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Zhang Yin Xing
Obstetrics
About me
Deputy Chief Physician, engaged in obstetrics and gynecology clinical, teaching and other work for more than 12 years, with abundant experience in obstetrics and gynecology clinical work and teaching. A member of the Obstetrics and Gynecology Medical Association of Huangshi City, has published multiple articles and monographs in domestic journals and holds patents.
Proficient in diseases
Mastering the diagnosis and treatment of common obstetrics and gynecology diseases, prevalent diseases, and difficult and critical diseases; specializing in the management of high-risk pregnancies, such as the diagnosis and treatment of hypertension in pregnancy, prenatal diagnosis, recurrent miscarriage, pregnancy complications/comorbidities, and rich experience in managing critical, urgent, and severe cases.
Voices
How to control gestational diabetes
For diabetes during pregnancy, it is important to manage the condition in pregnant women. Initially, for blood sugar control during pregnancy, we recommend that the blood sugar levels before meals and two hours after meals be less than or equal to 5.3 mmol/L and 6.7 mmol/L, respectively, and nighttime blood sugar levels should not be lower than 3.3 mmol/L. For patients with diabetes complicated by pregnancy, the blood sugar control during pregnancy should meet the following targets: early pregnancy blood sugar control does not need to be overly strict to prevent hypoglycemia. Blood sugar levels before meals and during the night, as well as fasting blood sugar, should be controlled between 3.3 to 5.6 mmol/L, and post-meal peak blood sugar levels should be between 5.6 to 7.1 mmol/L. For both diabetes during pregnancy and diabetes complicated by pregnancy, if blood sugar levels cannot meet the above standards through diet and exercise management, insulin or oral hypoglycemic drugs should be used for further blood sugar control. Pregnancy is a special physiological period, and blood sugar control in diabetic pregnant women must not only be within the normal range but also ensure reasonable nutrient intake for the mother and fetus, reducing the occurrence of maternal and fetal complications. Most patients with gestational diabetes can control their blood sugar satisfactorily through reasonable dietary control and appropriate exercise therapy. The total daily nutrient intake should be determined based on the weight before pregnancy and the rate of weight gain during pregnancy.
What should I do if I catch a cold during pregnancy?
During pregnancy, if a cold occurs, it should be analyzed based on the duration and type of the cold. Colds are generally categorized into common colds and influenza. Common colds are self-limiting, and typically heal on their own within 7 to 14 days without the need for medication. Influenza can be accompanied by high fever, and severe cases can lead to serious complications such as pneumonia, thus requiring early detection and treatment. If the cold occurs within two weeks after ovulation and does not lead to miscarriage, the pregnancy can usually continue, and there will generally be no long-term impact on fetal development. However, if a cold occurs between the first to third month of pregnancy, during the period of fetal organ differentiation, it might lead to abnormal fetal development. Additional examinations would be necessary during the mid-term of the pregnancy. Colds that occur after the third month of pregnancy typically have a minor impact on the fetus, and usually do not require special treatment.
What are the symptoms of threatened miscarriage?
Threatened miscarriage primarily refers to the occurrence of a small amount of vaginal bleeding before 28 weeks of pregnancy, often dark red or blood-stained discharge, with no pregnancy tissue expelled. The amount of bleeding generally does not exceed that of a menstrual period and may be accompanied by intermittent pain in the lower abdomen or the sacral area. During a gynecological examination, the cervix is not dilated, the membranes are intact, and the size of the uterus corresponds to the gestational age. After rest or treatment, the symptoms may alleviate, allowing the pregnancy to continue. If vaginal bleeding increases and lower abdominal pain intensifies, and all or part of the pregnancy tissue is expelled through the vagina, a miscarriage that cannot be avoided is considered. In this case, it is necessary to terminate the pregnancy promptly to avoid endangering the pregnant woman's life due to excessive bleeding.
How to treat eczema dermatitis in pregnant women?
Pregnant women's eczema is a relatively common disease during pregnancy. Eczema is a rash-like change in the skin that occurs after pregnancy. First, we must exclude a pregnancy-specific disease called cholestasis of pregnancy. Cholestasis of pregnancy primarily manifests as skin itching, starting initially in the palms and soles of the feet and can spread to various parts of the body, with abdominal itching being the most severe. It differs from eczema mainly in that eczema usually involves changes in the skin, but the itching from cholestasis of pregnancy does not show obvious changes on the skin surface. If cholestasis of pregnancy is excluded, we can manage the condition based on the dermatologist's advice. For mild cases, some topical medications, such as calamine lotion, can be used without significant effects on the baby. If the eczema is severe or even affects sleep, sedative medications may be used before bedtime, or some oral antihistamines can help treat the condition. (Please follow the doctor's prescription when taking any medication.)
What are the symptoms of threatened miscarriage?
Threatened miscarriage refers to a small amount of vaginal bleeding occurring before 28 weeks of pregnancy. Usually, the amount of bleeding does not exceed that of a normal menstrual period, and the blood may be dark red or appear as bloody vaginal discharge. The color of the bleeding is not significant. No pregnancy tissue is expelled initially, and this may be followed by episodic lower abdominal pain or back pain, although these symptoms may not occur. During a gynecological examination, the cervix is closed, the membranes are intact, and the size of the uterus corresponds to the gestational age. After rest and treatment, the symptoms may disappear, and the pregnancy can continue. If the amount of vaginal bleeding increases or lower abdominal pain intensifies, accompanied by the expulsion of pregnancy tissue, it progresses to inevitable miscarriage. Inevitable miscarriage refers to a miscarriage that cannot be avoided. Based on the symptoms of a threatened miscarriage, the amount of vaginal bleeding increases, and episodic lower abdominal pain intensifies, possibly accompanied by vaginal fluid discharge. During a gynecological examination for inevitable miscarriage, the cervix is dilated, and embryonic tissue or the amniotic sac can be seen obstructing the cervical opening.
Does postpartum breastfeeding cause bleeding?
Bleeding caused by postpartum breastfeeding generally occurs within 42 days after delivery, during which the mother has lochia secretion. Breastfeeding promotes the secretion of oxytocin, which acts on the uterus and causes it to contract, facilitating the expulsion of lochia and aiding in the recovery of the uterus. Typically, by 42 days postpartum, the uterus has returned to its non-pregnant size and the expulsion of lochia is essentially complete. Subsequent breastfeeding is not directly related to vaginal bleeding. Another situation is due to the increase in prolactin during lactation; menstrual periods may not have fully resumed in women who are breastfeeding, and abnormal uterine bleeding may occur. As long as the amount and duration of bleeding do not exceed normal menstrual flow, no special treatment is needed.
Does vomiting and breast swelling indicate pregnancy?
In the early stages of pregnancy, common symptoms such as nausea, vomiting, fatigue, and dizziness, known as early pregnancy reactions, typically appear around six weeks after missed menstruation. Around eight weeks of missed menstruation, due to the increase in estrogen and progesterone, one might experience breast tenderness, but these are not the main criteria for diagnosing pregnancy. The first clinical symptom of pregnancy is missed menstruation. For women of childbearing age with regular menstrual cycles, a noticeable delay in menstruation of ten days should initially prompt a consideration of pregnancy. This can be confirmed through elevated levels of blood HCG, followed by an ultrasound that reveals a visible gestational sac in the uterus to confirm the diagnosis.
Frequent urination and breast pain, is this pregnancy?
Frequent urination and breast pain are not necessarily symptoms of pregnancy. During pregnancy, the forward tilting of the uterus presses on the bladder, which can cause frequent urination. Breast pain generally occurs around the eighth week of pregnancy due to an increase in estrogen and progesterone, promoting the growth of mammary ducts and tissue. However, these are not exclusive symptoms of pregnancy. To confirm pregnancy, detection through blood and urine HCG tests, as well as ultrasound scans can be used. For blood HCG levels, they can be detected as elevated about ten days after intercourse, and urine HCG can be detected about 14 days after intercourse using a pregnancy test. Around six weeks after missing a period, an ultrasound can determine if there is any pregnancy tissue in the uterus.
What to do about a threatened miscarriage?
Threatened miscarriage refers to the occurrence of a small amount of vaginal bleeding before 28 weeks of pregnancy, often dark red, with no pregnancy tissue expelled, and may include pain in the lower abdomen and back. During a gynecological examination, the cervix is closed and the membrane is unruptured, and the pregnancy can continue if the symptoms disappear after rest and treatment. In handling a threatened miscarriage, it is first necessary to analyze the causes of the miscarriage. Common causes include embryonic factors, mainly chromosomal abnormalities. If the miscarriage is caused by chromosomal abnormalities, it is mostly unavoidable. Maternal factors, such as systemic diseases in pregnant women, include increased blood pressure, severe anemia, high fever, etc. Pregnancy can mostly continue with treatment of the cause. Abnormalities in the reproductive organs, such as uterine malformations, submucous and intramural fibroids, adenomyosis, etc., can lead to miscarriage. With appropriate treatment to preserve the pregnancy, there is hope to continue the pregnancy. If due to endocrine abnormalities, such as luteal phase deficiency or hypothyroidism, supplementing with progesterone and thyroid hormones can mostly allow the pregnancy to continue. Identifying the cause of a miscarriage is extremely important, as different causes can lead to different pregnancy outcomes.
Symptoms of Gestational Diabetes
The symptoms of gestational diabetes differ from those of non-pregnancy diabetes; non-pregnancy diabetes is mainly characterized by excessive drinking, eating, urination, and weight loss. During pregnancy, excessive drinking and eating may be physiological responses due to increased appetite, and frequent urination may be caused by the enlarged uterus pressing on the bladder during early pregnancy. Weight loss is generally not apparent in gestational diabetes due to the growth of the fetus, the uterus, and the increase in amniotic fluid. For women who had a higher body mass index before pregnancy and a family history of diabetes, it is recommended to start glucose tolerance screening from the time of planning to conceive. For those who gain weight rapidly after becoming pregnant and have a significant increase in amniotic fluid, we typically conduct routine diabetes screening between 24 to 28 weeks of pregnancy. Gestational diabetes has severe impacts on the pregnant woman, the fetus, and the newborn, thus early detection and treatment are advised.