1. Abnormal Pregnancy Time Limit and Ectopic Pregnancy
Xin Wu
Obstetric and Gynecology Hospital

2. Abortion Early abortion Late abortion Spontaneous abortion
Artificial abortion

3. Case 1
27, female, menopause 51 days, a small amount of vaginal bleeding 1 day, no obvious abdominal pain
Menstrual history: 12 3/30，menstrual rules
G3P0 2008, 2010 spontaneous abortion
Miscarriage requirements

4. Ultrasound: uterus 7×5×4cm，embryo sac 12×8×5，no obvious germ
尿HCG（+）
Routine blood and urine: normal

5. Gynecological examination
Vulva: married type
Vagina: smooth, a small amount of dark red blood stains
Cervix: closed, blood-stained, no obvious lifting pain
Palace: front-bit, 6w of pregnancy size, no tenderness
Annex: soft

6. QUESTIONS
Current diagnosis
Further examination
Treatment
Prognosis

7. QUESTIONS Current diagnosis: missed abortion？Threatened abortion?
Further examination: review ultrasound and serum HCG 3 days later，coagulation, observe vaginal bleeding and abdominal pain
Treatment: bed rest，progesterone miscarriage
Prognosis: endocrine factors and immune factors should be checked

8. Case 2
22, female, menopause 36w，Small amount of vaginal bleeding with paroxysmal abdominal pain 3 hours, half an hour of the vaginal fluid
Menstrual history: 12 3/30, menstrual rules
G1P0
Check-ups during pregnancy normal

9. Ultrasound: intrauterine single fetus, BPD 85mm, HC 298mm ,AC 312mm, FL 63mm, AFI 60mm
Vagina liquid PH test: blue
Routine blood and urine normal, blood pressure and body temperature normal

10. Abdominal examination
Top of Palace at 3cm under xiphoid
Regular contractions 20”/5-6’，moderate

11. Vaginal examination Cervical completely receptivity
Cervix can accommodate 2 fingers
No obvious amniotic sac
Diameters within the pelvic normal

12. QUESTIONS
Current diagnosis
Further observation
Further treatment

13. QUESTIONS
Current diagnosis: G1P0 36 weeks pregnant，premature birth labor
Further observation: CST, contractions,, anomalies
Further treatment: review cervical dilation and fetal head down 4 hours later

14. Case 3
29, female, menopause 42 days，a small amount of vaginal bleeding 3 days, sudden right lower abdominal pain 1 hour
Menstrual: /28，rule
G2P0 medical abortion 1 time in 2010

15. Ultrasound: Uterus size 6×5×4cm, endometrial 7mm, no obvious gestational sac, a mixed echo area 25×18×7mm inside the right ovaty
Urinary HCG（±）
Routine blood Hb 98 g/L
Bp 95/65 mmHg

16. Gynecological Examination
Vulva: marriged type
Vagina: smooth, a small amount of dark blood
Cervix: closed, blood-staining, give pain (+)
Palace: median, normal size, without tenderness
Annex: a 3cm block on the right side, tenderness(+)

17. QUESTIONS
Current diagnosis
Further examination
Treatment method

18. QUESTIONS Current diagnosis: Ectopic pregnancy?
Further examination: preoperative examination and blood HCG
Treatment method: Laparoscopy

19. Points Types of abortion
Definition of premature labor and prolonged pregnancy
Differential diagnosis of ectopic pregnancy, drug treatment and surgical treatment indications