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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.
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Will the fetus still move if the membranes rupture prematurely?
Premature rupture of membranes refers to the rupture of membranes before labor, with amniotic fluid leaking intermittently. Based on the timing of the rupture, it can be classified into term premature rupture of membranes and preterm premature rupture of membranes. Although amniotic fluid will leak after the membranes rupture, leading to a reduction in its volume, amniotic fluid continues to be produced. Therefore, the fetus will still continue to move actively inside the uterus. In most cases, there is no abnormality in fetal movements after membrane rupture. However, if the membranes have been ruptured for a long time, or if the fetus experiences intrauterine hypoxia due to other factors, a decrease or absence of fetal movements may occur. Thus, normally, fetal movements continue after membrane rupture, but they may decrease or disappear if hypoxia occurs.
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If at ten days pregnant, you determine through blood tests or urine tests that you are indeed pregnant and do not wish to continue the pregnancy, hoping for a natural miscarriage is not advisable. Natural miscarriage refers to the spontaneous expulsion of the gestational sac from the uterine cavity. In clinical practice, a natural miscarriage is something that can only be encountered, not sought after, as it occurs naturally and cannot be influenced externally. It primarily happens due to poor quality of the gestational sac. Since a natural miscarriage may or may not occur, if you do not wish to continue the pregnancy, waiting it out is not significantly beneficial. Instead, it is advisable to opt for medical intervention to terminate the pregnancy as soon as possible.
ectopic pregnancy symptoms
Ectopic pregnancy is not a normal state of pregnancy. Normally, the gestational sac should be located in the middle of the uterine cavity. An ectopic pregnancy refers to the implantation of the gestational sac outside the uterine cavity. Common types of ectopic pregnancy include tubal pregnancy, ovarian pregnancy, and abdominal pregnancy, with over 99% of ectopic pregnancies being tubal pregnancies. The symptoms of an ectopic pregnancy include the following aspects: 1. In the early stages of an ectopic pregnancy, there are no clinical symptoms because the early gestational sac is relatively small and does not stimulate the fallopian tube or the local area, thus causing no symptoms. 2. When the gestational sac grows to a certain size, it compresses the tube cavity, causing mild abdominal pain. This pain intensifies as the gestational sac grows and can lead to tearing pain, indicating a ruptured tubal pregnancy. 3. During an ectopic pregnancy, because the gestational sac cannot develop normally, the levels of estrogen and progesterone in the body are relatively low, leading to endometrial withdrawal bleeding, which manifests as a small amount of bright red vaginal bleeding.
Will the fetus have diabetes if the mother has gestational diabetes?
Gestational diabetes is a common complication during pregnancy, characterized by elevated levels during glucose tolerance tests conducted while a woman is pregnant. Gestational diabetes can significantly affect both the mother and fetus, but actively controlling blood sugar can generally minimize these impacts. If a baby is born to a mother with gestational diabetes, this baby has a higher likelihood of developing diabetes later in life compared to the general population, but it does not necessarily mean that they will. This is because such babies have a genetic predisposition and might experience insufficient pancreatic function as adults, which can lead to diabetes. Therefore, it is important for these newborns to undergo regular blood sugar monitoring as adults to determine if they have diabetes, and if so, to seek proactive treatment.
Difference between endometrial polyps and cervical polyps
Endometrial polyps and cervical polyps are two types of reproductive system polyps that are relatively common in women. Their differences lie in the following aspects: First, the location of the polyps is different. Endometrial polyps are located inside the uterine cavity, whereas cervical polyps grow in the cervical canal or on the external cervix. Second, the symptoms caused by each are different. Cervical polyps may cause symptoms or tend to cause abnormal vaginal bleeding outside of menstruation. In contrast, endometrial polyps typically lead to increased menstrual flow and generally do not cause bleeding outside of menstruation. Third, the examination methods are not completely the same. Endometrial polyps are primarily diagnosed through ultrasound, while cervical polyps are mainly checked through gynecological examination.
How is endometrial cancer staged?
Endometrial cancer is a common gynecological malignancy in women. Based on surgical and pathological results, endometrial cancer can be divided into four stages. Stage I is the mildest form of endometrial cancer, where the cancer is confined only within the endometrium and does not extend beyond the uterine serosa. Generally, stage 1a is when the cancer is less than half the width of the muscle, while stage 1b is when the cancer infiltrates more than half the width of the muscle. Stage II means the cancer has locally spread but only involves the cervix, without causing cervical stromal infiltration. Stage III involves local spread to the serosa and lymph nodes. Stage IV involves distant metastasis, such as to the liver and bones.
Is it easy to get pregnant with endometriosis?
Endometriosis, which has a relatively high incidence among women, refers to the condition where the endometrial tissue is located outside the uterine cavity. This condition can easily lead to infertility. Although endometriosis is a benign disease, it exhibits characteristics similar to those of malignant diseases, primarily manifesting as local infiltration that causes adhesions and can disrupt the function of the fallopian tubes and ovaries. First, it can lead to the presence of chocolate cysts on the ovaries, which can affect the ovulation function of the ovaries. Second, it can sometimes cause adhesions in the fallopian tubes or pelvic adhesions, affecting the egg-pickup function of the fallopian tubes. This prevents sperm and eggs from fertilizing within the fallopian tubes. Even if fertilization occurs, the impaired function of the fallopian tubes may also lead to an increased risk of ectopic pregnancy.
Will the gestational sac shrink if the embryo stops developing?
Embryo arrest, also known as missed abortion, refers to a condition in the early stages of pregnancy where the gestational sac does not develop normally due to various factors. Generally, the gestational sac will not begin to shrink until the embryo has been arrested for a considerable period. In the initial stages of embryo arrest, since the duration is relatively short, the trophoblastic cells within the gestational sac can still secrete estrogens, progesterone, and chorionic gonadotropin. These hormones stimulate the possible continued growth of the gestational sac in the short term. However, as the duration of the embryo arrest extends, the proliferation of the trophoblastic cells decreases, leading to a decline in hormone levels in the body. This reduces the stimulation to the gestational sac, causing it to gradually shrink, decrease in size, and possibly leading to a natural miscarriage.
Can an ultrasound detect an embryonic arrest?
Embryonic arrest refers to a condition in early pregnancy where no fetal heartbeat appears in the gestational sac. The diagnostic criteria mainly include the lack of observable primitive heart tube pulsation via ultrasound after two months of pregnancy, at which point embryonic arrest can be confirmed. The definitive diagnosis of embryonic arrest is primarily through ultrasound. The following situations observed during an ultrasound can lead to a diagnosis of embryonic arrest: 1. If the diameter of the gestational sac exceeds three centimeters without a clear fetal heartbeat or embryo visible inside, it can be diagnosed as embryonic arrest. 2. If an embryo is already present and approximately 10 days after the appearance of the embryo, an ultrasound still does not show a fetal heartbeat, this situation can also be determined as embryonic arrest.
Can a threatened miscarriage have a transvaginal ultrasound?
Whether or not to perform a transvaginal ultrasound during a threatened miscarriage mainly depends on the symptoms of the threatened miscarriage. A threatened miscarriage refers to the signs of a potential miscarriage, with common symptoms including vaginal bleeding and severe abdominal pain. If there is significant abdominal pain, a transvaginal ultrasound can be performed to determine the position of the gestational sac, or an abdominal ultrasound can also be done. If there is vaginal bleeding, performing a transvaginal ultrasound in this case may aggravate stimulation to the uterus and can easily lead to vaginal inflammation. In such cases, an abdominal ultrasound is generally recommended. Therefore, a transvaginal ultrasound can be performed if there is only abdominal pain during a threatened miscarriage, but it should not be done if there is concurrent vaginal bleeding.