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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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Can an ultrasound detect premature rupture of membranes?
Premature rupture of membranes (PROM) refers to the rupture of amniotic fluid before labor. The most common diagnostic method for PROM is based on the clinical symptoms of the patient, mainly intermittent vaginal discharge. PROM can be confirmed using pH test strips specific for this condition. Ultrasound can be used as an auxiliary diagnostic method for PROM because most pregnant women with PROM will show a decreased amount of amniotic fluid during an ultrasound. However, the specificity of using ultrasound to determine PROM is not strong. Although the membranes may rupture, amniotic fluid can still be continuously produced, so some pregnant women may still have a normal amount of amniotic fluid during an ultrasound. Therefore, in most cases of PROM, a reduction in amniotic fluid can be observed through ultrasound, but there are cases where the amniotic fluid level appears normal. In such instances, it's essential to analyze the patient's clinical symptoms.
What to do if the umbilical cord is wrapped around the neck once in late pregnancy?
During the late stages of pregnancy, a B-ultrasound might sometimes reveal that the fetus has the umbilical cord wrapped around its neck once. This condition is a physiological occurrence. Having the cord wrapped once around the neck does not cause intrauterine hypoxia or harm the growth and development of the fetus inside the womb. The vast majority of cases where the cord is wrapped are physiological, and whether the cord is wrapped around once or twice, there is no need for excessive worry. In the late stages of pregnancy, the most important thing when the cord is found wrapped around the neck is to monitor fetal movements. As long as the fetal movements are good, it indicates that the fetus is in a normal condition inside the womb. It is also important to keep up with regular prenatal check-ups to assess whether the fetal growth and development are normal. Additionally, it is not advised to take any action to intervene when the cord is wrapped around the neck, as neither adopting sleeping positions nor any other methods can release the cord from the neck. These methods are futile and sometimes might even harm the fetus.
What is the blood pressure for gestational hypertension?
Pregnancy-induced hypertension refers to a series of pathophysiological changes caused by elevated blood pressure in women during pregnancy. It is a severe complication of pregnancy that can have serious effects on both the mother and the fetus. The diagnostic standard for hypertension during pregnancy is the same as in non-pregnant periods, that is, a blood pressure greater than 140/90mmHg can be diagnosed as pregnancy-induced hypertension. However, pregnancy-induced hypertension can be classified based on whether it is combined with other conditions, as well as the severity of the condition. Depending on the severity, pregnancy-induced hypertension can be divided into categories such as gestational hypertension, pre-eclampsia, eclampsia, chronic hypertension, and chronic hypertension with superimposed pre-eclampsia. These classifications are mainly based on the severity of the condition, and it is essential to treat pregnancy-induced hypertension with standardized care.
Premature rupture of membranes causes
Premature rupture of membranes is a common complication during pregnancy, which can easily lead to intrauterine infection of the fetus and preterm delivery. The main causes of premature rupture of membranes include the following aspects: First, the most common cause is an infection in the vagina, which then leads to an ascending infection, triggering chorioamnionitis. When chorioamnionitis occurs, the fragility of the membranes increases, making them prone to rupture, leading to the leakage of amniotic fluid. Second, the membranes can rupture due to a blunt impact on the abdomen, such as an accidental strong hit, which can cause the membranes to suddenly break, leading to premature rupture of membranes. Third, an excessive amount of amniotic fluid, due to various reasons, can increase the pressure inside the amniotic cavity, potentially leading to spontaneous rupture of the membranes. These are the various reasons for premature rupture of membranes.
Premature rupture of membranes symptoms
Premature rupture of membranes refers to the rupture of the membranes before labor, and the symptoms of premature rupture of membranes include the following aspects: Firstly, a large amount of fluid will flow out of the vagina. Once the membranes rupture, amniotic fluid will flow out intermittently, releasing a colorless and odorless fluid, which will wet the underwear. Secondly, there may be a small amount of bleeding. When the membranes rupture, the capillaries at the edges of the membranes may bleed slightly, mixing with the amniotic fluid, resulting in some spotting or slight bleeding. Thirdly, there may be abdominal pain and the sensation of contractions. After the rupture of the membranes, this can stimulate the cervix, causing the release of inflammatory mediators from the cervix and inducing uterine contractions, leading to contractions and the sensation of abdominal pain. These are the symptoms of premature rupture of membranes.
Will urinary incontinence heal itself after a vaginal delivery?
During natural childbirth, because it can damage pelvic floor function, causing issues such as bladder prolapse, uterine prolapse, and a series of other pelvic floor dysfunctions, some women may experience urinary incontinence after giving birth. If urinary incontinence occurs after natural childbirth, it suggests that the damage to the pelvic floor functions is quite severe, and these conditions generally cannot heal on their own. First, a pelvic floor function test should be conducted to assess the condition of the pelvic floor. If the damage to the pelvic floor is minor, it can be improved through machine-assisted treatment and performing Kegel exercises, which also help enhance pelvic floor functions. If the evaluation reveals severe prolapse, pelvic floor reconstructive surgery is required to suture the prolapsed bladder or uterus back into place, which can improve urinary incontinence. Therefore, urinary incontinence after natural childbirth generally does not heal on its own.
Will premature rupture of membranes continuously cause leaking of fluid?
Premature rupture of membranes refers to the rupture of the membranes before labor, characterized by intermittent discharge of amniotic fluid from the vagina. To diagnose premature rupture of membranes, it is necessary to combine the patient's clinical symptoms with objective examinations. However, this does not mean that amniotic fluid will continuously leak after the membranes rupture. The leakage of amniotic fluid in cases of premature rupture of membranes is intermittent, primarily because many patients choose to rest in bed after the rupture. When lying flat, the amniotic fluid will not continuously leak out and may come out in spurts at times. Therefore, the belief that amniotic fluid will continuously leak following premature rupture of membranes is incorrect; intermittent leakage can also indicate a rupture. If premature rupture of membranes cannot be diagnosed based on the vaginal discharge alone, pH test strips may be used to test the fluid. If the pH test strip changes color, it can confirm the diagnosis of premature rupture of membranes.
Threatened miscarriage how many days naturally miscarry
Threatened miscarriage refers to the occurrence of symptoms suggesting a possible miscarriage, such as severe abdominal pain or vaginal bleeding. However, a threatened miscarriage does not always progress to an actual miscarriage. With appropriate treatment and oral medication, the majority of embryos can be saved during a threatened miscarriage. If the quality of the embryo is poor and the symptoms of threatened miscarriage continue to worsen, it may develop into a natural miscarriage. However, there is no specific clinical guideline on how many days it may take for a natural miscarriage to occur following a threatened miscarriage. If the symptoms of threatened miscarriage are mild, with only slight abdominal pain or vaginal bleeding, it may not lead to a natural miscarriage, or it might take up to a week to occur naturally. If the symptoms of threatened miscarriage are severe, featuring intense abdominal pain or heavy vaginal bleeding, it generally may result in a natural miscarriage within one to two days.
Spontaneous abortion embryonic pathological examination
After a natural miscarriage, pathological tests can be performed on the embryonic tissue. The main purposes of these tests include the following two aspects: First, to check if the chorionic villi in the embryonic tissue are edematous or if it is a hydatidiform mole. In cases of natural miscarriage, if it is a hydatidiform mole, it is necessary to determine whether it is a benign or malignant hydatidiform mole. If it is not a hydatidiform mole, it can be treated as a regular miscarriage. Secondly, testing the embryo can clarify the reasons for the miscarriage, such as checking the chromosomes of the embryo to determine if there are any issues with the chromosomes, which can be informative for the next pregnancy.
Is a threatened miscarriage the same as a biochemical pregnancy?
Threatened miscarriage and biochemical pregnancy are two important terms used to describe the state of pregnancy in early stages, but they are two completely different physiological states. First, threatened miscarriage refers to a situation where an intrauterine pregnancy has been confirmed and the gestational sac is unstable or affected by external stimuli, showing symptoms such as lower abdominal pain and spotting. These symptoms merely indicate signs of a possible miscarriage, and with timely treatment, it is possible to revert to a normal pregnancy. Second, a biochemical pregnancy is a type of natural miscarriage. It refers to early pregnancy where the HCG levels are relatively low, no clear gestational sac has formed, and upon re-examination, the HCG levels are found to decrease quickly, accompanied only by minimal vaginal bleeding.