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寶媽腹腔妊娠會來例假嗎？

出處：網(wǎng)絡(luò)收集 日期：2024-06-25 10:22:45 編輯：秩名

腹腔妊娠會來例假嗎

腹腔妊娠一般可以簡單劃分為原發(fā)性腹腔妊娠和繼發(fā)性腹腔妊娠兩種。受精卵直接種植于腹膜、大網(wǎng)膜等處稱為原發(fā)性腹腔妊娠，極為少見。而繼發(fā)性腹腔妊娠多發(fā)生于輸卵管妊娠流產(chǎn)或者破裂后，偶爾也可以繼發(fā)于卵巢妊娠或者子宮內(nèi)妊娠。
 
事實上，不管是宮內(nèi)懷孕還是宮外孕，只要是懷孕就不會來月經(jīng)。腹腔妊娠時也有可能會出現(xiàn)陰道出血，但這并不是月經(jīng)，而是由宮外孕造成的假象。根據(jù)患者具體臨床表現(xiàn)和檢查可以診斷腹腔妊娠。腹腔妊娠診斷標(biāo)準(zhǔn)有以下3點。
 
1、患者兩側(cè)輸卵管以及卵巢必須正常，而且沒有近期妊娠的證據(jù)。
 
2、患者子宮無腹膜瘺形成。
 
3、妊娠只存在于患者腹腔內(nèi)，不存在輸卵管妊娠等的可能性。B型超聲檢查，如果顯示宮腔空虛，胎兒位于子宮以外，有助于確診。
 

腹腔妊娠的癥狀體征

腹腔妊娠患者的年齡比女性平均生產(chǎn)年齡大，也就是說高齡產(chǎn)婦患有腹腔妊娠的概率更大。在腹腔妊娠早期，有輸卵管妊娠的相關(guān)癥狀，比如停經(jīng)、早孕反應(yīng)、腹痛以及陰道出血等，多數(shù)患者會有一次比較明顯的腹痛史，由輸卵管妊娠流產(chǎn)或者破裂引起。隨著時間推移，腹痛逐漸緩解，但是患者腹部逐漸增大。
 
在妊娠過程中，患者會經(jīng)常感腹部不適，比如惡心嘔吐，還可能伴有便秘、腹瀉腹痛等癥狀。腹痛情況與胎動相關(guān)，腹痛明顯時胎動明顯、胎動消失、腹痛也隨之消失。到腹腔妊娠晚期，患者可能會出現(xiàn)假臨產(chǎn)的癥狀。也有部分患者因為輸卵管妊娠流產(chǎn)或者發(fā)生破裂時失血過多，可有貧血表現(xiàn)。
 
1、如果胎兒中途死亡，則患者的腹部逐漸縮小，胎動也隨之消失、患者甚至難以覺察到，但是在其他病癥就診時，檢查可以發(fā)現(xiàn)腹腔內(nèi)的塊物。
 
2、如果胎盤附著于患者的腸管，或者胎兒壓迫了腸管可引起腸梗阻癥狀。如果胎兒死亡引發(fā)感染時，患者可出現(xiàn)高熱不退的現(xiàn)象，胎兒形成膿腫后可經(jīng)過腹部或者腸道穿孔流出。只有排除胎兒之后，患者體溫才能下降，在膿液排出時可見胎兒骨骼、毛發(fā)。
 
如果胎兒存活，最典型且具有診斷意義的體征就是可以聽到母體內(nèi)的血管雜音，該雜音來自于供應(yīng)異位胎盤擴(kuò)張增粗的卵巢動脈，比子宮血管雜音聲音更響，而且常常是在胎盤種植的一側(cè)。
 

腹腔妊娠的原因

腹腔妊娠一般可以簡單劃分為原發(fā)性腹腔妊娠和繼發(fā)性腹腔妊娠兩種，所以腹腔妊娠的原因也可以分為原發(fā)性和繼發(fā)性。孕婦之所以出現(xiàn)原發(fā)性腹腔妊娠，主要是因為在受孕過程中，受精卵直接種植于腹膜、腸系膜等處。但是這種腹腔妊娠的情況極為少見。
 
那么，什么情況下會發(fā)生繼發(fā)性腹腔妊娠呢？繼發(fā)性腹腔妊娠大多都發(fā)生在輸卵管妊娠流產(chǎn)或者破裂后，受精卵或者胚胎落入患者的腹腔，有一部分絨毛組織仍然可以附著于原著床部位，并且繼續(xù)向外生長，附著在盆腔腹膜表面。
 
一般情況下，這種腹腔妊娠因為胎盤附著異常，血液供應(yīng)嚴(yán)重不足，胎兒很難存活至足月，所以要及時治療，否則對孕婦本身也有一定的傷害。
 

腹腔妊娠的治療

女性發(fā)生腹腔妊娠是一種異常的妊娠情況及過程，對其身體有很大危害，所以一經(jīng)診斷確定，就應(yīng)盡快停止妊娠，手術(shù)剖腹取出胎兒。
 
在手術(shù)過程中，要特別慎重處理胎盤。因為胎盤種植于患者的腸管或者腸系膜等處，任意剝離將會患者引起大出血。因此，對胎盤的處理手段和方法要根據(jù)其胎兒存活及死亡時間等具體情況來決定。
 
胎盤如果輸附著于子宮、輸卵管或者闊韌帶上，可直接將胎盤連同附著器宮一并切除。胎盤如果附著在患者腹膜或者腸系膜等處，再加上胎兒存活或者死亡時間不久，就不能觸動胎盤，而是應(yīng)該在緊靠胎盤處結(jié)扎并切斷臍帶后再取出胎兒。將胎盤留置于患者腹腔內(nèi)，使其自行吸收。如果沒有未吸收而引發(fā)了感染，再根據(jù)具體情況切除或者引流。
 
如果胎兒死亡死亡時間較久，那么可以嘗試剝離胎盤。手術(shù)前做好輸血準(zhǔn)備，術(shù)后及時應(yīng)用抗生素預(yù)防感染。
 

腹腔妊娠的預(yù)防

腹腔妊娠對女性而言有一定危害性，因此要預(yù)防腹腔妊娠的發(fā)生，最重要的是養(yǎng)成良好的衛(wèi)生習(xí)慣。
 
1、注意生理期的衛(wèi)生，防止生殖系統(tǒng)受細(xì)菌感染。愛護(hù)自己的身體，避免不潔性行為，做好避孕措施，減少人工流產(chǎn)次數(shù)能夠減少盆腔感染機(jī)會。不吸煙、不酗酒、積極醫(yī)治各種婦科疾病，積極產(chǎn)檢也能夠有效減少腹腔妊娠的發(fā)生概率。
 
2、積極配合醫(yī)生治療各種婦科病，比如子宮內(nèi)膜異位癥。
 
3、在使用了誘發(fā)排卵藥物之后、疑為早孕時，或者是助孕成功后，要及時排除異位妊娠、復(fù)合妊娠等異常妊娠情況。

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