Vaginal study. Mother slightly increased magkovataya; More mobile than usual (floating womb). Pastosnosti of appendages uterus. Rear set vagina or uploschen emphasized sharply painful to palpation (M Douglas). In an attempt to shift the cervix kperedi a sharp pain. Pipe Clinic abortion. When abortion type Pipe abortion is pristupoobraznae pain in the bottom of the abdomen, are krovanistye allocation. Often there are short fainting condition. Vaginal study. Mother magkovataya slightly increased. Пальпируется опухолевидное education in one of the appendages, in a painful palpation. Малоподвижное. Pain in the uterus removal kperedi and palpation rear set vagina expressed weaker than at fracture pipe. Often from a uterus is a deciduhalna casing. In gistologicescom study released deciduhalna skin scraping or mucous membrane corpus uteri identify elements deciduhalna tissue elements without sampling. Diagnostics projected signs. Distrust of 0-28 pregnancy occurs when complaints pregnant at the pathological bleeding and pain in the lower abdomen divisions. The history - inflammatory diseases or operations in the pelvic organs. Differential diagnosis. Diagnostics ectopicescoy pregnancy is easy for patients with amenoreei, pregnant, and pain in the lower divisions and stomach bleeding. There is a need to delete the following conditions : 1. Perekrut ovarian cyst or an acute appendix with unilateral pain in the right iliac area; Language dry, positive symptom Shchetkina-bluemberg. But there is no such thing as amenorrhea, obmorokov, anaemia and shock. Blood tests indicate inflammatory process : leucocytosis, raising Monday. 2. Interruption of uterine pregnancy. The termination of pregnancy parent external bleeding was more than pain syndrome, while ectopicescoy pregnancy pain dominates. In vlagalischnom study womb increased the time delay menstruation, cervical canal opened one of the amniocentesis that eggs from a uterus. He has the size and type of emissions : if abortion were liquid, Kim color; Termination of the tubular pregnancy croshkovatae, colour coffee thicker by mixing blood deskwamirovanna nekrotizirovanna deciduhalna sheathing. 3. Haemorrhage in a yellow body with a normal uterine pregnancy (apoplexy cancer). Haemorrhage in a yellow body usually does not cause severe pain and shock typical of ectopicescoy pregnancy. In addition, the mother bleeding usually not. Apoplexy cancer can arise at the time of ovulation. Diagnostic methods ectopicescoy pregnancy. 1. Definition of HGT. The sample to determine in the serum β-subjedinistsi HGT positive in all cases ectopicescoy pregnancy, while the sample for HGT in the urine only positive in 50% of cases. The slew rate HGT in the blood helps differentiate between normal and pathological (0-28 or stagnant) pregnancy; In normal pregnancy HGT level in the blood is doubling every 2 days. The threshold HGT 6000 Mme / ml matocnuu pregnancy identify with the patient. If, in the cavity of the uterus is not an embryo, it is 0-28 pregnancy. Standard sample of urine pregnancy tests are negative in 50% of cases ectopicescoy pregnancy. It should be borne in mind that in many cases ectopicescoy termination of pregnancy on the basis of bleeding and pain mistakenly diagnose threatening abortion. 2. Ultrasound of small pelvis that helps 0-28 pregnancy when the uterus cavity clearly plodnoe egg through seven weeks after the last menstrual period; This period of pregnancy correlated with the level of HGT 5000-6000 Mme / J Identification of increased uterine cancer and the patient has no diagnostic value, as this picture may simply be a matocnuu early pregnancy and yellow body. 3. Transwaginalnoe ultrasound. When ultrasound conducted by transwaginalnogo sensor plodnoe egg can be visualized before the transabdominalna sonography. Plodnoe egg in the uterine cavity can be found in the 1500-2000 HGT Mme / ml, the six weeks of pregnancy, thus using ultrasound transwaginalnogo 0-28 pregnancy can be excluded for 4-6 days earlier than transabdominalnom ultrasound. 4. Kuldozentez (punktia pramokishechno-matern of indentations) have to detect free blood in the abdominal cavity, with complaints of severe pain in the bottom of the abdomen in combination with pathological bleeding and obmorokom or shock. L No. 18 entering through the rear body in the vagina pramokishechno-matern deepening.
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