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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 a natural miscarriage require a uterine curettage?
A natural miscarriage refers to the spontaneous expulsion of the gestational sac from within the uterine cavity, in contrast to a miscarriage induced through medical intervention. A natural miscarriage is not the same as a complete miscarriage, which occurs when the gestational sac is completely expelled from the uterus without any remnants. Whether a natural miscarriage is complete is typically determined about a week after the event by a follow-up ultrasound. If the uterine cavity has no remnants or only minimal fluid accumulation, the miscarriage is considered complete, and usually, no surgical cleaning of the uterus is required. However, if the ultrasound after a natural miscarriage reveals substantial remnants within the uterine cavity, this indicates an incomplete miscarriage, and surgical cleaning of the uterus is generally necessary.
Symptoms of Hypertension in Pregnant Women
During pregnancy, if a pregnant woman develops high blood pressure, initially there are no symptoms, because at the beginning the blood pressure just slightly exceeds 140/90mmHg. If the high blood pressure is only temporary, it generally does not affect the woman's body and therefore, she may not experience any symptoms. As the condition progresses, the symptoms of high blood pressure can cause physical harm to the woman, likely damaging the kidneys and causing proteinuria. The loss of protein can lead to edema in women, and as a result, many women's initial symptoms will appear as generalized swelling, which does not improve with rest. By measuring blood pressure and urinary protein, symptoms of hypertension in pregnant women can be detected. In the later stages of the disease, hypertension may sometimes be accompanied by dizziness, indigestion, and mild pain in the lower abdomen, which are all symptoms of hypertension in pregnant women.
What to do about dysmenorrhea caused by endometriosis?
There are two types of dysmenorrhea, primary dysmenorrhea and secondary dysmenorrhea. An important cause of secondary dysmenorrhea is endometriosis. The dysmenorrhea caused by endometriosis comes from specific diseases, and the interventions include the following aspects: First, symptomatic treatment should be conducted first, which means using pain relief medication to alleviate the pain. In clinical practice, various pain relief medications can be used for dysmenorrhea caused by endometriosis. Second, treatment should be aimed at the cause of the dysmenorrhea. Treatment for endometriosis currently includes both medicinal and surgical approaches. If surgical treatment is chosen, it can involve the removal of ectopic cysts or pelvic ectopic cysts, among other conditions; if medicinal treatment is chosen, methods such as pseudopregnancy or artificial menopause can be used.
Can threatened miscarriage be treated with medical abortion?
Threatened miscarriage only indicates signs of a potential miscarriage and does not necessarily result in a spontaneous miscarriage. During a threatened miscarriage, medication can be used to preserve the embryo. If one does not wish to continue the pregnancy upon signs of a threatened miscarriage, intervention can be managed like a normal miscarriage. In early pregnancy, if one chooses to have an abortion, there are two methods available: medical abortion and surgical abortion, which are not significantly different from each other. For the majority of typical women, medical abortion is an option during a threatened miscarriage, though it is notably painful and can be prolonged. Patients must be clearly informed about the specific procedures and drawbacks. Surgical abortion, on the other hand, tends to be simpler and less painful.
Can an arrested embryo be expelled naturally?
Embryonic arrest, also known as missed miscarriage, refers to the restriction of growth and development of the gestational sac in early pregnancy due to various factors, with no fetal heartbeat detected on an ultrasound at 9 weeks of pregnancy. When embryonic arrest occurs, a natural miscarriage may happen, but it's also possible that a natural miscarriage won't occur. Once embryonic arrest is confirmed, waiting for a natural miscarriage isn't advisable, as it is unpredictable and sometimes there might be no signs of miscarriage for a long time. Unrestricted waiting in such cases can harm a woman's body. Therefore, once embryonic arrest is diagnosed, hospitalization should be promptly sought, and artificial intervention methods such as surgical or medical abortion should be considered. While there is a possibility that the embryo could be expelled naturally, the likelihood is relatively low.
What should I do about endometrial polyps?
Endometrial polyps are a common condition in women, with many experiencing them. The treatment for endometrial polyps discovered during an ultrasound primarily depends on the size of the polyps and whether they cause clinical symptoms. Firstly, if the endometrial polyp is relatively small, less than 5mm, and does not cause significant clinical symptoms, it may not require intervention and can be monitored with regular check-ups. Secondly, if the endometrial polyp is larger than 1cm or causes a significant increase in menstrual flow, hysteroscopic surgery should be performed to excise the polyp.
Is embryonic arrest related to diet?
Embryo arrest, also known as missed miscarriage, refers to the absence of a fetal heartbeat in the early stages of pregnancy due to various factors affecting the gestational sac. Typically, if no fetal heartbeat and embryo are detected during an ultrasound at about 8 to 9 weeks of pregnancy, it can be diagnosed as embryo arrest. Currently, there are many reasons for embryo arrest in clinical practice, but many pregnant women look for causes in their daily life, such as diet and exercise. However, these factors are largely unrelated to embryo arrest. While diet plays a very important role in human health, the growth and development of an embryo are mainly influenced by its own genetic material, endocrine, and coagulation factors, which are generally unrelated to diet. Therefore, when embryo arrest occurs, one should not look for reasons in diet or other daily life factors; instead, it is advisable to undergo targeted medical examinations to determine the specific cause.
What are some medications for threatened miscarriage to stabilize the pregnancy?
When threatened miscarriage occurs, it is necessary to use medications to sustain the pregnancy. Commonly used medications include the following types: The first type is progesterone medications, which have the effects of stabilizing the uterus and suppressing the immune system; the second type is estrogen medications, which can promote the proliferation of the endometrium, providing a favorable environment for the implantation and growth of the gestational sac; third, traditional Chinese medicine formulations, which also have the effects of stabilizing the uterus, promoting the development of the gestational sac, and reducing bleeding. In addition, it is necessary to conduct examinations based on the symptoms of threatened miscarriage to determine if there are any abnormalities in coagulation indicators. If the threatened miscarriage is caused by abnormal coagulation indicators, anticoagulant medications can be used for treatment.
Do uterine polyps affect pregnancy?
Endometrial polyps refer to the hyperplasia of the endometrial lining due to inflammatory stimuli, resulting in many polypoid tissues. Whether endometrial polyps affect pregnancy mainly depends on the number and size of the polyps, and whether they cause clinical symptoms. First, if the polyps are small and few in number without causing an increase in menstrual flow, they generally do not affect pregnancy and do not require removal of the endometrial polyps, as removing them could instead easily damage the function of the endometrial lining. Second, if the polyps are large, over one centimeter, or there are multiple endometrial polyps, and they cause an increase in menstrual volume, this indicates that the endometrial polyps have impacted the woman's body. In such cases, it is necessary to use a hysteroscope to remove the endometrial polyps before trying to conceive.
What is the cause of nausea in threatened miscarriage?
Threatened miscarriage refers to signs of miscarriage during pregnancy, and some women with threatened miscarriage may experience nausea. This situation includes several reasons: First, threatened miscarriage is not the same as a natural miscarriage; women are still pregnant, hence early pregnancy reactions such as nausea are normal. If the nausea is mild, rest and observation are advisable. However, if severe, it is important to visit the hospital for an examination to rule out hyperemesis gravidarum. Second, some cases of threatened miscarriage are caused by gastrointestinal inflammation, such as acute gastritis causing uterine contractions, which then leads to threatened miscarriage. The nausea in these situations is due to acute gastritis, so the nausea is a symptom caused by the condition that leads to the threatened miscarriage, not a direct result of the threatened miscarriage itself.