case
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 PresentationTRANSCRIPT
![Page 1: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/1.jpg)
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.
![Page 2: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/2.jpg)
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?
![Page 3: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/3.jpg)
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
![Page 4: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/4.jpg)
Placenta previaPlacenta previa
前置胎盘前置胎盘
![Page 5: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/5.jpg)
Contents of the lecture
• Definition
• Etiology
★ Classification
★ Clinical manifestation
• Diagnosis
★ Management
![Page 6: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/6.jpg)
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.
![Page 7: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/7.jpg)
Etiology
. Ⅰ Trophoblastic development
retardation
. Over large placentaⅡ
. Ⅲ Endometrial lesion and damage
. Abnormal placenta:such asⅣ succenturiate placenta
![Page 8: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/8.jpg)
![Page 9: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/9.jpg)
1
2
6
![Page 10: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/10.jpg)
![Page 11: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/11.jpg)
![Page 12: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/12.jpg)
※Classification• complete placenta previa • partial placenta previa • marginal placenta previa
![Page 13: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/13.jpg)
Complete placenta previa
![Page 14: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/14.jpg)
Partial placenta previa
![Page 15: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/15.jpg)
Marginal placenta previa
![Page 16: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/16.jpg)
※Clinical manifestation
• Symptoms
• signs
![Page 17: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/17.jpg)
Symptoms
vaginal bleeding:vaginal bleeding:
PainlessPainlessrecurrent recurrent without any causewithout any cause
![Page 18: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/18.jpg)
![Page 19: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/19.jpg)
signs• General conditionGeneral condition : :Anemia Anemia
shock shock
• Abdominal examinationAbdominal examination : :
uterine size
engagement of fetal presentation
placental murmurplacental murmur
![Page 20: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/20.jpg)
uterine size
![Page 21: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/21.jpg)
engagement of fetal presentation
![Page 22: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/22.jpg)
Diagnosis
• Symptoms• Body signs• Vaginal examination• Ultrasound examination• Postpartum examination of
placenta and fetal membrane
![Page 23: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/23.jpg)
Vaginal examination
![Page 24: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/24.jpg)
Ultrasound examination
![Page 25: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/25.jpg)
rupture
![Page 26: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/26.jpg)
Management
• Anticipating therapy
• Termination of pregnancy
1.the indication of the termination of
pregnancy
2.cesarean section
3.vaginal delivery
![Page 27: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/27.jpg)
cesarean section
![Page 28: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/28.jpg)
vaginal delivery
![Page 29: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/29.jpg)
• Definition
• Etiology
★ Classification
★ Clinical manifestation
• Diagnosis
★ Management
Summary of the lecture
![Page 30: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/30.jpg)
Next lecture…Next lecture…
• Differentiation diagnosis
• Placenta abruption
![Page 31: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/31.jpg)
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.
![Page 32: Case](https://reader036.vdocuments.mx/reader036/viewer/2022081603/56815051550346895dbe5150/html5/thumbnails/32.jpg)
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?