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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.
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Premature rupture of membranes how is it shown on ultrasound?
Ultrasound is a commonly used auxiliary method for diagnosing premature rupture of membranes. After the membranes rupture prematurely, amniotic fluid intermittently leaks out from the uterine cavity, but the production of amniotic fluid often cannot keep up with the leakage. Therefore, the majority of pregnant women with premature rupture of membranes will experience a reduction in amniotic fluid volume. Ultrasound will reveal that there is still a small amount of amniotic fluid in the amniotic cavity, but the volume is much lower than the normal range; the maximum depth of the amniotic fluid should be less than three centimeters, and the amniotic fluid index should be less than eight centimeters, which is a common occurrence. However, sometimes, if not much amniotic fluid leaks out after premature rupture of membranes, the ultrasound may sometimes show that the amniotic fluid volume is normal. In such cases, it is necessary to combine this finding with the patient's clinical symptoms to jointly determine the presence of premature rupture of membranes.
Is excessive amniotic fluid likely to cause premature birth?
Polyhydramnios is relatively common during pregnancy and can have a certain impact on the fetus. There are many reasons that can cause polyhydramnios, but regardless of the cause, polyhydramnios tends to lead to preterm birth. When there is an excessive amount of amniotic fluid, it puts significant pressure on the amniotic sac, which can easily lead to premature rupture of membranes. Premature rupture of membranes itself can stimulate the cervix, release inflammatory mediators, thereby causing contractions and symptoms of preterm labor. After the membranes rupture prematurely, infection within the uterine cavity is likely to occur, generally meaning that the possibility of keeping the pregnancy going for a long duration is unlikely. Therefore, polyhydramnios is associated with a higher risk of preterm labor. In clinical practice, if excessive amniotic fluid is detected during prenatal check-ups, it is advised to control the diet, engage in appropriate physical activities, or use other methods to keep the amniotic fluid level within the normal range.
Can postpartum hemorrhage be treated?
Postpartum hemorrhage refers to bleeding exceeding 800 or 1000 milliliters within a short period after childbirth. It is currently the leading cause of maternal mortality in clinical practice. With the improvement of clinical treatment levels and the enhancement of diagnostic capabilities for postpartum hemorrhage, the vast majority of such cases can be well-managed. The keys to addressing postpartum hemorrhage effectively are early diagnosis and early intervention, which can lead to favorable outcomes. The main causes of postpartum hemorrhage include uterine atony, retained placenta and membranes, injuries to the soft birth canal, and coagulation disorders. When significant postpartum bleeding occurs, it is crucial to carefully investigate these four aspects to identify the cause and intervene accordingly, often leading to successful treatment outcomes.
Signs of premature birth
Preterm birth refers to childbirth occurring between 28 and 36 weeks plus six days of pregnancy. The signs of preterm birth include the following aspects. First, regular contractions occur, generally defined as four contractions within 20 minutes or eight contractions within 60 minutes. Second, there may be a small amount of "show," mainly due to minor bleeding caused by the separation of the fetal membrane from the uterine wall. Third, many women experience a significant feeling of heaviness in the lower abdomen, which is caused by the descent of the fetal head. Fourth, upon examination, it can be found that the cervical canal has shortened and the cervical opening has dilated. When the above symptoms occur, there should be a high suspicion of the risk of preterm birth, and medications should be used promptly as an intervention to try to avoid the occurrence of preterm birth.
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.