adenomyosis - pathology课件

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1、UltrasoundinthemanagementofIUGRDrPhilippaRamsayMBBSFRANZCOGDDUCOGUPOWCampusCentreRPAMedicalCentreSydneyAdventistHospitalStLeonardsIntra-uterinegrowthrestrictionvsSmallforgestationalageLowbirthweight(LBW):<2500gVerylowbirthweight(VLBW):<1500gSmallforgestation(SGA):<10thpercentileofweightf

2、orgestationPretermdelivery:<37completedweeksgestationLBW-term:LBW&>37completedweeksgestationIntra-uterinegrowthrestrictionvsSmallforgestationalageIntra-uterinegrowthrestrictionAfetuswithpathologicallyimpairedgrowthofvaryingdegreesSmallforgestationalageAfetuswhoisbelowthetenthcentileforges

3、tationalageforweight,length&headcircumferenceIntra-uterinegrowthrestrictionvsSmallforgestationalageIntra-uterinegrowthrestrictionpathologicallyimpairedgrowthmaybe<10thcentileor>10thcentileSmallforgestationalagepathologicallyimpairedgrowthconstitutionallysmallPerinatalproblemsassociatedwit

4、hIUGRFetaldistressduringlabour(3-5x)MeconiumaspirationNeonatalacidosisPolycythemiaHypoglycemiaNecrotizingenterocolitisImpairedgrowth&developmentIUGR:Morbidity&MortalityManningFA1995ThirdtrimesterfetaldeathStillbirthcomplicates5/1000birthsItisoftenunexplained(12-50%)IncirpiMetal.Stillbirth

5、evaluation:whattestsareneeded.AmJObstetGynecol1998;178:1121-1125CausesoflatefetaldeathCordandplacentalcomplications10-20%Maternalhypertensivedisease5-25%Maternalmedicalcomplications5-10%Congenitalmalformations5-10%Intrauterineinfections5-15%Erythroblastosis3-15%unexplained50%PitkinRMetal.

6、Fetaldeath:diagnosisandmanagement.AmJObstetGynecol1987;157:583-589RiskofneonataldeathfromIUGRCausesofIUGR-1MaternaldiseaseChronichypertensionRenaldiseaseCardiacdiseaseMaternal&fetalMalnutritionDrugsAlcoholTobaccoCausesofIUGR-2PrimaryfetalCongenitalmalformationsChromosomalanomaliesInfectio

7、nCMV,rubella,toxoPlacentaldysfunctionPlacentalinsufficiencyInfarction&separationMultiplebirthsRiskgroupsPoornutritionPre-eclampsiaRenaldiseaseHeartdiseaseInfectionMultiplegestationsGeneticabnormalitieslowSEstatuspoormaternalweightgainREF:GalbraithRSetal.Theclinicalp