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Zhang Lu
Obstetrics
About me
Graduated from the 7-year program in Clinical Medicine at Shandong University School of Medicine.
Proficient in diseases
Common obstetric diseases and various difficult miscellaneous diseases. For example, pre-eclampsia, gestational diabetes, fetal abnormalities, placental implantation, complications of twin pregnancies, gynecologic malignant tumors. Working at Qilu Hospital of Shandong University, a national key discipline.
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Definition of premature birth date
Premature birth, compared to miscarriage and full-term birth, is defined differently. A miscarriage refers to childbirth before 28 weeks, and a full-term birth is one that occurs after 37 weeks. Births that occur between 28 weeks and 36 weeks plus 6 days are collectively referred to as premature births. During this period, the fetus is relatively larger and has a certain level of maturity, so the survival rate is relatively high. However, it still falls short when compared to full-term infants. Generally, 34 weeks is used as a boundary: infants born from 28 to 34 weeks are referred to as early preterm, while those born between 34 weeks and 36 weeks plus 6 days are considered late preterm. Therefore, premature births are divided into these two main categories. In clinical practice, if there are signs of premature birth, it is recommended to try to extend the gestational age and aim for childbirth during the late preterm period.
How to recover from postpartum urinary incontinence?
During the process of natural childbirth, the presenting part of the fetus significantly compresses the woman's pelvic floor, causing conditions such as uterine prolapse and bladder prolapse. Postpartum, many women experience urinary incontinence. Postpartum urinary incontinence can be alleviated through the following methods. First, one can perform Kegel exercises independently. Kegel exercises, a set of movements that contract the pelvic floor muscles, are quite effective in treating mild urinary incontinence. Second, if the urinary incontinence is more pronounced, it is advisable to undergo assisted treatment at a hospital, mainly involving electrical stimulation. This can stimulate the local pelvic floor muscles, promoting recovery and alleviating symptoms of urinary incontinence. Third, if the symptoms are very severe and conservative treatment is ineffective, pelvic floor functional repair surgery should be considered.
Can premature rupture of membranes be detected?
Premature rupture of membranes, also known as water breaking or membrane rupture, refers to the rupture of the membranes before the onset of labor, causing amniotic fluid to intermittently flow out from the uterine cavity. This can pose certain risks, including umbilical cord prolapse, placental abruption, intrauterine infection, and fetal hypoxia. The diagnostic methods for premature rupture of membranes include the following: First, through clinical symptoms, if a large amount of fluid is found flowing out from the vagina, it can generally be determined as premature rupture of membranes. Second, if the amount of vaginal discharge is relatively small, in this case, pH test strips can be used for detection. When the pH test strips change color, it can be determined as water breaking. Third, ultrasound can be used as an auxiliary diagnostic method, as a decrease in the amount of amniotic fluid due to premature rupture of membranes can be detected through ultrasound.
Does an embryonic arrest require a dilation and curettage?
According to the different intervention methods, surgical abortion is needed during an abortion procedure, while medical abortion might not be necessary. Embryonic arrest, also known as missed abortion, occurs during pregnancy due to various factors which result in the absence of a fetal heartbeat in the gestational sac or fetus. Most cases of embryonic arrest occur during early pregnancy. If no fetal heartbeat is observed by the 9th week of pregnancy, it is diagnosed as embryonic arrest. Once embryonic growth ceases, it is crucial to intervene artificially as soon as possible to expel the gestational sac from the uterus. Common methods of artificial intervention include medical abortion and surgical abortion. If surgical abortion is chosen for an embryonic arrest, it involves direct curettage or evacuation of the uterus. Embryonic arrest can also be treated with medical abortion, which involves taking oral medication to stimulate uterine contractions, soften the cervix, and expel the gestational sac from the uterus. A follow-up is required about two weeks after the abortion. If there is no residual material in the uterine cavity, then curettage is not necessary; however, if substantive residuals or blood signals are present inside the uterine cavity, then curettage is needed.
Is postpartum hemorrhage dangerous?
Postpartum hemorrhage refers to bleeding exceeding 500 milliliters within a short period after childbirth, or bleeding exceeding 1000 milliliters within 24 hours after childbirth. Postpartum hemorrhage is relatively dangerous because a large amount of bleeding in a short period of time after childbirth can cause the mother to experience hemorrhagic shock, and in severe cases, can lead to maternal death. Postpartum hemorrhage is currently the leading risk factor for maternal mortality. With increased understanding of the disease and improved treatment levels, the majority of postpartum hemorrhages can be managed successfully. The treatment of postpartum hemorrhage primarily involves early detection and early intervention. If symptoms of significant bleeding occur, it is essential to carefully identify the cause of the bleeding and provide targeted treatment. This can control the condition early and prevent worsening.
What are the symptoms of premature birth?
Premature birth refers to delivery occurring between 28 and 36+6 weeks of pregnancy. The symptoms of premature birth primarily include the following aspects: First, regular uterine contractions occur. These contractions can lead to the descent of the fetal head and exert pressure on the cervix, which is necessary for the delivery of the fetus. It generally manifests as pain every three to five minutes, with each episode of pain lasting more than one minute, and both the frequency and intensity of the pain gradually increasing. Second, the appearance of "bloody show" occurs. As the fetus descends, it can cause the rupture of capillaries at the edge of the membranes, leading to bloody show. Third, there is a noticeable feeling of heaviness or pressure. Gynecological examinations can reveal dilation of the cervix and shortening of the cervical canal. When these symptoms appear, an assessment for premature birth should be conducted, and preparations for premature delivery should be made.
Why does a chocolate cyst cause infertility?
Chocolate cysts, also known as ovarian endometriomas, are a manifestation of endometriosis. Generally, it refers to the implantation of endometrial tissue on the ovaries, causing local infiltration and invasion, leading to cysts. Because the fluid inside the cyst resembles chocolate, they are called chocolate cysts. Chocolate cysts may cause infertility, for the following reasons: First, chocolate cysts can affect the function of the ovaries, causing ovulatory disorders and ovarian dysfunction. The secretion of estrogen and progesterone is relatively low, and these factors can lead to infertility. Second, chocolate cysts can cause adhesions within the pelvic cavity, affecting the egg-picking function of the fallopian tubes. This factor can also lead to female infertility.
Does an ectopic pregnancy cause breast tenderness in the early stages?
Ectopic pregnancy, as the name implies, refers to the implantation of the gestational sac outside the uterine cavity, with common implantation sites including the fallopian tubes, ovaries, and the pelvic abdomen. Although an ectopic pregnancy is a pathological condition, it still falls within the category of pregnancy. Therefore, the common early pregnancy symptoms, such as those seen in early pregnancy, still occur in ectopic pregnancies. Whether it's an intrauterine pregnancy or an ectopic pregnancy, breast pain during early pregnancy is common in most cases, primarily due to increased levels of estrogen and progesterone in women during early pregnancy. This leads to stimulation of the mammary glands and the proliferation of some mammary ducts, resulting in breast pain, which is normal. However, since the hormone levels in women with ectopic pregnancies are relatively lower, the sensation of breast pain is less than that in normal intrauterine pregnancies.
Premature birth is what it means.
Preterm birth refers to giving birth before full-term pregnancy, defined as delivery occurring between 28 and 36 weeks plus 6 days of gestation. Corresponding conditions are miscarriage and full-term delivery: before 28 weeks is termed a miscarriage, while delivery after 37 weeks is termed full-term birth. Because preterm infants already possess certain vital functions, most can survive with appropriate emergency intervention and treatment. However, the risks associated with preterm birth are relatively high and depend on the specific causes of prematurity. Some premature births are due to premature rupture of membranes, while others are medically induced, for example in cases of abruptio placentae or severe preeclampsia. Therefore, it is crucial in clinical practice to provide rational treatment for preterm labor, aiming to extend the duration of pregnancy as much as possible to avoid neonatal death.
Can premature rupture of membranes at 14 weeks heal?
Premature rupture of membranes refers to the rupture of the amniotic sac before labor, causing intermittent discharge of amniotic fluid. Premature rupture of membranes can occur at any stage of pregnancy, and it is generally believed in clinical practice that it is more likely to occur in the mid to late stages of pregnancy. The probability of occurrence before 20 weeks of pregnancy is relatively low. If premature rupture of membranes occurs at 14 weeks of pregnancy, once diagnosed, it is irreversible as there is currently no method to cure it. For 14-week premature rupture of membranes, an ultrasound, vaginal examination, and pH paper test should first be conducted to confirm whether it is indeed a premature rupture of membranes. If it is confirmed as a premature rupture of membranes, then the only option is to terminate the pregnancy; if it is not, the pregnancy can be continued.