S A B Xu

Early Pregnancy Complications ,[object Object],[object Object]

Definition of abortion ,[object Object],[object Object],[object Object],[object Object]

Etiology of spontaneous abortion ,[object Object],[object Object],[object Object]

Etiology of spontaneous abortion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Abortion classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Threatened abortion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Management of threatened abortion ,[object Object],[object Object],[object Object],[object Object],[object Object]

Inevitable abortion ,[object Object],[object Object],[object Object]

Management of inevitable or incomplete abortion ,[object Object],[object Object]

Yanwen Xu , M.D., PhD The First Affiliated Hospital of Sun Yat-sen University ECTOPIC PREGNANCY

[object Object],[object Object]

Residual uterus pregnancy Uterus

Etiology ,[object Object],[object Object],[object Object],[object Object]

Time of Rupture ,[object Object],[object Object],[object Object],[object Object]

Pathology ,[object Object],[object Object],[object Object],[object Object]

Clinical findings ,[object Object],[object Object],[object Object],[object Object]

Clinical findings ,[object Object]

Signs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Laboratory findings ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Normal Pregnancy Ectopic Pregnancy

Culdocentesis ,[object Object],[object Object],[object Object],[object Object]

Differential Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment in hemodynamically unstable patients----Salpingectomy

Treatment ,[object Object],[object Object],[object Object],[object Object]

Medical management ,[object Object],[object Object],[object Object],[object Object],[object Object]

Pre-eclampsia & eclampsia Yanwen Xu , M.D., PhD The First Affiliated Hospital of Sun Yat-sen University

Patient history ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Present pregnancy history and menstrual history ,[object Object],[object Object],[object Object]

Symptom and sign ,[object Object],Epiphora Proteinuria Abdominal edema at lower abdomen Fetal movement decrease in right side Dyspnea, orthopnea Insomnia, urinary frequency BP:136/80 BP:210/100

Events at 8/8 ,[object Object],watery discharge BP : 210/100mmHg BT:1’30”, CT:1’40” WBC:8.4x10 3 /ul RBC:3.19x10 6 /ul Hb : 10g/dl , Hct:29% Plt : 9.7K/μL O2, adalate, trandate(5mg) refer to ER BT:37.6 HR:129 BP:198/118 SpO2:100% RR:27/min Admission to 5FD BT:37.6 HR:120 BP:181/102 RR:22/min 5:40pm BP:161/104 HR:110 SaO2:100% MgSO4:10ml/hr

[object Object],接獲通知，前往探視送入 DR O2 mask 3L, SaO2:93% room air, SaO2:97%  70%  97% BP:232/148 ， HR:105 dyspnea could not lie down ， edema ， difficult in breathing ， cough with frothy sputum Induction Etomidate:20mg laryngoscopy Trandate:15mg LMA Cisatracurium:10mg laryngoscopy ENT standby 備 fiber ASA VE

[object Object],Maintenance Sevoflurane:0.2-0.3MAC add N 2 O Lasix:40mg Morphine:10mg midazolam:5mg bicarbonate:5amp ventilation: volume control ,PEEP:8 cmH 2 O suction 6:42 Operation 6:47 twin A F 1510g ， 1  7 twin B F 1698g ， 4  8 7:45 finish, IV:150ml blood loss:200ml On A-line ABG :7.05/77.3/162/21.5/-9.4/12.3/37/98.4/193/5.2/144/4.4/112.8/1.03 Endo:6.5mm fix 21cm

Lab data 8/8 pre OP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Lab data ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Definitions - pre-eclampsia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Definition of Eclampsia ,[object Object]

Definition of severe pre-eclampsia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Mild and severe preeclampsia <100000 >100000/mm 3 Platelet count Yes No HELLP Yes No cynosis Yes No Pulmonary edema Yes No RUQ pain Yes No Epigastric pain Yes No Visual disturbances Yes No headache <500 >500ml/24hr Urine output >=5 3+or4+ <5g/24hr 1+or2+ Urinary protein >=110 <110mmHg DAP >=160 <160mmHg SAP severe mild

Epidemiology ,[object Object],[object Object],[object Object]

Pathogenesis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pathogenesis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Faulty placentation Genetic, immunologic, inflammatory factors Maternal vascular disease Excessive trophoblast Reduced uteroplacental perfusion Endothelial activation Capillary leak hemoconcentration edema proteinuria Vasospasm Activation of coagulation thrombocytopenia Vasoactive agents: Prostaglandins nitric oxide endothelins Noxious agents: Cytokines Lipid peroxidases oliguria HTN seizures abruption liver ischemia

Pathophysiology - cerebral ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pathophysiology - circulation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pathophysiology - renal ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pathophysiology – Blood ,[object Object],[object Object],[object Object],[object Object],[object Object]

Pathophysiology – blood ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pathophysiology – liver ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pathophysiology – HELLP syndrome ,[object Object],[object Object],[object Object],[object Object],[object Object]

Pathophysiology –pulmonary system ,[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],Clinical Findings

Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Multisystem disease with varying clinical presentations.

Signs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Complications ,[object Object],[object Object],[object Object]

Treatment-mild preeclampsia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Assessment of fetal status ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment-severe preeclampsia ,[object Object],[object Object],[object Object],[object Object]

Management – Anticonvulsant therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Management – anticonvulsant therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Management – Anticonvulsant therapy ,[object Object],[object Object],[object Object],[object Object]

Management of eclamptic seizures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Management – Antihypertensive therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Management – Antihypertensive therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Conclusion ,[object Object],[object Object],[object Object],[object Object]

Maternal Mortality - Obstetrical Hemorrhage - 4(4%) D.I.C. 9(10%) Couvelaire uterus 17(16%) Abruptio placenta 7(7%) Placenta previa 66(63%) Uterine atony Patients (n=103) Indication

The placenta provides the fetus with oxygen and nutrients and takes away waste such as carbon dioxide via the umbilical cord.

Incidence ,[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object]

Etiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Mechanisms of bleeding ,[object Object],[object Object],[object Object]

Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical findings ,[object Object],[object Object],[object Object],[object Object],[object Object]

Accessory examinations ,[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment ,[object Object],[object Object],[object Object]

Treatment ,[object Object],[object Object]

Expectations (prognosis) ,[object Object],[object Object]

Definition ,[object Object],[object Object],[object Object],[object Object],[object Object]

Classification ,[object Object],[object Object],[object Object]

Etiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pathophysiology and pathology ,[object Object],[object Object],[object Object],[object Object]

Pathophysiology and pathology ,[object Object],[object Object]

Pathophysiology and pathology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object]

Management ,[object Object],[object Object],[object Object],[object Object],[object Object]

Delivery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

S A B Xu

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S A B Xu