高危妊娠

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出版社:科学出版社
出版日期:2001-3
ISBN:9787030093424
作者:詹姆斯 编
页数:1433页

章节摘录

版权页:   插图:   VAGINAL EXAMINATION There is no place for digital vaginal examinaaon in thediagnosis ofplacenta previa. Such an exanunation mayprovoke hemorrhage. Since local causes are likely tobe benign, speculum examination is probably wiselydeferred until after ultrasonography has excluded thediagnosis. Digital vaginal exanunation is only indi-cated in an operating theatre with full preparationfor cesarean section (see below). PLACENTAL LOCALIZATION Various radiological methods have been used. Some,such as soft tissue placentography (using X-rays),radioisotope radiography, pelvic angiography and thermography are no longer used, Magnetic resonanceimaging may be a diagnostic technique of the futurebut at present high cost limits availability. Diagnostic ultrasound scanning is safe, accurate andnon-invasive. It is a common practise for many obste-tric units in developed countries to offer a screeningtransabdominal ultrasound scan to all women before 20 weeks gestation. However, the earlier the scan isperformed, the more likely the placenta is to be foundin the lower pole of the uterus. For example, about 28% of placentas in women scanned before 24 weekare found to be 'low' but by 24 weeks this drops to 18% and only 3% are low lying by term .Con- versely, a false negative scan for a low placenta is foundin as many as 7% of cases. Such results are com-moner when the placenta is posterior, the bladder is over filled, the fetal head obscures the margin of theplacenta or the operator fails to scan the lateral uterinewall.A low-lying placenta is commoner inearlypregnancy because the lower segment does not exist.This apparent change in placental position is due to enlargement of the upper segment and formation of the lower segment with many apparently low placen-tas being food to be above the lower segment. Comeau et al. and Ruparelia and Chapman have shown that the more advanced the pregnancy is, the more accurate a scan diagnosis of placenta previa will be. Some obstetricians advocate that all women with a low placenta on an early scan should be rescanned at 32-34 weeks. Because of the fairly low incidence of placenta previa at term, the rationale for this practise has been questioned. Routine rescanning not only increases the work load of ultrasonography depart-ments but generates enormous patient anxiety. Although some units are continuing with such a prac-tise, others only rescan if there is an indication such as abnormal presentation, vaginal bleeding or the pla- centa was covering the os on the first scan. The use of transvaginal ultrasonography in cases of suspectedplacental previa has,been shown to improve the accu-racy of diagnosis especially with posterior placentaprevias. This procedure has been shown to be safeand well tolerated.

内容概要

编者:(美国)詹姆斯(David K.James)

书籍目录

List of Contributors Preface to the first edition Preface 1. Prepregnancy education G. Turner 2. Organization of prenatal care and identification of risk M. Coppens, D. K. James 3. Genetics, risks and genetic counseling P. A. Farndon, M. D. Kilby 4. Sociodemograpluc factors: Age, parity, social class and etluucity H. I. J. Wildschut 5. Maternal weight and weight gain H. I. J. Wildschut 6. Bleeding in early pregnancy S. Rosevear 7. Recurrent miscarriage G. M. Stirrat, P. G. Wardle 8. Bleeding in late pregnancy J. C. Konje, D. J.Taylor 9. Multiple pregnancy C. A. Crowther 10. Abnormalities of alpha-fetoprotein and other biochemical tests J. Jankowitz, R. A. Williamson 11. The routine obstetric ultrasound scan C. R. Harman 12. Chorionic villus sampling and placental biopsy W. Holzgreve, P. Miny 13. Amniocentesis T. G. Overton, N. M. Fisk 14. Fetal blood sampling before labor P. W. Soothill 15. Fetal tissue biopsies M. I. Evans, M. P. Johnson, E. P. Hoffmann, W. Holzgreve 16. Multifetal pregnancy reduction and selective termination M. I. Evans, L. Littmann, C. Tapin, M. P. Johnson 17. Assessing fetal health C. R. Harman, S. Menticoglou, F. A. Manning 18. Fetal growth restriction: evaluation and management C. P. Weiner, A. A. Baschat 19. Hydramnios, oligohydramnios T. G. Teoh, N. M. Fisk 20. Fetal death C. P. Weiner 21. Fetal hydrops J. Smoleniec, C. P. Weiner, D. James 22. Fetal hemolytic disease C.P. Weiner 23. Fetal thrombocytopenia M. J. Whittle 24. Fetal arrhythmias J. E. Crosson, J. I. Brenner 25. Fetal cardiac anomalies G. Rizzo, A. Capponi, C. Romanini 26. Craniospinal and facial abnormalities E. D. Gurewitsch, J. Streltzoff, F. A. Chervenak 27. Genitourinary malformations W. Holzgreve, P. Miny, M. I. Evans 28. Gastrointestinal abnormalities P. Stone 29. Skeletal abnormalities D. R. Griffin 30. Fetal endocrinology S. C. Robson 31. Fetal tumors K. D. Wenstrom 32. Presentation and diagnosis of fetal infection J. A. Towbin 33. Maternal and fetal viral infections including listeriosis and toxoplasmosis J. Yankowitz, J. G. Pastorek II 34. Other infectious conditions in pregnancy J. E. Sampson, M. G. Gravett 35. Drug addiction J. J. Walker 36. Medication during pregnancy B. B. Little 37. Hypertension in pregnancy M. Hallak 38. Diabetes in pregnancy M. B. Landon, S. G. Gabbe 39. Cardiac disease M. W. Tomlinson, D. B. Cotton 40, Thyroid disease C. A. Major, M. P. Nageotte 41. Pituitary and adrenal disease M. B. Landon 42 Anemia E. A. Letsky 43. Other hematological conditions E. H. Horn, J. M. Davies, L. Kean 44. Respiratory disorders M. de Swiet 45. Hepatic and gastrointestinal disease B. N. J. Walters 46. Neuromuscular diseases J. R. Carhuapoma, M. W. Tomlinson, S. R. Levine 47. Renal disease T. Asrat, M. P. Nageotte 48. Autoimmune disease D. Ware Branch, T. Flint Porter 49. Spine and joint disorders in pregnancy M.J. Mendelow, R. B. Blasier 50. Thromboembolic disease M. de Swiet 51. Skin disease C. T. C. Kennedy, P. Kyle 52. Gynecological disease (non-malignant) J. Hutton 53. Malignant disease in pregnancy A. R. Munkarah, R. Morris 54. Trauma in pregnancy R. Bobrowski 55. Abdominal pain in pregnancy K. Mahomed 56. Threatened and actual preterm labor including mode of delivery J. M. Svigos, J. S. Robinson, R. Vigneswaran 57. Prelabor rupture of the membranes J. S. Robinson, J. M. Svigos, R. Vigneswaran 58. Breech presentation Z. J. Penn 59. Unstable lie I. Z. Mackenzie 60. Prolonged pregnancy S. Chua, S. Arulkumaran 61. Labor: an overview P. J. Steer 62. Labor induction including pregnancy termination for fetal anomaly I. Z. Mackenzie 63. Poor progress in labor including augmentation, malpositions and malpresenta-tions S. Chua, S. Arulkumaran 64. Fetal distress in labor P. J. Steer, P. Danielian 65. Anesthesia for high risk parturients L. C. Tsen, S. Datta 66. Assisted vaginal delivery P. C. Dennen, R. Hayashi 67. Previous cesarean section J. E. Dickinson 68. Cesarean section J. E. Dickinson 69. Postpartum hemorrhage and other problems of the third stage E. H. Park, B. P. Sachs 70. Resuscitation and immediate care of the newborn N. Marlow, P. Baker 71. Counseling about pediatric problems W.J. van Wijngaarden, T. Stephenson 72. Puerperal problems E. H. Park, B. P. Sachs 73. Postnatal contraception and sterilization J. Hutton 74. Critical care of the obstetric patient M. Maresh, D. James, K. Neales Appendix-Normal values in pregnancy M. M. Ramsay Index

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《高危妊娠:处置的选择(第2版•英文影印版)》由科学出版社出版。

作者简介

《高危妊娠:处置的选择(第2版)》是国际上关于高危妊娠的有较大影响的专著。有103位世界知名专家参加编写,主编是英国诺丁汉女王医疗中心David K.James教授和英国帝国医学院西敏寺医院产科Philip J.Steer教授。《高危妊娠:处置的选择(第2版)》涉及了母婴医学的各个方面,其中反映的独特资料被许多其他同类书所采用。

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