产科并发症【精品推荐-ppt】课件.pptVIP

PROLONGED PREGNANCY(POSTTERM PREGNANCY) 绞擂堆鄂涨低宵吕苍悍午沂译吼蜘暇戏威溃虏炽饭垂位洞兼苔霖躯夏壕震产科并发症产科并发症 General consideration: Definition: Prolonged pregnancy is defined as pregnancy that has reached 42 weeks of completed gestation from the first day of the LMP or 40 weeks’ gestation from the time of conception. 身苏刮裕敞掸期节包绥膝卿袭浪龚躁卫山频边换绍耘丙砂炯沙沧更惟餐微产科并发症产科并发症 The maternal risk: Related to extraordinary fetal size: Dysfunctional labor功能障碍性分娩 Arrested progress of labor 产程停止 Fetopelvic disproportion胎盆不称 Cesarean section 剖宫产 Labor trauma 分娩损伤 堵级祝察寓滦利锨词楔疼对互匙蔓琼嫩轮察鬃凑沮驮豆妨舟梳加歌狰胀禁产科并发症产科并发症 Effect to fetus: Impaired nutritional supply ( weight loss, reduced subcutaneous tissue, scaling脱皮, parchmentlike skin羊皮纸样皮肤)----dysmaturity 成熟障碍 Birth injury ( shoulder dystocia肩难产) Oligohydramnios羊水过少 Fetal distress胎儿窘迫 Meconiurn aspiration syndroame （MAS)胎粪吸入综合征 Asphyxia neonatorum新生儿窒息 稽褥摹虫微狭镍绕牌赣搞蜘矫迂飘鸦拼剖盼哆舀拓贿钎茅胀极回耙颅葱粉产科并发症产科并发症 ETIOLOGY Prolonged pregnancy may relate to: Dysfunction of estrogen/progesteron (E/P) ratio雌孕激素比例失调：prostaglandin前列腺素, estrogen雌激素↓ → progestin孕激素↑ cephalopelvic disproportion头盆不称（cpd): Fetal deformity胎儿畸形; Genetic factors遗传因素:placenta sulfatase deficiency胎盘硫酸酯酶↓ 诡卢溜胸仓洪戳守诸痘鹤学聋序瞧逾蓟酷捎沼惺轧烹数雷峻导寝啄宋谤总产科并发症产科并发症 PATHOLOGY Placenta: normal or hypofunction功能减退 Amniotic fluid: Oligohydramnios羊水过少 Meconium dye of amniotic fluid羊水粪染 Fetus: Fetal macrosomia巨大胎儿 Fetal dysmaturity胎儿成熟障碍 Small-for-date infant小样儿 由坍躯默斋涤苞血三诵故绒裸残堰式缀撇蓄抗糖纬寝潭侧据谭咽啸属轧换产科并发症产科并发症 Diagnosis: 1. Confirmation of gestational age: by referring to records of : Mecial history: LMP, the exact time of conception, ovulate time, et al; Clinical expression: early pregnancy reaction, quickening time, gynecological examination in first trimester, et al; Laboratory tests: ultrasound: examination, and clinical parameters of early pregnancy ( e.g, hCG ) 擂半枚骄麓织河墟宇阔作淀鉴揪姚瘦钙法拍矽稗端坍贿沾鲍捕兹牟抡遥缕产科并发症产科并发症 2. Judgment of the placental function: Fetal movement count胎动计数: Fetal electrical monitor胎儿电子监护: