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147
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.
Voices
What should be noted if the umbilical cord is wrapped around the neck once at 39 weeks of pregnancy?
At 39 weeks of pregnancy, finding a single loop of umbilical cord around the neck during an ultrasound should not be a concern; this condition is quite common among pregnant women and does not have a significant impact on the fetus, nor does it affect natural childbirth. At this time, the following aspects should be noted: First, attention should be paid to any abnormal fetal movements. If there is an increase or decrease in fetal movement, it is necessary to come to the hospital for an examination to rule out hypoxia. Second, be aware of signs of labor, including bloody show and contractions. If these conditions occur, you should come to the hospital promptly to await birth. Third, it is important to attend routine prenatal check-ups a week later. Do not overly focus on the cord around the neck, as it generally does not cause hypoxia or affect the method of childbirth.
Can a threatened miscarriage still preserve the pregnancy?
When threatened miscarriage occurs, attempts are generally made to carry out treatment to save the pregnancy. Whether the treatment can successfully save the pregnancy mainly depends on the severity of the symptoms, whether the treatment is timely, and the quality of the embryo itself. Firstly, if it is a mild threatened miscarriage, such as mild lower abdominal pain or light vaginal bleeding, in most cases, the pregnancy can be saved; if the symptoms are very severe, with heavy vaginal bleeding and intense abdominal pain, sometimes the pregnancy may not be saved. Secondly, when threatened miscarriage occurs, treatment should be selected based on the cause, including rest and medication. If the treatment is not timely, the pregnancy may not be saved. Thirdly, if the quality of the gestational sac is good, then even if a mild threatened miscarriage occurs, the pregnancy can often be saved; however, if the quality of the gestational sac is poor, then even with medication treatment, the pregnancy often cannot be saved.
How to relieve breast engorgement after childbirth?
Many new mothers experience breast swelling and pain after childbirth, primarily due to the poor secretion of breast milk leading to accumulation within the milk ducts, causing discomfort. There are several ways to facilitate milk flow and relieve breast pain: First and foremost, it is important to encourage the newborn to suckle more frequently, as this promotes milk expulsion and alleviates breast pain. Secondly, in addition to encouraging frequent suckling, using a breast pump can also help. Both manual and electric breast pumps are suitable for use. Thirdly, massaging the lumpy areas of the breast can help relieve the sensation of pain. These are some methods to ease breast pain by facilitating milk flow.
Can a missed miscarriage miscarry naturally?
Missed miscarriage and spontaneous miscarriage are two terms describing early pregnancy conditions, but there is a significant difference between them. Missed miscarriage refers to the absence of a fetal heartbeat confirmed by ultrasound in early pregnancy, which indicates that the embryo has stopped developing. On the other hand, spontaneous miscarriage refers to the spontaneous expulsion of the gestational sac from the uterine cavity. In the case of a missed miscarriage, it is important to expedite the miscarriage process to expel the gestational sac from the uterus, minimizing the impact on the mother. It is possible for a missed miscarriage to lead to a spontaneous miscarriage, but it may not happen automatically. For a missed miscarriage, if a spontaneous miscarriage occurs, that is preferable. However, if there are no signs of spontaneous miscarriage, it is not advisable to wait indefinitely. Prompt medical intervention is recommended, and the choice of medical or surgical abortion is available.
Will hCG levels drop in a threatened miscarriage?
Threatened miscarriage refers to the signs of a potential miscarriage, but this does not necessarily mean that a miscarriage will definitely occur or is inevitable. Whether HCG levels decline during a threatened miscarriage depends primarily on the cause of the threatened miscarriage and the ultimate outcome. First, if the gestational sac is developing well and it is only a mild case of threatened miscarriage, the HCG levels will not decrease and will continue to rise. Second, if the threatened miscarriage is caused by poor embryo development or embryonic arrest, the HCG levels will naturally decline. Third, if the condition of the threatened miscarriage is severe and eventually leads to a miscarriage or inevitable miscarriage, the HCG levels will also decline. Therefore, whether HCG levels decline during a threatened miscarriage largely depends on the cause and the severity of the condition.
How is premature birth defined?
Preterm birth is defined in relation to miscarriage and full-term birth. A birth before 28 weeks of pregnancy is considered a miscarriage; a birth after 37 weeks of pregnancy is considered full-term; and a birth between 28 weeks and 36 weeks and six days is considered preterm. Since preterm birth occurs in the late stages of pregnancy, the fetus has a certain chance of survival. However, efforts should be made to delay the timing of preterm birth as much as possible to increase the survival rate of the fetus. It is generally believed that births between 28 and 34 weeks are considered early preterm, during which the survival probability of the fetus is relatively low; whereas births after 34 weeks up to 36 weeks and six days are considered late preterm, during which the maturity of the fetus is higher and the survival rate is also relatively high.
Can there still be fetal movement if the membranes rupture at five months of pregnancy?
Being about five months pregnant generally corresponds to around twenty weeks of pregnancy. During this period, if premature rupture of membranes (PROM) occurs, fetal movements are usually still perceptible. This is because, although amniotic fluid intermittently leaks due to PROM, it continues to be produced. Therefore, a certain amount of amniotic fluid remains within the amniotic cavity, providing space for fetal activity, allowing the mother to feel fetal movements. However, sometimes there may be abnormal changes in fetal movements, such as an increase or decrease. For a five-month pregnancy with PROM, regardless of the presence of fetal movements, it is generally not recommended to attempt to preserve the pregnancy. This is because the success rate of sustaining the pregnancy is very low at this stage. Even if the pregnancy could be extended by about a month to reach twenty-four weeks, the survival rate of the fetus remains extremely low. Therefore, when PROM occurs at five months of pregnancy, although fetal movements can still be detected, it is not possible to maintain the pregnancy, and it is necessary to promptly opt for induction of labor to terminate the pregnancy.
Is premature rupture of membranes serious?
Premature rupture of membranes refers to the rupture of the amniotic sac before labor begins. The severity of premature rupture of membranes primarily depends on the gestational week when the rupture occurs, as well as whether there are complications such as intrauterine infection or fetal distress. First, for term premature rupture of membranes, which occurs after 37 weeks, the fetus is relatively mature and larger in size; therefore, this condition is not considered severe, and prompt delivery is usually sufficient. Second, for preterm premature rupture of membranes, since the maturity of the fetus is not high and the size is relatively small, there is a higher risk of preterm birth which makes this situation more risky. Third, premature rupture of membranes can easily lead to fetal intrauterine hypoxia or intrauterine infection. If these two conditions occur, it indicates a more serious situation, and pregnancy should be terminated promptly to prevent further deterioration of the condition.
What to do when the umbilical cord is wrapped around the neck at 39 weeks of pregnancy?
At 39 weeks of pregnancy, it is full-term and nearing the expected delivery date. During this period, if the umbilical cord is found to be wrapped around the neck, it is a normal occurrence and there is no need for excessive worry. Umbilical cord wrapping around the neck is a normal variation that does not affect fetal growth and development, nor does it cause fetal hypoxia, and it also does not affect the method of childbirth. Therefore, for a 39-week pregnancy with the umbilical cord wrapped around the neck there is no difference from a normal pregnancy. Just follow the normal procedures for routine prenatal checks and waiting for childbirth. If there are no signs of labor, then continue to wait until after week 40 to go to the hospital for childbirth. However, if there are signs of labor, you should go to the hospital in time, wait for childbirth, and pay attention to enhanced monitoring during the process. There is no need to intervene with the umbilical cord being wrapped around the neck, nor is there any way to proactively intervene with it.
Does ovarian teratoma affect pregnancy?
Ovarian teratomas are a common type of benign ovarian tumor, and most ovarian teratomas do not affect the ability to become pregnant. This is because ovarian teratomas generally do not cause ovulation disorders, do not affect the function of the fertilized egg, and typically do not lead to pelvic inflammation, so the majority of patients with ovarian teratomas can become pregnant normally. However, if the ovarian teratoma is relatively large, greater than five centimeters, this condition may affect the function of the ovaries, or cause the teratoma to rupture or become infected after pregnancy. For teratomas larger than five centimeters, it is generally recommended to undergo laparoscopic surgery to remove the teratoma before attempting pregnancy, to prevent the teratoma from affecting the pregnancy.