adenomyosis - pathology课件

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1、UltrasoundinthemanagementofIUGRDrPhilippaRamsayMBBSFRANZCOGDDUCOGUPOWCampusCentreRPAMedicalCentreSydneyAdventistHospitalStLeonardsIntra-uterinegrowthrestrictionvsSmallforgestationalageLowbirthweight(LBW):<2500gVerylowbirthweight(VLBW):<1500gSmallfor

2、gestation(SGA):<10thpercentileofweightforgestationPretermdelivery:<37completedweeksgestationLBW-term:LBW&>37completedweeksgestationIntra-uterinegrowthrestrictionvsSmallforgestationalageIntra-uterinegrowthrestrictionAfetuswithpathologicallyimpairedgro

3、wthofvaryingdegreesSmallforgestationalageAfetuswhoisbelowthetenthcentileforgestationalageforweight,length&headcircumferenceIntra-uterinegrowthrestrictionvsSmallforgestationalageIntra-uterinegrowthrestrictionpathologicallyimpairedgrowthmaybe<10thcenti

4、leor>10thcentileSmallforgestationalagepathologicallyimpairedgrowthconstitutionallysmallPerinatalproblemsassociatedwithIUGRFetaldistressduringlabour(3-5x)MeconiumaspirationNeonatalacidosisPolycythemiaHypoglycemiaNecrotizingenterocolitisImpairedgrowth&

5、developmentIUGR:Morbidity&MortalityManningFA1995ThirdtrimesterfetaldeathStillbirthcomplicates5/1000birthsItisoftenunexplained(12-50%)IncirpiMetal.Stillbirthevaluation:whattestsareneeded.AmJObstetGynecol1998;178:1121-1125CausesoflatefetaldeathCordandp

6、lacentalcomplications10-20%Maternalhypertensivedisease5-25%Maternalmedicalcomplications5-10%Congenitalmalformations5-10%Intrauterineinfections5-15%Erythroblastosis3-15%unexplained50%PitkinRMetal.Fetaldeath:diagnosisandmanagement.AmJObstetGynecol1987;

7、157:583-589RiskofneonataldeathfromIUGRCausesofIUGR-1MaternaldiseaseChronichypertensionRenaldiseaseCardiacdiseaseMaternal&fetalMalnutritionDrugsAlcoholTobaccoCausesofIUGR-2PrimaryfetalCongenitalmalformationsChromosomalanomaliesInfectionCMV,rubella,tox

8、oPlacentaldysfunctionPlacentalinsufficiencyInfarction&separationMultiplebirthsRiskgroupsPoornutritionPre-eclampsiaRenaldiseaseHeartdiseaseInfectionMultiplegestationsGeneticabnormalitieslowSEstatuspoormaternalweightgainREF:GalbraithRSetal.Theclinicalp