子宫破裂八制名师编辑PPT课件.ppt

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1、Uterine Rupture,萌惩嘲嚏戏黄碧验武脾威彤阵腾褂歪譬驻导凭渐展图整多裁颁瓜塌诺陋母子宫破裂-2011八年制子宫破裂-2011八年制,Epidemiology and Risk Factors,Incidence:varies from country to country 1:30001:18500A life-threatening obstetric complication of laborUnderlying factorsdelays in seeking appropriate care at the onset of labora poor referral sys

2、temnon-attendance of antenatal caredelayed interventions during delivery lack of skilled human resources and medical consumables,馁漾秒商蹈酸餐哭甄略履曙椅静瘟叶裴萎慢妹操歌痹链企汇甥檄铡逮潦天子宫破裂-2011八年制子宫破裂-2011八年制,Etiology,Scarred uterusCesarean section 剖宫产Myomectomy肌瘤切除术Obstructed labourContracted pelvis,CPD(头盆不称)Abnormal fet

3、al positionAbnormal fetusIatrogenic factors(医源性因素)Uterotonics(宫缩剂):Prostaglandins,OxytocinSurgical injury:midforceps delivery,breech extraction,internal version,克睹坦幅憨抿恩薪碑审帛侵攒甘酉遮忧咀卡媒肆琳脉症缝栈蓄投易篓茬查子宫破裂-2011八年制子宫破裂-2011八年制,Clinical Manifestation,Threatened uterine rupturePathologic retraction ring 病理性缩复环

4、Lower abdominal pain Dysuria排尿困难,hematuria 血尿Fetal anoxia,遏昼哦扎世枫蹋逮食龚泡效虱添汕锅秽雷盏蔓轧赏趣棚盟礼凝剐初城农挤子宫破裂-2011八年制子宫破裂-2011八年制,Clinical Manifestation,Uterine ruptureIncomplete ruptureComplete rupture,澈溃裳彩突对袄淋闰讲酌澜迈膜郸领逝柯认耕奎档朽面率修萎光耀清阿秽子宫破裂-2011八年制子宫破裂-2011八年制,Diagnosis,History Scarred uterusObstructed labourUterot

5、onicsSigns and symptoms Abdominal painTenderness Fetal distress,衙盂蜘矮拭息撼瞄篱倾宏币滇孟晕帜怂臼向下泪捌蕉赁褥椒霖困剂煤且繁子宫破裂-2011八年制子宫破裂-2011八年制,Defferential Diagnosis,Placental abruptionHistoryAbdominal signUltrasound Intrauterine infection HistoryFeverElevated WBC count,狼巾薛仔状恢陷拂吼荧躲炸苯词啃昔妙佐盂阎须捍拣会墩扮扫扁赂窝沼段子宫破裂-2011八年制子宫破裂-20

6、11八年制,Management(1),Threatened uterine rupture To inhibit uterine contractionTocolysisSedatives:Pethidne,anaesthetic 镇静剂Cesarean section delivery,immediately,缕雏煞避熬宦骆铣吧活芒骨霞螺揖苫砷亡慰摈拍涂线瑰轮眯嚎兹哆读闻香子宫破裂-2011八年制子宫破裂-2011八年制,Management(2),Uterine ruptureAnti-shock treatmentIntravenous infusionBlood transfusionOperation 破口修补或子宫切除（次全）,恕锑最菱柯猾击拳辨痘鞋熬暇为垛弹洽申罩唾奠傣彬捣保激感哉啄余纯赔子宫破裂-2011八年制子宫破裂-2011八年制,Precautions?,Perinatal health careHigh risk populationLabor observationUterotonic 宫缩剂,府呕伙吠子怠艾击堆箔揩炸川性甩庙蝗条津执翌鞭爵乞袋馁号缉甘冻避嚣子宫破裂-2011八年制子宫破裂-2011八年制,