In April in Beijing, the car is like a flowing water and a dragon.One of my night shifts was spring rain. The 24 -year -old female Xiaohua came to see the emergency department with a man of the same age.She rejected B -ultrasound examination. Is this swollen?
Xiaohua Qingxiu’s face was frowning, and the nightmare beauty care immediately tested her vital signs such as body temperature and blood pressure.
"Body temperature: 36.8 ° C, blood pressure: 115/72mmHg." Mei Xiaohu told me.
Ask Xiaohua to sit down, and I started asking her medical history.
Xiaohua, who is generally menstrual, has been postponed for 10 days this time. Yesterday, she had a pain in her abdomen. She thought she thought about eating abdominal pain caused by unclean food. Xiaohua took an analgesic tablet by sherself.It was painful today, and now she still feels a sense of anxiety.
"Dr. Fu, I got married in October last year. I want to know if I am pregnant?" Xiaohua asked me anxiously.
"Xiaohua, you need to check the urine pregnancy test and pelvic ultrasound, and I need to do a gynecological examination for you."
"But Dr. Fu, I have no urination now and I can’t do a B -ultrasound." Xiaohua said.
"I give you the B -ultrasound of the vagina, no need to urinate." I explained.
"Dr. Fu, I will check my urine to determine whether I am pregnant. If I want this baby, I want this baby. Do vaginal B -ultrasound and gynecological examination, will I hurt my baby? I don’t want to do it." Xiaohua said.
The history of sexual life in Xiaohua has menopause and lower abdominal pain.First of all, you need to check the urine pregnancy test to eliminate pregnancy. If you are pregnant, you need to check whether B -ultrasound to eliminate whether ectopic pregnancy is also ectopic pregnancy.For the situation without urination, vaginal B ultrasound is the first choice.
Vaginal ultrasound is an intraocular ultrasound, and vaginal probe is a micro probe.The vaginal probe has a higher resolution than the abdominal probe.The probe is close to the cervix and vaginal dome in the vagina, so that the pelvic organs are in the near area where the pelvic organs are in a bundle.Ovarian follicle monitoring, early ectopic pregnancy, early pregnancy and other observations, the image display is clearer than the abdomen ultrasound.
For the beautiful eyebrows of early pregnancy and urination, and obese eyebrows, vaginal ultrasound is particularly suitable. It does not need to fill the bladder. The pelvic organs are in a natural state.If early pregnancy, it can be clearly displayed when the embryo sac diameter is 2mm.
The operation method is applied by the vaginal probe head end to the coupling agent, put on plastic case (for isolation and disinfection), and the B -ultrasound doctor will apply the coupling agent on the surface.The doctor’s right hand holds the vaginal probe handle, gently separates the vulva mouth with his left hand, and slowly puts the probe into the vagina, close to the dome and cervix for examination.
However, the vaginal probe is not suitable for unmarried women, menstrual periods, vaginal malformations, vaginitis, and vaginitis because they need to be put in vaginal operation.
"Xiaohua, from the above operation steps, it can be seen that the ultrasound of vagina is very safe. Ultrasonic probes are only close to the dome and cervix."I explained.
After listening to my explanation, Xiaohua reluctantly agreed and took the test sheet I opened.
Fifteen minutes later, Xiaohua returned with the man’s company.After receiving her laboratory examination form, the results above the urine pregnancy test (+), B -ultrasound reminder: 7mm thick endometrium, no abnormal echo in the uterine cavity, 2.0 × 1.5cm low echo can be seen on the left attachment area.It seems to be visible yolk, pelvic effusion 8.5cm.Exically pregnancy?
A gynecological examination was performed for Xiaohua, combining her medical history, physical examination, and auxiliary examination. Her diagnosis was heterosexual pregnancy (ectopic pregnancy), and she needs to be hospitalized immediately.
We followed Xiaohua for laparoscopic surgery. During the operation, we found that Xiaohua had 1000ml of bleeding in the abdominal cavity.Surgery, surgery smoothly.In the removing object, we saw the fluff with a diameter of 0.5cm and sent the pathology.
One day after the operation, when I went to the room, Xiaohua was full of tears, holding my watch and thanking it.
"Dr. Fu, in fact, my stomach has been hurt for 1 week, and I feel that I am pregnant, but I am afraid of going to the hospital. I think that even if I am pregnant, I will be somewhat uncomfortable! I came over that night because my stomach was really my stomach that nightI have been hurting, and I am a little worried, but I still do n’t want to do the B -ultrasound. It ’s not that you explain to me bitterly that night. I may go home again to observe.My life? "
For ectopic pregnancy (ectopic pregnancy), 95%of them are fallopian tube pregnancy, and typical manifestations are menopause, abdominal pain, and vaginal bleeding.As a common acute abdomen in obstetrics and gynecology, ectopic pregnancy is due to abdominal hemorrhage and severe abdominal pain, that is, the situation of the small Chinese in the text. If the bleeding continues, the mild occurs, and the hemorrhage shock occurs in severe cases.
Xiaohua in the article, if there is no subsequent B -ultrasound, gynecological examination, etc. at night, she is also likely to go home to observe again.It is also unable to return to the sky.Do not underestimate this disease with an incidence of 2%to 3%. It is the main reason for the death of early pregnancy pregnant women.
About ectopic pregnancy (ectopic pregnancy):
Extradium pregnancy of more than 1.95%is fallopian tube pregnancy. The cause of fallopian tube pregnancy is mainly: fallopian tube inflammation, fallopian tube pregnancy or surgical history, dysplasia of fallopian tube or abnormal dysfunction, and contraceptive failure.
In addition, huge uterine fibroids or ovarian tumors compress the fallopian tube to change the pelvic form, which may also cause ectopic pregnancy; endometriosis to change the pelvic environment and increase the possibility of ectopic pregnancy.If patients with perfection after cesarean section are perfected in the scar part, they will cause ectopic pregnancy in the scar.
2. How to prevent the occurrence of ectopic pregnancy?
Actively prevent and treat genital pathogen infections, prevent pelvic inflammation, actively treat gynecological diseases, choose appropriate contraceptive methods and childbirth methods, and minimize pelvic operation and surgery within a reasonable range.
3. How to prepare for pregnancy after ectopic pregnancy?
1) Patients with surgical removal of fallopian tubes, such as bilateral fallopian tubes, have been removed. It is recommended to go directly to the reproductive center and test the baby.If a unilateral tubal is removed, it is recommended to perform fallopian tubal angiography and check the fluidity of the fallopian tube. If the reserved one side of the fallopian tube is unobstructed and the function is good, ovulation can be monitored, and the same room can be guided.pregnant.However, IVF technology cannot completely avoid the occurrence of repercussive pregnancy.
2) After conservative treatment or tubal tube cutting embryo, the patient retains bilateral fallopian tubes, with a chance of 50%to 80%.Later injury may lead to fallopian tube obstruction or poor function. Therefore, it is also recommended that the vulcan tube angiography check clearly clearly monitors the tubal pumopa and guide the same room.
Dr. Fu Hong’s warm reminder: For the little master who has sex, once your menstruation should not come, and you have discomfort such as abdominal pain, vaginal bleeding, etc., and a regular hospital for medical treatment to eliminate ectopic pregnancy is the most wise.choose!
What needs to be reminded is that due to the high risk of re -elevated pregnancy, a small master with a history of ectopic pregnancy is re -pregnancy, and the blood HCG (human chorionic gonadotropin) and progesterone value need to be closely monitored.There are abdominal pain, vaginal bleeding and other discomfort, and need to seek medical treatment in time.
References: 1. "Obstetrics and Gynecology" 9th edition.
Some content organizes an article from Li Yuan, a reproductive expert of WeChat public account.
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