子宫破裂8ppt课件.ppt

生活家饮食保健孕期选择食用油的学问邢台市第四病院罕见护理应急预案猪气喘病综合防制技术动物营养系列理想蛋白与氨基酸模式的研究进展皮肤病的诊断包括病史体格检查和必要的实验室检查我国有关食物添加剂营养强化剂食物新资本的治理律例与标准 Rupture of uterus 子宫破裂 Lin Jianhua M.D., Ph.D., Professor Department Of Obstetrics Gynecology Renji Hospital Affiliated to SJTU School of Medicine Definition Separation of the muscular wall of the uterus usually occurs during labor occasionally happen during the later weeks of pregnancy causes During pregnancy weak scar after previous operations on the uterus History of cesarean section (VBAC,vaginal birth after c- section) myomectomy excision of a uterine septum previous perforation of uterus(DC, hysteroscopy, forceps delivery During labor: uterine hyper-stimulation(oxytocin with pitocin induction or argmentation of labor) obstructed labor(macrosomia, feopelvic dispropotion) intrauterine manipulation(internal version,manual removal of an adherent placenta) forcible dilatation(cervical tear) a weak scar(C-section or other operations) types Incomplete rupture complete rupture depending on whether the peritoneal coat is torn through or not Symptoms and signs 1. Rupture of scar be gradual that symptom is very slight in incomplete rupture abdominal pain wrongly attributed to the onset of labor severe pain and shock occurs in complete (suddenly pain) fetal distress bleeding in vagina 2.Spontaneous rupture during obstructed labor prolonged labor violent uterine actions, *pathologic retraction ring disporpotion, malpresentation(transverse lie) fetal distress a sharp, tearing pain in lower abdomen pulse rapid blood pressure fall fetus may be felt in the abdominal cavity 3. Rupture by oxytocin drugs: be follow the administration of oxytocin the danger is less if the drug is given as a dilute intravenous drip given in an increasing fashion Prognosis has a high mortality peri-natal morbidity is high 生活家饮食保健孕期选择食用油的学问邢台市第四病院罕见护理应急预案猪气喘病综合防制技术动物营养系列理想蛋白