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妇产科学英语课件之李桂英-Fetal Distress, Preterm Labour, Pregnacy associated Syndrome
Fetal distress
Obstetrics and Gynecology hospital of Fudan University
Guiying Li, Associate Professor ;Definition
The term fetal distress describes the condition that the health, even the life of the fetus is threatened by acute or chronic oxygen deficiency, with a series of symptoms of hypoxia, acidosis,hypercapnia,hyperlactacidemia etc.;Damage
The main reason leading to the death of fetus and neonate.
The main reason causing mental retardation of children.
60% of genetic counseling of congenital diseases is mental retardation;
90% of mental retardation is due to oxygen deficiency during antepartum, intrapartum or postpartum and 10% genetic factors;
In condition of severe asphyxia, 4.1% suffer from mental retardation;
When neonatal asphyxia is improved in 20 minutes, 36.4% retard mentally.;;Etiology
Five key aspects of gaining adequate gas exchange for fetus
Sufficient oxygen in maternal blood
Smooth blood circulation of uterine placenta
Normal gas blood exchange in villi gap
Unobstructed umbilical blood circulation
Normal cardiopulmonary function and hemoglobin of fetus;Category
Acute fetal distress mainly happens in labor stage. Reasons: prolapse of umbilical cord, placenta previa, placental abruption, prolonging of labor stage, uterine overcontraction or incordination.
Chronic fetal distress often happens in late pregnancy. Reasons: hypertensive disorders complicating pregancy, chronic nephritis, diabetes mellitus, severe anemia, ICP, postterm pregnancy.
;Clinical Manifestation
Fetal movements (FM) decrease or disappear: FM10 times/12hours or 3 times/hour, and fetal heart rates can suddenly disappear after FM diappear for 24 hours.
Fetal heart rates become faster or slower.
Meconium-stained amniotic fluid: oxygen deficiency causes gastrointestinal vasoconstriction, hyperperistalsis, anal sphincter relaxation, meconium discharge and pollution of amniotic fluid.
Oligohydramnios: oxygen deficiency leads to vasocontriction of renal vessel, re
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