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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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Principles of Treatment for Premature Rupture of Membranes
The treatment principles for premature rupture of membranes depend on the gestational age at which the rupture occurs. First, if the rupture happens after thirty-four weeks of pregnancy, expectant management is generally adopted, and it is advised to terminate the pregnancy as soon as possible without recommending continuing the pregnancy. After thirty-four weeks, the fetus has a higher survival rate and greater maturity. If membrane rupture occurs after this period, continuing the pregnancy poses more risks to the fetus than potential benefits, hence it is recommended to let nature take its course or terminate the pregnancy promptly. Second, if the rupture occurs before thirty-four weeks of pregnancy, as the fetus is relatively small and has a lower survival rate, it may be appropriate to use medications to prolong the pregnancy while ensuring there is no infection and the fetus is not suffering from hypoxia, and to promote fetal lung maturity. However, if maternal complications or fetal hypoxia occur, pregnancy should also be terminated timely.
What causes premature rupture of membranes?
Premature rupture of membranes refers to the rupture of the membranes before labor begins, leading to the discharge of amniotic fluid. The causes of premature rupture of membranes include the following aspects: First, there is inflammation on the membranes. If there is vaginitis or cervicitis that is not treated in time, this inflammation can spread to the membranes, subsequently causing chorioamnionitis and leading to premature rupture of membranes. Second, there is excessive pressure inside the uterine cavity. The main cause of excessive uterine pressure is too much amniotic fluid. Excessive amniotic fluid can sometimes also stimulate the membranes, causing excessive pressure on the membranes and leading to rupture. Third, it occurs when there is excessive pressure from uterine contractions. Excessive pressure from contractions can exert external pressure on the membranes, also causing premature rupture.
Does threatened miscarriage require hospitalization?
Threatened miscarriage refers to the signs of a miscarriage occurring. The treatment for threatened miscarriage and whether hospitalization is needed mainly depend on the severity of the condition. Firstly, for mild cases of threatened miscarriage, such as a small amount of brown or black discharge, or mild lower abdominal pain, the symptoms are very mild. In such cases, hospitalization is not needed since the treatment methods at home are no different from those in the hospital. Secondly, if the symptoms of the threatened miscarriage are severe, such as intense lower abdominal pain or a substantial amount of vaginal bleeding, hospital treatment is necessary. This is mainly because treatments like IV infusion or intramuscular injection of medication can be administered in the hospital. Also, the close monitoring in the hospital helps in assessing changes in the condition.
Is postpartum insomnia depression?
Many women postpartum find themselves unable to sleep and feel that they might be suffering from depression, but this idea is not necessarily correct. There are several reasons for insomnia after childbirth. First, the female endocrine system will recover to its normal range postpartum, and during this recovery process, fluctuations in the woman's physical state can lead to insomnia. Second, many women face the task of caring for a child postpartum, and if they are overly tired, it can also lead to insomnia. Third, while postpartum depression can cause insomnia, insomnia alone is not a sufficient criterion for diagnosing postpartum depression. If postpartum depression is suspected, it is essential to consult with a psychiatric specialist and undergo a thorough assessment to determine if postpartum depression is present.
How many days does postpartum bleeding lochia last?
Postpartum lochia refers to the need for the contents of the uterine cavity to be expelled over a certain period of time after childbirth. Postpartum lochia generally lasts about six to eight weeks and is divided into three stages: bloody lochia, serous lochia, and white lochia. The first stage, known as bloody lochia, primarily involves the expulsion of accumulated blood in the uterine cavity. Postpartum bleeding lochia generally lasts about one week after childbirth. During this week, the amount of bleeding gradually decreases, and the color changes from bright red to dark red and then to black. Generally, it is believed that postpartum bleeding lochia should not exceed two weeks. If bleeding lochia persists beyond two weeks, an ultrasound should be conducted to determine whether there are any remnants in the uterine cavity, along with a vaginal examination to check for any abnormalities in the cervix and vaginal walls.
Postpartum hemorrhage refers to excessive bleeding following childbirth.
Postpartum hemorrhage refers to vaginal bleeding exceeding 500ml shortly after childbirth, or vaginal bleeding exceeding 1000ml within 24 hours after childbirth. Postpartum hemorrhage is a critical situation in clinical practice and is the leading cause of maternal death. For postpartum hemorrhage, it is essential first to identify the cause. Common causes of postpartum hemorrhage include uterine atony, retained placenta or membranes, trauma to the birth canal, and coagulopathy. In cases of postpartum hemorrhage, treatment should start with addressing the cause, such as using drugs that promote uterine contraction, massaging the uterus, and paying attention to cleaning the uterus and suturing any tears. Simultaneous symptomatic treatment should also be administered, which involves the transfusion of blood products to improve circulating blood volume and prevent the onset of hemorrhagic shock.
Can pregnancy swelling of the feet cause varicose veins?
After pregnancy, many women experience swollen feet, which can be due to pathological or physiological reasons. However, swollen feet can often lead to varicose veins. Swollen feet generally indicate local retention of water and sodium or obstructed venous return. When a large amount of blood accumulates in the veins, it can easily cause varicose veins. However, during pregnancy, the duration of foot swelling is not very long, generally lasting about one to two months. After childbirth, the swelling of the feet quickly alleviates. Therefore, even though swollen feet may cause varicose veins, the severity is usually mild and it will alleviate after childbirth.
Can you go to the bathroom if the membranes rupture early?
Premature rupture of membranes, as the name suggests, refers to the rupture of the amniotic sac before labor commences, leading to intermittent discharge of amniotic fluid from the uterine cavity. After the membranes rupture prematurely, whether choosing to deliver or attempting to prolong the pregnancy, bed rest is required, and one should not get up to use the toilet. If one needs to use the toilet, it must be done on the bed. Standing up to use the toilet like a normal person can bring about the following risks: 1. It can cause excessive loss of amniotic fluid, leading to low levels of amniotic fluid, which can cause fetal hypoxia in the uterus. 2. Standing up to use the toilet can lead to cord prolapse or placental abruption, which can cause acute fetal hypoxia within the uterine cavity. Therefore, with premature rupture of membranes, one should not stand up to use the toilet.
What tests are done for endometrial polyps?
Endometrial polyps are common among women, and the size and number of these polyps vary from person to person. Small polyps can range from 1 to 2 mm, while large polyps can range from 1 to 2 cm. The number of polyps can be one or two, or about ten. The following methods are mainly used to examine endometrial polyps: First, it is important to inquire about symptoms. Most endometrial polyps do not present clinical symptoms, but some can cause increased menstrual flow or abnormal vaginal discharge. Second, the most important method to examine endometrial polyps is to perform an ultrasound. By observing the echo of the endometrium through ultrasound, a judgment can be made. Third, endometrial polyps can be examined through hysteroscopy. This method allows for direct visualization of the endometrium, providing a definitive role in diagnosing endometrial polyps. After confirmation, electrosurgical resection can be performed for treatment at any time.
Is it serious if the membranes rupture prematurely at 39 weeks of pregnancy?
At 39 weeks of pregnancy, if the membranes rupture suddenly, this condition is not serious. Membrane rupture at 39 weeks is also a sign of impending labor, and 39 weeks is already considered a full-term pregnancy. At this stage, the fetus is relatively large and mature, already considered a full-term baby, therefore, it is completely possible to give birth normally. For membrane rupture at 39 weeks, it is advisable to give birth as soon as possible. If natural labor contractions can be initiated, then one can wait to give birth on their own. If after observing for four to six hours, there are still no contractions, drugs can be used to induce labor to deliver the baby. In the vast majority of cases with membrane rupture at 39 weeks, the baby is fine, so the situation is not serious.