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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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Difference between endometrial polyps and cervical polyps
Endometrial polyps and cervical polyps are two types of reproductive system polyps that are relatively common in women. Their differences lie in the following aspects: First, the location of the polyps is different. Endometrial polyps are located inside the uterine cavity, whereas cervical polyps grow in the cervical canal or on the external cervix. Second, the symptoms caused by each are different. Cervical polyps may cause symptoms or tend to cause abnormal vaginal bleeding outside of menstruation. In contrast, endometrial polyps typically lead to increased menstrual flow and generally do not cause bleeding outside of menstruation. Third, the examination methods are not completely the same. Endometrial polyps are primarily diagnosed through ultrasound, while cervical polyps are mainly checked through gynecological examination.
How is endometrial cancer staged?
Endometrial cancer is a common gynecological malignancy in women. Based on surgical and pathological results, endometrial cancer can be divided into four stages. Stage I is the mildest form of endometrial cancer, where the cancer is confined only within the endometrium and does not extend beyond the uterine serosa. Generally, stage 1a is when the cancer is less than half the width of the muscle, while stage 1b is when the cancer infiltrates more than half the width of the muscle. Stage II means the cancer has locally spread but only involves the cervix, without causing cervical stromal infiltration. Stage III involves local spread to the serosa and lymph nodes. Stage IV involves distant metastasis, such as to the liver and bones.
Is it easy to get pregnant with endometriosis?
Endometriosis, which has a relatively high incidence among women, refers to the condition where the endometrial tissue is located outside the uterine cavity. This condition can easily lead to infertility. Although endometriosis is a benign disease, it exhibits characteristics similar to those of malignant diseases, primarily manifesting as local infiltration that causes adhesions and can disrupt the function of the fallopian tubes and ovaries. First, it can lead to the presence of chocolate cysts on the ovaries, which can affect the ovulation function of the ovaries. Second, it can sometimes cause adhesions in the fallopian tubes or pelvic adhesions, affecting the egg-pickup function of the fallopian tubes. This prevents sperm and eggs from fertilizing within the fallopian tubes. Even if fertilization occurs, the impaired function of the fallopian tubes may also lead to an increased risk of ectopic pregnancy.
Will the gestational sac shrink if the embryo stops developing?
Embryo arrest, also known as missed abortion, refers to a condition in the early stages of pregnancy where the gestational sac does not develop normally due to various factors. Generally, the gestational sac will not begin to shrink until the embryo has been arrested for a considerable period. In the initial stages of embryo arrest, since the duration is relatively short, the trophoblastic cells within the gestational sac can still secrete estrogens, progesterone, and chorionic gonadotropin. These hormones stimulate the possible continued growth of the gestational sac in the short term. However, as the duration of the embryo arrest extends, the proliferation of the trophoblastic cells decreases, leading to a decline in hormone levels in the body. This reduces the stimulation to the gestational sac, causing it to gradually shrink, decrease in size, and possibly leading to a natural miscarriage.
Can an ultrasound detect an embryonic arrest?
Embryonic arrest refers to a condition in early pregnancy where no fetal heartbeat appears in the gestational sac. The diagnostic criteria mainly include the lack of observable primitive heart tube pulsation via ultrasound after two months of pregnancy, at which point embryonic arrest can be confirmed. The definitive diagnosis of embryonic arrest is primarily through ultrasound. The following situations observed during an ultrasound can lead to a diagnosis of embryonic arrest: 1. If the diameter of the gestational sac exceeds three centimeters without a clear fetal heartbeat or embryo visible inside, it can be diagnosed as embryonic arrest. 2. If an embryo is already present and approximately 10 days after the appearance of the embryo, an ultrasound still does not show a fetal heartbeat, this situation can also be determined as embryonic arrest.
Can a threatened miscarriage have a transvaginal ultrasound?
Whether or not to perform a transvaginal ultrasound during a threatened miscarriage mainly depends on the symptoms of the threatened miscarriage. A threatened miscarriage refers to the signs of a potential miscarriage, with common symptoms including vaginal bleeding and severe abdominal pain. If there is significant abdominal pain, a transvaginal ultrasound can be performed to determine the position of the gestational sac, or an abdominal ultrasound can also be done. If there is vaginal bleeding, performing a transvaginal ultrasound in this case may aggravate stimulation to the uterus and can easily lead to vaginal inflammation. In such cases, an abdominal ultrasound is generally recommended. Therefore, a transvaginal ultrasound can be performed if there is only abdominal pain during a threatened miscarriage, but it should not be done if there is concurrent vaginal bleeding.
Is embryonic arrest related to emotions?
Embryonic arrest refers to a condition during early pregnancy, around 9-10 weeks, where no fetal heartbeat is detected. In clinical practice, there are many causes of embryonic arrest, including chromosomal abnormalities, uterine malformations, infections, immune factors, and coagulation factors. However, many women do not investigate these reasons after experiencing embryonic arrest. Instead, they look for causes in their daily lives, such as dietary factors or emotional factors. In reality, embryonic arrest is generally not closely related to everyday life factors. Even if emotions fluctuate, such as becoming irritable or easily provoked, which might affect the gestational sac, such impacts usually manifest as symptoms of threatened miscarriage, but generally do not lead to embryonic arrest. Therefore, there is generally no correlation between embryonic arrest and emotional states.
Does postpartum hemorrhage require a blood transfusion?
The definition of postpartum hemorrhage is bleeding greater than 500 milliliters approximately 24 hours after vaginal delivery. Whether blood transfusion is necessary for postpartum hemorrhage mainly depends on the specific amount of bleeding. For average women, if the hemoglobin level is normal before delivery and the bleeding is between 500-1000 milliliters, the body can compensate for the anemia through normal adjustments, and generally, a blood transfusion is not required. However, if the bleeding exceeds 1000 milliliters, this situation is considered massive hemorrhage and must be treated with a blood transfusion, otherwise it may lead to hemorrhagic shock or DIC (Disseminated Intravascular Coagulation).
Can a miscarried embryo be expelled naturally?
Embryonic arrest refers to the lack of natural development of the gestational sac in early pregnancy, characterized by the absence of a fetal heartbeat. If there is still no fetal heartbeat or embryo detected during an ultrasound at 8-9 weeks of pregnancy, it should be diagnosed as embryonic arrest. After embryonic arrest occurs, the vast majority require medical intervention. Of course, some cases of embryonic arrest can resolve naturally, leading to a miscarriage. However, this is not a reliable occurrence and is relatively rare in clinical practice. Moreover, the longer the wait, the greater the potential harm to the woman's health. For embryonic arrest, once diagnosed, it is urgent to intervene medically to remove the gestational sac from the uterus, minimizing harm to the woman. Common methods include medical abortion or a dilation and curettage surgery, either of which can be chosen.
Can you have intercourse with an arrested embryo development?
It is not recommended to have sexual intercourse when embryo arrest occurs. Embryo arrest, also known as missed miscarriage, refers to the abnormal development of the gestational sac during early pregnancy, and no fetal heartbeat is detected on an ultrasound by the ninth week of pregnancy. Once embryo arrest is diagnosed in clinical practice, a dilation and curettage surgery should be performed as soon as possible to minimize the impact on the fetus. However, during embryo arrest, since the gestational sac itself is not developing normally and is unstable, it is not advisable to have sexual activity. Sexual activity could stimulate the uterus to contract, leading to bleeding, which is not conducive to managing the embryo arrest. Moreover, sexual activity can easily lead to gynecological inflammation. If sexual activity causes gynecological inflammation, it is necessary to treat the inflammation before proceeding with the abortion, which can delay the process. Therefore, it is not recommended to have sexual intercourse during embryo arrest.