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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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Is embryonic arrest related to emotions?
Embryonic arrest refers to a condition during early pregnancy, around 9-10 weeks, where no fetal heartbeat is detected. In clinical practice, there are many causes of embryonic arrest, including chromosomal abnormalities, uterine malformations, infections, immune factors, and coagulation factors. However, many women do not investigate these reasons after experiencing embryonic arrest. Instead, they look for causes in their daily lives, such as dietary factors or emotional factors. In reality, embryonic arrest is generally not closely related to everyday life factors. Even if emotions fluctuate, such as becoming irritable or easily provoked, which might affect the gestational sac, such impacts usually manifest as symptoms of threatened miscarriage, but generally do not lead to embryonic arrest. Therefore, there is generally no correlation between embryonic arrest and emotional states.
Does postpartum hemorrhage require a blood transfusion?
The definition of postpartum hemorrhage is bleeding greater than 500 milliliters approximately 24 hours after vaginal delivery. Whether blood transfusion is necessary for postpartum hemorrhage mainly depends on the specific amount of bleeding. For average women, if the hemoglobin level is normal before delivery and the bleeding is between 500-1000 milliliters, the body can compensate for the anemia through normal adjustments, and generally, a blood transfusion is not required. However, if the bleeding exceeds 1000 milliliters, this situation is considered massive hemorrhage and must be treated with a blood transfusion, otherwise it may lead to hemorrhagic shock or DIC (Disseminated Intravascular Coagulation).
Can a miscarried embryo be expelled naturally?
Embryonic arrest refers to the lack of natural development of the gestational sac in early pregnancy, characterized by the absence of a fetal heartbeat. If there is still no fetal heartbeat or embryo detected during an ultrasound at 8-9 weeks of pregnancy, it should be diagnosed as embryonic arrest. After embryonic arrest occurs, the vast majority require medical intervention. Of course, some cases of embryonic arrest can resolve naturally, leading to a miscarriage. However, this is not a reliable occurrence and is relatively rare in clinical practice. Moreover, the longer the wait, the greater the potential harm to the woman's health. For embryonic arrest, once diagnosed, it is urgent to intervene medically to remove the gestational sac from the uterus, minimizing harm to the woman. Common methods include medical abortion or a dilation and curettage surgery, either of which can be chosen.
Can you have intercourse with an arrested embryo development?
It is not recommended to have sexual intercourse when embryo arrest occurs. Embryo arrest, also known as missed miscarriage, refers to the abnormal development of the gestational sac during early pregnancy, and no fetal heartbeat is detected on an ultrasound by the ninth week of pregnancy. Once embryo arrest is diagnosed in clinical practice, a dilation and curettage surgery should be performed as soon as possible to minimize the impact on the fetus. However, during embryo arrest, since the gestational sac itself is not developing normally and is unstable, it is not advisable to have sexual activity. Sexual activity could stimulate the uterus to contract, leading to bleeding, which is not conducive to managing the embryo arrest. Moreover, sexual activity can easily lead to gynecological inflammation. If sexual activity causes gynecological inflammation, it is necessary to treat the inflammation before proceeding with the abortion, which can delay the process. Therefore, it is not recommended to have sexual intercourse during embryo arrest.
Causes of Late Postpartum Hemorrhage
Late postpartum hemorrhage refers to a significant amount of vaginal bleeding that occurs two to three weeks after a cesarean section or natural childbirth. The causes of late postpartum hemorrhage include the following aspects. First, the presence of residuals in the uterine cavity, such as when the placenta or membranes remain within the uterine cavity after childbirth, can repeatedly stimulate the endometrium causing bleeding. Second, poor healing of the uterine incision during a cesarean section can lead to post-cesarean bleeding, a condition that easily causes late postpartum hemorrhage. Third, poor healing of episiotomy or perineal laceration wounds after natural childbirth can also potentially lead to late postpartum hemorrhage.
Is it dangerous for the umbilical cord to be wrapped around the neck during the mid-stage of pregnancy?
During a mid-pregnancy ultrasound, it is sometimes indicated by the presence of a U-shaped or W-shaped notch behind the fetus's neck that the fetus may have the umbilical cord wrapped around its neck. During pregnancy, it is perfectly normal for the umbilical cord to wrap around the neck, and it generally does not affect the fetus or pose any danger. The length of the umbilical cord during pregnancy is approximately 30 to 80 centimeters, which is quite long relative to the size of the uterine cavity. Hence, many umbilical cords have excess length that can wrap around the neck or limbs of the fetus, leading to the umbilical cord being coiled around the neck or limbs. However, current research indicates that whether the umbilical cord is wrapped around the neck or limbs once or twice, it does not affect the fetus. It does not cause intrauterine hypoxia or affect the growth and development of the fetus, nor does it influence the mode of delivery. A natural childbirth can still be an entirely viable option.
Symptoms of premature rupture of membranes infection
Premature rupture of membranes refers to the breaking of the fetal membrane before the onset of labor, followed by the leakage of amniotic fluid. The greatest risk of premature rupture of membranes is the potential to cause an infection in the amniotic cavity. The symptoms of infection due to premature rupture of membranes include the following aspects: First, the smell and color of the amniotic fluid will change. The amniotic fluid may become purulent and have a foul smell, which suggests an infection within the amniotic cavity. Second, blood tests can reveal elevated infection markers, primarily an increase in white blood cells and C-reactive protein well above the normal range. Third, the patient may experience contractions or lower abdominal tenderness and rebound pain. When there is an infection in the amniotic cavity, symptoms of peritonitis may occur, along with manifestations of contractions, presenting as episodic pain in the lower abdomen. These are the symptoms of infection from premature rupture of membranes.
Does a threatened miscarriage require a uterine curettage?
Threatened miscarriage, as the name suggests, refers to signs indicating a potential miscarriage. Whether a curettage is necessary in cases of threatened miscarriage mainly depends on the pregnancy outcome. For threatened miscarriage, treatment is chosen based on the patient's wishes. If the patient desires to continue the pregnancy and try to preserve it, medication can be used initially for conservation. However, if a woman experiencing threatened miscarriage does not wish to continue the pregnancy, she can opt for artificial intervention to induce the miscarriage. Miscarriage can be induced through oral medication or through a curettage procedure. Thus, curettage is not necessarily required for a threatened miscarriage, and even if the pregnancy is to be terminated, medication can be used as an alternative. Therefore, there is no inevitable connection between threatened miscarriage and curettage.
How to Control Gestational Diabetes
During pregnancy, if the pregnant woman has diabetes, it is essential to control blood sugar reasonably. Otherwise, high blood sugar can seriously affect both the fetus and the pregnant woman, and in severe cases, it can cause diabetic ketoacidosis in the pregnant woman and fetal death in utero. Diabetes in pregnant women can be intervened in the following ways: First, through dietary control, eat less sugary foods, such as sweets, pastries, and fruits. Second, it is necessary to be moderately active during pregnancy, taking a walk or maintaining 5,000 to 10,000 steps daily, which helps in the consumption of glucose in the body. Third, if the above two methods are ineffective, insulin should be used to control diabetes.
What should I do if the fetal umbilical cord is wrapped around the neck once?
During the prenatal ultrasound, it is sometimes discovered that the umbilical cord is wrapped around the fetus's neck, which concerns many pregnant women who fear it may cause fetal hypoxia in utero or affect natural childbirth. However, this concern is not accurate. Currently, in clinical practice, an umbilical cord around the neck is considered a normal physiological phenomenon. Around 30%-40% of fetuses may have the umbilical cord wrapped around their neck. It is acceptable for the umbilical cord to be wrapped around the neck once or twice, as this neither impacts the fetus's oxygen levels nor affects the mode of childbirth; natural birth can still be considered. Therefore, when the umbilical cord is wrapped around the neck once, no intervention is required. Follow the normal prenatal check-up routine and pay attention to fetal movements in daily life. As long as the fetal movements are normal, it indicates that the fetal condition in the uterus is good.