《前置胎盘英》ppt课件

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1、PlacetalPreviaLongXiaoyu龙晓宇XuanWuHospital宣武医院Case1.30G3P2at32weeks’gestation,painlessvaginalbleeding.Fourweeksago,postcoitalvaginalspotting2.BP:110/70mmHg,abdomenissoftuterusnontender,FHR:140-150bpmCase1Whatismostlikelydiagnosis?Whatisyournextstep?Lo

2、ng-termmanagementofthispatient?WhatarethemostcommoncausesofAntepartumHemorrhage?COMMONCAUSESPlacentaPreviaPlacentalAbruptionPretermlaborUNCOMMONCAUSESUterineruptureFetal(chorionic)vesselruptureCervicalorvaginallacerationsCervicalorvaginallesions,in

3、cludingcancerCongenitalbleedingdisorderUnknown(byexclusionoftheabove)PlacentalPreviaUnderstandthatplacentapreviaandplacentalabruptionaremajorcausesofantepartumhemorrhageKnowthepainlessvaginalbleedingisconsistentwithplacentapreviaUnderstandthattheultr

4、asoundexaminationisagoodmethodforassessingplacentallocationObjectivesDefinedastheinferioredgeofplacentaloadattheloweruterinesegment,orevenreachtheinternalcervicalosafter28weeksgestation.Incidencerate:Internal：0.24%~1.57%；International：0.5%~0.9%。Place

5、ntalPrevia“theplacentaoverlyingtheinternalosofthecervix”ClassificationClassificationComplete(central)placentapreviaPartialplacentapreviaMarginalplacentapreviaLow-lyingplacentapreviaWhataretheriskfactorsforplacentalPrevia?QuestionETIOLOGYIncreasedmate

6、rnalageUterinefactors:PreviousCSInstrumentationoftheuterinecavity(DandCformiscarriagesorInducedAbortions)Placentalfactors:MultiparityMultiplegestationPriorplacentapreviaETIOLOGYManifestationItcharacteristicallypresentswithunprovokedandrepeatedpainles

7、svaginalbleeding.ClinicalPresentationManifestationTheclassificationofpreviaplacentasometimesdeterminestheoccurrenceperiodandthevolumeoflosingblood.TotalplacentapreviaEarly(20-28wks)LargeamountSeveraltimesPartialplacentapreviaBetweentotalandmarginalBl

8、eedingtimeandvolumeCentralplacentapreviaEarly(20-28wks)LargeamountSeveraltimesPartialplacentapreviaBetweentotalandmarginalMarginalplacentapreviaLate(37-40WKSorinlabor)LessbleedingsymptomSeverebloodlosingleadstoseveralshocksigns,suchaspaleness,weakand