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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
Does abortion pills cause infertility?
In clinical practice, there are many types of abortion drugs. Their primary purpose is to kill the embryo or fetus and then promote uterine contractions to expel the fetus from the uterus. From the perspective of the drugs alone, abortion drugs do not cause infertility because the drugs are metabolized quickly. However, if abortions are performed repeatedly multiple times, this may potentially lead to infertility. The cause of infertility in such cases is not related to the drugs but due to the repeated abortions, which could affect the woman's endometrium, cervix, and fallopian tubes. Therefore, it is advisable for women to minimize unnecessary abortions to reduce the risk of infertility caused by the abortions.
Can childbirth lead to heart failure?
Childbirth refers to the delivery of a fetus through vaginal delivery or cesarean section, and it represents a significant strain on a woman’s heart. Regardless of the type of delivery, there is a possibility of leading to heart failure to some extent. Especially during the second stage of labor, pregnant women often exert greater effort, significantly increasing the load on the heart. If there is poor heart function or pre-existing cardiac disease, it could lead to heart failure. In some cases, if the heart disease is severe and cannot withstand delivery, a cesarean section must be chosen. However, cesarean delivery can also lead to heart failure, mainly due to a large amount of blood flowing back to the peripheral circulation from the uterus after the fetus is delivered, causing a significant increase in the preload on the heart and easily leading to the onset of heart failure.
Does a missed miscarriage have any symptoms?
Embryo arrest, also known as missed abortion, refers to the influence of various factors on the growth and development of the gestational sac in early pregnancy, resulting in the absence of a fetal heartbeat. In the early stages, embryo arrest is imperceptible, as it often shows no signs. It is incorrect for some women to judge embryo arrest based on the presence of abdominal pain or changes in pregnancy reactions. Reactions to embryo arrest only appear after a certain period. When the embryo has been arrested for a longer period, the body may treat the gestational sac as a foreign object and attempt to expel it. This situation may present symptoms of threatened miscarriage, such as abdominal pain and vaginal bleeding. Under these circumstances, one can visit the hospital for an ultrasound to assess the condition of the fetal heartbeat. The absence of a fetal heartbeat confirms the presence of embryo arrest.
How is premature rupture of membranes diagnosed?
Premature rupture of membranes refers to the rupture of the membranes before labor, with amniotic fluid leaking intermittently. For the diagnosis of premature rupture of membranes, the following methods are primarily used. First, through the symptoms of the patient, when the membranes rupture prematurely, a clear liquid intermittently leaks from the vagina. However, this liquid must be distinguished from vaginal secretions and urine. Second, judgement can be made based on the presence of fern-like crystals in the amniotic fluid. A small amount of the liquid can be taken and observed under a microscope, and if distinct fern-like crystals are observed, it can be concluded that there is premature rupture of membranes. Third, the use of premature rupture of membranes test strips can aid in diagnosis. If the test strip changes color upon contact with the leaking fluid, it can be definitively diagnosed as premature rupture of membranes. Fourth, ultrasound can serve as a supplementary method, as amniotic fluid often decreases with premature rupture of membranes, and an ultrasound can reveal amniotic fluid levels below the normal range.
How is premature rupture of membranes diagnosed?
Premature rupture of membranes refers to the rupture of the membranes before the onset of labor, followed by the leakage of amniotic fluid. It is necessary to distinguish premature rupture of membranes from increased vaginal discharge and urinary incontinence. The methods to diagnose premature rupture of membranes include the following aspects: First, symptomatically, after the rupture of membranes, a clear liquid intermittently leaks from the vagina, accompanied by mild abdominal pain or bloody show. Second, after the rupture of membranes, the liquid leaking from the vagina can be tested with pH paper, which in most cases will change color, confirming the diagnosis of premature rupture of membranes. Third, an ultrasound can be used to observe a reduction in the amount of amniotic fluid within the amniotic cavity. Fourth, the leaking fluid can be examined under a microscope to observe "fern-like" crystallization, which can also confirm the diagnosis of premature rupture of membranes.
Why does endometriosis cause infertility?
Endometriosis is a common cause of infertility. The reasons endometriosis leads to infertility mainly include the following aspects: First, if endometriosis occurs above the ovaries, this condition is referred to as ovarian chocolate cysts. This disease can cause ovarian ovulation disorders. Second, endometriosis easily leads to pelvic adhesions, which can affect the function of the fallopian tubes, making it difficult for the fimbrial end of the tubes to capture eggs. Endometriosis is very common among women with infertility; therefore, a thorough examination is essential when screening for causes of infertility. If endometriosis is present, surgical or medical treatment should be chosen to improve the symptoms of endometriosis as much as possible and alleviate the causes of infertility.
Preterm labor signs
Premature birth refers to delivery between 28 to 36 weeks plus 6 days of pregnancy. Due to the lower body weight and immature organ development of the fetus, premature birth can lead to decreased survival rates and increased morbidity in newborns. The signs of impending premature birth include the following aspects: First, the occurrence of regular contractions, which are the most common sign of premature birth. If intermittent lower abdominal pain occurs, it should be taken seriously, and fetal heart rate monitoring may be necessary for assessment. Second, the appearance of blood in the vaginal discharge often indicates that the fetal presenting part is descending, which is also a sign of premature birth. Third, a physical examination may reveal shortening of the cervical canal and dilation of the cervix, suggesting the possibility of premature birth. When these conditions occur, they should be taken seriously, and medication may be necessary for treatment. (Specific medications should be used under the guidance of a physician.)
Can acute salpingitis cause infertility?
If there is inflammation in the fallopian tubes, it can potentially lead to infertility. Inflammation causes the fallopian tubes to thicken, affecting their function. Firstly, the function of the fimbrial end of the fallopian tube is impacted, which affects the tube's ability to capture eggs. Secondly, the inflammation can affect the union of sperm and egg within the fallopian tube, making fertilization difficult. Moreover, inflammation of the fallopian tubes can also increase the likelihood of an ectopic pregnancy. This happens because when the fallopian tubes are inflamed, their ability to transport the fertilized egg to the uterus is impaired, leading to ectopic pregnancies. Therefore, it is crucial for women with fallopian tube inflammation to undergo adequate anti-inflammatory treatment before trying to conceive. Commonly used medications include cephalosporins and penicillin.
Can you get pregnant with an ovarian teratoma?
Ovarian teratomas are common benign solid tumors of the ovaries and generally do not affect pregnancy in women. Ovarian teratomas are usually small; if they are under three centimeters, surgery may not be necessary, and regular ultrasound monitoring is sufficient. This is because small ovarian teratomas can be difficult to locate during surgery, and the procedure can cause some damage to the ovaries. However, in the following situations, it is advisable to treat the teratoma before attempting to conceive: First, if the teratoma is larger than five centimeters, it should be removed regardless of whether it is benign or malignant, as even benign teratomas can cause complications during pregnancy such as rupture, infection, or malignant transformation. Second, if the teratoma grows rapidly over a short period, this suggests the possibility of malignancy. In such cases, the teratoma should be surgically removed and sent for pathological examination before attempting to conceive.
How long should one stay in bed for a threatened miscarriage?
Threatened miscarriage, as the name implies, is the appearance of signs of miscarriage, such as lower abdominal pain, bleeding, and a feeling of heaviness. For threatened miscarriage, it is appropriate to choose bed rest for treatment, but absolute bed rest is not necessary during threatened miscarriage. Prolonged bed rest is not always beneficial for the recovery of a woman’s health. Being bedridden for a long time can cause constipation, prevent vaginal bleeding from being expelled, and lead to mental stress. It is generally recommended to get out of bed for light activities during the day, aside from normal sleeping hours. Simple, light activities will not worsen the miscarriage. Generally, after a threatened miscarriage, it is advised to rest in bed for 3-5 days at most, and during this period, it is necessary to get out of bed intermittently.