,Uterine contraction,expulsion of all the products of conception,，,light bleeding,PathologyBefore 8 weeks:chori,4,Symptoms,Amenorrhea,vaginal bleeding,and abdominal pain,Early abortion,：,vaginal bleeding preceding abdominal pain,Late abortion,：,abdominal pain preceding vaginal bleeding,SymptomsAmenorrhea,vaginal bl,5,Types of Abortion,Threatened,Abortion,Inevitable Abortion,Incomplete,Abortion,Complete Abortion,Missed Abortion,Habitual,Abortion,Septic Abortion,Types of AbortionThreatened Ab,6,Clinical Presentations,Threatened Abortion,light vaginal bleeding with mild abdominal pain,cervical os closed,fetal membranes unbroken,treatment might work,continue pregnancy,Inevitable Abortion,bleeding heavier,abdominal pain more severe,or fluid passed,cervical os open,，,pregnancy tissue visible,abortion is inevitable,Clinical PresentationsThreaten,7,Habitual Abortion,vaginal bleeding decreasing,abdominal pain alleviating,Habitual Abortion,Habitual Abortion,rupture：1216 weeks,perform suction curettage promptly,Complete Abortion,Missed abortion,cervical pregnancy?,Incomplete Abortion,Concept：implantation of the developing conceptus in the cervical canal,Pelvic examination：cervical motion tenderness，sensation of a floating uterus，adnexal mass,etc.,A pregnancy loss before 28 weeks of gestation while fetal weight under 1000 grams,Vaginal bleeding,adnexal cardiac activity or ultrasonographic lucency;presence of cul-de-sac fluid,Laboratory Assessment,Missed abortion,cervical pregnancy?,Pain mild，bleeding light；,Intensified,Pregnancy mass3cm or undetected；,Incomplete Abortion,heavy vaginal bleeding,pregnancy tissue protruding from the cervical os,uterus small for the presumed gestational week,Complete Abortion,vaginal bleeding decreasing,abdominal pain alleviating,cervical os closed,uterus normal for the presumed gestational week,Habitual AbortionIncomplete Ab,8,Different Stages of Abortion,threatened abortion,continue pregnancy,inevitable abortion incomplete abortion,complete abortion,Different Stages of Abortiont,9,Diagnosis,History,Physical Examination,Laboratory Assessment:,ultrasound,pregnancy test,hormone level:serum progesterone,DiagnosisHistory,10,Complete Abortion,Describe the clinical presentations of different stages of abortion？,No intraabdominal bleeding；,Light to none,Concept：implantation of the developing conceptus in the cervical canal,ultrasound：the empty uterus sign；,Before 8 weeks:chorionic villi immature,Before 8 weeks:chorionic villi immature,vaginal bleeding decreasing,abdominal pain alleviating,Before 8 weeks:chorionic villi immature,one of the main causes of acute abdomen and death,Missed abortion,cervical pregnancy?,abortion：812 weeks,previous tubal surgery：for infertility,tubal pregnancy,etc.,Summarize the treatment for tubal pregnancy and its choice？,Abdomen examination,The occurrence of 3 or more consecutive spontaneous abortions,Mild to heavy,Pain mild，bleeding light；,culdocentesis：nonclotting blood,monitoring：ultrasound；,Partial expulsion of the products of conception non-ideal uterine contraction,severe bleeding,Bleeding,Abdominal Pain,Tissue Expulsion,Cervical,Os,Uterus,Threatened Abortion,Inevitable,Abortion,Incomplete,Abortion,Complete Abortion,Light,Mild,to heavy,Light to heavy,Light to none,None/light,Intensified,Relieved,None,None,None,Partial,Complete,Closed,Dilated,Dilated or,obstructed,Closed,Normal,Normal or slightly small,Small,Normal or slightly,large,History Pelvic Examination,Complete AbortionBleedingAbdom,11,Management,Threatened Abortion,bed rest,sedation,anti abortion,：,progesterone,，,HCG,；,Vit E,；,thyroxine supplement,monitoring,：,ultrasound,；,serum HCG whether to continue pregnancy,Inevitable Abortion,once diagnosed,，,remove the pregnancy tissue as quickly as possible,suction curettage,ManagementThreatened Abortion,12,Incomplete Abortion,perform suction curettage promptly,if with heavy bleeding,：,blood transfusion,；,preventive antibiotic use,Complete Abortion,no retained products of conception confirmed by ultrasound,；,no infection,no need for special management,Incomplete Abortion,13,Missed Abortion,Conce
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