(精选)Antepartum Hemorrhage教学课件.pptVIP

Chapter 12 AntepartumHemorrhage;一.? Placenta PreviaDefinition ：  After 28 pregnant weeks placental implantation over the cervical os or in the lower uterine segment.;Etiology ： The cause of placenta previa remains unclear . but possi-ble etiologic factors. as 1、poorly vascularized endometrium. 2、large placenta. 3、Abnormal placenta 4、placenta implanted in the lower  uterine segment;Classification1、cmplete placenta previa.2、partial placenta previa3、marginal placenta previa  ; Clinical manifeslation1、symptoms： sudden painless vaginal bleeding ,bleeding results from detachment of placental tissue as the lower uterine lengthens and the subsequent Inability; of the lower segment to contract , vessels contrict to stop the bleeding 。2、signs: uterus usually is soft and  nontender , the fetal presenting  part is not into the pelvic inlet 。;Diagnosis 1、History, After 28 pregnant  weeks , sudden painless  intermittent vaginal bleeding .2、Sings , anaemia or shock . 3、Vaginal examination  preparations for transfusion  opreration delivery , if the  diagnosis of placenta previa; is sufficient or profuse vaginal  bleeding , the vaginal examina- tion should be omitted .4、ultrsound examination .5、examination of the placental and  fetalmembrane After delivery.;Etiology1、Local vascular injury results in  vascular rupture into the decidua  basalis, bleeding , and hematoma formation。2、Mechanical factors 3、abrupt uterine contract4、uterine venous pressure rise  abruptly ;Classification1、revealed 2、concealed 3、mixed Patho physiology blood can be trapped between plancenta and uterine wall ， then infiltrates the uteine wall uteropla-cental apoplexy。;Clinical manifestation1、characterized by vaginal bleeding  uterine irritability maternal blood  pressure serum fibrinogen le