

Liu Wen Li

About me
Liu Wenli, female, master's degree student, associate chief physician, graduated from the Department of Obstetrics and Gynecology of Hebei Medical University, currently working at the Second Affiliated Hospital of Xingtai Medical College in the Department of Obstetrics and Gynecology. Has attended and exchanged at conferences multiple times, and has published several papers in national core journals. One personal publication: "Clinical observation of the alleviation of cisplatin chemotherapy side effects by garlicin injection" published in the August 2008 issue of the 24th volume of "Chinese Journal of Misdiagnosis".
Proficient in diseases
Specializes in the diagnosis and treatment of common and frequent diseases in obstetrics and gynecology, as well as gynecologic tumors, endocrine disorders, and minimally invasive procedures.

Voices

Premature birth: Cesarean section or natural delivery?
Whether to opt for cesarean or vaginal delivery for preterm birth needs a comprehensive grasp of the pregnant woman's entire condition before assessing and deciding on the mode of childbirth. First, it's necessary to check if the woman has any complications and the severity of these complications, as well as whether her physical condition allows for vaginal delivery. Additionally, the changes in fetal heart rate must be considered. If the fetal heart rate is particularly poor, and the duration of vaginal delivery is long such that the child cannot endure it, then a cesarean section may be needed. Beyond these conditions, it is also important to evaluate the state of the pelvis, the size of the fetus, and the condition of the cervix. Generally, if vaginal delivery is possible for preterm births, it is still encouraged.

Does placenta previa cause preterm birth?
Placenta previa is likely to lead to premature birth. Why is that? Placenta previa refers to the condition where the placenta is positioned lower in the uterus, and the most common symptom is recurrent, painless bleeding during pregnancy. This is because the low-lying placenta often leads to frequent bleeding. If the bleeding is minimal, there is still hope to maintain the pregnancy, allowing the fetus to grow longer inside the uterus. However, in the event of heavy bleeding, if the baby remains in the uterus without delivery, a critical situation can arise due to blood loss, potentially leading to the disappearance of fetal heart activity. At this point, the pregnancy would need to be terminated, thus often resulting in premature birth.

Premature rupture of membranes is what symptom?
Premature rupture of membranes occurs when the amniotic sac breaks before regular contractions start. The most obvious symptom of this condition is vaginal discharge, which is involuntary, meaning it cannot be controlled, and the amount of fluid discharged is typically greater than normal vaginal discharge. Often, the fluid released after water breaking is clearer and thinner than normal vaginal discharge, which is typically thicker. The fluid can be colorless and transparent, indicating clarity, but it might appear slightly yellow if the amniotic fluid is not in good condition. Therefore, with these symptoms, it is important to seek medical attention to determine if the water has broken.

Does postpartum hemorrhage affect appetite?
Postpartum hemorrhage can be significant, leading to anemia, which in turn affects appetite. After anemia occurs, the blood supply to the gastrointestinal tract is reduced, causing relative hypoxia and impacting the function of the gastrointestinal tract, thereby affecting appetite. If the postpartum bleeding is minimal and consists only of normal lochia, it generally does not affect appetite. Furthermore, whether postpartum hemorrhage affects appetite also greatly depends on individual differences. Regardless of its impact on appetite, postpartum recovery requires comprehensive and adequate energy intake to ensure physical recovery and milk secretion. Therefore, it is important to eat more and include a diet rich in protein and nutrients for better recovery.

Is hospitalization necessary for embryonic arrest?
This is not necessarily the case; it depends on the specific situation. Firstly, we need to consider the timing of the embryo arrest. If the embryo arrest occurs within 70 days of pregnancy, generally, hospitalization is not needed, and a miscarriage can often be handled on an outpatient basis. However, if the embryo stops developing after 70 days of pregnancy, even reaching three or four months, then hospitalization is required for a induced labor. This is because the fetus is relatively larger, making outpatient treatment problematic and riskier. Additionally, we must also consider if the pregnant woman has any complications. If there are complications alongside the embryo arrest, it is generally safer to be hospitalized.

How to treat gestational diabetes?
The treatment principle for gestational diabetes is to control blood sugar and then ensure the normal development of the child. There are many methods to control blood sugar. First, it involves diet management guided by a doctor, adjusting the diet's structure and quantity, followed by post-meal exercise. If after a week of adjusted diet and post-meal exercise, blood sugar levels still do not meet the standards, insulin injections can be used to keep the pregnant woman's blood sugar within the prescribed range. This can help reduce the impact of diabetes on the fetus and the pregnant woman.

Does premature rupture of membranes require induction of labor?
The management of premature rupture of membranes varies depending on the gestational age. If the rupture occurs very early in pregnancy, the doctor will assess the maturity of the fetus. If it seems that the child still has a long way to mature, or it is difficult to conservatively maintain the pregnancy until maturity, induction of labor may be recommended. If the doctor feels that the fetus is mature enough, then induction of labor may be considered, which involves the administration of drugs to induce labor. If it is between these two scenarios, expectant management may be advised, which involves not inducing labor, along with infection prevention, bed rest, etc. Since infection can occur after a long duration of membrane rupture, it is important to closely monitor infection indicators during this period. If an infection is detected, labor may be induced using drugs to expedite delivery.

How long does a blighted ovum naturally miscarry?
There are two situations regarding a pregnancy with an empty sac. One situation is that the embryo does not develop well and remains an empty sac. In another situation, it is possible to wait for another 4 to 5 days or a week and then recheck with an ultrasound. It might be that the development is just occurring later than usual, and thus, no embryonic bud has developed at the time of the initial ultrasound, displaying an empty sac. As for how long it will take for the empty sac to be expelled, there is no definite timeframe. In some cases, it is not necessary to wait for it to be expelled naturally; active measures such as medication treatment or surgical abortion can be taken.

How to deal with one loop of umbilical cord around the neck detected by four-dimensional ultrasound?
If the umbilical cord is wrapped around the neck once, there is no need to worry about it, because having the umbilical cord wrapped around the neck once is not as terrifying as it seems. If you want to give birth, it is completely feasible, and for most people with the umbilical cord wrapped around the neck once, if there are no other adverse factors, it generally does not affect the delivery. Moreover, even if you want to do something about it, you are powerless. It's not something that the pregnant woman herself can improve. Besides, there are cases where the umbilical cord is wrapped around two or three times, and they have given birth as well, so there is absolutely no need for anxiety.

What should I do if the umbilical cord is wrapped around the neck once during the mid-pregnancy?
The incidence of the umbilical cord wrapping around the neck once is quite high, accounting for about one-fifth of pregnant women. Generally, if the umbilical cord is loosely wrapped around the child's neck, and if the cord is long enough, it usually does not have a significant impact on the fetus. However, if the umbilical cord is tightly wrapped around the neck, and additionally, if the cord is relatively short, it can sometimes lead to pulling and thinning of the cord, causing obstruction in the blood vessels within the cord. This can result in oxygen deficiency for the baby. Therefore, during the mid-pregnancy period when umbilical cord entanglement occurs, it is important to enhance monitoring. Regular prenatal check-ups, counting fetal movements by oneself, and frequent monitoring of fetal heart rate changes are advisable.