(精编)【医学教学课件】早产.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;1. Bed rest： 2. Corticosteroids: to accelerate fetal lung maturity Betamethason 倍他米松: 12mg IM 1/24 hr ×2 doses Dexamethasone地塞米松: 6 mg IM 1/12 hr × 4 doses 3. Antibiotics: no benefit in delaying preterm birth. 4. Tocolysis：; ; Some cases in which preterm labor should not be suppressed. Maternal factors: Fetal factors: Maternal factors: Severe hypertensive disease Pulmonary or cardiac disease Advanced cervical dilation Maternal hemorrhage;Fetal factors: Fetal death or lethal anomaly Fetal distress Intrauterine infection Therapy adversely affecting the fetus Estimated fetal weight≥2500g Erythroblastosis fe