妇产科学-Abortion-课件.ppt

1、AbortionDept.of Ob/Gy of Drum Tower Hospital Huyali1PPT课件DefinitionnNature or induced expulsion of fetus from uterus before it is able to survive.n20 weeks from the first day of the last period or a fetus weighing 500g(developed countries)n28 weeks from the first day of the last period or a fetus we

2、ighing 12week-8 weeks.Absence of uterine growth,loss of some early pregnancy symptoms,slight bleeding,DIC18PPT课件Types of the spontaneous abortionnRecurrent abortion:more than two consecutive spontaneous abortion,nHabitual abortion:3 spontaneous abortion Early abortion-great likelihood of chromosomal

3、 abnormalityLater abortion-maternal cause:incompetent cervix,immunologic factors,anatomic deformities19PPT课件Treatment of spontaneous abortion nThreatened abortion:Bed restProscribing intercourse Follow up:bleeding,pain,if ultrasonograph shows a nonviable or developing to Inevitable abortion evacuati

4、on should be carried out.20PPT课件Treatment of spontaneous abortionnIncomplete abortion:immediate evacuation and control bleeding,preventing infection,emotional support21PPT课件Treatment of spontaneous abortionnMissed abortion:Check the platelet count and coagulation factors.If they are normal evacuatio

5、n at once.If they are low prevent DIC first.Sometimes curretage is difficult and give prostgland to induce abortion22PPT课件An Overview of Abortion in the United States23PPT课件Pregnancies in the United States(Approximately 6.3 Million Annually)52%52%48%48%0%0%10%10%20%20%30%30%40%40%50%50%60%60%of preg

6、nanciesUnintendedIntendedSource:Henshaw,1998 (1994 data)24PPT课件 Outcomes of Unintended Pregnancies(Approximately 3.0 Million Annually)47%47%40%40%13%13%0%0%10%10%20%20%30%30%40%40%50%50%60%60%of unintended pregs.AbortionsBirthsMiscarriagesSource:Henshaw,1998 (1994 data)25PPT课件Incidence of Pregnancy

7、and Abortion:Unintended pregnancy and abortion are common among all groups of women.Almost half of all pregnancies are unintended.Almost half of unintended pregnancies end in abortion.26PPT课件Who Has Abortions:Age33.0%33.0%23.1%23.1%13.5%13.5%8.1%8.1%18.6%18.6%0.7%0.7%3.1%3.1%Source:Jones et al.,2002

8、33.0%33.0%23.1%23.1%13.5%13.5%8.1%8.1%18.6%18.6%0.7%0.7%3.1%3.1%Source:Jones et al.,200220-24岁25-29岁30-34岁15-19岁27PPT课件Who Has Abortions:Marital Status67.3%67.3%17.0%17.0%15.6%15.6%Source:Jones et al.,2002未婚已婚离婚28PPT课件Who Has Abortions:Race/Ethnicity40.9%40.9%31.7%31.7%0.9%0.9%6.4%6.4%20.1%20.1%Sour

9、ce:Jones et al.,2002*Non-Hispanicwhiteblackasianhispanic29PPT课件Who Has Abortions:Religious Identification42.8%42.8%27.4%27.4%7.6%7.6%22.2%22.2%Source:Jones et al.,2002protestantcatholicothernon30PPT课件Who Has Abortions:Prior Pregnancies36%36%25%25%27%27%12%12%Source:Jones et al.,2002Previous abortion

10、 and birthPrevious abortionnonePrevious birth31PPT课件Who Has Abortions,Why and When in Pregnancy:Women having abortions are predominantly young,single,from minority groups and low-income.Most women have multiple reasons for choosing to have an abortion.Almost 90%of abortions occur in the first trimes

11、ter.32PPT课件Percent of Abortions Performed by Each Type of Provider0%0%10%10%20%20%30%30%40%40%50%50%60%60%70%70%80%80%1980198019821982198419841986198619881988199019901992199219941994199619961998199820002000%of abortionsAbortionclinicOtherclinicHospitalPhysicianofficeSource:Finer and Henshaw,200333PP

12、T课件Percentage of Maternal Mortality Worldwide Due to Unsafe AbortionMaternal deaths(600,000 per year)87%13%Source:WHO,1998(Estimates for 19952000)Unsafe abortionOther causes34PPT课件Abortion Risks in PerspectiveChance of deathRisk from terminating pregnancy:per year:Before 9 weeks 1 in 500,000 Between

13、 9 and 10 weeks 1 in 300,000 Between 13 and 15 weeks 1 in 60,000 After 20 weeks 1 in 8,000Risk to persons who participate in:Motorcycling 1 in 1,000 Automobile driving 1 in 5,900 Power-boating 1 in 5,900 Playing football 1 in 25,000Risk to women aged 1544 from:Having sexual intercourse(PID)1 in 50,0

14、00 Using tampons 1 in 350,000 Source:Gold,1990;Trussell,199835PPT课件 Abortions by Gestational Age(Weeks Since Last Menstrual Period)57.6%57.6%20.3%20.3%10.2%10.2%6.2%6.2%4.3%4.3%1.5%1.5%0%0%10%10%20%20%30%30%40%40%50%50%60%60%70%70%of abortions99-1011-1213-1516-2021+WeeksSource:Elam-Evans et al.,2002

15、 (1999 data)36PPT课件Deaths per 100,000 Abortions or Births0.20.20.30.30.60.61.81.83.73.712.712.70.60.66.66.60 02 24 46 68 8101012121414Deaths per 100,000911-1216-20BirthsAbortions by gestationSource:Gold 1990 (19811985 data)37PPT课件Percentage Distribution of Abortion Deaths29%29%18%18%16%16%14%14%23%23%0%0%10%10%20%20%30%30%of deathsAnesthesiaHemorrhageInfectionEmbolismOtherSource:Lawson et al.,1994 (19831987 data)38PPT课件Thank you!39PPT课件