Differential diagnosis of ectopic pregnancy in the abdominal cavity

When an ectopic pregnancy occurs in the abdominal cavity, if it is a live fetus, abdominal examination can reveal that the outline of the uterus is unclear, the fetal limbs are close to the abdominal wall, the fetal position is mostly transverse, the presenting part is high, and the fetal heart sound is very clear; if it is a dead fetus, there is no fetal heart sound, and after a few months, the adhesion of organs or greater omentum surrounds the dead fetus, forming a connective tissue cyst. Gynecological examination shows that the cervix is ​​high and small, the uterus is smaller than the gestational month, and is biased to one side. The fetus can be touched next to the uterus. Attention should be paid to identification:

Abdominal mass

Gynecological abdominal masses are often ovarian tumors. Tumor growth is slower than abdominal pregnancy. There is no history of amenorrhea or pregnancy reaction. There is no sense of fetal movement, generally no abdominal pain, no sense of fetal shape during abdominal examination, and no fetal heartbeat. Gynecological examination shows that the uterus is normal in size, and the masses on one side of the appendages are mostly cystic. B-ultrasound and abdominal line examination can distinguish.

Intrauterine pregnancy

Ectopic pregnancy in the abdominal cavity should be differentiated from intrauterine pregnancy. Generally speaking, the size of the uterus in an intrauterine pregnancy is consistent with the month of amenorrhea. There is no other discomfort except pregnancy reaction. Fetal movement begins at 18-20 weeks of pregnancy. Abdominal examination shows a clear uterine outline, the fetus is wrapped in the uterus, the fetal position and fetal heart rate are clear, vaginal examination shows a soft cervix, and no other uterus can be felt next to the uterus. The cervical opening gradually opens after labor. B-type ultrasound examination shows normal pregnancy characteristics and the uterus is inside the outline.

Intrauterine pregnancy, a thick layer of soft tissue can be seen around the fetus on the plain film, representing the uterine wall, which can be identified on a good quality X-ray film. In abdominal pregnancy, the fetus is outside the uterus, surrounded by only a thin layer of amniotic sac, and there is no uterine wall between the fetus and the mother's abdominal wall, so this soft tissue shadow cannot be seen.