- First Trimester (0 to 13 Weeks)
- Second Trimester (14 to 26 Weeks)
- Third Trimester (27 to 40 Weeks)
Ectopic pregnancy
Spontaneous abortion
Septic abortion
Gestational trophoblastic disease (GTD)
Nausea and vomiting
Spontaneous abortion
loss of pregnancy before 20 weeks or loss of a fetus weighing <500 g
20 - 40% in all pregnancy
Approximately 75% of spontaneous abortions occur before 8 weeks of gestation
先兆性流產 (Threatened abortion)
一般女性 25% 機率會出現陰道出血, 但不一定會流產
迫切性流產(Inevitable abortion) : 子宮頸已打開
延遲流產 / 過期流產 (Missed abortion)
懷孕前20週以前 - 統稱為流產 (abortion)
懷孕20週後 - 胎兒因為某些原因離開了母體, 則稱為早產 (preterm labor)
PV : whether the cervix has dilated, and whether any tissue has been passed
Septic abortion
Spontaneous or other abortion complicated by PID
Fever, abdominal pain, vaginal discharge, vaginal bleeding, and history of recent pregnancy.
Common cause : incomplete spontaneous or therapeutic abortion
Obtain quantitative serum β-hCG level
Fluid resuscitation, broad-spectrum IV antibiotics, and early obstetric consultation for evacuation
* Ampicillin/sulbactam, 3 g IV, or clindamycin, 600 mg , plus gentamicin, 1 to 2 mg/kg IV
Hyperemesis gravidarum 妊娠劇吐
Volume depletion to hypokalemia or ketonemia
0.3% to 3%
GTD also may present with intractable vomiting
ketonuria
The presence of abdominal pain in nausea and vomiting of pregnancy
or hyperemesis gravidarum is highly unusual
and should suggest another diagnosis.
孕吐常見但通常不會腹痛 !!!!
Cholelithiasis and cholecystitis are more common in pregnant women
HELLP (懷孕腹痛的重要鑑別診斷)
Phenothiazines, Ondansetron
Admission guidelines : uncertain diagnosis, intractable vomiting,
persistent ketone or electrolyte abnormalities after volume repletion,
and weight loss of >10% of prepregnancy weight.
- Prochlorperazine 10 mg (Novamin)
- Chlorpromazine 25 mg (Wintermin)
- Metoclopramide 10mg (Primperan)
- Promethazine 第一代抗組織胺藥
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