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The patient Yan Hong (pseudonym) was a bit annoying recently because unexpected pregnancy disrupted her original career and living plan.After thinking with her husband for a long time, she finally decided to give up the child.However, after coming to the hospital for consultation, she began to tangle again.
Because there are two ways of "surgery" and "drugs", each of which is mainly beneficial and disadvantages. How to choose it or she must be determined by her own, so this problem is placed in front of Yan Hong …
Patient Yan Hong is 35 years old and is an employee of a local company with two boys.She usually has a regular menstruation, and the cycle is about 25 days, but since the end of September 10th, she has not had a sign of menstruation in October.At first she didn’t care too much, and felt that it was just a short period of posture, but the symptoms of vomiting and sleepiness followed her alert, suspecting that she was pregnant unexpectedly.
Therefore, the patient went to the pharmacy to buy early pregnancy test sticks. Because the morning urine was measured more accurately, it was decided to use it on the morning of the 15th.At five o’clock, she quickly went to the toilet to test, and the pregnancy test stick prompted two red lines. Seeing this, she was stunned for a moment.In less than two hours, the blood HCG results returned, and the value> 100,000, prompting pregnancy.After getting this result, Yan Hong and her husband were very entangled with whether the child wanted the child. After repeated thinking, he finally decided not to want this child.
The next day, the patient found the results of the examination of the examination of the foreign hospital. After seeing the patient’s blood HCG value, I conducted a specialized physical examination and influencing academic examination.Among them, the tip of the examination: The president of the lower abdomen shows about 8.0cm surgical scars, and there is no tenderness.The gynecological examination can be seen: the vulva develops normally, the vagina is smooth, and a small amount of white secretions; the cervical column, smooth, no pain; no obvious abnormalities are seen in double attachments.Ultrasonic reminder: See 1.9*1.6cm gestational sac in the uterine cavity, and the yolk sac, fetal buds and primitive heart tube beating in the uterine cavity.
Therefore, after understanding the patient Yan Hong’s demand and the results of related examinations, the outpatient clinic was "early pregnancy, requiring to terminate pregnancy, and scar uterus" to take admission.
After learning that I was pregnant, the patient checked a lot of miscarriage information on the Internet. Some suggestions were abortion of drugs, and some suggestions were surgical abortion. Seeing different suggestions, the patient Yan Hong was chaotic.good?Therefore, on the first day of hospitalization, she found me and asked the specific way of abortion.
Divine abortion and surgical abortion are the main ways to abortion. They have their own advantages and disadvantages, which are suitable for different people. Among them, the drug abortion is generally orally by oral methalone tablets and macaro.Then the uterine contraction forced the embryo to be excreted from the body.However, the drug flow has strict indications and contraindications. It is usually used for women under 40 years of age and within 7 weeks (49 days).Increase.
Because the patient had menopause for 40 days, the ultrasound was visible to the gestational sac, and the willingness to terminate pregnancy was clearly required.After improving the five conventional examinations such as coagulation and routine urine, the taboos of no medicinal flow were clear, and the drug abortion was used for drug abortion on the second day of admission.After the gestational sac is discharged, review the ultrasound prompt in the uterine cavity to explore the uneven quality echo group with a range of 3.9cm*1.0cm.
After the completion of the Qing Palace, the patient had no obvious abnormalities.
1. Take meterone and maco anterior glycol to fast and ban drink one hour before and after. The drug should be delivered with cold water.
2. After taking the medicine, some patients have symptoms of gastrointestinal discomfort such as nausea and vomiting or diarrhea. After these symptoms occur, the doctor is notified in time, and targeted treatment measures are taken in accordance with the doctor’s advice.
3. After taking the front alcohol tablets, pay attention to the leaving discharge in the container. If there is suspicious embryo tissue, use the call device to notify the medical staff in time.
4. Abdominal pain and vaginal bleeding during the medication. If you urinate, please help your family to support it, especially at night, please be sure to follow.Bleeding or abdominal pain at night must be informed of the nurse, especially the scar uterus (such as the history of cesarean section).
After the drug flow was completed, the result of the review of the ultrasound was the uneven quality echo group in the uterine cavity, and the range was 3.9cm*1.0cm, which prompted incomplete abortion.After the completion of the Qing Dynasty, the patient was in good condition, no obvious discomfort, and no performance of fever and abdominal pain.
Since the patient’s request to be discharged, it was successfully discharged after the physical examination and examination and confirming that the patient’s condition was better. However, in order to avoid vaginal bleeding and monitoring the treatment effect, he asked him to return to the hospital to review regularly.
1. Forbidden sexual life and basin bath in January.
2. After the drug is aborted, you should go to the hospital for review on time. If there are more bleeding, abdominal pain, etc.
3. After receiving the drug flow, women should at least take at least 3 days to rest, so that the body can be fully rest and recovered, and avoid excessive fatigue.Some traditional Chinese medicines with activating blood circulation can be used to promote uterine contraction and excrete embryo tissue, which can reduce the amount of bleeding and bleeding time.
4. Pay attention to the dietary tonic after the clearing palace, eat more high -quality protein to enhance your physique, and at the same time eat some blood supplement foods, prohibit greasy and stimulate food.
5. Immediately after abortion, efficient contraceptive measures should be implemented to avoid re -pregnancy again.
Yan Hong (pseudonym) has experienced many patients with abortion in the drug flow and abortion. As for the good choice of medicine, the flow of people is good. In fact, there are strict indications in clinical practice.
However, before miscarriage, patients need to conduct a comprehensive examination of patients, including hematuria routine, leucorrhea routine, gynecological examination, infection project screening, blood type, coagulation time, ultrasound, etc., to determine that patients are intrauterine pregnancy.Only after it is determined that it is internal pregnancy, can drug flow or abortion.
As for which treatment method to choose, the specific analysis is required:
If the patient is not more than 40 years old, pregnancy is within 49 days, and the liver function is normal. If there is no obvious taboos, you can choose the drug flow.
If the patient is pregnant within 10 weeks, there is no serious internal medicine disease, and those with no obvious uterine position or morphological abnormalities are suitable for abortion.However, some special circumstances, such as those who are not easy to expose cervix, those with uterine fibroids, those with uterine scars, cervical pregnancy, uterine scar pregnancy, etc. The flow of people is very risky.Essence
Because of the 40 days of menopause and no obvious taboos, the patients at this diagnosis were finally decided to adopt a meterone+maco -macaroline drug flow.After 3 days of drug abortion, the review of the ultrasound reminding abortion incomplete abortion, so the Qing Dynasty surgery was thoroughly eliminated by the tissue left in the uterine cavity.
Although the abortion operation of the drug is relatively simple and safer, it still hurts patients.Therefore, for childcare women who do not have pregnancy, they should take contraceptive measures in sex to avoid accidental pregnancy again.
Name: Shi Yitong
Unit: Hegang People’s Hospital
Department: Gynecology
Title: Indications
