

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

What should a pregnant woman do if she has a cold and fever?
It is common for pregnant women to experience colds and fevers during pregnancy, as it is unlikely that the 40-week pregnancy period will go smoothly without issues. Cold and fever are common symptoms during this time and how to handle them mainly depends on the severity of the condition: Firstly, for a common cold, if there is only mild fever with a temperature below 38.5°C, or symptoms like nasal congestion, nasal pain, or sore throat, it is generally not recommended to take any medication, as colds are self-limiting diseases, primarily recovering through the body's immune system. Secondly, if the cold symptoms are very severe, exhibiting high fever with a temperature above 38.5°C, or symptoms like thick phlegm, this may indicate the possibility of influenza or signs of pneumonia. In such cases, it is important to conduct a blood test and to use antibiotics for treatment.

What is postpartum urinary incontinence?
Many women experience urinary incontinence after childbirth, and the severity varies from person to person. The causes of postpartum urinary incontinence include the following aspects. First, during pregnancy, the enlargement of the uterus can significantly press on the female pelvic floor, causing damage to pelvic floor function. Second, for women who have a vaginal delivery, the fetus needs to pass through the vagina. This process can further exacerbate damage to the female pelvic floor. These factors together can lead to pelvic floor dysfunction, resulting in conditions like uterine prolapse, bladder prolapse, and even urinary incontinence. For postpartum urinary incontinence, interventions such as Kegel exercises and electrical stimulation therapy should be used together to alleviate clinical symptoms and minimize impact on daily life. If conservative treatments are ineffective, pelvic floor repair surgery should be considered.

How to prevent premature rupture of membranes
Premature rupture of membranes is a common complication during pregnancy. Although it is not very severe, it can easily lead to premature delivery and intrauterine infection. If the premature rupture of membranes is not treated promptly, it can also lead to fetal death in utero or cause severe infection in the mother. Prevention is generally emphasized for premature rupture of membranes. First, it is important to prevent vaginal inflammation, as if vaginal inflammation occurs and is not treated promptly, these inflammations can cause infection of the membranes, which then leads to membrane rupture. Second, it is necessary to control uterine contractions. If the intensity of the contractions is very strong, medication should be used early to suppress the contractions, to minimize the exogenous pressure on the membranes. Third, attention should be paid to controlling the amount of amniotic fluid. If there is an excessive amount of amniotic fluid, it is important to carefully look for the causes and intervene. Excessive amniotic fluid can produce high endogenous pressure on the membranes, which also makes them more likely to rupture prematurely. (Please consult a professional physician for medication guidance and do not medicate blindly.)

Premature rupture of membranes causes and symptoms
The symptoms of premature rupture of membranes include the following aspects: First, the most important symptom is the intermittent discharge of clear fluid from the vagina, which is often the most typical symptom of premature rupture of membranes. Second, abdominal pain can occur, as the rupture of the membranes can stimulate contractions causing pain. Third, sometimes there may be a small amount of spotting, mainly due to a small amount of bleeding caused when the membranes rupture. The causes of premature rupture of membranes include the following aspects: First, excessive amniotic fluid can cause high pressure inside the amniotic cavity, which may sometimes lead to spontaneous rupture of the membranes. Second, if there is local inflammation, such as chorioamnionitis, it can also cause the membranes to rupture under severe conditions, leading to premature rupture of membranes.

Does an ectopic pregnancy cause early breast tenderness?
Ectopic pregnancy is a pathological condition in the early stages of pregnancy. Although it is a pathological state, it is still considered a pregnancy, so common early pregnancy reactions still occur in patients with ectopic pregnancies, including mild breast tenderness in the early stages. The reason for this tenderness is because after pregnancy, the levels of estrogen and progesterone in a woman's body increase. These hormones stimulate the mammary glands, causing slight proliferation and manifested as breast tenderness. Even in cases of ectopic pregnancy, the levels of estrogen and progesterone in a woman's body will rise, thus causing breast tenderness. However, in ectopic pregnancies, the increase in estrogen and progesterone is not particularly high, so the stimulation to the mammary glands is not as strong as in a normal intrauterine pregnancy. Thus, there is breast tenderness in the early pregnancy, but it is lower than in normal intrauterine pregnancies.

What are the causes of premature birth?
Preterm birth refers to delivery between 28 and 36+6 weeks of pregnancy. Due to the lighter weight and lower maturity of the fetus at this stage, the survival rate of newborns is often reduced. The causes of preterm birth include the following aspects: First, the presence of vaginal inflammation can easily lead to premature rupture of membranes, which in turn triggers contractions and can lead to preterm labor. Second, in twin or multiple pregnancies, the increased irritability of the uterine wall can easily cause spontaneous contractions, which in turn lead to preterm labor. Third, an excess of amniotic fluid can increase the pressure inside the amniotic cavity, easily stimulating spontaneous uterine contractions or premature rupture of membranes. Additionally, if the cervical canal is congenitally short, or if there has been previous cervical surgery, this can also easily lead to preterm labor.

How long does it take to be considered infertile when trying to conceive?
Pregnancy for women requires a certain amount of time to be successful, and if one cannot become pregnant in the short term, it does not necessarily mean infertility. It could be due to irregular ovulation or incorrect timing of sexual activity. In clinical practice, it is generally considered that if one has been trying to conceive normally without deliberate contraception and still cannot become pregnant after a year, then infertility should be diagnosed. For cases where conception hasn't occurred after a year of trying, examinations should be carried out for both partners to determine if there are any pathological factors. First, the male partner should have chromosome and sperm analysis; Second, the female partner should be checked for chromosomal infections, immune factors, rheumatology factors, etc. After clearly identifying the reasons, interventions should be made as much as possible to guide normal conception.

Does an ectopic pregnancy hurt in the early stages?
Ectopic pregnancy refers to the implantation of the gestational sac outside the uterine cavity, with common implantation sites including the fallopian tubes, ovaries, and pelvic cavity. Early ectopic pregnancy can also cause some pain, with common reasons for the pain including the following: First, the main reason is the enlargement of the uterus under the stimulation of estrogen and progesterone in the body, which pulls on the surrounding tissues and ligaments, such as the round ligament of the uterus, uterosacral ligaments, or bilateral adnexa, causing lower abdominal traction pain. This presents as a feeling of heaviness or menstrual-like sensation. This pain is a normal physiological manifestation during early pregnancy and is present in both intrauterine and ectopic pregnancies. Second, in early ectopic pregnancy, sometimes the gestational sac can cause mild irritation and pressure on local tissues, leading to mild localized pain, which is often not very noticeable.

Premature rupture of membranes symptoms
Premature rupture of membranes, as the name implies, refers to the clinical symptoms caused by the rupture of the amniotic sac before labor. These symptoms include the following aspects. First, there will be a leakage of amniotic fluid from the vagina, manifesting as wet pants or a wet bedsheet, which is a primary indication of premature rupture of membranes. Second, when the membranes rupture prematurely, there is often a small amount of bloody show. This is mainly because there are small capillaries on the membranes that also bleed when the membranes rupture, causing blood to mix with the amniotic fluid. Third, premature rupture of membranes often is accompanied by significant contractions, as the increase in pressure within the amniotic cavity during contractions can cause the membranes to rupture. When these situations occur, it is important to promptly go to the hospital to undergo an ultrasound and gynecological examination to confirm whether there is a premature rupture of membranes.

Can a teratoma be detected by ultrasound?
Teratomas are a common type of solid tumor in the ovaries, and the vast majority of ovarian teratomas are benign. The most common method to examine teratomas in women is to perform an ultrasound. Generally, an abdominal ultrasound can be done 3-7 days after the menstrual cycle has ended to observe the ultrasonic echo of both ovaries. Normally, both ovaries are uniform in size and echo. If the ultrasound suggests the presence of a substantive mass on the ovary, which has a strong echo, or indicates the presence of fat or bone echoes, then this condition is highly suspected to be a teratoma. For ovarian teratomas, if the size is relatively small and there are no clinical symptoms, temporary observation is possible. However, if it is larger than five centimeters, laparoscopic removal is generally recommended.