1、 Premature deliveryProlonged pregnancyPremature Rupture of Membranes( PROM)ContentPRETERM LABOR早 产Preterm Labor: Labor occurs after 28 weeks but before 37 weeks (ie.196258days) gestation. Infants born during these phase are premature infants.The premature infants weight is between 1000 and 2499g. Th
2、e prognosis of the premature infant is correlated with its gestational age, weight.Definition: Etiology:1.Obstetric complications产科并发症2.Medical complications内科并发症3.Surgical complications外科并发症4.Genital tract anomalies生殖道畸形1.Obstetric complications: Severe hypertensive state or pregnancy Anatomic diso
3、rder of the placenta( abruptio placentae, placenta previa) Premature rupture of membranes Polyhydramnios or oligohydramnios Multiple pregnancy Previous laceration（裂伤） of cervix or uterus2.Medical complications: Pulmonary or systemic hypertension Renal disease Heart disease Infection: genital tract i
4、nfection, urinary tract infection, pyelonephritis肾盂肾炎, acute systemic infection Heavy cigarette smoking Alcoholism or drug addiction Severe anemia3.Surgical complications: Conization of cervix宫颈锥切术 Previous incision in uterus or cervix ( cesarean delivery剖宫产术)4.Genital tract anomalies Bicornuate双角,
5、subseptate纵隔, or unicormuate单角 uterus Congenital cervical incompetency先天性宫颈闭合不全Clinical Finding Vaginal bleeding-bloody mucous vaginal discharge or “bloody show”; Dilatation扩张 and effacement消退 of cervix-change in dilatation or effacement of at least 1cm or a cervix that is well effaced and dilatated
6、 (at least 2 cm);2. Laboratory Studies Completely blood count with differential Cervix discharge cultures ：should be sent for gonorrhea淋病 and chlamydia衣原体. Fetal fibronectin纤连蛋白（Ffn): negative test is effective at ruling out imminent delivery(within 2 weeks)；positive test （Ffn50ng/ml): result is sen
7、sitive at predicting preterm birth.分泌物3. Accessory examination: Ultrasound examination for fetal size, position, placenta location，and cervical length.Cervical length30nm: prognosticating premature delivery.Infundibulum漏斗 length of cervical internal os25% Cervical length or Amniocentesis to ascertain fetal lung maturity, the amnio fluid羊水 be tested for lecithin卵磷脂/ sphingomyelin鞘磷脂 (L/S) ratio
