最后审阅: 18 九月 2021
最后更新: 05 八月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 阴道出血,伴有或不伴有血块

其他诊断因素

  • 耻骨弓上疼痛
  • 腰痛
  • 近期性交后出血
  • 子宫结构异常
  • 外伤史

危险因素

  • 老年
  • 子宫畸形
  • 细菌性阴道病
  • 血栓形成倾向
  • 父母染色体异常
  • 维生素 D 缺乏
  • 既往自然/人工流产
  • 不孕症/辅助受孕
  • 非甾体抗炎药 (NSAID)
  • 咖啡因
  • 酒精
  • 吸烟
  • 超重/肥胖
  • 甲状腺功能障碍
  • 糖尿病

诊断性检查

首要检查

  • 经阴道超声扫描
  • 血清 β-hCG 滴度

需考虑的检查

  • 经腹超声扫描
  • 血清孕酮
  • 尿妊娠试验
  • 全血细胞计数(FBC
  • RH 血型
  • 狼疮抗凝物/抗心磷脂抗体
  • 盆腔超声检查
  • 妊娠产物的细胞遗传学分析
  • 双亲核型
  • 阴道拭子

治疗流程

撰稿人

作者

Ida Muslim, MBChB, MRCOG

Consultant Obstetrician & Gynaecologist

The Women’s Centre

Gloucestershire Royal Hospital

Gloucester

UK

利益声明

IM declares that she has no competing interests.

Jothi Doraiswamy, MBBS, MRCOG

Locum Consultant in Obstetrics and Gynaecology

Gloucestershire Royal Hospital

Gloucester

UK

利益声明

JD declares that she has no competing interests.

鸣谢

Dr Ida Muslim and Dr Jothi Doraiswamy would like to gratefully acknowledge Dr Isaac Babarinsa and Professor Tim Draycott, previous contributors to this topic.

利益声明

IB and TD declare that they have no competing interests.

同行评议者

Jo Trinder, MD

Consultant Obstetrician and Gynaecologist

St Michael's Maternity Wing

Bristol Royal Infirmary

Bristol

UK

利益声明

JT is the primary author of one randomised controlled trial cited in this topic. This trial was funded by an NHS Research and Development Grant and a donation from Exelgyn, the manufacturer of misoprostol. JT has accepted honoraria for speaking to groups of midwives and doctors about miscarriage management.

John Bachman, MD

Consultant in Family Medicine

Parker D Sanders and Isabella Sanders Professor of Primary Care

Rochester

MN

利益声明

JB declares that he has no competing interests.

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