妇产科课件-female genital system infection课件.pptx

Female Genital System infection Wang Yu MD PhDDepartment of Obstetrics and GynecologyRen Ji Hospital, School of Medicine ,Shanghai Jiao Tong UniversityNatural defenses of genital tractVulvaInherent resistance to infectionFungicidalProper apposition of introitus by of labiaVaginaClose apposition of vaginal wallWell developed stratified squamous epitheliumVaginal floraVaginal acidityCervixFunctional closure of cervixThick mucus plugImmune –abundance of plasma cell in sub epithelial layer and high concentration of cytotoxic T cell Uterus Periodic shedding of surface endometrium during mensesTubesPeristalsis movementContents Vulvovaginal infectionCervicitisPelvic inflammatory disease (PID)Section 1 Vulvovaginal infectionVulvitisBartholinitis/Bartholin’s cystTrichomonas vaginitisCandidiasisBacterial vaginosisAtrophic vaginitisLactobacilliSelf-cleaningThicken vaginal epitheliumResistance↑Result in large quantities of glycogen in epithelial cellsKill or inhibit pathogensLactic acid production↑Produce H2O2Acid environment (3.5-4.0)Promote growth of normal vaginal floraVulvitisEtiology Contamination by urine, stool, and Vaginal secretionsCarbohydraturia stimulation in DMDamp in vulvaClinical findings PainItchingburning sensationCongestion, swelling and anabrosis in vulva Clinical findings Treatment Treat with primary diseaseHip bath with 0.1% povidone iodine or 1/5000 potassium permanganateKeep dry in vulvaBartholinitis/Bartholin’s cystAnatomy of Bartholin’s glandsPosition: the base of each bulbOpeningSecretion: viscid, clear and stringyEtiology Infection Congenital narrowing of ductObstruction of main duct of bartholinRetention of secretions and cystic dilatationClinical findings BartholinitisPainTendernessDyspareuniaSurrounding tissues become edematous and inflamedFluctuant, tender massBartholin’s cystNo systemFluctuant mass can be palpableClinical findings Treatment Drain the abscess Marsupialization for preservation of the gland functionAntibiotics (Ampicillin) in the