systemic disease

immune factors

Reproductive organ abnormalities

other

Symptoms include a small amount of vaginal bleeding after menopause, which is less than menstrual flow, sometimes accompanied by slight lower abdominal pain, low back pain, and lumbar spine pain. The cervix is ​​not dilated, the fetal membranes are not ruptured, and no products of pregnancy are discharged. If the bleeding stops or the abdominal pain disappears, the pregnancy is sustainable.

Miscarriage is inevitable, vaginal bleeding has increased, paroxysmal abdominal pain has worsened, the size of the uterus is consistent with or slightly smaller than the number of weeks after menopause, and the cervix has been dilated.

The bleeding does not stop, the abdominal pain is relieved, the products of pregnancy are partially discharged, and the uterus is smaller than the number of weeks after menopause.

All the products of pregnancy have been expelled from the body, vaginal bleeding has gradually stopped, abdominal pain has gradually disappeared, the cervix has been closed, and the uterus is close to normal size.

Three or more spontaneous miscarriages in a row with the same partner

Abdominal examination: Patients with fallopian tube pregnancy miscarriage or rupture will have obvious tenderness and rebound pain in the lower abdomen, mainly on the affected side; when bleeding is prolonged, there will be shifting dullness to percussion.

Pelvic examination: Cervical lifting pain or swinging pain is one of the main signs of fallopian tube pregnancy; when intra-abdominal bleeding is prolonged, the uterus will appear to be floating when examined

Those with unstable vital signs or signs of intra-abdominal bleeding

Those with progressive ectopic pregnancy (blood hCG>3000U)/L or continuously elevated, with fetal heartbeat and large mass in the adnexal area

Those with unreliable follow-up

Those with contraindications or ineffectiveness of drug treatment

Persistent ectopic pregnancy

Methotrexate: inhibits trophoblast proliferation, destroys villi, and causes embryonic tissue necrosis, shedding, and absorption.

Regular uterine contractions occur, accompanied by progressive shortening of the cervical canal, and the cervix has not yet dilated.

There are regular uterine contractions, progressive changes in the cervix, and dilation of the cervix.

Beta-adrenoceptor agonists: ritodrine, albuterol

Magnesium sulfate: Patients should be closely observed for signs of poisoning

Calcium channel blockers: Those who have taken magnesium sulfate should be used with caution to prevent a sharp drop in blood pressure.

prostaglandin synthase inhibitor

Mild

Severe

It first manifests as fixed eyeballs, dilated pupils, head turned to one side, trismus, followed by trembling of the corners of the mouth and facial muscles for a few seconds, and then the muscles of the whole body and limbs become rigid (the dorsal side is stronger than the ventral side). The hands are clenched and the arms are straightened, and a strong seizure occurs. twitch. During convulsions, breathing pauses and the face turns blue. The twitching lasts for about a minute, the intensity weakens, and the muscles all over the body relax, and then they stretch and inhale to resume breathing. During convulsions, the patient loses consciousness. When the condition becomes milder, the number of convulsions decreases, and the convulsions wake up quickly. However, sometimes the convulsions are frequent and last for a long time, and the patient can fall into a deep coma. During the convulsions, various traumas such as lip and tongue bites, falls, and even fractures are prone to occur. Vomiting occurs during coma. Can cause suffocation or aspiration pneumonia.

Pregnant women with high blood pressure have no proteinuria before 20 weeks of pregnancy. If urine protein ≥0.3g/24h or random urine protein ≥ ( ) appears after 20 weeks of pregnancy; or if urine protein suddenly increases after 20 weeks of pregnancy, blood pressure further rises, or Thrombocytopenia (<100x109/L).

Blood pressure ≥140/90mmHg before pregnancy or before 20 weeks of pregnancy, but not significantly aggravated during pregnancy; or hypertension is first diagnosed after 20 weeks of pregnancy and continues beyond 12 weeks postpartum

If your blood pressure is elevated during the initial measurement, you need to rest for an hour before taking the measurement again to accurately reflect your blood pressure. Turn over test (ROT): Measure the blood pressure while the pregnant woman is lying on her left side. After the blood pressure stabilizes, turn over to the supine position for 5 minutes and then measure the blood pressure. If the diastolic blood pressure in the supine position is ≥20 mmHg compared with the left lateral position, it indicates a tendency to develop preeclampsia, and its positive predictive rate is 33%.

Collect 24-hour urine for urine protein detection. If the 24-hour urine protein quantity is ≥0.3g, it is abnormal.

Edema in late pregnancy Edema is not obvious, but the body weight increases by more than 0.5kg within a week. Hidden edema

Headache, dizziness, chest tightness, nausea, vomiting

Convulsions and coma are the most serious manifestations

Patients with gestational hypertension and preeclampsia can expect treatment until pregnancy termination at 37 weeks

For patients with severe preeclampsia whose pregnancy is <24 weeks, and those whose condition is unstable after treatment, it is recommended to terminate the pregnancy between 24 and 28 weeks of gestation. The decision on whether to receive expectant treatment will be based on the condition of the mother and child, as well as local medical conditions and medical standards.

Ensure rest: It is advisable to lie on the left side, which can reduce the pressure of the uterus on the abdominal aorta and inferior vena cava, increase the return blood flow and improve the blood supply of the uterus and placenta. Lying on the left side for 24 hours can reduce diastolic blood pressure by 10mmHg

Adjust your diet: Salt does not need to be strictly restricted, but pregnant women with generalized edema should limit their salt intake.

Closely monitor mother and child status

Intermittent oxygen inhalation

toxic reactions

Things to note

Assist doctors in controlling convulsions

Dedicated care to prevent injuries

Reduce stimulation to avoid triggering convulsions

Close supervision

Be prepared to terminate your pregnancy

Skin itching: generally starts from the palms and soles of the feet and gradually extends to the proximal ends of the limbs, and can even develop to the face

jaundice

Serum cholic acid measurement (most important) uninduced skin itching and serum TBA > 10 μmol/L

Liver function test

Pathological examination

Relieve itching symptoms, restore liver function, reduce blood bile acid levels, and strengthen monitoring of fetal intrauterine conditions to improve pregnancy outcomes.