What is ectopic pregnancy Ectopic pregnancy, also known as ectopic pregnancy, is called ectopic pregnancy when the fertilized egg is deposited in any part of the uterine cavity other than the uterus. According to the different parts of the uterine cavity, there are tubal pregnancy, ovarian pregnancy, abdominal pregnancy, cervical pregnancy and uterine stump pregnancy. Ectopic pregnancy is one of the most common gynecologic emergencies and is often missed and misdiagnosed, which increases the potential danger. The more common type of ectopic pregnancy is tubal pregnancy, in which the fertilized egg grows larger and larger within one to two months after menopause thereby bursting the fallopian tube, causing hemorrhage, shock and even endangering the woman’s life. There is no obvious difference between ectopic pregnancy and normal pregnancy in the early stage, but as the embryo grows up, it can penetrate the wall of the fallopian tube or abort from the umbilical end of the fallopian tube to the abdominal cavity, resulting in intra-abdominal hemorrhage, and even threatening the pregnant woman’s life due to hemorrhagic shock. Therefore, it is necessary to diagnose as early as possible and make corresponding treatment in time. I. Diagnosis 1. Posterior fornix puncture: Since intra-abdominal blood is most likely to accumulate in the uterorectal recess, even if the amount of blood is not much, it can be suctioned out through posterior fornix puncture. If an 18-gauge long needle is used to puncture the uterorectal cavity from the posterior vaginal fornix, the extraction of dark red non-coagulable blood will be a positive result, indicating the presence of intra-abdominal blood accumulation. 2.Pregnancy test: When the embryo survives or the trophoblast cells are viable, the syncytiotrophoblast cells secrete hCG, and the pregnancy test can be positive. As the hCG level in ectopic pregnancy patients is lower than that in normal pregnancy, the general hCG measurement method has a low positive rate, and more sensitive β-hCG radioimmunoassay or monoclonal antibody enzyme labeling method must be used for detection. 3, ultrasound diagnosis: early tubal pregnancy, ultrasound visualization of the uterus can be seen to increase, but the uterine cavity is empty, there is a hypoechoic area next to the uterus. This image is not the acoustic characteristics of tubal pregnancy, and it is necessary to exclude the possibility of early intrauterine pregnancy with gestational corpus luteum. Ultrasound detection of gestational sac and fetal heartbeat is very important for the diagnosis of ectopic pregnancy, such as pregnancy is located outside the uterus, can be diagnosed as ectopic pregnancy; gestational sac is located in the uterus, can be excluded from the ectopic pregnancy. ultrasound early diagnosis of interstitial pregnancy is clinically important, can be shown to be protruding uterine horns on the side of the uterus, the local myometrium is thickened, with a clear gestational sac. 4, laparoscopy: laparoscopy can be used when necessary. 5, endometrial pathology: diagnostic scraping is only applicable to patients with more vaginal bleeding, the purpose is to exclude intrauterine pregnancy. Uterine cavity discharge should be routinely sent to the pathology examination, slice if you see villi, can be diagnosed as intrauterine pregnancy, such as only see meconium and no villi, although should be considered as ectopic pregnancy, but can not be diagnosed. Second, the treatment of ectopic pregnancy 1, surgical treatment: the principle of the treatment of tubal pregnancy to surgical treatment. Generally, surgery should be carried out after diagnosis. Surgery generally adopts total salpingectomy. Those who have sterilization requirements can ligate the opposite side of the fallopian tube at the same time. For young women with fertility requirements, if the contralateral fallopian tube has been removed or has obvious lesions, conservative surgery is feasible to preserve the fallopian tube and its function. According to the patient’s general condition, the location of the pregnant egg and the degree of tubal pathology to choose the operation, such as umbilical pregnancy pregnancy pregnant egg pressure out of the operation, juxtapubic pregnancy incision to remove the pregnant egg, isthmus pregnancy feasible foci of excision and end of the anastomosis, the use of microsurgical techniques can improve the pregnancy rate. The treatment of tubal interstitial pregnancy can be performed according to the lesion condition with hysterectomy or total hysterectomy on the affected side of the uterine horn. In recent years, laparoscopy has been carried out at home and abroad to diagnose and treat tubal pregnancy. Autologous blood transfusion is one of the effective measures to rescue acute ectopic pregnancy, especially important in the absence of blood source. Recovery of intraperitoneal blood must meet the following conditions: pregnancy time less than 12 weeks, unbroken membranes, bleeding time less than 24 hours, blood is not contaminated, microscopic erythrocyte rupture rate is less than 30%. 2, drug treatment: Chinese medicine treatment is still one of the means of treatment of tubal pregnancy in China. Advantage is that it eliminates the trauma of surgery, preserves the affected fallopian tube, and can also treat the coexisting inflammation and adhesion, so as to restore the function of the fallopian tube. According to the Eight Syllabus of Chinese Medicine, this disease belongs to the actual symptom of stasis obstruction in the lower abdomen, and pain is caused by the lack of communication, so it is treated by the principle of activating blood circulation to eliminate blood stasis, and eliminating and stopping hemorrhage. The main formula is Danshen, Red Peony, Peach Kernel, and then add and subtract according to the symptoms. Acute hemorrhagic type is added with Dosan Tang or Ginseng and Forsythia Tang; hematoma mass type is added with Sanlang and Curcuma longa. Combination of traditional Chinese and western medicine treatment should strictly grasp the indications for surgery, where interstitial pregnancy, severe intra-abdominal bleeding, conservative treatment is not effective or the embryo continues to grow should be operated as early as possible. Third, the health care after ectopic pregnancy 1, pay attention to diet and nutrition, ensure protein intake. 2.Combine work and rest, do not do heavy physical labor, minimize abdominal pressure, constipation can be used light laxative, to prevent the rupture of the mass. 3.Regular follow-up: one month after discharge from the hospital or after menstruation, come back to the hospital for examination and retest ultrasound.