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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.
Voices
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.
What are the symptoms of hemorrhoids in pregnant women?
After pregnancy, the volume of the female uterus increases, and in late pregnancy, the fetus descends into the pelvis. These factors can compress the veins in the pelvic area, obstructing blood flow around the anus, causing venous blood stagnation around the anus, and making it easy for pregnant women to develop hemorrhoids or for pre-existing hemorrhoids to worsen during pregnancy. The symptoms of hemorrhoids in pregnant women include the following aspects: first, you can feel polyp-like tissue outside the anus with your hand. Second, when hemorrhoids are severe, they can cause the prolapse of hemorrhoidal tissue or be accompanied by anal bleeding. Third, hemorrhoids can sometimes be accompanied by constipation, and hemorrhoids during pregnancy should be treated through diet, exercise, and medication.
Can placenta previa with the umbilical cord wrapped around the neck one time be delivered vaginally?
Placenta previa and umbilical cord around the neck are two relatively common clinical conditions during pregnancy, and they have different impacts on natural childbirth. First, having the umbilical cord wrapped around the neck once is a very normal physiological occurrence, and it generally does not affect the ability to have a natural childbirth in any situation. Therefore, from the perspective of the umbilical cord around the neck, it does not affect natural childbirth. Second, placenta previa refers to the lower edge of the placenta being close to the internal os of the cervix. Whether natural childbirth is possible mainly depends on the type of placenta previa. If it is a partial or central placenta previa, such conditions generally cannot proceed with natural childbirth, as they might cause significant bleeding, necessitating an elective cesarean section. However, in the case of marginal placenta previa, where there is still some distance between the lower edge of the placenta and the cervical os, attempting natural childbirth might be possible, provided that preparations for a cesarean section are in place.
Can premature rupture of membranes be detected?
Premature rupture of membranes refers to the rupture of membranes before labor, manifested as vaginal discharge and abdominal pain, among other symptoms. The diagnosis of premature rupture of membranes is primarily conducted through the following methods: First, based on the patient's symptoms. The most typical symptom of premature rupture of membranes is the discharge of clear fluid from the vagina. This can generally be identified as amniotic fluid by the naked eye, which helps in diagnosing premature rupture of membranes. Second, if the amount of vaginal discharge is minimal, PH test strips can be used for detection. A change in the PH strip may indicate a diagnosis of premature rupture of membranes. Third, an ultrasound can also generally assess premature rupture of membranes, as the amount of amniotic fluid will decrease when the membranes have ruptured. These methods combined can confirm the presence of premature rupture of membranes.
What to do if the amniotic sac breaks early?
Premature rupture of membranes refers to the rupture of the membranes before labor begins. The management of premature rupture of membranes depends on the timing of the rupture and the condition of the fetus in the uterine cavity. First, for premature rupture of membranes after 34 weeks of pregnancy, since the gestational age is relatively advanced, the fetus is larger and more mature. In this case, the risks associated with continuing the pregnancy are higher. For premature rupture of membranes after 34 weeks, it is generally advised to allow natural progression or to deliver as soon as possible, and it is not recommended to attempt to prolong the pregnancy. Second, for premature rupture of membranes before 28 weeks of pregnancy, since the fetus is very small and the success rate of prolonging the pregnancy is relatively low under these circumstances, it is generally advised to terminate the pregnancy. Third, for premature rupture of membranes between 28 and 34 weeks, an attempt can be made to prolong the pregnancy as much as possible. However, if fetal hypoxia or infection occurs, the pregnancy should be terminated promptly.
36 weeks umbilical cord around the neck 2 weeks how to correct
At 36 weeks of pregnancy, which is approximately 9 months, it is close to full-term gestation. If an ultrasound reveals that the umbilical cord is wrapped around the neck twice, it often indicates the presence of a W-shaped notch behind the neck. Having the umbilical cord wrapped around the neck twice is a normal physiological occurrence and does not affect the growth and development of the fetus. Many pregnant women, upon hearing about the umbilical cord around the neck, fear it might affect fetal growth and development or cause ischemia or hypoxia, and thus want to correct it through various methods. Firstly, it is unnecessary to correct the umbilical cord around the neck as it is a physiological change. Secondly, there is no known method to correct this condition; neither dietary activities nor any other methods can intervene with the umbilical cord being wrapped around the neck. Therefore, there is no need, nor is there a way, to intervene with the umbilical cord wrapping; it is sufficient to simply observe and wait.
What department should a pregnant woman visit if she has a cold?
During pregnancy, if a pregnant woman catches a cold, she should visit the hospital promptly. The departments she needs to consult include the following: Firstly, she needs to visit the obstetrics department. The purpose of visiting obstetrics is not to treat the cold, but to assess whether the fetus has been affected by the cold and to evaluate the safety of the medications used for treating the cold. Secondly, she should consult the department of respiratory medicine. A cold falls under the purview of respiratory diseases, and a respiratory doctor should be consulted to determine whether medication is necessary. If it is a mild cold, medication is generally not required. However, for a severe cold, medication to reduce fever or antiviral drugs may be used, but these must be discussed with the obstetrician before use.