复旦大学上海医学院妇产科学系英文教案

1、最新资料推荐最新资料推荐妇产科夏贤副主任妇产科夏贤副主任教研（科）姓名职称医师授课题目早产和胎膜早破节次3 4授课对象2013 级临床医学专业留学生班授课日期2017.10.17一 ObjectivesUnderstanding the definition and causes of preterm labor .Understanding the diagnosis and treatment of preterm labor.Understanding the definition and causes of premature rupture of menbranes (PROM).U

2、nderstanding the diagnosis and treatment of PROM.二 Contents of coursesDefinition of pretermlaborLabor that occurs before 36 completed weeks(36+6 weeks) gestation is defined as preterm labor.Causes of pretermlaborThere are four main direct reasons for preterm births:spontaneous unexplainedpreterm lab

3、or with intact membranes,idiopathic pretermpremature rupture of membranes (PPROM),delivery formaternal or fetal indications,twins and higher-ordermultifetal births.Diagnosisof pretermlaborDocumented uterine contractions(4 per 20 minutes or 8 per 60 minutes)Documented cervical change (cervical efface

4、ment of 80% or cervical dilatation of 2cm more)Forecast:uterine activity monitoring.Ultrasound Examination of Cervical length Fetal FibronectinTreatments of preterm laborAssessment,Rest bedUterine tocolytic therapy,Corticosteroid Therapy,Antibiotic Therapy,Labor and delivery.Definition ofPROMPrematu

5、re rupture of the membranes (PROM) is defined as amniorrhexis (spontaneous rupture of membranes) prior to the onset of labor at any stage of gestation.Causes of PROMThe cause of PROM is not clearly understood, perhaps associated with the follow factors:Trauma, sexual intercourse, lax of internal os

6、of uterine, abnormal membrane physiology, vaginal and cervix infection, increased of intra-uterine pressure, abnormalities in presentation and position, smoking and other factors.DiagnosisofPROMFluid passing through the vagina suddenly, and then small amounts of fluid flow through the vagina intermi

7、tently, particularly when the increased of abdorminal pressure.Sterile vaginal speculum examination, the Nitrazine (PH) test, the “fern” test can be usedto diagnose PROM.Treatments of PROM Conservative expectant management Management of chorioamnionitis Tocolytic therapyUse of corticosteroids Labor

8、and delivery Surfactant therapy三Teaching Plan and Time Distribution（一） Contents and time plan (90min)preterm labor:Definition of pretermlabor:10minIntroduction: 5 minLeading cause of perinatal morbidity and mortality is preterm labor. The incidence of preterm labor is 5-15%, and the incidence remain

9、s greater than 11% in US. Survival rates have increased and morbidity has decreased because of technologic advances.Causes of preterm labor:10minDiagnosisof pretermlabor:10minTreatments of preterm labor :10minPremature rupture of membranes (PROM):Definition and predisposing factors :5min,Causes of P

10、ROM: 10minDiagnosis: :10minManagements:10min.PROM occurs in about 10-15% of all delivery. PROM is associated with 10% of term pregnancy.Summary:Summary: 5min,Case analysis: 5 min.Through the case analysis, review examination, diagnosis, differential diagnosis and treatment.（二）Key points and Difficul

11、tyKey points：Diagnosis of preterm labor and PROM. Difficulty：Treatment of preterm labor and PROM.（三）Key wordsPretern LaborPremature rupture of membrane（四）Teaching toolsFigure、table、model、etc.（五）Case analysisA 24-year old woman, gravida 2, para 1, 33 wk gestation, fluid passing through the vagina, have mild uterine contractions.Examination, treatment?Questions:What is the definition of preterm labor?What are the causes of premature rupture of membrane?Explain the treatment of preterm labor.Explain the treatment of premature rupture of membrane(六) References:textbook,