cervical pregnancy
Introduction
Introduction to Cervical Pregnancy Fertilization of the fertilized egg and development in the cervical canal is called cervical pregnancy, very rare. More common in the mother. There are menopause and early pregnancy reactions, the main symptoms are vaginal bleeding or bloody secretions, the amount of bleeding is generally from less to more, but also intermittent vaginal bleeding. The main signs are that the cervix is significantly enlarged, softening and bluening, the outer edge of the cervix is very thin, the inner mouth is tight, and the size and hardness of the palace are normal. The embryonic tissue and the cervical tissue adhere closely to each other and are difficult to separate. The main part is under the uterus. There is no villous tissue in the uterus. The trophoblasts and syncytium cells in the pregnancy can grow into the cervical muscle layer, and the fetus can survive. Cervical glands can be seen at the attachment basic knowledge The proportion of illness: 0.02% Susceptible people: more common in women Mode of infection: non-infectious Complications: shock
Cause
Cervical pregnancy etiology
(1) Causes of the disease
It is not clear that it may be related to the following factors:
1. The fertilized egg runs too fast, and has already entered the cervical canal before it has the ability to grow, where it grows and grows.
2. Abortion, mid-term induction of labor, cesarean section and intrauterine device to damage the endometrium or intrauterine environment, affecting the normal implantation of pregnant eggs.
3. Uterine dysplasia, uterine malformation, uterine fibroids, endocrine disorders, assisted reproductive technology are also possible related factors.
(two) pathogenesis
The embryonic tissue and the cervical tissue adhere closely to each other and are difficult to separate. The main part is under the uterus. There is no villous tissue in the uterus. The trophoblasts and syncytium cells in the pregnancy can grow into the cervical muscle layer, and the fetus can survive. The gland is visible at the attachment.
Prevention
Cervical 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. When placing intrauterine devices and performing intrauterine operations such as abortion, it is essential to strictly observe the operating routine and prevent infections.
3. Pelvic soft tissue infection should be treated early, and it should be completely cured at one time.
4. Active treatment of endometriosis.
5. After the use of induced ovulation drugs, suspected early pregnancy, or after successful pregnancy, we should promptly exclude ectopic pregnancy and compound pregnancy.
6. Promote the dangers of smoking and ban drug use.
Complication
Cervical pregnancy complications Complications
In severe cases, it can be manifested as a sudden large amount of vaginal bleeding that is shocked and even life-threatening.
Symptom
Cervical pregnancy symptoms Common symptoms Vaginal bleeding Cervical enlargement Cervical soft uterus is a gourd-like abortion stop menstrual mucus less
1. Symptoms have menopause and early pregnancy reaction, can be seen in primipara or maternal, in the past there was induced abortion, induction of labor or cesarean section, vaginal bleeding, bloody secretions or a small amount of bleeding, followed by a large number of vaginal bleeding, bleeding time Most of them start at 5 weeks of pregnancy, and bleeding often occurs in 7 weeks to 10 weeks of pregnancy.
2. Gynecological examination of the cervix becomes larger, the coloration is very obvious, the quality is soft, the cervix can be dilated, sometimes dark red or purple-red tissue can be seen, and the cervix seems to have tissue incarceration, but attempts to separate the tissue and the cervix by finger test A large amount of bleeding can occur. The most characteristic change is that the uterus is hyacinth when the gynecological triad is diagnosed. The uterus is small, slightly hard, the cervix is large, soft, and sometimes the uterus is pulsating. This is typical. The performance of cervical pregnancy.
Examine
Cervical pregnancy check
1. Peripheral blood is positive cells, positive pigment anemia, normal platelets, and normal or elevated white blood cells.
2. Positive pregnancy test.
3. Pathological examination is the basis for determining the diagnosis.
4. Ultrasound examination is a commonly used auxiliary examination method in recent years. The uterus is enlarged when examined, but there is no gestational sac in the official cavity, the cervix is enlarged, the gestational sac is seen in the neck tube, or the irregular echo, the cervix Closed.
Diagnosis
Diagnosis of cervical pregnancy
diagnosis
According to the medical history and clinical manifestations, it is generally possible to make a diagnosis of cervical pregnancy, but clinically it is rare to make a diagnosis before surgery. This may be because the disease is relatively rare, so doctors often rarely consider the possibility of cervical pregnancy. After these patients have menopause, vaginal bleeding occurs earlier, often misdiagnosed as intrauterine pregnancy abortion, at this time the cervical tissue destruction is very shallow, so it can be cured by curettage, so some cervical pregnancy is not clearly diagnosed.
Diagnostic criteria
Clinical diagnosis of cervical pregnancy should meet the following criteria:
1 After a period of menopause, vaginal bleeding occurred, but no acute abdominal pain.
2 The cervix is soft and disproportionately enlarged, and its size can be greater than or equal to the size of the uterus.
The 3B ultra-examination indicates that the embryo is completely implanted in the cervical canal.
4 The internal cervix is closed and the external cervix is partially dilated.
The final diagnosis must be based on pathological examination. The pathological diagnosis of cervical pregnancy must meet the following criteria:
There must be a cervical gland in the tissue opposite the placenta planting site.
2 Placenta should be in close contact with the cervix.
3 All or part of the placental tissue must be below the level of the uterine blood vessels entering the uterus, or below the uterine anterior and posterior peritoneal reflex levels.
4 no pregnancy products in the uterine cavity.
Differential diagnosis
Cervical pregnancy should first be differentiated from general abortion. Generally, the abortion tends to increase, while the cervix does not increase. The cervical enlargement is not obvious during cervical pregnancy, but the cervix is disproportionately enlarged, often equal to or greater than the palace. Body, inevitable abortion and late abortion are both internal and external cervix expansion; cervical cervix, the external cervix is slightly dilated, the internal mouth is closed, the general intrauterine pregnancy abortion, placental tissue attached to the uterine wall, located in the mouth Upper cervical gestation, the placenta is attached to the level below the mouth. In addition, cervical pregnancy must be differentiated from cervical fibroids, uterine submucosal fibroids and cervical cancer.
