第一节孕妇监护 一、产前检查的时间 二、首次产前检查

外阴及阴道的自然防御功能 两侧大阴唇自然合拢,遮掩阴道口、尿道口 由于盆底肌的作用,阴道口闭合,阴道前后壁紧 贴,可以防止外界的污染。经产妇的阴道松弛, 这种防御功能较差 ·阴道自净作用阴道上皮在卵巢分泌的雌激素影 响下增生变厚,增加对病原体侵人的抵抗力,同 时上皮细胞中含有丰富糖原,在乳杆菌(优势菌) 作用下分解为乳酸,维持阴道正常的酸性环境 (pH≤4.5,多在3.8~4.4),使适应于弱碱性环境 中繁殖的病原体受到抑制

Definition Fetal distress is defined as depletion of oxygen and accumulation of carbon dioxide,leading to a state of \hypoxia and acidosis during intra-uterine life

Major causes of death for pregnancy women ( maternal mortality) Postpartum hemorrhage (28%) · heart diseases pregnancy-induced hypertension (or Amniotic fluid embolism) infection

定义 fetal distress: 胎儿在宫内有缺氧征象危及胎 儿健康和生命者.是一种综合症 状,是剖宫产的适应证之一

病因 一、遗传基因缺陷 二、环境因素 三、母体因素 四、胎盘内分泌功能不足 五、免疫因素

epidemiology Labor and delivery between28-36+6 weeks 5%-10% be the leading cause of perinatal morbidity and mortality Survival rates have increased and morbidity has decreased because of technologic advances

定义 postpartum hemorrhage 胎儿娩出后24消失内出血量超过500ml 者称为产后出血。 目前此定义暂适用于剖宫产和平产,但 存在争议

妊娠滋养细胞疾病:来源于胎盘绒毛滋养细胞 的疾病,包括葡萄胎、侵蚀性葡萄胎、绒癌和 一类少见的胎盘部位滋养细胞肿瘤

A prolapse is a downward or forward displacement of one of the pelvic organs from its normal location. *A variety of terms are used to describe female genital prolapse. *A cystocele is a downward displacement of the bladder. *A cystourethrocele is a cystocele that imcludes the urethra as part of the prolapsing organ complex