預防早產新觀念_Prevention of preterm parturition預防早產新觀念预防早产分娩课件.ppt

13 to 28 of the pregnancy are called the second trimester * Müllerian anomalies affect up to four percent of females. The anomaly is considered a congenital disorder, meaning it occurs during?fetal development?and is present at birth. As an embryo forms, two paired müllerian ducts develop into the?female reproductive?tract which includes the fallopian tubes, uterus, cervix, and upper two thirds of the vagina. A wide variety of malformations can occur when this system is disrupted. There is not one cause of müllerian anomalies. Some may be hereditary, others may be attributed to a random?gene mutation?or developmental defect. Diethylstilbestrol?(DES, former?BAN?stilboestrol) is a synthetic nonsteroidal?estrogen?that was first synthesized in 1938. DES (in tablets up to 5?mg) was approved by the United States?Food and Drug Administration?on September 19, 1941 for four indications:?gonorrheal?vaginitis,?atrophic vaginitis,?menopausal?symptoms, and postpartum?lactation?suppression to prevent breast engorgement.[5]?The gonorrheal vaginitis indication was dropped when the?antibiotic?penicillin?became available. From its very inception, the drug was highly controversial From the 1940s until the late 1980s, DES was FDA-approved as?estrogen-replacement therapy?for estrogen deficiency states such as?ovarian dysgenesis,?premature ovarian failure, and after?oophorectomy. ES-exposed daughters are at an increased risk of abnormalities of the reproductive tract, including vaginal epithelial changes (which as vaginal adenosis, means a type of tissue develops on the surface of the vagina that is not generally found there), an increased cervical transformation zone, and uterine abnormalities, such as?T-shaped uterus. * Hysterosalpingography?(HSG) is a?radiologic?procedure to investigate the shape of the uterine cavity and the shape and patency of the?fallopian tubes. It entails the injection of a radio-opaque material into the?cervical?canal and usually?fluoroscopy?with image intensi