妇产科学课件早产(英文版).ppt

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2025-03-04 发布于云南
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妇产科学课件早产(英文版).ppt

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Pretermlabor

DefinitionPrematruelaborordeliveryLaborspontaneouslyoccurringafter28weeks’butbefore37weeks’gestation,fetalweight2500gMaincauseofneonatalmorbidityindevelopedcountries

EtiologyObstetriccomplicationsPlacentaabnormalities:Placentaprevia,placentaabruption,Diabetes,hypertensionPolyhydramnios,oligohydramniosPrematureruptureofmembraneMultiplegestationPreviouslacerationofcervixoruterusShortinternalbetweenpregnancies(3months)

MedicalcomplicationsInfection:Decidua,fetalmembrane,amnioticfluid,urinarytractinfectionConizationofcervixHeavycigarettesmokingAlcoholismordrugaddictionMaternaltraumaSevereanemiaEtiology

SurgicalcomplicationAnyintra-abdominalprocedureGenitaltractanomaliesIncompetentcervixUterineanomalies:Bicornuate,unicornuateuterus,subseptateEtiology

DiagnosisClinicalmanifestationUterinecontractionsPersistentlowerabdominalcrampingordiscomfortableRegular,twiceduring10min’s,durationis30seconds,lastingfor30minDistinctionoftrueandfalselaborEffacementanddilatationofcervix2cmor80%effaced

EffacementanddilatationofcervixDigitalexaminationisthetraditionalmethodusedtodetectcervicalmaturation,butquantifyingthesechangesisoftendifficult.7

Prematureruptureofmembranes(PROM)VaginalbleedingSomewithabruptioplacentaorplacentapreviaIncreasedvaginaldischargeandpressureIncompetentcervixDiagnosis

LaboratorystudiesUltrasound:fetus,placentaDischargeexaminationCervicalsecretionculturesforchlamydia,ureaplasmaurealyticum,gonorrhoeaAmniocentesisL/SratioorfoamstabilitytestUrinalysis,cultureandsensitivitytestingDiagnosis

PredictionTransvaginalultrasoundCervicallength30mm,highnegativepredictivevalue,inthesecondandthirdtrimestersFetalfibronectinProteinofthechoriodecidualmatrixLessthan50ng/mlfromcervicovaginalsecretionsafter20weeks,untildeliverybeginsInposteriorfornix,negativeswab,