产科并发症【精品推荐-ppt】.pptVIP

LATER PREGNANCY COMPLICATIONS;Premature delivery Prolonged pregnancy Premature Rupture of Membranes( PROM) ;PRETERM LABOR 早 产; 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: 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;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 is sensitive at predicting preterm birth.分泌物;3. Accessory examination: Ultrasound examination for fetal size, position, placenta location，and cervical length. Cervical length30nm: prognosticating premature delivery. Infundibulum漏斗 length of cervical internal os25% Cervical length or Amniocentesis to ascertain fetal lung maturity, the amnio fluid羊水 be tested for lecithin卵磷脂/ sphingomyelin鞘磷脂 (L/S) ratio ; principle