产科学英文课件：17 子宫破裂 rupture of uterusPPT文件格式下载.pptx

产科学英文课件：17 子宫破裂 rupture of uterusPPT文件格式下载.pptx

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,fetalmacrosomia,contractedpelvisInducedlabor:

withoxytocin,withprostaglandinsObstetricmanagementforcepsuse,IntrauterinemanipulationOthers:

directuterinetrauma（eg,caraccident,fall）violence（eg,gunshot）,Types,Incompleterupture：

overlyingvisceralperitoneum（uterineserosa）ispresentcompleterupture：

full-thicknessdisruptionoftheuterinewall,anative,unscarreduterus:

auteruswithasurgicalscar:

（cesareandelivery,uterinerepair,myomectomy）,fetaldistress（78%）:

prolonged,late,orrecurrentvariabledecelerationsorfetalbradycardiasareoftenthefirstandonlysignsofuterinerupture.diminishedbaselineuterinepressure;

lossofuterinecontractility;

abdominalpain（5-22%）;

recessionofthepresentingfetalpart;

hemorrhage（11-67%）;

shock（29-46%）;

Symptomsandsigns,1.Ruptureofscar,symptomisveryslightinincompleteruptureabdominalpainwronglyattributedtotheonsetoflaborseverepainandshockoccursincomplete（suddenlypain）fetaldistressbleedinginvagina,2.Spontaneousruptureduringobstructedlabor,prolongedlaborviolentuterineactionspathologicretractionringfetaldistressasharp,tearingpaininlowerabdomenpulserapidbloodpressurefallfetusmaybefeltintheabdominalcavity,Pathologicretractionring:

developsduringlabor.Theringformsatthejunctionoftheactiveupperandtherelativelypassiveloweruterinesegments.,Diagnosis,standardsignsandsymptomsultrasonographycontinuouselectronicfetalmonitoringCTMRIuterinewall:

2-3.5mm,ManagementoftheRupturedUterusThemostcriticalaspectsoftreatment:

atimelydiagnosis;

minimizingthetimefromtheonsetofsignsandsymptomsuntilthestartofdefinitivesurgicaltherapy;

（10-37mins）,Treatment:

immediatestabilizationofthemotherandthedeliveryofthefetusareimperative.TypeofuterineruptureExtentofuterineruptureDegreeofhemorrhageGeneralconditionofthemotherMothersdesireforfuturechildbearing,Prevention:

Multiplepreviouscesareandeliveries;

Previousclassicmidlinecesareandelivery;

Previouscesareandeliverywithaninterdeliveryintervaloflessthan2years;

Previouscesareandeliverywitheitherlaborinductionoraugmentation;

Previouscesareandeliveryinawomancarryingamacrosomicfetusweighing4000g;

Previousuterinemyomectomyaccomplishedbymeansoflaparoscopyorlaparotomy;

Keynote,Thecausesoftheruptureoftheuterine?

pathologicretractionring?