Basic knowledge of common diseases in obstetrics and gynecology

Here I would like to introduce to you some basic knowledge about common obstetrics and gynecology diseases. With the rapid development of today's society, people's living standards have improved, and women are facing increasingly heavy survival pressure. As a result, more and more women are suffering from gynecological and obstetric diseases. Obstetrics and gynecology is one of the four major disciplines of clinical medicine, and plays an important role in protecting women's physical and reproductive health and preventing and treating various gynecological and obstetric diseases. Next, I will introduce to you some basic knowledge about common obstetrics and gynecology diseases.

1. Gestational diabetes

1. Pregnancy complicated with diabetes includes two situations, namely, diabetes before pregnancy and diabetes that occurs or is discovered for the first time after pregnancy. The latter is also known as gestational diabetes (GDP). Gestational diabetes accounts for more than 80% of the total number of pregnancies complicated by diabetes and 1%-5% of the total number of pregnancies. Most patients can recover after delivery. However, 33.3% of patients still develop diabetes 5-10 years after delivery, so regular follow-up is necessary.

Diagnostic criteria (only any one of the following items needs to be met): ① Two abnormal results of oral glucose tolerance test; ② Two fasting blood glucose levels ≥5.8mmol/L, any blood glucose level ≥11.1mmol/L, and fasting blood glucose level ≥5.8mmol/L again. The latter are the majority.

2. Impact of diabetes on mother and child

1. Impact on pregnant women Pregnant women with diabetes are prone to complications such as gestational hypertension, polyhydramnios, premature rupture of membranes and premature birth. In addition, diabetic patients have multiple functional defects in their white blood cells, so the rate of obstetric infection increases. Due to insufficient sugar utilization, abnormal labor process, postpartum hemorrhage and increased surgical delivery rate often occur.

2. Impact on the fetus and newborn: The high concentration of glucose in the blood of diabetic pregnant women can easily pass through the placenta, but insulin cannot. It can long-term stimulate the pancreatic islets of the fetus to produce large amounts of insulin, increase the synthesis of fetal protein and fat, and inhibit fat degradation. Therefore, the incidence of macrosomia is high. In addition, the incidence of fetal malformations is also high, and it can cause stillbirth, neonatal hypoglycemia and respiratory distress syndrome.

3. Handling principles

1. Children with diabetes who have serious complications, such as impaired renal function, severe cardiovascular disease, etc., should not become pregnant. If you are pregnant, it is advisable to terminate the pregnancy as soon as possible.

2. For those who continue their pregnancy, obstetricians and internal medicine physicians should actively cooperate to control blood sugar at 6.11-7.77mmol/L through diet or drug treatment. The pregnancy is usually terminated between 37 and 38 weeks. If obstetric complications such as placental dysfunction are found during prenatal examinations, appropriate treatment will be given after weighing the pros and cons. Vaginal delivery is generally preferred. If there is macrosomia, placental dysfunction, or other obstetric indications, cesarean section should be performed. Prevent puerperal infection and postpartum hemorrhage during the puerperium.

5. Diagnostic examination

1. Blood sugar measurement is the main basis for diagnosing diabetes, and it is also an important indicator for detecting the condition and control of diabetes. Diabetes can be diagnosed if fasting blood sugar levels are ≥5.8mmol/L twice.

2. 50g glucose tolerance test is also known as sugar screening. It is often used to screen for gestational diabetes at 24-28 weeks of pregnancy. Method: Dissolve 50g of glucose powder in 200ml of water and consume within 5 minutes. Count the time from the time you start taking the sugar solution, and draw venous blood to measure blood sugar 1 hour later. If the blood sugar level is ≥7.8mmol/L 1 hour after taking the sugar, a glucose tolerance test should be performed.

3. 75g glucose tolerance test (OGTT): It is often used to confirm the diagnosis of patients with abnormal results or unclear diagnosis in the 50g glucose tolerance test. Method: Eat normally for three days, fast for 12 hours, draw fasting blood sugar, then dissolve 75g of glucose in 3000ml of warm water and drink it within 5 minutes, starting from the first sip. Blood was drawn to measure blood sugar at three time points: 1, 2, and 3 hours later. Normal blood sugar values ​​were 5.6, 10.3, 8.6, and 6.7 mmol/L. If any two of these points exceed normal values, gestational diabetes can be diagnosed.

1. Examination of complications includes fundus examination, 24-hour urine protein quantification, urine sugar, urine ketones, liver and kidney function, etc.

6. Nursing: Omitted. Newborn care: Newborns should be cared for as premature babies regardless of their weight. When the newborn is born, umbilical cord blood is taken to test blood sugar, and 25% glucose solution is given regularly 30 minutes later to prevent hypoglycemia. At the same time, attention should be paid to prevent hypocalcemia, hyperbilirubinemia and neonatal respiratory distress syndrome. The blood sugar levels of most newborns can return to normal within 6 hours after birth.

VI. Health Education: 1. It is very important to test blood sugar and urine sugar regularly. The standard for good blood sugar control is: fasting blood sugar <7.0mmol/L, 1h postprandial blood sugar <8mmol/L.

2. Avoid eating too much food at one time, and encourage eating small meals frequently. Eat more green vegetables, beans, whole grains, low-sugar fruits, and stick to a low-salt diet. Try not to eat fruits with high sugar content such as bananas, grapes, persimmons, pears, oranges, apples, etc. Eat more fruits with low sugar content such as winter melon, tomatoes, cucumbers, etc.

3. Porridge can cause blood sugar to rise rapidly and maintain blood sugar levels for a short time, resulting in unstable blood sugar, which is not good for pregnant women and fetuses. So try to eat less porridge

4. During pregnancy, insulin is the only drug that can be used to control blood sugar. The dosage and time of medication should be correctly mastered.

5. Pay attention to personal hygiene and cut your nails regularly. Keep warm and prevent colds.

6. Live a regular life, pay attention to rest, and ensure adequate sleep. But you should also do appropriate exercise, such as aerobic exercise or walking. Keep your emotions stable and listen to light music, which can relieve your emotions and provide prenatal education for your baby.

The above is my introduction to some basic knowledge about common obstetrics and gynecology diseases. You should go to the relevant department of the hospital for routine examination in time to understand your condition. I hope my introduction can be helpful to you.