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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
Can premature rupture of membranes be detected by ultrasound?
Premature rupture of membranes refers to the rupture of the amniotic sac before labor begins. The diagnosis of premature rupture of membranes is mainly based on clinical symptoms, gynecological examination, and ultrasound assessment. Ultrasound can only serve as an auxiliary tool for diagnosing premature rupture of membranes. This is because, during premature rupture, an ultrasound might sometimes show a reduction in amniotic fluid due to significant fluid leakage, although amniotic fluid can also regenerate quickly. In such cases, an ultrasound done for premature rupture of membranes might still show the amniotic fluid level within the normal range. Therefore, the diagnosis of premature rupture of membranes heavily relies on clinical symptoms and gynecological examination. The presence of a large amount of fluid leaking from the vagina and a change in color on the amniotic fluid test strip during a gynecological examination are crucial for confirming the diagnosis. Ultrasound, in this context, serves only as a supplementary diagnostic method.
Can alpha-fetoprotein diagnose liver cancer?
Alpha-fetoprotein, also known as AFP, reflects the function of the liver and whether there are any diseases present. The accuracy and specificity of alpha-fetoprotein in diagnosing liver cancer are relatively high. In non-pregnant individuals, whether male or female, an elevated alpha-fetoprotein level should raise suspicions of liver disease, and it is advisable to promptly undergo ultrasound or CT scans to determine the presence of liver cancer or other liver diseases. However, during pregnancy, as the fetus grows and develops, a certain amount of alpha-fetoprotein is released. Therefore, when testing the blood of pregnant women, an increase in alpha-fetoprotein is observed. This condition is a physiological change and does not indicate the occurrence of liver diseases such as liver cancer in women. Thus, alpha-fetoprotein can serve as an auxiliary method for diagnosing liver cancer, but only in non-pregnant individuals.
Are cervical polyps prone to miscarriage?
Cervical polyps are a common disease in women, mainly caused by local inflammation of the cervix which leads to localized tissue hyperplasia, appearing as polypoid changes. For cervical polyps, the majority of them are unlikely to cause miscarriage. Before pregnancy, it is generally recommended to check the cervix for polyps during pre-pregnancy examinations. If polyps are found, they should be removed before pregnancy. If cervical polyps are discovered during pregnancy, a joint decision should be made based on the patient's symptoms and clinical manifestations. If the cervical polyp is relatively small, it may not require treatment. However, if the cervical polyp repeatedly causes bleeding or inflammation, then it should be removed during pregnancy. Removing the polyp in accordance with standard treatment procedures is generally not likely to cause miscarriage.
How long does it take for an ectopic pregnancy to bleed?
Ectopic pregnancy test strips indicate that the gestational sac is implanted outside the uterine cavity, with the most common type being a tubal pregnancy. The bleeding caused by a tubal pregnancy includes two types: vaginal bleeding and intra-abdominal bleeding. Firstly, the vaginal bleeding caused by an ectopic pregnancy mainly occurs because the gestational sac lacks a normal developmental environment, with relatively low levels of estrogen and progesterone. This leads to insufficient endometrial proliferation, resulting in regressive bleeding. Typically, vaginal bleeding appears around the fifth week of an ectopic pregnancy, but the amount of bleeding is generally small. Secondly, if the gestational sac in an ectopic pregnancy is relatively large, it can cause the local rupture of the fallopian tube, leading to intra-abdominal bleeding. This usually occurs around the seventh to eighth week of pregnancy. If the gestational sac is too small, even if there is mild abdominal pain, it will not cause intra-abdominal bleeding.
Does endometriosis affect pregnancy?
Endometriosis is a common gynecological condition, which involves the implantation of endometrial tissue outside the uterine cavity. Endometriosis is a common cause of infertility: Firstly, when endometriosis occurs, it often affects the function of the ovaries. For example, ovarian chocolate cysts can affect the release of endocrine hormones in the ovaries, as well as cause ovarian ovulation disorders or premature ovarian failure. Secondly, endometriosis can cause inflammation in the pelvic cavity and adhesions within the pelvis. This will impact the function of the fallopian tubes, causing ovulation disorders in the tubes, as well as disorders in the transport function of the tubes. This can prevent fertilization, or after the sperm and egg have combined, the fallopian tubes may not be able to transport the fertilized egg to the uterine cavity, thus increasing the risk of ectopic pregnancy.
What should I do about an ectopic pregnancy?
Ectopic pregnancy, as the name suggests, refers to the implantation of the gestational sac outside the uterine cavity, with the more common types including tubal pregnancy, ovarian pregnancy, and abdominal pregnancy. Ectopic pregnancy is mainly diagnosed through ultrasound and blood tests. If an ectopic pregnancy is confirmed or highly suspected, treatment should begin, primarily choosing between conservative medication treatment or surgical treatment based on the severity of the condition. 1. If the condition is mild, with HCG levels less than 1000 U/L and the mass volume smaller than 3 cm, conservative medication treatment can be chosen. 2. If the condition is severe, with a larger mass volume and significantly elevated HCG levels, surgical treatment is recommended. Currently, with the advancement of minimally invasive surgery, the majority of ectopic pregnancies can be treated using laparoscopy.
What are the signs of premature birth?
Preterm birth refers to delivery occurring between the 28th and 36th week +6 days of pregnancy. Firstly, it is advised to prioritize prevention and identify the symptoms of preterm labor as early as possible to allow for early treatment. Signs of preterm labor include the following aspects: First, the occurrence of regular contractions, such as 4 contractions within 20 minutes or 8 contractions within 60 minutes, with each contraction lasting more than a minute; second, the appearance of a small amount of bloody show, which is a sign of imminent labor; third, many times pregnant women will experience a significant feeling of heaviness. Upon examination, cervical dilation and a shortening of the cervical canal may be found. When these symptoms appear, it is important to rest in bed promptly and undergo treatment with medications.
Premature birth refers to childbirth happening before the normal completion of pregnancy, specifically before 37 weeks of gestation.
Premature birth, as the name implies, occurs when labor happens too early. Premature birth is generally defined by gestational age, specifically when delivery occurs between 28 and 36 weeks and 6 days of pregnancy. In contrast, miscarriage refers to delivery before 28 weeks; full-term birth refers to delivery between 37 and 41 weeks and 6 days; and post-term birth refers to delivery after 42 weeks of pregnancy. Premature birth can be quite harmful to the fetus, as during this period the fetus is smaller in size and less mature. If premature birth occurs, the survival rate of the fetus is relatively low. Causes of premature birth in clinical practice include vaginal inflammation, premature rupture of membranes, twin pregnancy, and shortened cervical canal. Therefore, prevention of premature birth should target these underlying causes.
What should be done for a threatened miscarriage?
Threatened miscarriage, as the name suggests, is a precursor to miscarriage, typically manifesting in several ways: first, a feeling of heaviness or pain in the lower abdomen; second, vaginal bleeding. The presence of these two symptoms often indicates signs of a miscarriage. Regarding the management of threatened miscarriage, whether to proceed with treatment to preserve the pregnancy primarily depends on the severity of the condition and the value of preserving the pregnancy. First, for minor cases of threatened miscarriage, if there is only slight bleeding and mild abdominal pain, medication can be used to inhibit uterine contractions and reduce bleeding. Second, if there is significant vaginal bleeding and severe abdominal pain, and if the embryo has already been confirmed to have ceased developing, preserving the pregnancy is generally not recommended. It is advised to terminate the pregnancy promptly or let it proceed naturally. (Medication should be used under the guidance of a doctor.)
How is endometriosis diagnosed?
Endometriosis refers to the occurrence of endometrial tissue outside the uterine cavity, a common gynecological condition that often leads to painful menstruation, pain during intercourse, and infertility. Diagnosing endometriosis involves several approaches. First, inquire about the patient's clinical symptoms, including any painful menstruation and pain during intercourse. Second, a pelvic ultrasound should be performed to observe the situation inside the pelvis, assessing for any ovarian endometriotic cysts or pelvic endometriotic lesions. Third, a blood test for CA-125 can be conducted, as the levels of CA-125 tend to increase with endometriosis. Fourth, laparoscopy can be used to collect local tissue for pathological examination, which is the gold standard in diagnosing endometriosis.