产科并发症（英文）PPT课件.ppt

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

2、een1000and2499g.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:Severehypertensivestateorpregn

3、ancyAnatomicdisorderoftheplacenta(abruptioplacentae,placentaprevia)PrematureruptureofmembranesPolyhydramniosoroligohydramniosMultiplepregnancyPreviouslaceration（裂伤）ofcervixoruterus2.Medicalcomplications:PulmonaryorsystemichypertensionRenaldiseaseHeartdiseaseInfection:genitalt

4、ractinfection,urinarytractinfection,pyelonephritis肾盂肾炎,acutesystemicinfectionHeavycigarettesmokingAlcoholismordrugaddictionSevereanemia3.Surgicalcomplications:Conizationofcervix宫颈锥切术Previousincisioninuterusorcervix(cesareandelivery剖宫产术)4.GenitaltractanomaliesBicornuate双角,subs

5、eptate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-changeindilatationoreffacem

6、entofatleast1cmoracervixthatiswelleffacedanddilatated(atleast2cm);2.LaboratoryStudiesCompletelybloodcountwithdifferentialCervixdischargecultures：shouldbesentforgonorrhea淋病andchlamydia衣原体.Fetalfibronectin纤连蛋白（Ffn):negativetestiseffectiveatrulingoutimminentdelivery(within2weeks

7、)；positivetest（Ffn>50ng/ml):resultissensitiveatpredictingpretermbirth.分泌物3.Accessoryexamination:Ultrasoundexaminationforfetalsize,position,placentalocation，andcervicallength.Cervicallength>30nm:prognosticatingprematuredelivery.Infundibulum漏斗lengthofcervicalinternalos>25%Cervi

8、callengthorAmniocentesistoascertainfetallungmaturity,theamniofluid羊水