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LATERPREGNANCYCOMPLICATIONS.ppt

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LATERPREGNANCYCOMPLICATIONS.ppt

Content Premature delivery Prolonged pregnancy Premature Rupture of Membranes ( PROM) Definition: Preterm Labor: Labor occurs after 28 weeks’ but before 37 weeks’ (ie.196~258days) gestation. Infants born during these phase are premature infants. The premature infant’s weight is between 1000 and 2499g. The prognosis of the premature infant is correlated with its gestational age, weight. Premature infant Etiology: 1.Obstetric complications 产科并发症 2.Medical complications 内科并发症 3.Surgical complications 外科并发症 4.Genital tract anomalies 生殖道畸形 1.Obstetric complications: Severe hypertensive state or pregnancy Anatomic disorder of the placenta( abruptio placentae, placenta previa) Premature rupture of membranes Polyhydramnios or oligohydramnios Multiple pregnancy Previous laceration(裂伤) of cervix or uterus 2.Medical complications: Pulmonary or systemic hypertension Renal disease Heart disease Infection: genital tract infection, urinary tract infection, pyelonephritis肾盂肾炎, acute systemic infection Heavy cigarette smoking Alcoholism or drug addiction Severe anemia 3.Surgical complications: Conization of cervix宫颈锥切术 Previous incision in uterus or cervix ( cesarean delivery剖宫产术) 4.Genital tract anomalies Bicornuate双角, subseptate纵隔, or unicormuate单角 uterus Congenital cervical incompetency先天性宫颈闭合不全 Clinical Finding Diagnosis 1.Symptom and Sign Uterine contractions—more than 2 in one-half hour; Vaginal bleeding-bloody mucous vaginal discharge or “bloody show”; Dilatation扩张 and effacement消退 of cervix-change in dilatation or effacement of at least 1cm or a cervix that is well effaced and dilatated (at least 2 cm); 2. Laboratory Studies Completely blood count with differential Cervix discharge cultures :should be sent for gonorrhea淋病 and chlamydia衣原体. Fetal fibronectin纤连蛋白(Ffn): negative test is effective at ruling out imminent delivery(within 2 weeks); positive test (Ffn50ng/ml): result

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