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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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How is premature rupture of membranes diagnosed?
Premature rupture of membranes refers to the rupture of the membranes before the onset of labor, followed by the leakage of amniotic fluid. It is necessary to distinguish premature rupture of membranes from increased vaginal discharge and urinary incontinence. The methods to diagnose premature rupture of membranes include the following aspects: First, symptomatically, after the rupture of membranes, a clear liquid intermittently leaks from the vagina, accompanied by mild abdominal pain or bloody show. Second, after the rupture of membranes, the liquid leaking from the vagina can be tested with pH paper, which in most cases will change color, confirming the diagnosis of premature rupture of membranes. Third, an ultrasound can be used to observe a reduction in the amount of amniotic fluid within the amniotic cavity. Fourth, the leaking fluid can be examined under a microscope to observe "fern-like" crystallization, which can also confirm the diagnosis of premature rupture of membranes.
Why does endometriosis cause infertility?
Endometriosis is a common cause of infertility. The reasons endometriosis leads to infertility mainly include the following aspects: First, if endometriosis occurs above the ovaries, this condition is referred to as ovarian chocolate cysts. This disease can cause ovarian ovulation disorders. Second, endometriosis easily leads to pelvic adhesions, which can affect the function of the fallopian tubes, making it difficult for the fimbrial end of the tubes to capture eggs. Endometriosis is very common among women with infertility; therefore, a thorough examination is essential when screening for causes of infertility. If endometriosis is present, surgical or medical treatment should be chosen to improve the symptoms of endometriosis as much as possible and alleviate the causes of infertility.
Preterm labor signs
Premature birth refers to delivery between 28 to 36 weeks plus 6 days of pregnancy. Due to the lower body weight and immature organ development of the fetus, premature birth can lead to decreased survival rates and increased morbidity in newborns. The signs of impending premature birth include the following aspects: First, the occurrence of regular contractions, which are the most common sign of premature birth. If intermittent lower abdominal pain occurs, it should be taken seriously, and fetal heart rate monitoring may be necessary for assessment. Second, the appearance of blood in the vaginal discharge often indicates that the fetal presenting part is descending, which is also a sign of premature birth. Third, a physical examination may reveal shortening of the cervical canal and dilation of the cervix, suggesting the possibility of premature birth. When these conditions occur, they should be taken seriously, and medication may be necessary for treatment. (Specific medications should be used under the guidance of a physician.)
Can acute salpingitis cause infertility?
If there is inflammation in the fallopian tubes, it can potentially lead to infertility. Inflammation causes the fallopian tubes to thicken, affecting their function. Firstly, the function of the fimbrial end of the fallopian tube is impacted, which affects the tube's ability to capture eggs. Secondly, the inflammation can affect the union of sperm and egg within the fallopian tube, making fertilization difficult. Moreover, inflammation of the fallopian tubes can also increase the likelihood of an ectopic pregnancy. This happens because when the fallopian tubes are inflamed, their ability to transport the fertilized egg to the uterus is impaired, leading to ectopic pregnancies. Therefore, it is crucial for women with fallopian tube inflammation to undergo adequate anti-inflammatory treatment before trying to conceive. Commonly used medications include cephalosporins and penicillin.
Can you get pregnant with an ovarian teratoma?
Ovarian teratomas are common benign solid tumors of the ovaries and generally do not affect pregnancy in women. Ovarian teratomas are usually small; if they are under three centimeters, surgery may not be necessary, and regular ultrasound monitoring is sufficient. This is because small ovarian teratomas can be difficult to locate during surgery, and the procedure can cause some damage to the ovaries. However, in the following situations, it is advisable to treat the teratoma before attempting to conceive: First, if the teratoma is larger than five centimeters, it should be removed regardless of whether it is benign or malignant, as even benign teratomas can cause complications during pregnancy such as rupture, infection, or malignant transformation. Second, if the teratoma grows rapidly over a short period, this suggests the possibility of malignancy. In such cases, the teratoma should be surgically removed and sent for pathological examination before attempting to conceive.
How long should one stay in bed for a threatened miscarriage?
Threatened miscarriage, as the name implies, is the appearance of signs of miscarriage, such as lower abdominal pain, bleeding, and a feeling of heaviness. For threatened miscarriage, it is appropriate to choose bed rest for treatment, but absolute bed rest is not necessary during threatened miscarriage. Prolonged bed rest is not always beneficial for the recovery of a woman’s health. Being bedridden for a long time can cause constipation, prevent vaginal bleeding from being expelled, and lead to mental stress. It is generally recommended to get out of bed for light activities during the day, aside from normal sleeping hours. Simple, light activities will not worsen the miscarriage. Generally, after a threatened miscarriage, it is advised to rest in bed for 3-5 days at most, and during this period, it is necessary to get out of bed intermittently.
Will the fetus still move if the membranes rupture prematurely?
Premature rupture of membranes refers to the rupture of membranes before labor, with amniotic fluid leaking intermittently. Based on the timing of the rupture, it can be classified into term premature rupture of membranes and preterm premature rupture of membranes. Although amniotic fluid will leak after the membranes rupture, leading to a reduction in its volume, amniotic fluid continues to be produced. Therefore, the fetus will still continue to move actively inside the uterus. In most cases, there is no abnormality in fetal movements after membrane rupture. However, if the membranes have been ruptured for a long time, or if the fetus experiences intrauterine hypoxia due to other factors, a decrease or absence of fetal movements may occur. Thus, normally, fetal movements continue after membrane rupture, but they may decrease or disappear if hypoxia occurs.
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If at ten days pregnant, you determine through blood tests or urine tests that you are indeed pregnant and do not wish to continue the pregnancy, hoping for a natural miscarriage is not advisable. Natural miscarriage refers to the spontaneous expulsion of the gestational sac from the uterine cavity. In clinical practice, a natural miscarriage is something that can only be encountered, not sought after, as it occurs naturally and cannot be influenced externally. It primarily happens due to poor quality of the gestational sac. Since a natural miscarriage may or may not occur, if you do not wish to continue the pregnancy, waiting it out is not significantly beneficial. Instead, it is advisable to opt for medical intervention to terminate the pregnancy as soon as possible.
ectopic pregnancy symptoms
Ectopic pregnancy is not a normal state of pregnancy. Normally, the gestational sac should be located in the middle of the uterine cavity. An ectopic pregnancy refers to the implantation of the gestational sac outside the uterine cavity. Common types of ectopic pregnancy include tubal pregnancy, ovarian pregnancy, and abdominal pregnancy, with over 99% of ectopic pregnancies being tubal pregnancies. The symptoms of an ectopic pregnancy include the following aspects: 1. In the early stages of an ectopic pregnancy, there are no clinical symptoms because the early gestational sac is relatively small and does not stimulate the fallopian tube or the local area, thus causing no symptoms. 2. When the gestational sac grows to a certain size, it compresses the tube cavity, causing mild abdominal pain. This pain intensifies as the gestational sac grows and can lead to tearing pain, indicating a ruptured tubal pregnancy. 3. During an ectopic pregnancy, because the gestational sac cannot develop normally, the levels of estrogen and progesterone in the body are relatively low, leading to endometrial withdrawal bleeding, which manifests as a small amount of bright red vaginal bleeding.
Will the fetus have diabetes if the mother has gestational diabetes?
Gestational diabetes is a common complication during pregnancy, characterized by elevated levels during glucose tolerance tests conducted while a woman is pregnant. Gestational diabetes can significantly affect both the mother and fetus, but actively controlling blood sugar can generally minimize these impacts. If a baby is born to a mother with gestational diabetes, this baby has a higher likelihood of developing diabetes later in life compared to the general population, but it does not necessarily mean that they will. This is because such babies have a genetic predisposition and might experience insufficient pancreatic function as adults, which can lead to diabetes. Therefore, it is important for these newborns to undergo regular blood sugar monitoring as adults to determine if they have diabetes, and if so, to seek proactive treatment.