Ectopic pregnancy
Introduction
Introduction Ectopic pregnancy refers to the implantation of a pregnant egg outside the uterus called ectopic pregnancy, commonly known as ectopic pregnancy. But the meaning between the two is slightly different, ectopic pregnancy refers to all pregnancy outside the uterus, and ectopic pregnancy refers to the pregnancy of the pregnant egg outside the normal implantation site, including cervical pregnancy, uterine muscle wall pregnancy, palace angle Pregnancy, etc., so ectopic pregnancy has a broader meaning and is accepted by the obstetrics and gynaecology community. Ectopic pregnancy can occur in the fallopian tube, ovary, abdominal cavity, broad ligament, etc., of which tubal pregnancy is the most common, accounting for about 90% to 95% of the incidence.
Cause
Cause
Ectopic pregnancy refers to the implantation of a pregnant egg outside the uterus called ectopic pregnancy, commonly known as ectopic pregnancy. Ectopic pregnancy can occur in the fallopian tube, ovary, abdominal cavity, broad ligament, etc., of which tubal pregnancy is the most common, accounting for about 90% to 95% of the incidence. Although the pathogenesis of ectopic pregnancy has not been accurately recorded in the past doctors in traditional Chinese medicine, according to its clinical manifestations and signs, combined with modern medical knowledge of the disease, the etiology and pathogenesis are discussed as follows: The organs of the fetus, the palace, are connected to each other through the veins, the organs, the blood, and the meridians.
Examine
an examination
Related inspection
Gynecological ultrasound examination vaginal gynecological routine examination pregnancy test
Its incidence is related to tubal inflammation, fallopian tube surgery, intrauterine device placement, tubal dysplasia or dysfunction, fertilized egg migration and tumor compression around the fallopian tube.
Chronic salpingitis
Clinically, it can be divided into fallopian tube mucositis and perivascular inflammation, both of which are common causes of ectopic pregnancy. Severe fallopian tube mucositis can completely block the fallopian tube and cause infertility. The lighter mucosal folds cause the lumen to narrow, and the peristalsis affects the normal operation of the fertilized egg in the fallopian tube, causing it to be blocked and implanted there. The inflammation around the fallopian tube is mainly in the serosal layer or the sarcoplasmic layer of the fallopian tube. Inflammatory exudation causes adhesion around the fallopian tube, causing the fallopian tube to be distorted, and the peristalsis of the narrow wall of the lumen is weakened, thereby affecting the operation of the fertilized egg.
Fallopian tube surgery
Various forms of tubal sterilization, if the formation of the fallopian tube fistula or recanalization, may lead to tubal pregnancy. The anastomosis or fallopian tube surgery after tubal sterilization may lead to tubal pregnancy due to stenosis.
Intrauterine device placement
With the widespread use of intrauterine devices, the incidence of ectopic pregnancy is increased, which may be related to salpingitis caused after placement.
Tubal dysplasia or dysfunction
Tubal dysplasia often manifests as long tubal, poor muscular development, and lack of mucociliary. Double fallopian tubes, diverticulum or parasitic umbrellas can all be the cause of tubal pregnancy.
Fertilized egg
One side of the ovary ovulates, if the fertilized egg moves through the uterine cavity or abdominal cavity to the contralateral fallopian tube, it is called fertilized egg. Fertilized eggs can develop into tubal pregnancy in the contralateral fallopian tube due to excessive migration time and increased development.
other
Tumors around the fallopian tubes, such as uterine fibroids or ovarian tumors, are affected by the pressure to the fallopian tubes, which affects the smoothness of the fallopian tubes and hinders the operation of the fertilized eggs. Endometriosis, previous ectopic pregnancy, and fertility techniques are also associated with the onset of ectopic pregnancy.
Diagnosis
Differential diagnosis
Differential diagnosis
1. Intrauterine pregnancy: the uterus is equal to the menopause month. B-ultrasound can be seen in the uterus with a gestational sac or a carcass and fetal heart.
2. Acute appendicitis: metastatic right lower quadrant pain, McPherson point tenderness, ruminant pain, with fever, high blood, no history of menopause. There was no abnormality in the gynecological examination and the urine pregnancy test was negative.
3. Nest cyst swelling: sudden pain on the lower abdomen, more related to body position changes, no history of menopause. Gynecological examination of the uterus can touch the edge of a clear mass, urine pregnancy test is negative, B-ultrasound can confirm the diagnosis.
Chronic salpingitis, which can affect the normal delivery of pregnant eggs, is the most common cause of tubal pregnancy. Tubal pregnancy rupture, a large number of internal bleeding can be life-threatening.
diagnosis
1. Have typical clinical manifestations.
2. Gynecological examination: Before the rupture, the uterus is enlarged and soft, but less than the menopause month, one side of the attachment can touch a small mass, and there is light tenderness. After rupture, the vaginal sputum is full; the cervix has a sowing pain; the uterus is slightly larger and softer, and there is a sense of floating when there is bleeding; the uterus can touch the mass, the quality is soft, the boundary is unclear, and the tenderness is obvious.
3. Urine pregnancy test is positive.
4. Serum HCG 6251 U/L, but quantitatively measured non-multiplied every 48 hours, but below this value.
5. B-ultrasound: There is no gestational sac in the palace, and there is a low echo area next to the palace.
6. After the puncture, the puncture is not coagulated, suggesting that the tubal pregnancy is ruptured.
