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1、LATERPREGNANCYCOMPLICATIONSDONGMEIHUDepartmentGynecology&ObstetricsZhujiangHospitalSouthMedicalUniversityPrematuredeliveryProlongedpregnancyPrematureRuptureofMembranes(PROM)ContentPRETERMLABOR早產(chǎn)PretermLabor:Laboroccursafter28weeks’butbefore37weeks’(ie.196~258da
2、ys)gestation.Infantsbornduringthesephaseareprematureinfants.Theprematureinfant’sweightisbetween1000and2499g.Theprognosisoftheprematureinfantiscorrelatedwithitsgestationalage,weight.Definition:PrematureinfantMatureinfantEtiology:1.Obstetriccomplications產(chǎn)科并發(fā)癥2.Med
3、icalcomplications內(nèi)科并發(fā)癥3.Surgicalcomplications外科并發(fā)癥4.Genitaltractanomalies生殖道畸形1.Obstetriccomplications:SeverehypertensivestateorpregnancyAnatomicdisorderoftheplacenta(abruptioplacentae,placentaprevia)PrematureruptureofmembranesPolyhydramniosoroligohydramniosMult
4、iplepregnancyPreviouslaceration(裂傷)ofcervixoruterus2.Medicalcomplications:PulmonaryorsystemichypertensionRenaldiseaseHeartdiseaseInfection:genitaltractinfection,urinarytractinfection,pyelonephritis腎盂腎炎,acutesystemicinfectionHeavycigarettesmokingAlcoholismordruga
5、ddictionSevereanemia3.Surgicalcomplications:Conizationofcervix宮頸錐切術(shù)Previousincisioninuterusorcervix(cesareandelivery剖宮產(chǎn)術(shù))4.GenitaltractanomaliesBicornuate雙角,subseptate縱隔,orunicormuate單角uterusCongenitalcervicalincompetency先天性宮頸閉合不全ClinicalFinding&Diagnosis1.Sympt
6、omandSignUterinecontractions—morethan2inone-halfhour;Vaginalbleeding-bloodymucousvaginaldischargeor“bloodyshow”;Dilatation擴張andeffacement消退ofcervix-changeindilatationoreffacementofatleast1cmoracervixthatiswelleffacedanddilatated(atleast2cm);2.LaboratoryStudiesCo
7、mpletelybloodcountwithdifferentialCervixdischargecultures:shouldbesentforgonorrhea淋病andchlamydia衣原體.Fetalfibronectin纖連蛋白(Ffn):negativetestiseffectiveatrulingoutimminentdelivery(within2weeks);positivetest(Ffn>50ng/ml):resultissensitiveatpredictingpretermbirth.分泌物
8、3.Accessoryexamination:Ultrasoundexaminationforfetalsize,position,placentalocation,andcervicallength.Cervicallength>30nm:prognosticatingprematuredelivery.Infundibulum