1.Preterm labor and Prematurity2.ppt
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This document discusses preterm labor and prematurity. It begins with definitions of preterm labor as onset of labor before 37 weeks of gestation. Preterm labor is the leading cause of preterm birth, which accounts for 80-90% of perinatal mortality. The document then outlines risk factors for preterm labor including infections, bleeding, smoking, and previous preterm labor. It also describes diagnosing preterm labor and complications for both mother and infant. The management of preterm labor is then outlined, including tocolysis to delay labor, steroid administration to aid lung development, and arranging neonatal intensive care for delivery.
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Symptoms of preterm labor can include regular contractions, pelvic pressure or pain, backache, vaginal bleeding or discharge, and a change in vaginal discharge. If preterm labor is suspected, immediate medical attention is required. Treatment may include medications to stop or slow down labor, steroid injections to help speed up fetal lung development, and bed rest.
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(1) Preterm labor is defined as labor beginning before 37 weeks of gestation and is a significant cause of perinatal morbidity and mortality, with an incidence of 5-10%.
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(3) Management involves attempts to arrest preterm labor if it is not too preterm, including bed rest, hydration, antibiotics if infection is present, tocolytic drugs, and corticosteroids to aid fetal lung maturation if delivery is likely
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Tetanus is caused by Clostridium tetani bacteria entering the body through wounds and producing neurotoxins. It causes painful muscle spasms and can be fatal. There are different types including generalized tetanus with whole body spasms, neonatal tetanus in infants, and localized tetanus near the wound. Treatment involves controlling spasms, administering tetanus immunoglobulin and antibiotics, and providing supportive care. Prognosis depends on factors like age and how quickly symptoms develop, with neonatal tetanus having over 75% fatality rate without treatment.
MILK .ppt
Milk is the secretion of mammary glands in humans and animals. It provides complete nutrition for newborns as their sole food source. Milk contains water, proteins like casein, lipids, lactose, vitamins, and minerals. Casein proteins make up the majority of milk proteins and give milk its white color when suspended in colloidal casein micelles. When milk is fermented or acidified, casein proteins precipitate out to form curds. Milk's pH, fat content, protein composition and other properties can vary between species and individual animals.
10 Screening.ppt
- Epidemiological screening involves identifying unrecognized disease in asymptomatic individuals to detect disease earlier and improve outcomes.
- For a screening program to be introduced, the condition must be an important health problem, there must be an accepted screening test that is accurate and easy to perform, and treatment started early based on screening should be more effective than treatment after symptoms develop.
- The accuracy of screening tests are determined by their sensitivity, specificity, positive predictive value, and negative predictive value when compared to a gold standard diagnostic test. Sensitivity measures the test's ability to identify true positives while specificity measures its ability to identify true negatives.
Kernicturus-1.ppt
This document discusses neonatal jaundice. It covers the clinical manifestations such as jaundice and signs of prematurity. It also discusses kernicterus, a neurological syndrome caused by bilirubin deposition in the brain that can cause issues with motor skills and hearing. The document outlines investigations like blood tests and treatments including phototherapy, exchange transfusions, and medications. It emphasizes prevention through monitoring bilirubin levels and recognizing risk factors.
mean comparison.pptx
The document discusses statistical methods for comparing means between groups, including t-tests and analysis of variance (ANOVA). It provides information on different types of t-tests (one sample, independent samples, and paired samples t-tests), assumptions of t-tests, and how to perform t-tests in SPSS. It also covers one-way ANOVA, including its assumptions, components of variation, properties of the F-test, and how to run a one-way ANOVA in SPSS. Examples are provided for each statistical test.
1. asphyxia.PPT
This document discusses perinatal asphyxia, including its causes, effects, management, and prevention. Some key points:
- Perinatal asphyxia can be caused by issues with maternal oxygenation, placental blood flow, umbilical cord complications, or prolonged fetal head compression during delivery.
- Effects of asphyxia include hypoxemia, metabolic acidosis, multi-organ dysfunction affecting particularly the brain, kidneys, heart and lungs. Cerebral effects range from reversible synaptic changes to selective neuronal necrosis.
- Management involves maintaining normal oxygen and carbon dioxide levels, fluids, seizures control, and therapeutic hypothermia for severe cases meeting certain criteria.
- Prevention of perin
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1.Preterm labor and Prematurity2.ppt
- 1. Preterm labor and Prematurity Asheber Gaym M.D. January 2009
- 2. Outline • Definition of preterm labor • Discuss etiology of preterm labor • Describe be diagnosis of preterm labor • List complications of preterm labor • Outline management of preterm labor Asheber Gaym,2009 2
- 3. Definitions and Epidemiology • Preterm labor- onset of labor before 37 completed weeks and after the 20th week of pregnancy. • Affects 10% of pregnancies on average. • Preterm labor is the commonest cause of preterm birth which leads to the prematurity, responsible for 80-90% of perinatal mortality in the developed world. This makes prevention of preterm labor a major focus of obstetric care is these settings. • Early diagnosis, short term tocolysis and appropriate management of delivery assist to reduce perinatal morbidity and mortality. • Preterm birth results from preterm labor and delivery or preterm pregnancy termination as part of the management of high risk of pregnancies. Asheber Gaym,2009 3
- 4. Asheber Gaym,2009 4 Etiology of Preterm Labor – Risk Factors Maternal Fetal Others PROM Antepartum hemmorhage Past history of preterm labor Pre eclampsia/eclampsia Uterine myoma Smoking Cocaine, heroin use Anemia RH Isoimmunization Low socioeconomic status Sexually transmitted infections Multiple pregnancy Polyhydramnios Idiopathic – majority Subclinical chorioamnionitis Iatrogenic- CST, ECV, Amniocentesis, PUBS
- 5. Diagnosis of Preterm Labor • Confirmed Gestational Age <37 completed weeks and • Regular, painful, rhythmic uterine contractions recurring at least twice in 20 minutes plus • A cervical dilatation of at least 2 cms or • Ruptured membranes or • Cervical effacement of > 80% or • Documented cervical change during follow up Asheber Gaym,2009 5
- 6. Complications of Preterm Labor Maternal Perinatal (Complications of Prematurity) Increased risk of caesarean delivery Complications of tocolytic drugs Respiratory Distress Syndrome Intraventricular hemmorhage Necrotizing enterocolitis Retrolental fibroplasia Bronchopulmonary dysplasia Feeding problems ( absence or reduced sucking reflex) Neonatal infection and sepsis – reduced resistance to infection Birth trauma Hypothermia Hypoglycemia, hypocalcaemia, hypomagnesaemia, hyperbilirubinemia Perinatal asphyxia Long term neurologic sequel Asheber Gaym,2009 6
- 7. Asheber Gaym,2009 7 Outline of Management of Preterm Labor Management Specifics for preterm delivery General labor management Same as any labor management Tocolysis Cervix <4 cms, fetal well being ok, no fetal distress, immature fetus tocolytic drugs may be administered to delay labor for as long as possible. Could be short term tocolysis for few days until lung maturation agents are administered or long term tocolysis if successful. Intrapartum fetal well being monitoring More intensive as the risk of fetal distress and asphyxia is higher than term labor. Atraumatic vaginal delivery The risk of fetal trauma during delivery is much higher for the preterm fetus. Thus all attempts must be made to effect an atraumatic delivery including a generous episiotomy; prophylactic forceps delivery; avoid ventouse delivery and gentle handling during delivery. Steroid administration If short term tocolysis is successful, steroid administration reduces the risk of RDS and IVH from 28- 32 weeks gestation
- 8. Outline of Management of Preterm Labor Management Specifics for preterm delivery Neonatal Intensive Care Should be arranged beforehand. Delivery should be effected in a facility with NICU. Preferably referral should be of the mother before delivery rather than referring a premature neonate Traditional management techniques Bed rest Fluid rehydration- 1-2 L of crystalloid/colloid administered Analgesics/sedatives administration Choice of tocolytic agents 1st line – Beta mimetics (e.g. Ritodrine ); Magnesium sulphate 2nd line- Prostaglandin synthase inhibitors (e.g. Indomethacine) ; Smooth muscle relaxants ( e.g. Nifedipine) Asheber Gaym,2009 8