産婦人科メモ2
・母体死亡率
1950年 出産 237万人
死亡 4117人 ⇒ 176.1人/10万 (約2/1000人)
2004年 出産 111万人
死亡 49人 ⇒ 4.3/10万 (1/20000人)
…けれど、せちがらい…
・「性感染症の既往は?」ときいてもわからないもの
「クラミジア」「カンジダ」と固有名詞で聞き出す
・女性の月経歴は信用ならない。不正出血もあるし
尿hCG(妊娠反応)重要!!
血液のhCG定量も有益!!! 1000 IU/Lの上下で、上なら子宮外妊娠、下なら流産、と確率が変わる。
定量で1500以下と少なければ、流産になる可能性が高ければ、観察、も手段。
定量で5000以下、4cm未満ならMTXも手段
・卵巣出血は黄体期に80%
・不妊、男性の妊娠力の評価は…
量 >2ml
pH 7.2〜7.8
濃度 >20x10^6/ml
数 >40x10^6
運動率 >50%(前進)
or >25%(高速直進)
奇形率 <30%
生存率 >50%
WBC <1x10^6
・採卵 20mmくらいまで育てて…
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