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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.;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;2. Laboratory Studies
Completely blood count with differential
Cervix discharge cultures :should be sent for gonorrhea淋病 and chlamydia衣原体.
Fetal fibronectin纤连蛋白(Ffn):
negative test is effective at ruling out imminent delivery(within 2 weeks);
positive test (Ffn50ng/ml): result is sensitive at predicting preterm birth.分泌物;3. Accessory examination:
Ultrasound examination for fetal size, position, placenta location,and cervical length.
Cervical length30nm: prognosticating premature delivery.
Infundibulum漏斗 length of cervical internal os25% Cervical length or
Amniocentesis to ascertain fetal lung maturity, the amnio fluid羊水 be tested for lecithin卵磷脂/ sphingomyelin鞘磷脂 (L/S) ratio
; principle: If the fetu
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