expired baby
Introduction
Expired birth introduction Born to the full age of 42 weeks or more ( 294 days) is called expired birth (postterminfant also known as postmaurity), if the placental function is normal intrauterine growth and development, birth weight 4000g is called giant, and the placenta is obvious Aging, dysfunction, leading to fetal dystrophy, growth and development stagnation, called placental dysfunction syndrome. Expired birth-pregnancy with good placenta function, good clinical appearance, flexible eyes, white skin, like a few days after birth, subcutaneous fat is full, nails are longer, hair is thicker, mane disappears, and auricle cartilage is elastic. The nipple is prominent. Overdue births with insufficient placental function are mainly manifested in the disappearance of fetal fat, progressive hypoxia and fetal intrauterine malnutrition, which are divided into three phases according to their degree. basic knowledge The proportion of illness: 0.001% Susceptible people: good for the fetus Mode of infection: non-infectious Complications: meconium aspiration syndrome hypoglycemia
Cause
Expired childbirth
It is still not very clear, and it is often related to the following factors: 1 excessive progesterone and too little estrogen at the end of pregnancy; 2 frequent bed rest, too little activity; 3 abnormal fetal position and fetal malformation; 4 good nutritional conditions, excessive vitamin E; 5 genetic factors and personal physique; 6 uterine contraction fatigue.
Prevention
Expired child prevention
Do a good job of prenatal examination of the system, pay attention to the weight of pregnant women, such as continuous measurement of estriol has a downward trend, you should consider termination of pregnancy.
The expired child with normal placental function has a good prognosis. Because the skull is hard, the cardia is small, the skull is narrow, and the shape of the head is poor. It is easy to cause dystocia. If the placental function is insufficient, the prevalence and mortality are higher. In particular, the second phase of the symptoms of the child, due to acute hypoxia, inhalation of amniotic fluid contaminated meconium, often have severe respiratory symptoms or hypoxic intracranial hemorrhage.
Complication
Expired complications Complications meconium aspiration syndrome hypoglycemia
The main clinical problems of expired births are expired, placental degeneration, multiple infarction and villus degeneration resulting in placental insufficiency syndrome. The fetus may not get enough nutrients from the mother, but consume a lot of soft tissue. Due to incomplete placenta, expired The child is prone to suffocation (asphyxia and resuscitation) during childbirth; meconium aspiration syndrome (respiratory disease), which can be abnormally severe in expired children. Because the amount of amniotic fluid has been reduced, the inhaled meconium is not diluted; Neonatal hypoglycemia occurs when there is insufficient glycogen storage at birth; because anaerobic metabolism rapidly consumes the remaining glycogen reserves, the occurrence of suffocation at birth will aggravate hypoglycemia.
Symptom
Symptoms of expired birth symptoms Common symptoms Amniotic fluid placenta calcified epidermis keratinized placenta
Clinical manifestation
Expired birth-pregnancy with good placenta function, good clinical appearance, flexible eyes, white skin, like a few days after birth, subcutaneous fat is full, nails are longer, hair is thicker, mane disappears, and auricle cartilage is elastic. The nipple is prominent.
Overdue births with insufficient placental function are mainly manifested in the disappearance of fetal fat, progressive hypoxia and fetal intrauterine malnutrition, which are divided into three phases according to their degree.
The fetal fat disappears, and the keratinized layer of the epidermis can be soaked due to the loss of fetal fat protection. After drying, it will wrinkle, crack, and desquamate.
On the basis of the first phase, the hypoxia is progressively intensified, the peristalsis is accelerated, the anal sphincter is relaxed, and the meconium is discharged, so the umbilical cord, the amniotic membrane, the skin is stained with meconium, and the respiratory tract is inhaled meconium and amniotic fluid.
In addition to the above symptoms, fetal nails, fetal fat, skin and umbilical cord can be dyed yellow-green because the meconium has been discharged into the amniotic fluid for a long time.
Pathological change
Due to the aging of the placenta, calcification, increased infarct area, reduced placental weight, narrow chorionic space, thickened villus wall, decreased placental function and increased fetal compression of the uterus, resulting in slower uterine blood flow and reduced uterine blood supply Lead to progressive hypoxia.
Examine
Expired birth check
Prenatal checkup
First, determine the placental function 1. Fetal movement count; 2. hPL measurement; 3. Urinary E3 ratio determination; 4. B-ultrasound, including double apical meridian, placental function grading, amniotic fluid volume, etc.; 5. Amniocentesis; 6. NST , OCT test, etc.
Second, the fetal electronic monitor detection.
Third, B-ultrasound detection.
Fourth, amniocentesis.
Postpartum fetal examination
First, blood gas analysis.
Second, chest X-ray examination.
Diagnosis
Expired birth diagnosis
diagnosis
Fetuses born at gestational age of 42 weeks or more ( 294 days) can be diagnosed as expired.
According to the history and neonatal asphyxia, the diagnosis of neonatal asphyxia:
1. Newborn face and body skin bruising;
2. Breathing superficial or irregular;
3. The heartbeat rules are strong and powerful, with a heart rate of 80-120 beats/min;
4. Responding to external stimuli, muscle tension is good;
5. Laryngeal reflex exists.
