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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.
Voices
Is there a difference between gestational diabetes and regular diabetes?
Gestational diabetes and common diabetes, although both types of diabetes, have significant differences between them. First, gestational diabetes is a disease specifically occurring during pregnancy and often only appears during the gestational period. After pregnancy, the majority of women will revert to a normal blood sugar state, so the main focus for gestational diabetes is on screening and intervention during pregnancy; Second, common diabetes is a chronic disease that accompanies an individual throughout their life, requiring long-term management of blood sugar through various methods. Therefore, the main difference between the two lies in the duration of the disease. Pregnant women with common diabetes, if they become pregnant, are referred to as having diabetes compounded by pregnancy, which also requires strict blood sugar management, but its mechanism of occurrence and principles of treatment differ from those of gestational diabetes.
Will swollen feet during pregnancy lead to premature birth?
Swelling of the feet is a common clinical symptom after pregnancy, but generally, foot swelling is not directly related to preterm birth. However, sometimes, if pathological factors cause foot swelling, it may lead to preterm birth. The most common cause of foot swelling during pregnancy is the increased size of the uterus compressing the veins and arteries in the pelvis, causing obstruction of venous return, which leads to swelling of the feet. However, this is a physiological change and does not cause preterm birth. Pathological factors, such as hypertension during pregnancy or renal diseases during pregnancy, might cause generalized edema. If the condition is severe, medical intervention for medically induced preterm birth may be required. However, it is the primary disease that causes preterm birth, not the swelling of the feet.
Postpartum depression should seek what clinic?
Postpartum depression is relatively common in clinical practice and can severely harm women's health. If not intervened in time, it can lead to serious pathological changes in the mother, and in severe cases, lead to grave consequences. Mothers suspected of having postpartum depression should seek medical attention promptly, with the most common department being the psychiatric outpatient clinic. Although postpartum depression is related to childbirth, general obstetric outpatient clinics are not particularly specialized in treating depression. Consultations with specialized psychiatric or psychological doctors should be sought to determine the presence of postpartum depression. If confirmed, psychological counseling should be provided, along with pharmacological treatment. Without examination and treatment, there might be incidences of self-harm in pregnant women.
Can you have sexual intercourse with an ectopic pregnancy?
Ectopic pregnancy refers to the embryo implanting outside the uterine cavity, with the vast majority being tubal pregnancies. Generally, intercourse is not recommended during an ectopic pregnancy. Firstly, during the treatment of an ectopic pregnancy, intercourse is inappropriate. If sexual activity occurs during an ectopic pregnancy, the movements are often too vigorous, and the emotions too intense, which is not conducive to the recovery of the body from an ectopic pregnancy. Moreover, it can easily stimulate the rupture of the ectopic mass, potentially leading to substantial intra-abdominal bleeding. Secondly, even after successful treatment of an ectopic pregnancy, such as post-surgery, it is also advised not to engage in sexual intercourse in the short term. This is because the body is generally weaker after ectopic pregnancy treatment and needs some time to recover before engaging in intercourse. It is generally recommended to wait until about a month after an ectopic pregnancy treatment, or until a menstrual cycle has passed, before engaging in sexual intercourse. However, it is crucial to use contraception during intercourse, as it is advised not to get pregnant again shortly after an ectopic pregnancy. Typically, it is recommended to consider pregnancy again after six months.
Symptoms of Postpartum Hemorrhage
Postpartum hemorrhage is the leading cause of death in pregnant women. The symptoms of postpartum hemorrhage include the following aspects: First, it initially presents as significant vaginal bleeding, where the bleeding may exceed 500 milliliters in a short period or 800-1000 milliliters within 24 hours, predominantly featuring fresh blood. Second, there can be abdominal pain or other symptoms caused by the underlying etiology, such as postpartum hemorrhage due to soft birth canal injuries, which can manifest as tears in the vagina or cervix. Third, there can be signs of shock, such as confusion, lowered blood pressure, and an increased heart rate, all of which are symptoms used to diagnose postpartum hemorrhage.
Ectopic pregnancy starts to cause abdominal pain at how many weeks?
Ectopic pregnancy refers to the implantation of the gestational sac outside the uterus, with over 95% of ectopic pregnancies being tubal pregnancies. Symptoms of ectopic pregnancy include lower abdominal pain, vaginal spotting, and shock. In many cases, there are no obvious clinical symptoms in the early stages of an ectopic pregnancy. This is because the gestational sac is relatively small, causing less irritation locally and not leading to significant abdominal pain. However, if the ectopic pregnancy grows significantly, it can irritate the fallopian tube and also stimulate the peritoneum, causing abdominal pain. Around five weeks, significant pain can be felt, but as the pregnancy progresses, this pain can increase in severity and may lead to rupture of the tubal pregnancy, causing hemorrhagic shock, which then necessitates emergency medical intervention.
Can premature rupture of membranes be detected by ultrasound?
Premature rupture of membranes refers to the rupture of the amniotic sac before labor begins. The diagnosis of premature rupture of membranes is mainly based on clinical symptoms, gynecological examination, and ultrasound assessment. Ultrasound can only serve as an auxiliary tool for diagnosing premature rupture of membranes. This is because, during premature rupture, an ultrasound might sometimes show a reduction in amniotic fluid due to significant fluid leakage, although amniotic fluid can also regenerate quickly. In such cases, an ultrasound done for premature rupture of membranes might still show the amniotic fluid level within the normal range. Therefore, the diagnosis of premature rupture of membranes heavily relies on clinical symptoms and gynecological examination. The presence of a large amount of fluid leaking from the vagina and a change in color on the amniotic fluid test strip during a gynecological examination are crucial for confirming the diagnosis. Ultrasound, in this context, serves only as a supplementary diagnostic method.
Can alpha-fetoprotein diagnose liver cancer?
Alpha-fetoprotein, also known as AFP, reflects the function of the liver and whether there are any diseases present. The accuracy and specificity of alpha-fetoprotein in diagnosing liver cancer are relatively high. In non-pregnant individuals, whether male or female, an elevated alpha-fetoprotein level should raise suspicions of liver disease, and it is advisable to promptly undergo ultrasound or CT scans to determine the presence of liver cancer or other liver diseases. However, during pregnancy, as the fetus grows and develops, a certain amount of alpha-fetoprotein is released. Therefore, when testing the blood of pregnant women, an increase in alpha-fetoprotein is observed. This condition is a physiological change and does not indicate the occurrence of liver diseases such as liver cancer in women. Thus, alpha-fetoprotein can serve as an auxiliary method for diagnosing liver cancer, but only in non-pregnant individuals.
Are cervical polyps prone to miscarriage?
Cervical polyps are a common disease in women, mainly caused by local inflammation of the cervix which leads to localized tissue hyperplasia, appearing as polypoid changes. For cervical polyps, the majority of them are unlikely to cause miscarriage. Before pregnancy, it is generally recommended to check the cervix for polyps during pre-pregnancy examinations. If polyps are found, they should be removed before pregnancy. If cervical polyps are discovered during pregnancy, a joint decision should be made based on the patient's symptoms and clinical manifestations. If the cervical polyp is relatively small, it may not require treatment. However, if the cervical polyp repeatedly causes bleeding or inflammation, then it should be removed during pregnancy. Removing the polyp in accordance with standard treatment procedures is generally not likely to cause miscarriage.
How long does it take for an ectopic pregnancy to bleed?
Ectopic pregnancy test strips indicate that the gestational sac is implanted outside the uterine cavity, with the most common type being a tubal pregnancy. The bleeding caused by a tubal pregnancy includes two types: vaginal bleeding and intra-abdominal bleeding. Firstly, the vaginal bleeding caused by an ectopic pregnancy mainly occurs because the gestational sac lacks a normal developmental environment, with relatively low levels of estrogen and progesterone. This leads to insufficient endometrial proliferation, resulting in regressive bleeding. Typically, vaginal bleeding appears around the fifth week of an ectopic pregnancy, but the amount of bleeding is generally small. Secondly, if the gestational sac in an ectopic pregnancy is relatively large, it can cause the local rupture of the fallopian tube, leading to intra-abdominal bleeding. This usually occurs around the seventh to eighth week of pregnancy. If the gestational sac is too small, even if there is mild abdominal pain, it will not cause intra-abdominal bleeding.