復(fù)旦大學(xué)上海醫(yī)學(xué)院婦產(chǎn)科學(xué)系英文教案

1、2017年復(fù)旦大學(xué)上海醫(yī)學(xué)院婦產(chǎn)科學(xué)系英文教案教研室（科）婦產(chǎn)科姓名夏賢職稱副主任醫(yī)師授課題目早產(chǎn)和胎膜早破 節(jié)次3 4授課對(duì)象2013級(jí)臨床醫(yī)學(xué)專業(yè)留學(xué)生班授課日期201 一 Objectives1. Understanding the definition and causes of preterm labor .2. Understanding the diagnosis and treatment of preterm labor.3. Understanding the definition and causes of premature rupture of menbranes (

2、PROM).4. Understanding the diagnosis and treatment of PROM. 二 Contents of courses 1. Definition of preterm laborLabor that occurs before 36 completed weeks(36+6 weeks) gestation is defined as preterm labor. 2. Causes of preterm laborThere are four main direct reasons for preterm births: (1) spontane

3、ous unexplained preterm labor with intact membranes, (2) idiopathic preterm premature rupture of membranes (PPROM), (3) delivery for maternal or fetal indications, (4) twins and higher-order multifetal births.3. Diagnosis of preterm laborDocumented uterine contractions(4 per 20 minutes or 8 per 60 m

4、inutes)Documented cervical change (cervical effacement of 80% or cervical dilatation of 2cm or more)Forecast:uterine activity monitoring. Ultrasound Examination of Cervical length Fetal Fibronectin 4. Treatments of preterm labor(1) Assessment, (2) Rest bed(3) Uterine tocolytic therapy,(4) Corticoste

5、roid Therapy, (5) Antibiotic Therapy,(6) Labor and delivery.5. Definition of PROMPremature rupture of the membranes (PROM) is defined as amniorrhexis (spontaneous rupture of membranes) prior to the onset of labor at any stage of gestation.6. Causes of PROMThe cause of PROM is not clearly understood,

6、 perhaps associated with the follow factors: Trauma, sexual intercourse, lax of internal os of uterine, abnormal membrane physiology, vaginal and cervix infection, increased of intra-uterine pressure, abnormalities in presentation and position, smoking and other factors.7. Diagnosis of PROM Fluid pa

7、ssing through the vagina suddenly, and then small amounts of fluid flow through the vagina intermitently, particularly when the increased of abdorminal pressure.Sterile vaginal speculum examination, the Nitrazine (PH) test, the “fern” test can be used to diagnose PROM.8. Treatments of PROMConservati

8、ve expectant management Management of chorioamnionitisTocolytic therapyUse of corticosteroidsLabor and deliverySurfactant therapy三Teaching Plan and Time Distribution（一） Contents and time plan (90min)preterm labor:1 Definition of preterm labor:10min2 Introduction: 5 min Leading cause of perinatal mor

9、bidity and mortality is preterm labor. The incidence of preterm labor is 5-15%, and the incidence remains greater than 11% in US. Survival rates have increased and morbidity has decreased because of technologic advances.3 Causes of preterm labor:10min4 Diagnosis of preterm labor:10min5 Treatments of

10、 preterm labor :10minPremature rupture of membranes (PROM):1. Definition and predisposing factors :5min,2. Causes of PROM: 10min3. Diagnosis: :10min4. Managements:10min.PROM occurs in about 10-15% of all delivery. PROM is associated with 10% of term pregnancy.Summary:1. Summary: 5min,2. Case analysi

11、s: 5 min.Through the case analysis, review examination, diagnosis, differential diagnosis and treatment.（二）Key points and Difficulty Key points：Diagnosis of preterm labor and PROM. Difficulty：Treatment of preterm labor and PROM.（三）Key words Pretern Labor Premature rupture of membrane（四）Teaching tool

12、sFigure、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:1. What is the definition of preterm labor?2. What are the causes of premature rupture of membrane?3. Explain the treatment of preterm labor.4. Explain the treatment of premature rupture of membrane (六) References: text