Case
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Case Case A 32 years old woman,now pregnan cy for 33 weeks.Last night during sleepi ng she suffered from severe painless vag inal bleeding without any cause ,and the b lee- ding stopped spontaneously 15 minutes later.Now the patient’s Bp is 90/60mm Hg, P is 98 bpm.
description
Case. A 32 years old woman,now pregnancy for 33 weeks .Last night during sleeping she suffered from severe painless vaginal bleeding without any cause ,and the blee- ding stopped spontaneously 15 minutes later.Now the patient’s Bp is 90/60mmHg, P is 98 bpm. Questions. - PowerPoint PPT Presentation
Transcript of Case
CaseCase A 32 years old woman,now pregnancyfor 33 weeks.Last night during sleepingshe suffered from severe painless vaginalbleeding without any cause ,and the blee-ding stopped spontaneously 15 minuteslater.Now the patient’s Bp is 90/60mmHg,P is 98 bpm.
QuestionsQuestions
• What is the possible disease the patient suffered from?
• What accessory examination should be done?
• How to manage the patient and what is the treating principle for this disease?
Key wordsKey words
placenta previa 前置胎盘fetal presentation 胎先露
Trophoblastic Trophoblastic 滋养叶的滋养叶的succenturiate placenta succenturiate placenta 副胎盘副胎盘Engagement Engagement 衔接衔接placental murmur placental murmur 胎盘血管鸣胎盘血管鸣Postpartum 产后Anticipating therapy 期待疗法cesarean section 剖宫产vaginal delivery 阴式分娩Placenta abruption 胎盘早剥
Placenta previaPlacenta previa
前置胎盘前置胎盘
Contents of the lecture
• Definition
• Etiology
★ Classification
★ Clinical manifestation
• Diagnosis
★ Management
Definition If the placenta is
attached to the low segment of uterus,its low edge reaches or covers the internal OS of cervix and is below the fetal presentation,it is called placenta previa.
Etiology
. Ⅰ Trophoblastic development
retardation
. Over large placentaⅡ
. Ⅲ Endometrial lesion and damage
. Abnormal placenta:such asⅣ succenturiate placenta
1
2
6
※Classification• complete placenta previa • partial placenta previa • marginal placenta previa
Complete placenta previa
Partial placenta previa
Marginal placenta previa
※Clinical manifestation
• Symptoms
• signs
Symptoms
vaginal bleeding:vaginal bleeding:
PainlessPainlessrecurrent recurrent without any causewithout any cause
signs• General conditionGeneral condition : :Anemia Anemia
shock shock
• Abdominal examinationAbdominal examination : :
uterine size
engagement of fetal presentation
placental murmurplacental murmur
uterine size
engagement of fetal presentation
Diagnosis
• Symptoms• Body signs• Vaginal examination• Ultrasound examination• Postpartum examination of
placenta and fetal membrane
Vaginal examination
Ultrasound examination
rupture
Management
• Anticipating therapy
• Termination of pregnancy
1.the indication of the termination of
pregnancy
2.cesarean section
3.vaginal delivery
cesarean section
vaginal delivery
• Definition
• Etiology
★ Classification
★ Clinical manifestation
• Diagnosis
★ Management
Summary of the lecture
Next lecture…Next lecture…
• Differentiation diagnosis
• Placenta abruption
CaseCase A 32 years old woman,now pregnancyfor 33 weeks.Last night during sleepingshe suffered from severe painless vaginalbleeding without any cause ,and the blee-ding stopped spontaneously 15 minuteslater.Now the patient’s Bp is 90/60mmHg,P is 98 bpm.
QuestionsQuestions
• What is the possible disease the patient suffered from?
• How to manage the patient and what is the treating principle for this disease?
• How to manage the patient and what is the treating principle for this disease?
