《产科并发症英》PPT课件

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1、LATERPREGNANCYCOMPLICATIONSPrematuredeliveryProlongedpregnancyPrematureRuptureofMembranes(PROM)ContentPRETERMLABOR早产PretermLabor:Laboroccursafter28weeks’butbefore37weeks’(ie.196~258days)gestation.Infantsbornduringthesephaseareprematureinfants.Theprematureinfant’sweightis

2、between1000and2499g.Theprognosisoftheprematureinfantiscorrelatedwithitsgestationalage,weight.Definition:Etiology:1.Obstetriccomplications产科并发症2.Medicalcomplications内科并发症3.Surgicalcomplications外科并发症4.Genitaltractanomalies生殖道畸形1.Obstetriccomplications:Severehypertensivestat

3、eorpregnancyAnatomicdisorderoftheplacenta(abruptioplacentae,placentaprevia)PrematureruptureofmembranesPolyhydramniosoroligohydramniosMultiplepregnancyPreviouslaceration（裂伤）ofcervixoruterus2.Medicalcomplications:PulmonaryorsystemichypertensionRenaldiseaseHeartdiseaseInfect

4、ion:genitaltractinfection,urinarytractinfection,pyelonephritis肾盂肾炎,acutesystemicinfectionHeavycigarettesmokingAlcoholismordrugaddictionSevereanemia3.Surgicalcomplications:Conizationofcervix宫颈锥切术Previousincisioninuterusorcervix(cesareandelivery剖宫产术)4.GenitaltractanomaliesB

5、icornuate双角,subseptate纵隔,orunicormuate单角uterusCongenitalcervicalincompetency先天性宫颈闭合不全ClinicalFinding&Diagnosis1.SymptomandSignUterinecontractions—morethan2inone-halfhour;Vaginalbleeding-bloodymucousvaginaldischargeor“bloodyshow”;Dilatation扩张andeffacement消退ofcervix-changei

6、ndilatationoreffacementofatleast1cmoracervixthatiswelleffacedanddilatated(atleast2cm);2.LaboratoryStudiesCompletelybloodcountwithdifferentialCervixdischargecultures：shouldbesentforgonorrhea淋病andchlamydia衣原体.Fetalfibronectin纤连蛋白（Ffn):negativetestiseffectiveatrulingoutimmin

7、entdelivery(within2weeks)；positivetest（Ffn>50ng/ml):resultissensitiveatpredictingpretermbirth.分泌物3.Accessoryexamination:Ultrasoundexaminationforfetalsize,position,placentalocation，andcervicallength.Cervicallength>30nm:prognosticatingprematuredelivery.Infundibulum漏斗lengtho

8、fcervicalinternalos>25%CervicallengthorAmniocentesistoascertainfetallungmaturity,theamniofluid羊水