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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
Is moxibustion useful for breech presentation and nuchal cord?
Fetal breech presentation and nuchal cord can be effectively addressed with moxibustion. Breech positions are common in early pregnancy but typically resolve to a head-first position by 32 weeks and become relatively stable. Higher incidences of breech positions are noted in cases of fetal abnormalities, twin pregnancies, abnormal amounts of amniotic fluid, uterine abnormalities, and narrow pelvis. If a breech position is still present after 32 weeks, moxibustion treatment can be considered. Moxibustion is applied at the Zhiyin acupoint (located 0.1 inches beside the nail corner on the outer side of the little toe) and is generally recommended once daily for 15 to 30 minutes, with one week constituting a treatment course. Afterward, the improvement in the fetal position can be evaluated. The purpose of using moxibustion is to promote fetal activity, which may help resolve nuchal cord entanglement during fetal movements.
Can pregnant women with gestational diabetes eat grapes?
Fruits are natural vitamins, and consuming fruits appropriately during pregnancy is extremely significant for supplementing vitamins, which can promote fetal growth. Patients with gestational diabetes are not entirely forbidden from eating fruits; however, it's essential to control the intake of fruits, ideally between 100 to 150 grams per day. Grapes are not completely off-limits, but since grapes have a high sugar content, if consumed, the quantity should be controlled to avoid eating too much. Opting for fruits like kiwis and apples, which have lower sugar content, is a better choice for those with gestational diabetes during pregnancy. Gestational diabetes can affect both the pregnant woman and the fetus. For the pregnant woman, it can increase the rate of miscarriages and is likely to complicate with gestational hypertension. Lowered immunity can lead to infections, particularly urinary and reproductive system infections, may cause excessive amniotic fluid, and increase the likelihood of difficult labor due to a larger baby. The impact on the fetus can lead to congenital disabilities, a significantly large baby, or restricted fetal growth, so it is crucial to control blood sugar levels during pregnancy. While ensuring the pregnant woman is not hungry, insulin can be used when necessary to maintain stable blood sugar levels during pregnancy.
What are the symptoms of gestational diabetes?
Diabetes during pregnancy, compared to diabetes outside of pregnancy, still presents symptoms such as polydipsia, polyphagia, and polyuria, but does not manifest as weight loss. Due to the increase in body weight from the enlarging uterus, fetus, and amniotic fluid during pregnancy, signs of weight loss are not evident. There are generally two types of diabetes in pregnancy. One is when diabetes pre-exists before pregnancy, which is termed diabetes mellitus with pregnancy; the other is when blood sugar levels were normal before pregnancy and diabetes develops during pregnancy, known as gestational diabetes. Over 90% of pregnant women with diabetes have gestational diabetes. Those with gestational diabetes have abnormal glucose metabolism, but most can return to normal after childbirth; however, the risk of developing Type 2 diabetes in the future increases.
How to prevent umbilical cord entanglement in late pregnancy
There are no effective prevention methods for nuchal cord, which is the most common form of umbilical cord entanglement where the cord wraps around the fetus's neck, limbs, or trunk. Nuchal cord occurs in 90% of these cases, frequently involving the cord wrapping around the neck once. This phenomenon can be observed in 20% of deliveries and is associated with factors such as an overly long umbilical cord, a small fetus, excessive amniotic fluid, and frequent fetal movements. An excessively long umbilical cord is mostly a physiological occurrence since the cord floats in the amniotic fluid and its actual length cannot be accurately measured, with no effective methods to prevent its occurrence. Excessive amniotic fluid and a small fetus are linked to certain pregnancy complications, such as diabetes-induced polyhydramnios and restricted fetal growth. Actively controlling blood sugar during pregnancy can prevent such issues. Frequent fetal movements are physiological for some pregnant women. Women who experience more frequent fetal movements throughout pregnancy are likely to encounter nuchal cord. Clinically, nuchal cord does not require special management unless it leads to obstructions in fetal descent, fetal distress, or variations in fetal heart rate. It does not impact delivery or fetal development.
What should I do if I get vaginitis during pregnancy?
Vaginitis during pregnancy should be actively treated, generally choosing vaginal medications. Vaginal medications typically do not enter the bloodstream and are not absorbed by the fetus, thus not affecting the growth and development of the fetus. Vaginitis during pregnancy can lead to chorioamnionitis, and intrauterine infection of the fetus may lead to premature rupture of membranes, subsequently causing preterm birth or miscarriage. During pregnancy, the vaginal environment undergoes changes. There is an increase in the number of vaginal epithelial cells and secretions, which appear as white, paste-like substances. The glycogen level in the vaginal epithelial cells rises, the lactic acid content increases, and the pH decreases, making it prone to fungal vaginitis. However, this environment is unfavorable for the growth of other pathogenic bacteria and is beneficial in preventing bacterial infections.
What should I do if the umbilical cord is wrapped around the neck once?
Umbilical cord wrapping around the neck once is a very common phenomenon, occurring in 20% of fetuses. When the umbilical cord wraps around the neck once, if the umbilical blood flow and fetal movements are normal, it indicates that the cord wrapping does not affect the fetus and will not have a direct impact on the fetus's intrauterine growth and development. However, during childbirth, attention must be paid to the possibility that the umbilical cord wrapping may cause difficulties in the descent of the presenting part of the fetus, leading to abnormal umbilical blood flow. If difficulties in the descent of the presenting part and changes in the fetal heart rate occur during delivery, the possibility of umbilical cord wrapping should be considered. If necessary, a cesarean section should be performed to terminate the pregnancy. There are no medications or other treatments that can alleviate umbilical cord wrapping; instead, enhanced prenatal monitoring is sufficient.
What should pregnant women do about oral ulcers?
Generally speaking, for recurrent oral ulcers, due to hormonal changes during pregnancy, most female patients experience fewer occurrences of oral ulcers. If oral ulcers occur during pregnancy, treatment can be based on the cause: First, if the oral ulcers are caused by bites or burns, Kangfuxin solution or watermelon frost spray can be used for local treatment to accelerate the healing of the ulcer. Second, if the oral ulcers are due to vitamin deficiency, the patient should pay attention to oral hygiene and can appropriately take oral vitamin tablets to enhance resistance and promote the healing of the ulcer. During the outbreak of ulcers, it is important to avoid eating spicy and irritating foods, and antibiotics are not needed for oral ulcers. (Medication should be used under the guidance of a physician.)
What impact does thalassemia have on the fetus?
Thalassemia is a common autosomal genetic disease with a high incidence in the southern regions of our country, divided into alpha type and beta type, and based on severity, it is further classified into silent, mild, moderate, and severe types. For fetuses with silent and mild thalassemia, there are usually no obvious symptoms, and no treatment is required; for moderate and severe thalassemia fetuses, we aim to prevent their birth, so it is necessary to conduct relevant tests on both spouses before and during early pregnancy to determine whether they carry the pathogenic genes for thalassemia. For fetuses with moderate or severe thalassemia, intrauterine growth retardation, abnormal skeletal development, and enlargement of the liver and spleen can occur; fetuses with severe thalassemia mostly die in utero or after birth. Fetuses with moderate thalassemia require long-term treatments after birth, such as blood transfusions, iron removal, and splenectomy, and even with such treatments, it is difficult for them to develop into adulthood.
How should pregnant women screen for albinism?
Prenatal screening for albinism primarily involves chromosomal testing during pregnancy. Albinism is a single-gene hereditary disease caused by a defect in a single gene. It mainly occurs in children of consanguineous marriages where both parents carry the albinism gene. This is not a routine prenatal screening; it is only conducted if there has been a case of albinism in the family. Fetal chromosomal examination generally takes place between the 16th to 24th weeks of pregnancy during amniocentesis, where fetal cells are collected to conduct genetic testing to determine if the fetus carries the albinism gene.
What effect does thalassemia in pregnant women have on the fetus?
Thalassemia is a common hereditary hemolytic disease caused by genetic defects regulating globin synthesis, leading to reduced or absent globin production. This results in shortened red blood cell lifespan and subsequently chronic hemolytic microcytic hypochromic anemia. Thalassemia is classified into α-thalassemia and β-thalassemia. α-thalassemia is more common and includes silent carrier state, trait, HBH disease, and Hb Bart's hydrops fetalis. The silent carrier state shows no clinical symptoms with a 2% chance of hydrops fetalis in newborns. The trait generally causes mild anemia with a 3%-5% chance of hydrops fetalis in newborns. HBH disease often presents with moderate to severe permissive anemia, typically accompanied by hepatosplenomegaly, depressed nasal bridge, and widened eye distance, giving a distinct anemic appearance. β-thalassemia is categorized into mild, severe, and intermediate β-thalassemia. Mild β-thalassemia does not show visible physical changes, mainly presenting as mild anemia. Severe β-thalassemia can exhibit extramedullary hematopoiesis causing distinctive facial features, delayed sexual development, and poor growth. The severity of intermediate β-thalassemia varies; some patients require regular blood transfusions to sustain life, allowing survival into adulthood.