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Liu Wei Jie
Obstetrics
About me
Graduated from Hebei Medical University, deputy chief physician, popular science author. Enthusiastic about public welfare popular science. With more than ten years of clinical work, I have performed numerous obstetrics and gynecology surgeries. I hope to use my years of clinical experience to solve everyone's medical doubts.
Proficient in diseases
Skilled in diagnosing complex ectopic pregnancies, embryonic arrest, prenatal nutrition, gestational diabetes, embryonic arrest, miscarriage, prenatal examinations, prenatal screening, non-invasive testing, Down syndrome screening, placenta previa, placental abruption, cesarean section, vaginal delivery, vaginitis, pelvic inflammatory disease, uterine fibroids, ovarian cysts, HPV infection, colposcopy, cervical erosion, cervical cin, and molar pregnancy, as well as their diagnosis and treatment.
Voices
Do you need to be hospitalized for uterine evacuation after a missed miscarriage?
The criteria for diagnosing embryo arrest generally involve the appearance of the embryonic bud and heart tube between six to eight weeks. If these are not visible beyond eight weeks, the situation is referred to as embryonic arrest. Embryonic arrest requires abortion, which for safety reasons typically involves hospitalization and a combination of medication and uterine evacuation. However, if the gestational sac is relatively small, an outpatient abortion procedure might be sufficient. Whether hospitalization is necessary should be assessed by a doctor, who will consider factors such as previous scar pregnancies, the condition of a scarred uterus, and the size of the current gestational sac, to make a comprehensive decision.
Endometrial polyp pain sensation
Do endometrial polyps feel painful? Generally, endometrial polyps do not cause any pain unless there is malignant transformation. In such cases, one might experience discomfort or a dragging pain in the lower abdomen. How are endometrial polyps typically diagnosed? They are diagnosed due to clear changes such as excessively heavy menstrual flow. An ultrasound can reveal polyps, or if the menstrual flow is too heavy, a dilation and curettage (D&C) procedure is performed, and the material removed is sent for pathological examination to confirm the presence of endometrial polyps. If the polyp is small, it can be left alone as 27% of them resolve on their own. However, if the polyp is large and causes changes in menstruation or affects fertility, a hysteroscopy is necessary.
What are the warning signs of postpartum hemorrhage?
Postpartum hemorrhage generally does not have warning signs but usually has precipitating factors. These factors include maternal fear, psychological tension, macrosomia or twin pregnancy, as well as conditions like uterine fibroids, placental abruption, or placenta previa. In cases of placenta previa during a cesarean section, there is a high likelihood of severe bleeding. There is only one condition that might signal an impending postpartum hemorrhage, which is placental abruption. If placental abruption occurs, it can cause severe abdominal pain along with issues of hypertension during pregnancy. If a person with pregnancy-induced hypertension experiences severe abdominal pain, this could be a precursor to postpartum hemorrhage.
Can premature birth be natural birth?
First, let's discuss the concept of preterm birth, which is defined as births occurring between less than 37 weeks and more than 28 weeks of gestation. There are many reasons for preterm birth, such as genetic factors, premature rupture of membranes, or complications during pregnancy. If the pelvic size is adequate and the child can tolerate delivery, then vaginal delivery is preferred; however, if the fetus is too small or there are complications during pregnancy such as gestational hypertension, gestational diabetes, or if the mother's health status is not good, it is recommended to opt for a cesarean section to ensure a timely delivery.
Does postpartum hemorrhage count as dystocia?
Postpartum hemorrhage is one of the very important causes that endanger the lives of mothers. Although hemorrhage is not considered as dystocia, conditions of dystocia can induce severe hemorrhage. This is because complications such as trauma to the birth canal and uterine atony might occur after dystocia. These issues are triggers for severe postpartum hemorrhage. Even in normal cesarean sections, there can be cases of severe postpartum hemorrhage, thus postpartum hemorrhage is not counted as dystocia, but dystocia can easily induce severe postpartum hemorrhage.
Why is uterine curettage necessary for postpartum hemorrhage?
We encounter a situation where postpartum hemorrhage is caused by the presence of residual material inside the uterus, which can influence the contraction of the uterus. This condition can lead to severe postpartum hemorrhage. The most important solution for postpartum hemorrhage is to immediately stop the bleeding. Therefore, by removing the residual material from the uterine cavity, the uterus can return to its normal contraction, achieving the purpose of immediately stopping the bleeding. It is also very common to need uterine evacuation after childbirth, as this process might cause some trauma to the uterus. Although it can be somewhat traumatic, this trauma is minimal compared to severe postpartum hemorrhage. In such cases, we must carefully weigh the pros and cons and decisively decide to proceed with the evacuation of the uterus.
The hazards of anemia in pregnant women
Firstly, the occurrence of anemia during pregnancy is very common, and most cases are mild anemia, but a small proportion can be severe. The harm of anemia comes from two aspects: one is that it is harmful to the fetus, as anemia during pregnancy can affect the intellectual development of the fetus, which is very clear. Another harm comes from the mother, such as the possibility of postpartum hemorrhage or infection. If a cesarean section is performed, our hemoglobin must not be lower than 80 grams. If it is below 80 grams, a blood transfusion or intraoperative blood preparation is needed.
What is the earliest gestational week that a premature baby can survive?
Preterm infants, how many weeks can survive, first let's talk about the concept of preterm birth. The concept of preterm birth is more than 28 weeks but less than 37 weeks, this is called premature birth. However, with the improvement of neonatal resuscitation technology, in China, if it’s after 26 weeks, the vast majority of newborns can also survive. But after survival, the cost is quite high. For instance, if it's in a top-tier hospital, the cost for newborns born between 26 and 28 weeks can be around several hundred thousand yuan. So, even after some medical insurance policy reimbursements, you would still have to spend around tens of thousands of yuan on your own.
The difference between postpartum hemorrhage and menstruation
The difference between postpartum hemorrhage and menstruation varies whether it is a vaginal delivery or a cesarean section. The timing of postpartum bleeding varies, and it also relates to postpartum lochia. If the bleeding occurs within 24 hours, it is called severe postpartum hemorrhage; most frequently, we encounter bleeding after 24 hours. Typically, for vaginal deliveries, bleeding occurs within seven days. In cesarean sections, due to the uterine incision, healing is needed, and the duration of bleeding varies by individual and health, commonly lasting from one to two months post-operation. Postpartum bleeding is due to incomplete healing of the uterine lining, which is different from menstrual bleeding. Menstrual bleeding is usually heavier in the initial days and the blood is dark red with a cyclic pattern. In contrast, postpartum bleeding does not have a cyclic nature; it usually consists of fresh red or dark blood, whereas menstrual bleeding typically involves dark blood.
Does ovarian teratoma affect pregnancy?
In gynecology, teratomas are a very common type of ovarian cyst. If a teratoma is discovered during the pre-pregnancy period, its size should be considered. If the teratoma is larger than five centimeters in diameter and is accompanied by abnormalities on a CT scan, it is recommended to undergo surgery before attempting to conceive. If the teratoma is very small, such as two to three centimeters in diameter, it does not affect future pregnancy. If a teratoma is discovered during early pregnancy, opinions vary. Some recommend surgical treatment after the first trimester, while others suggest a pregnancy observation plan. Teratomas during pregnancy are prone to complications such as ovarian cyst torsion, which can cause abdominal pain. Therefore, if you have a teratoma and successfully conceive, be mindful of any pain.