對於計畫懷孕而喜獲麟兒的婦女來說,胎兒無疑是上天給的美好禮物,有時天不從人願,常在沒有預警下失去了腹中的小生命,這種無情的打擊造成孕婦及家人的傷痛。
懷孕中胚胎或胎兒沒有生命跡象,三個月前稱為流產,週數達三個月之後的流產稱為死胎或是胎死腹中,也有些學者定義20週以後為死胎。
媽媽通常是因為感覺不到胎動或者是在例行性產檢以超音波檢查的狀態下發現。有些死胎發生早在第一孕期,有些發生在接近臨盆甚至在待產中,顯示死胎發生的原因其實是非常多樣的。
發生的原因大致上可以分為與母體、胎兒或與胎盤有關。
與母體有關的原因如母親本身身體的疾病像是高血壓與糖尿病,感染、內分泌、免疫性疾病,與胎兒有關的原因如染色體、基因異常,發育不良,與胎盤有關的原因如病變或是血流不足,臍帶打結或扭轉等,但是約¼的死胎找不出原因。
其他的危險因子像是抽煙、酗酒、吸毒、肥胖與母親年齡等都被認為與死胎的發生有關係
死胎的發生對任何母親來說都是ㄧ件悲傷的事情,以醫生的立場除了安慰母親之外是需要找出最有可能的原因避免下次再發生類似的憾事 。另外如產後憂鬱症其實在這些傷心的母親身上也很可能會發生,家人也需要多注意。
印象中照片為紐西蘭的 Wakatipu 湖。是毛利傳說裡,被勇士殺死的巨人留下的跳動心臟。願傷心過的媽媽們保持勇氣與希望。
============================
For expecting mothers, babies are gifts from the God. However, some babies are lost unexpectedly, causing grievances for the mother and her families.
Babies that are spontaneously lost during the first trimester are called miscarriages, and those lost after the first trimester are called stillbirths. Although in some countries stillbirths are defined as fetal loss after 20 weeks.
Stillbirths are usually discovered mothers who don't feel fetal movements or incidentally during regular pregnancy ultrasound surveillances. Some still births occur early in 2nd trimester, whilst some occur towards the end of the pregnancy, suggesting different underlying mechanisms.
Causes of stillbirths can be classified as mother, fetus or placenta related. Examples of causes relating to the mother include diabetes and hypertension (or eclampsia), infection and autoimmunity; relating to the fetus include abnormal chromosomes, fetal growth retardation; relating to the placenta include blood flow insufficiency or twisted umbilical cord. Although about in 25% of cases no cause can be found.
Factors like smoking, alcohol and illicit drug, obesity and Mother's advanced age use are related to increased risk of fetal loss.
It is one of the saddest things to see a Mother who lost her child. From an obstetrician's point of view, identifying the cause may help to prevent recurrences of such tragedy. Carers' support and vigilance for mothers who lost their babies is important as postpartum depression can unfortunately also occur.
(Picture is taken at Lake Wakatipu, which from the Maori Legend it is the remaining beating heart of the Giant Matau, who was slain by a warrior to rescue his beloved girl. Hope mums keep hope and courage.)
同時也有12部Youtube影片,追蹤數超過878的網紅時事英文 Podcast by ssyingwen,也在其Youtube影片中提到,本月初,一項新法律在美國德州生效,禁止懷孕六週後進行人工流產,成為先進國家中最嚴格的墮胎法之一。反觀世界第二大羅馬天主教國,墨西哥最高法院週二裁定,懲罰墮胎違憲,成為墨西哥女性健康與人權倡導者的重大勝利。 講義 👉 本集限定公開下載 PDF:https://bit.ly/3Acfk2E ...
「pregnancy ultrasound」的推薦目錄:
- 關於pregnancy ultrasound 在 李木生醫師 Facebook 的最讚貼文
- 關於pregnancy ultrasound 在 康康醫師超音波共筆 Facebook 的精選貼文
- 關於pregnancy ultrasound 在 A Happy Mum Facebook 的最佳貼文
- 關於pregnancy ultrasound 在 時事英文 Podcast by ssyingwen Youtube 的最佳解答
- 關於pregnancy ultrasound 在 [email protected] Youtube 的最佳貼文
- 關於pregnancy ultrasound 在 Anh Minh Youtube 的最佳解答
- 關於pregnancy ultrasound 在 Ultrasound: An Early View of Baby - YouTube 的評價
pregnancy ultrasound 在 康康醫師超音波共筆 Facebook 的精選貼文
最近很紅的 子宮外孕系列🤣
在很之前的文章就有提到,早期懷孕時做超音波的重要性。
➡️其中一項就是要確認「子宮內懷孕」& 排除「子宮外孕」!
最近相關的衛教文章已經很多,今天就不贅述「子宮內懷孕」的重要性。
---
子宮外孕有很多種,只要不是在子宮內膜的都稱作「子宮外孕」。
✏️發生的位置不外乎:輸卵管、卵巢、子宮角、子宮頸、剖腹產疤痕、闊韌帶或是腹腔內。
最多最多的就是輸卵管外孕,佔了約95%。
✏️診斷方式不一定單次看診就能確定,很多都是需要多次門診超音波或抽血追蹤,才有辦法確診的。
#抽血
懷孕之後,血清懷孕指數(β-HCG)會隨著週數上升。
✏️通常如果數值>1500,陰道超音波仍看不到懷孕組織;或是數值>5000,腹部超音波看不到懷孕組織,這時候就要懷疑是否有子宮外孕。
✏️也可能會安排連續抽血,看看β-HCG上升的幅度是否正常,如果上升的狀況並不好,也懷疑不是正常的懷孕。
#超音波
超音波是我們最重要的工具!
此時做陰道超音波是比較準確的,主要是能夠更準確的判斷子宮內膜的狀況,還有兩邊卵巢/或是輸卵管有病灶可以看得更清楚!
以下就較常見的,超音波可幫助診斷的子宮外孕來做說明
#輸卵管外孕
最常見,也算是相對容易判斷的外孕種類。
此時檢查會有以下幾項特點:
✔️子宮內沒有出現懷孕囊,子宮內膜相對增厚
✔️有清楚的看到左右兩側的卵巢,並且無類似懷孕囊的組織在其中
✔️卵巢旁邊有一團類似懷孕囊的組織,且套上血流有明顯的Ring of fire sign
✔️若外孕已破裂,會出現骨盆腔積液,甚至會淹過子宮
#卵巢外孕
✔️子宮內沒有出現懷孕囊,子宮內膜相對增厚
✔️某側卵巢內有類似懷孕囊的組織,且套上血流有明顯的Ring of fire sign
✔️卵巢旁找不到其他類似子宮外孕的組織
#子宮角(Cornual pregnancy)
有另一個名詞叫做interstitial pregnancy(主要是長在子宮肌肉內的外孕都算),而cornual pregnancy特指長在子宮角的外孕。
✔️追溯懷孕囊和子宮內膜的相對位置,並沒有連接到內膜的部分
✔️通常位置都比較偏離正中,都要追蹤到很偏很邊邊的位子
✔️子宮肌肉層的厚度比較薄,有可能小於5mm
#子宮頸
#子宮頸外孕 和 #剖腹產疤痕外孕 比較難一眼區分,由於剖腹產疤痕的位置通常都在子宮低位,也就是接近子宮頸附近,因此有時候需要追蹤超音波,才能比較準確的判斷是那種外孕。
✔️懷孕囊在子宮頸。這是診斷的基本條件,但是有一項較難區隔的,就是正在流產的懷孕->此時的懷孕囊通常形狀比較不規則,有時胎兒心跳已消失,再過幾個小時去看,就已經排出大量血塊,超音波追蹤也看不到懷孕組織了
✔️子宮頸會慢慢腫大,變成一個沙漏狀的子宮
✔️子宮內頸通常是閉合的
#子宮疤痕(剖腹產疤痕) (Cesarean scar pregnancy, CSP)
✔️子宮內膜和子宮頸沒有看到懷孕囊
✔️懷孕囊在子宮下段的前壁
✔️膀胱和懷孕囊之間沒有看到健康的子宮肌肉組織
✏️借用科內老師的文獻,把CSP分成四個分級(借用論文的圖片)
Grade I:懷孕囊佔子宮下段前壁的深度小於50%
Grade II:懷孕囊佔子宮下段前壁的深度大於50%
Grade III:懷孕囊凸出子宮肌肉層
Grade IV:整個懷孕囊內已看不清楚胚胎,形狀不固定,且富含血管
📖相關文獻: New ultrasound grading system for cesarean scar pregnancy and its implications for management strategies: An observational cohort study
為什麼要分類?主要跟治療方式有很大的相關。
由輕度到嚴重的疤痕懷孕,各有適合的治療方式,選擇恰當的藥物/手術/保守治療,可以降低病人的風險。
---
另外提一下,剖腹產本身就是植入性胎盤的一個危險因子。
現在發現很多早期懷疑剖腹產疤痕懷孕的病患,雖然後來胚囊好像慢慢往子宮內長回去,看似好像可以繼續懷孕,但是若有合併前置胎盤,變成植入性胎盤的風險大大提升!
甚至有些是早期就變成植入性胎盤,沒有辦法繼續懷孕下去,需要把子宮拿掉的案例。
因此能不能繼續拚下去?就需要連續超音波的追蹤來輔助。
當然😳
時不時也是會出現案例報告,像是週數很大的腹腔內懷孕遲遲沒有破裂...(上天保佑)
但是不管哪種的子宮外孕,都是風險很大,有可能隨時破裂,發生腹腔內大出血造成休克!
大家千萬不要輕忽呀~~~
#子宮外孕
#子宮疤痕懷孕
#植入性胎盤
pregnancy ultrasound 在 A Happy Mum Facebook 的最佳貼文
This was taken during the first check up for Baby #4 back in August when I was 8 weeks pregnant.
I was all alone at the clinic and had to wait for over two hours before I got to see my gynae. There were butterflies in my stomach and that anxiety was aggravated by the fact that it was freezing cold and I had forgotten to bring along my sweater. I tried to distract myself by walking around, doing leg lifts, reading the papers and scrolling mindlessly on social media.
There was only one thought and one hope on my mind... "Please be safe, Baby, and let Mama see that flickering dot".
I still vividly recall how dreadful it was when we were greeted by an empty sac, a lack of heartbeat and the words "Your baby is gone" when I went through a miscarriage years ago. The pain, the hurt, the sense of loss, the immense guilt and regret - it gets buried over time but never goes away. It was one of the darkest periods of my life and one that you have to go through to truly understand.
So this time round, all I was hoping was to see that heartbeat, for me to know that the baby is there and is doing fine. Boy or girl, really, it doesn't matter as long as the baby is healthy. That was all I could ask and hope for. And when I spotted that flicker, a huge flood of relief swept over me and I couldn't help but smile as I stared at the screen and saw my baby for the first time. Well, we subsequently failed one of the markers during the Oscar test and were told there was a chance of abnormality and risk involved. But that is a story for another day.
Today, I am just happy to share that we have crossed the 20-week mark and are doing well. I have been feeling the flutters and that is just one of the most amazing sensations ever. I will be doing a detailed scan tomorrow and will share more updates soon. Oh yes, and the gender reveal that many of you have been asking me about, it will be up this week, yeah?
#ahappymum #pregnancy #hellobaby #ultrasound #feelingthankful
pregnancy ultrasound 在 時事英文 Podcast by ssyingwen Youtube 的最佳解答
本月初,一項新法律在美國德州生效,禁止懷孕六週後進行人工流產,成為先進國家中最嚴格的墮胎法之一。反觀世界第二大羅馬天主教國,墨西哥最高法院週二裁定,懲罰墮胎違憲,成為墨西哥女性健康與人權倡導者的重大勝利。
講義
👉 本集限定公開下載 PDF:https://bit.ly/3Acfk2E
👉 嘖嘖訂閱版本:https://bit.ly/ssyingwen_notes
🍼 網站 (相關文章 / 影片):https://ssyingwen.com/ssep52
🖼️ IG 單字卡: https://bit.ly/ssyingwenIG
———
本集 timestamps
0:00 Intro
1:37 第一遍英文朗讀
4:00 新聞 & 相關單字解說
18:22 額外單字片語
24:34 第二遍英文朗讀
———
臉書社團 (朗讀文字):https://www.facebook.com/groups/ssyingwen/posts/301461465073433/
朗讀內容參考了
VOA: https://www.voanews.com/americas/mexicos-top-court-decriminalizes-abortion-watershed-moment
NPR 1: https://www.npr.org/2021/09/07/1034925270/mexico-abortion-decriminalized-supreme-court
NPR 2: https://www.npr.org/2021/09/01/1033202132/texas-abortion-ban-what-happens-next
The Dallas Morning News: https://www.dallasnews.com/news/world/2021/09/07/mexico-lifts-abortion-ban-even-as-texas-embraces-it/
The Guardian: https://www.theguardian.com/us-news/2021/sep/09/biden-administration-sue-texas-abortion-law
———
本集提到的單字片語:
Texas 德州
SB 8 (Senate Bill 8) 德州參議院第八議案
Abortion(s) 人工流產、墮胎
Near-total abortion ban 幾乎完全的墮胎禁令
Rape 強姦
Incest 亂倫
Pro-choice 捍衛選擇權
Pro-life 捍衛生命權
Forced pregnancy 強迫懷孕
Democrats 民主黨
Republicans 共和黨
Heartbeat 心跳
Fetal heartbeat 胎兒的心跳
Scientists 科學家們
Embryo 胚胎
Ultrasound 超音波
Fetus 胎兒
Border 邊境
Mexico 墨西哥
Brazil 巴西
Roman Catholic Church 羅馬天主教會
Supreme court 最高法院
Unanimously一致通過的
Decriminalizes 除罪化
Legalize 合法化
Latin America 拉丁美洲
Conservative 保守
Illegal 違法的
Argentina 阿根廷
Irony / ironic / ironically
Sarcasm / sarcastic
Coahuila 墨西哥北部與德州鄰近的州
Mexico City 墨西哥城
Trimester 三個月
Restrictive 嚴格限制的
Insidious 陰險的
Draconian 苛刻的
Cruel 殘忍的
Abortion rights 墮胎權
Roe v. Wade 羅訴韋德案
Landmark decision / judgement
Viability 胎兒在母體外有生存能力
Governor 州長
Attorney general 司法部長
Abortion providers 提供墮胎的醫療機構
Sue 起訴、吿
Whistleblower 吹哨者
Mum 沈默
Clearly 明顯的
Unconstitutional 違反憲法
Kamala Harris 賀錦麗
Not negotiable 不容商量的
Jen Psaki 白宮發言人
Unequivocal 毫不含糊的、非常明確的
Irrational 不理智的
Super Typhoon Chanthu 強颱璨樹
Philippines 菲律賓
Hurricane Ida 颶風艾達
♥️ 喜歡時事英文 podcast 嗎?♥️
你可以支持我繼續錄製 podcast 👉 https://bit.ly/zeczec_ssyingwen
————
#podcast #墮胎權 #女權 #學英文 #英文筆記 #英文學習 #英文 #每日英文 #托福 #雅思 #雅思英語 #雅思托福 #多益 #多益單字 #播客 #國際新聞 #英文新聞 #英文聽力 #taiwanpodcast
![post-title](https://i.ytimg.com/vi/y17xZLJDysA/hqdefault.jpg)
pregnancy ultrasound 在 [email protected] Youtube 的最佳貼文
早產專題 - 陳耀敏婦產科專科醫生@FindDoc.com
FindDoc Facebook : https://www.facebook.com/FindDoc
FindDoc WeChat : 快徳健康香港 FindDoc
FindDoc Instagram:@finddochk
(一)早產有什麼影響或常見併發症? 00:06
(二)有哪些導致早產的高危因素? 00:48
(三)如何預防早產? 01:20
(四)如何延緩早產? 02:11
(本短片作健康教育之用,並不可取代任何醫療診斷或治療。治療成效因人而異,如有疑問,請向專業醫療人士諮詢。)
參考資料:
1. World Health Organization. (2018, February 19). Preterm birth. Retrieved December 4, 2019 from https://www.who.int/en/news-room/fact-sheets/detail/preterm-birt
2. Lawn, J. E., Davidge, R., Paul, V. K., Xylander, S. V., Johnson, J. D. G., Costello, A., … Molyneux, L. (2013). Born Too Soon: Care for the preterm baby. Reproductive Health, 10(S1). doi: 10.1186/1742-4755-10-s1-s5
3. Romero, R., Nicolaides, K. H., Conde-Agudelo, A., Obrien, J. M., Cetingoz, E., Fonseca, E. D., … Hassan, S. S. (2016). Vaginal progesterone decreases preterm birth ≤ 34 weeks of gestation in women with a singleton pregnancy and a short cervix: an updated meta-analysis including data from the OPPTIMUM study. Ultrasound in Obstetrics & Gynecology, 48(3), 308–317. doi: 10.1002/uog.15953
4. Salim, R., Garmi, G., Nachum, Z., Zafran, N., Baram, S., & Shalev, E. (2012). Nifedipine Compared With Atosiban for Treating Preterm Labor. Obstetrics & Gynecology, 120(6), 1323–1331. doi: 10.1097/aog.0b013e3182755dff
資料來源:https://www.FindDoc.com
查詢醫生資訊:
https://www.finddoc.com/
![post-title](https://i.ytimg.com/vi/beOdMB5JSPY/hqdefault.jpg)
pregnancy ultrasound 在 Anh Minh Youtube 的最佳解答
Our monthly check up at the doctor's office today got us all disappointed since we didn't get to see the baby on the ultrasound
this time. We always get excited for every doctor's appointment but I guess this doctor just wanted to touch my belly instead which was kind on weird. Hopefully we will see our baby at our next monthly check up! Plus I got the TDAP whipping cough vaccine as well just in case for the baby. Extra precaution.
STAY CONNECTED.....
YOUTUBE: https://www.youtube.com/anhminhnet
EMAIL: anhminh@anhminh.net
FACEBOOK: https://www.facebook.com/anhminhfan
INSTAGRAM: https://instagram.com/anhminhledoan
SNAPCHAT ?: anhminhnet
TWITTER: https://twitter.com/anhminhnet
![post-title](https://i.ytimg.com/vi/eB0GwPhrL4g/hqdefault.jpg?sqp=-oaymwEbCKgBEF5IVfKriqkDDggBFQAAiEIYAXABwAEG&rs=AOn4CLC4d0e3k6OS2p5Tpj06i4YkYRcySg)
pregnancy ultrasound 在 Ultrasound: An Early View of Baby - YouTube 的推薦與評價
An ultrasound during pregnancy is useful in evaluating the baby's general health and anatomy. [Show ID: 35150]Please Note: Knowledge about ... ... <看更多>