intra-abdominal pregnancy
Introduction
Introduction to abdominal pregnancy Abdominal pregnancy (abdominalpregnancy) is a pregnancy in the uterus, fallopian tubes, ovaries and wide ligaments outside the abdominal cavity, which is a rare ectopic pregnancy, according to its occurrence can be divided into primary abdominal pregnancy and secondary abdominal cavity Pregnancy, the former is extremely rare. Because the placenta attachment site of abdominal pregnancy is different from the attachment of the placenta in the uterus under normal conditions, the blood supply is very poor, so the fetal development is also poor, only 5% to 10% of the patients can survive to full term, and the rest are at different gestational ages. Death in the abdominal cavity, its soft tissue is absorbed, bones remain, or mummified, petrified. basic knowledge Sickness ratio: 0.0001% Susceptible population: pregnant women Mode of infection: non-infectious Complications: abdominal abscess peritonitis
Cause
Cause of abdominal pregnancy
Cause (40%):
Primary abdominal pregnancy is rare, the cause of which is unknown, but some scholars believe that the peritoneal epithelium may be transformed into the secondary renal tubular epithelium, especially in the abdominal cavity or pelvic cavity with ectopic endometrium present, so that the fertilized egg implantation, Developed into a primary abdominal pregnancy.
Prevention
Abdominal pregnancy prevention
In recent years, the incidence of ectopic pregnancy has increased. This is an important issue before us. Although the exact cause of the disease is not yet clear, many factors related to it are clear and reduce its risk factors. It can achieve the purpose of prevention.
1. Strengthen publicity and education and social governance of sexually transmitted diseases.
2. Active treatment of endometriosis.
3. After the use of induced ovulation drugs, suspected early pregnancy, or after successful pregnancy, should promptly exclude ectopic pregnancy and compound pregnancy.
4. Promote the dangers of smoking and ban drug use.
Complication
Abdominal pregnancy complications Complications abdominal abscess peritonitis
Abdominal abscess refers to a certain gap or part of the abdominal cavity due to tissue necrosis and liquefaction, entrapped by the intestines, viscera, abdominal wall, omentum or mesentery, forming a localized pus accumulation. Including underarm abscess, pelvic abscess and intestinal abscess.
Symptom
Abdominal pregnancy symptoms Common symptoms High fever abdominal pain Menopause Internal bleeding Vaginal bleeding Abdominal discomfort Biochemical pregnancy
The age of patients with abdominal pregnancy is often older than the average age of the mother. In the early stages there are symptoms of tubal pregnancy. If menopause, vaginal bleeding, early pregnancy reaction and abdominal pain, most of them have a history of obvious abdominal pain. Caused by miscarriage or rupture of tubal pregnancy. After the abdominal pain relieved the abdomen gradually increased. Symptoms of abdominal discomfort during pregnancy may include nausea and vomiting, constipation, diarrhea, abdominal pain and other symptoms. Abdominal pain can be manifested as obvious fetal movement, fetal movement disappeared, and abdominal pain disappeared. Symptoms of false labor can occur in patients with advanced pregnancy. Some patients may have anemia due to more abortion during abortion or rupture of the tubal pregnancy.
Examine
Examination of abdominal pregnancy
1.B-ultrasound
The uterus is evenly enlarged to the size of 2 to 3 months of gestation. There is no space in the uterine cavity. The uterus can be seen in the uterus. From the various stages to the full-term fetus, the survivor can see the fetal heart. The dead can be seen that the fetus has been deformed and the skull overlaps. The amniotic fluid is less, and the placenta is attached to other organs or tissues. For example, a probe can be built in the B-timed uterine cavity to assist in diagnosis.
2. Abdominal X-ray film
In the abdominal pregnancy of about 20 weeks or more, abdominal X-ray film is helpful for diagnosis. The fetal position is high in the live fetus, often in the transverse position, the limb extension is abnormal, the fetal head is deformed in the stillbirth, the limb is distorted, and the spine is visible. Malformation, lateral radiographs are often located under the abdominal wall, the site is covered in front of the mother's spine, the soft tissue development of the uterus and placenta is not clear, if the condition is MRI or CT examination, it can show that the fetus and placenta are located outside the uterus.
3. Uterine lipiodol angiography
Urinary iodine angiography can also be performed when the abdominal pregnancy is highly suspected. If the fetus is located outside the uterine cavity, it can be diagnosed as abdominal pregnancy. It should be noted that the uterine cavity has increased, and 10 ml of lipiodol may not be enough to fill the uterus. Use up to 20 ~ 30ml.
Diagnosis
Diagnosis of abdominal pregnancy
diagnosis
1. Cervical pregnancy: refers to the implantation and development of fertilized eggs in the cervical canal. Although rare, once the disease occurs, the condition is critical and the treatment is difficult. The clinical manifestations are menopause, early pregnancy reaction, vaginal bleeding or bloody secretions. Sudden vaginal bleeding can endanger the patient's life, without abdominal pain. In addition to -HCG, B-mode ultrasound can be diagnosed in the cervical gestational sac. Different methods can be used according to the amount of vaginal bleeding after diagnosis.
2. Ovarian pregnancy: refers to the implantation, growth and development of fertilized eggs in ovarian tissue. Clinical manifestations are very similar to tubal pregnancy, but are often diagnosed as tubal pregnancy or misdiagnosed as ruptured ovarian corpus luteum. Laparoscopic diagnosis is extremely valuable, but pathological examination is still needed for diagnosis.
