前置胎盘英文课件讲课教案.pptx

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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:140-150bpmCase1WhatarethemostcommoncausesofAntepartumHemorrhag

2、e?COMMONCAUSESPlacentaPreviaPlacentalAbruptionPretermlaborUNCOMMONCAUSESUterineruptureFetal(chorionic)vesselruptureCervicalorvaginallacerationsCervicalorvaginallesions,includingcancerCongenitalbleedingdisorderUnknown(byexclusionoftheabove)PlacentalPrev

3、iaUnderstandthatplacentapreviaandplacentalabruptionaremajorcausesofantepartumhemorrhageKnowthepainlessvaginalbleedingisconsistentwithplacentapreviaUnderstandthattheultrasoundexaminationisagoodmethodforassessingplacentallocationObjectivesDefinedastheinf

4、erioredgeofplacentaloadattheloweruterinesegment,orevenreachtheinternalcervicalosafter28weeksgestation.Incidencerate:Internal：0.24%~1.57%；International：0.5%~0.9%。PlacentalPrevia“theplacentaoverlyingtheinternalosofthecervix”ClassificationClassificationCo

5、mplete(central)placentapreviaPartialplacentapreviaMarginalplacentapreviaLow-lyingplacentapreviaWhataretheriskfactorsforplacentalPrevia?QuestionETIOLOGYIncreasedmaternalageUterinefactors:PreviousCSInstrumentationoftheuterinecavity(DandCformiscarriagesor

6、InducedAbortions)Placentalfactors:MultiparityMultiplegestationPriorplacentapreviaETIOLOGYManifestationItcharacteristicallypresentswithunprovokedandrepeatedpainlessvaginalbleeding.ClinicalPresentationManifestationTheclassificationofpreviaplacentasometim

7、esdeterminestheoccurrenceperiodandthevolumeoflosingblood.TotalplacentapreviaEarly(20-28wks)LargeamountSeveraltimesPartialplacentapreviaBetweentotalandmarginalBleedingtimeandvolumeCentralplacentapreviaEarly(20-28wks)LargeamountSeveraltimesPartialplacent

8、apreviaBetweentotalandmarginalMarginalplacentapreviaLate(37-40WKSorinlabor)LessbleedingsymptomSeverebloodlosingleadstoseveralshocksigns,suchaspaleness,weakandquickpulseandhypotension.Malpresentationmaybeexists,andfloatingpresentationcou