【医学ppt课件】早产

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1、LATERPREGNANCYCOMPLICATIONSDONGMEIHUDepartmentGynecology&ObstetricsZhujiangHospitalSouthMedicalUniversityPrematuredeliveryProlongedpregnancyPrematureRuptureofMembranes(PROM)ContentPRETERMLABOR早产PretermLabor:Laboroccursafter28weeks’butbefore37weeks’(ie.196~258da

2、ys)gestation.Infantsbornduringthesephaseareprematureinfants.Theprematureinfant’sweightisbetween1000and2499g.Theprognosisoftheprematureinfantiscorrelatedwithitsgestationalage,weight.Definition:PrematureinfantMatureinfantEtiology:1.Obstetriccomplications产科并发症2.Med

3、icalcomplications内科并发症3.Surgicalcomplications外科并发症4.Genitaltractanomalies生殖道畸形1.Obstetriccomplications:SeverehypertensivestateorpregnancyAnatomicdisorderoftheplacenta(abruptioplacentae,placentaprevia)PrematureruptureofmembranesPolyhydramniosoroligohydramniosMult

4、iplepregnancyPreviouslaceration（裂伤）ofcervixoruterus2.Medicalcomplications:PulmonaryorsystemichypertensionRenaldiseaseHeartdiseaseInfection:genitaltractinfection,urinarytractinfection,pyelonephritis肾盂肾炎,acutesystemicinfectionHeavycigarettesmokingAlcoholismordruga

5、ddictionSevereanemia3.Surgicalcomplications:Conizationofcervix宫颈锥切术Previousincisioninuterusorcervix(cesareandelivery剖宫产术)4.GenitaltractanomaliesBicornuate双角,subseptate纵隔,orunicormuate单角uterusCongenitalcervicalincompetency先天性宫颈闭合不全ClinicalFinding&Diagnosis1.Sympt

6、omandSignUterinecontractions—morethan2inone-halfhour;Vaginalbleeding-bloodymucousvaginaldischargeor“bloodyshow”;Dilatation扩张andeffacement消退ofcervix-changeindilatationoreffacementofatleast1cmoracervixthatiswelleffacedanddilatated(atleast2cm);2.LaboratoryStudiesCo

7、mpletelybloodcountwithdifferentialCervixdischargecultures：shouldbesentforgonorrhea淋病andchlamydia衣原体.Fetalfibronectin纤连蛋白（Ffn):negativetestiseffectiveatrulingoutimminentdelivery(within2weeks)；positivetest（Ffn>50ng/ml):resultissensitiveatpredictingpretermbirth.分泌物

8、3.Accessoryexamination:Ultrasoundexaminationforfetalsize,position,placentalocation，andcervicallength.Cervicallength>30nm:prognosticatingprematuredelivery.Infundibulum