

Zhang Lu

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.

Voices

Can trichomonas get pregnant?
If a woman undergoing a vaginal secretion test is found to have trichomonas, she should be diagnosed with trichomoniasis. It is not recommended for women with trichomoniasis to become pregnant; they should first treat the trichomoniasis before attempting conception. If pregnancy occurs while trichomoniasis is present, the inflammation might spread through the cervix into the uterine cavity, affecting the implantation and later development of the gestational sac. Even if the gestational sac develops in the early stages, there might be complications such as intrauterine infection or premature rupture of membranes later on. Therefore, once diagnosed with trichomoniasis, treatment with medications should be initiated, typically healing within a week. After experiencing another menstrual cycle, it is then completely safe to try to conceive.

Should the uterus be removed due to severe postpartum hemorrhage?
Whether postpartum hemorrhage requires hysterectomy primarily depends on the severity of the hemorrhage and the specific causes of the postpartum hemorrhage. First, if the amount of postpartum hemorrhage is very substantial, leading to conditions like DIC in the pregnant woman, and if not removing the uterus may cause ongoing bleeding, it is essential to remove the uterus quickly to reduce vaginal bleeding. Second, if the postpartum hemorrhage is caused by issues like amniotic fluid embolism or poor contraction of the uterus, and conservative treatments are ineffective, it is also necessary to make a prompt decision to remove the uterus.

Causes of Infertility in Endometriosis
Endometriosis is a common gynecological disease that severely troubles women's daily lives. Besides causing painful menstruation, endometriosis is also a common cause of infertility. The reasons for infertility caused by endometriosis include the following aspects: First, endometriosis often leads to the formation of chocolate cysts on the ovaries, which can affect ovarian function and cause impaired ovarian function. Second, endometriosis can sometimes affect the function of the fallopian tubes, causing adhesions in the fallopian tubes. This may result in difficulties in egg pickup, preventing the sperm and egg from meeting and forming a fertilized egg in the fallopian tubes, leading to infertility.

How many times for endometrial cancer chemotherapy?
Post-surgical treatment for endometrial cancer often requires adjunct therapies, commonly including chemotherapy and radiotherapy. The frequency of chemotherapy primarily depends on whether the pathological results of the endometrial cancer reveal high-risk factors. If no high-risk factors are present, regular observation and follow-ups are generally advised. However, if high-risk factors are present, such as lymph node metastasis or local infiltration, this condition requires 4-6 cycles of chemotherapy after surgery, supplemented by radiotherapy. Thus, for endometrial cancer, if high-risk factors exist, chemotherapy is needed for 4-6 cycles; if no high-risk factors are present, chemotherapy is generally unnecessary, and regular follow-ups suffice.

How to preserve a pregnancy after embryonic arrest
Embryonic arrest, also known as missed miscarriage, refers to a condition during early pregnancy where if no fetal heartbeat is detected by ultrasound during weeks 8 to 9 of pregnancy, it should be diagnosed as embryonic arrest. Embryonic arrest indicates that the gestational sac has ceased to live, and in such cases, efforts to preserve the pregnancy are pointless as they are meaningless. However, it is important to analyze the reasons behind embryonic arrest to guide future pregnancies. Common causes of embryonic arrest include abnormalities in chromosomes, infections, immunity, and rheumatological markers. When embryonic arrest occurs, tests should be conducted targeting these indicators to clearly identify the abnormal factors, thereby guiding and potentially increasing the success rate of subsequent pregnancies.

What should a pregnant woman do if she has candidal vaginitis?
During pregnancy, changes occur in the vaginal flora of women, leading to decreased resistance in the vagina. Many pregnant women develop candidal vaginitis. Once diagnosed with candidal vaginitis, it is essential to undergo proper treatment. However, many pregnant women worry that medication might affect the fetus, which is a misconception. There are safe medications available for treating candidal vaginitis during pregnancy, and proper treatment generally does not harm the fetus. On the other hand, if candidal vaginitis is left untreated and allowed to progress, the inflammation might spread through the cervix into the uterine cavity, potentially leading to chorioamnionitis. In severe cases, it can cause premature rupture of membranes or intrauterine infection. Therefore, it is crucial for pregnant women diagnosed with candidal vaginitis to seek proper treatment.

Does vaginitis affect pregnancy?
If a woman has vaginitis, it can affect her ability to become pregnant. First, during the period of preparing for pregnancy, vaginitis can interfere with the combination of sperm and egg, which can easily lead to unsuccessful fertilization. Second, if a woman has vaginitis after becoming pregnant, it is essential to treat it promptly. Otherwise, the inflammation of the vagina can easily lead to cervicitis, which can then spread upward, causing chorioamnionitis. If chorioamnionitis continues to spread to the interior of the uterine cavity, it can cause premature rupture of membranes and intrauterine infection. Therefore, if symptoms of vaginitis are present, it is necessary to promptly perform routine vaginal discharge tests to identify the type of inflammation and treat it accordingly, whether before or during pregnancy. Vaginitis is treatable with medication in both circumstances.

Embryonic arrest means
Embryonic arrest, as the name implies, refers to the cessation of embryo development. In clinical practice, it is also called fibroid miscarriage. Embryonic arrest is a pathological condition. Normally, in the early stages of pregnancy, as activity increases, the gestational sac gradually begins to show a yolk sac, embryo bud, and fetal heartbeat. If the fetal heartbeat is still not visible after a certain period, it indicates that the gestational sac is in a state of decay and that the embryo has stopped developing. Generally, 9 weeks of pregnancy is considered the final deadline for diagnosis. If no fetal heartbeat is detected during an ultrasound at 9 weeks of pregnancy, it can be diagnosed as embryonic arrest. Once diagnosed, it is advisable to proceed with an abortion as soon as possible to minimize harm to the woman’s body. If embryonic arrest occurs consecutively more than twice, a thorough examination of both partners should be conducted to determine the cause, to guide the next pregnancy.

Does endometriosis cause infertility?
Endometriosis is a common cause of infertility, primarily due to the ectopic implantation of endometrial tissue in the pelvic cavity or other locations. Endometriosis leads to infertility mainly because it affects ovarian function, such as causing ovulatory disorders. Additionally, endometriosis can cause pelvic adhesions, affecting the function of the fallopian tubes, such as their ability to pick up eggs. Women with infertility should be checked for endometriosis, and if confirmed, surgical or medicinal treatments can be considered to improve the condition and potentially increase the chances of conception. Therefore, endometriosis is a cause of infertility, and careful examination for endometriosis should be conducted in patients with infertility.

Is embryonic arrest common?
Embryonic Arrest, also known as missed abortion, refers to a condition in early pregnancy where the gestational sac does not develop normally. By the end of the ninth week of pregnancy, no definitive fetal heartbeat can be seen on an ultrasound. Recently, embryonic arrest has become relatively more common in clinical practice, primarily due to various life stresses and the impact of various chemicals. Additionally, the age at which women are having children is gradually increasing, with many women over 30, and even over 35, having their first child. These women, being older, tend to have poorer egg quality, thus increasing the likelihood of embryonic arrest. Women who have previously experienced embryonic arrest should make comprehensive pre-pregnancy preparations and undergo appropriate tests, as well as seek pre-pregnancy guidance to increase the chances of a successful future pregnancy.