Android pelvis
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THIS SLIDE CONTAINS these are points about android pelvis Introduction Aetiology Diagnosis Mechanism of labour Management complication
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Cervical stitches
Cervical insufficiency, also known as cervical incompetence, is a condition where the cervix is unable to retain a pregnancy at term due to a functional or structural defect. It is characterized by painless dilatation of the cervix resulting in premature rupture of membranes and delivery, usually occurring in the second or third trimester. Cervical cerclage procedures aim to surgically suture the cervix closed to prevent premature opening. There are several techniques for cervical cerclage placement depending on the location and indication, including McDonald, Shirodkar, emergency/rescue cerclages, and pessary or balloon alternatives. Cerclage procedures can be done through the vagina or abdomen depending
Augmentation of labour-Clinical Teaching
This document discusses augmentation of labor and induction of labor. It begins by defining augmentation of labor as stimulating uterine contractions after spontaneous labor begins, typically using oxytocin or rupturing membranes. It notes concerns about overuse of cesarean sections and need for evidence-based guidance. The principles of respecting women's autonomy and safety are outlined. Recommendations include only augmenting labor with a clear medical need, monitoring women on oxytocin, and performing it where complications can be managed. Induction methods like prostaglandins, Foley catheters, and oxytocin are described depending on cervical status.
Induction, augmentation and trial of labor
The document discusses induction of labor, including definitions, methods, and indications. It describes the three main methods of induction - medical, surgical, and combined. The medical method involves prostaglandins like misoprostol and oxytocin to induce contractions. The surgical method is artificial rupture of membranes. The combined method uses both medical induction and rupture of membranes. Some common indications for induction include post-term pregnancy, preeclampsia, and fetal growth restriction. Risks of induction include uterine hyperstimulation and failed induction requiring c-section. Strict monitoring is important during any induction procedure.
Ectopic pregnancy BY DR SHASHWAT JANI
An ectopic pregnancy occurs when a fertilized egg implants outside of the uterus, usually in the fallopian tubes. If not treated promptly through medication or surgery, it can cause the tube to rupture and result in life-threatening bleeding. Diagnosis is usually based on symptoms of abdominal pain and vaginal bleeding in early pregnancy, along with transvaginal ultrasound and beta-hCG blood tests. While ectopic pregnancies were once fatal, modern medical techniques have reduced the mortality rate by 90% through early detection and treatment to remove or destroy the growing pregnancy.
Abnormal labor
Abnormal labor or dystocia can be caused by problems with uterine contractions (uterine dysfunction), issues with the baby's size or position (fetopelvic disproportion), or a narrow pelvis (contracted pelvis). Common types include protracted or arrested dilation, shoulder dystocia, and breech presentation. Obstructed labor occurs when progress stalls despite adequate contractions, typically due to a mechanical obstruction, and can lead to serious maternal complications if not addressed. Management may involve resuscitation, expedited delivery depending on fetal/maternal status, and transfer to a higher level facility for those in advanced labor.
Placenta previa
This document discusses bleeding during pregnancy, specifically focusing on bleeding in late pregnancy known as ante partum hemorrhage. It describes the main causes of ante partum hemorrhage as placenta previa and abruptio placenta. Placenta previa is defined as an abnormally positioned placenta that covers all or part of the cervical os, and can cause inevitable bleeding. The document outlines the prevalence, causes, degrees, diagnosis, and management of placenta previa. Nursing care for women with placenta previa focuses on careful assessment and monitoring of maternal and fetal status, with the goals of preventing complications and delivering a healthy infant.
Abnormal uterine action
This document discusses abnormal uterine action during labor, including definitions, types, causes, diagnosis, and management. The main types discussed are uterine inertia, ineffective contractions, abnormal polarity, incoordinate contractions including spastic lower segment and constriction ring, cervical dystocia, precipitate labor, tonic contractions, and retraction ring. The importance of assessing uterine tone, frequency and strength of contractions is emphasized for diagnosis. Management depends on the specific abnormality but may include oxytocin augmentation, amniotomy, operative vaginal delivery, or cesarean section.
Pph1 [autosaved]
The third stage of labor, which involves delivery of the placenta, is the most crucial stage for the mother's health. A major complication is postpartum hemorrhage (PPH), excessive bleeding after childbirth. PPH can be primary (within 24 hours) or secondary (24+ hours later). The main causes of primary PPH are uterine atony (95%), retained tissue, trauma, and coagulopathy. Treatment involves controlling bleeding through uterine massage, medications, and in severe cases, surgery. While clinical examination and ultrasound are used for diagnosis, homeopathy may also help prevent PPH complications.
Recommended
Cervical stitches
Cervical insufficiency, also known as cervical incompetence, is a condition where the cervix is unable to retain a pregnancy at term due to a functional or structural defect. It is characterized by painless dilatation of the cervix resulting in premature rupture of membranes and delivery, usually occurring in the second or third trimester. Cervical cerclage procedures aim to surgically suture the cervix closed to prevent premature opening. There are several techniques for cervical cerclage placement depending on the location and indication, including McDonald, Shirodkar, emergency/rescue cerclages, and pessary or balloon alternatives. Cerclage procedures can be done through the vagina or abdomen depending
Augmentation of labour-Clinical Teaching
This document discusses augmentation of labor and induction of labor. It begins by defining augmentation of labor as stimulating uterine contractions after spontaneous labor begins, typically using oxytocin or rupturing membranes. It notes concerns about overuse of cesarean sections and need for evidence-based guidance. The principles of respecting women's autonomy and safety are outlined. Recommendations include only augmenting labor with a clear medical need, monitoring women on oxytocin, and performing it where complications can be managed. Induction methods like prostaglandins, Foley catheters, and oxytocin are described depending on cervical status.
Induction, augmentation and trial of labor
The document discusses induction of labor, including definitions, methods, and indications. It describes the three main methods of induction - medical, surgical, and combined. The medical method involves prostaglandins like misoprostol and oxytocin to induce contractions. The surgical method is artificial rupture of membranes. The combined method uses both medical induction and rupture of membranes. Some common indications for induction include post-term pregnancy, preeclampsia, and fetal growth restriction. Risks of induction include uterine hyperstimulation and failed induction requiring c-section. Strict monitoring is important during any induction procedure.
Ectopic pregnancy BY DR SHASHWAT JANI
An ectopic pregnancy occurs when a fertilized egg implants outside of the uterus, usually in the fallopian tubes. If not treated promptly through medication or surgery, it can cause the tube to rupture and result in life-threatening bleeding. Diagnosis is usually based on symptoms of abdominal pain and vaginal bleeding in early pregnancy, along with transvaginal ultrasound and beta-hCG blood tests. While ectopic pregnancies were once fatal, modern medical techniques have reduced the mortality rate by 90% through early detection and treatment to remove or destroy the growing pregnancy.
Abnormal labor
Abnormal labor or dystocia can be caused by problems with uterine contractions (uterine dysfunction), issues with the baby's size or position (fetopelvic disproportion), or a narrow pelvis (contracted pelvis). Common types include protracted or arrested dilation, shoulder dystocia, and breech presentation. Obstructed labor occurs when progress stalls despite adequate contractions, typically due to a mechanical obstruction, and can lead to serious maternal complications if not addressed. Management may involve resuscitation, expedited delivery depending on fetal/maternal status, and transfer to a higher level facility for those in advanced labor.
Placenta previa
This document discusses bleeding during pregnancy, specifically focusing on bleeding in late pregnancy known as ante partum hemorrhage. It describes the main causes of ante partum hemorrhage as placenta previa and abruptio placenta. Placenta previa is defined as an abnormally positioned placenta that covers all or part of the cervical os, and can cause inevitable bleeding. The document outlines the prevalence, causes, degrees, diagnosis, and management of placenta previa. Nursing care for women with placenta previa focuses on careful assessment and monitoring of maternal and fetal status, with the goals of preventing complications and delivering a healthy infant.
Abnormal uterine action
This document discusses abnormal uterine action during labor, including definitions, types, causes, diagnosis, and management. The main types discussed are uterine inertia, ineffective contractions, abnormal polarity, incoordinate contractions including spastic lower segment and constriction ring, cervical dystocia, precipitate labor, tonic contractions, and retraction ring. The importance of assessing uterine tone, frequency and strength of contractions is emphasized for diagnosis. Management depends on the specific abnormality but may include oxytocin augmentation, amniotomy, operative vaginal delivery, or cesarean section.
Pph1 [autosaved]
The third stage of labor, which involves delivery of the placenta, is the most crucial stage for the mother's health. A major complication is postpartum hemorrhage (PPH), excessive bleeding after childbirth. PPH can be primary (within 24 hours) or secondary (24+ hours later). The main causes of primary PPH are uterine atony (95%), retained tissue, trauma, and coagulopathy. Treatment involves controlling bleeding through uterine massage, medications, and in severe cases, surgery. While clinical examination and ultrasound are used for diagnosis, homeopathy may also help prevent PPH complications.
Cervical incompetence
This document discusses cervical incompetence, also known as cervical insufficiency. It defines cervical incompetence as the inability of the uterine cervix to retain a pregnancy in the absence of contractions or labor during the second trimester. The document outlines the causes, diagnosis, and management of cervical incompetence, with a focus on cervical cerclage procedures like the McDonald and Shirodkar techniques. Cervical cerclage involves surgically placing a suture around the cervix to reinforce it and prevent painless dilation during pregnancy.
Instrumental vaginaldelivery...
This document provides information on instrumental vaginal delivery. It begins by defining instrumental delivery as using an instrument like forceps or vacuum extractor to assist with vaginal birth. It then discusses the indications and contraindications for both vacuum extraction and forceps delivery. For vacuum extraction, it describes the types of cups used, application technique, and potential complications. For forceps delivery it discusses the history and types of forceps, parts of the forceps, and the technique for low forceps application. The document emphasizes that modern obstetrics favors low forceps delivery over other higher forms of instrumental delivery due to lower risks of morbidity and mortality.
Intrauterine growth retardation (IUGR)
1) Intrauterine growth restriction (IUGR) refers to babies whose birth weight is below the 10th percentile for gestational age. It can affect preterm, term, or post-term babies.
2) The incidence of IUGR is about 3-10% in developed countries. IUGR babies have an increased risk of perinatal mortality and morbidity that progressively increases as birth weight percentile decreases.
3) IUGR can be symmetrical, affecting growth uniformly, or asymmetrical, where the head is larger than the abdomen indicating preferential shunting of nutrients to the brain. Causes include placental insufficiency, infections, and genetic/structural abnormalities.
Shoulder dystocia
Shoulder dystocia occurs when the baby's shoulders become stuck after delivery of the head. It has a low incidence rate of 0.2-1% and risk factors include fetal macrosomia, obesity, diabetes and others. Diagnosis is made when normal maneuvers by the midwife fail to deliver the baby. Management involves calling for help, clearing the baby's airways, and performing maneuvers like McRoberts and Rubin's to rotate the shoulders and decrease their diameter in order to allow delivery. More invasive maneuvers like cleidotomy may be needed if these fail to deliver the anterior shoulder.
3 malpresentations.warda (3)- FACE PRESENTATION
Face presentations occur when the fetal chin is the presenting part instead of the vertex. They are classified into four positions based on the position of the chin. Mentoanterior positions are more common and favorable than mentoposterior positions. Labor is usually prolonged in face presentations due to delayed engagement and lack of molding of the facial bones. Management depends on the position, with mentoanterior positions usually allowing vaginal delivery while mentoposterior positions often requiring assistance. Brow presentations are the rarest type and usually do not have a defined mechanism of labor.
Management of normal labour
This document provides information on the management of normal labor. It defines labor and delivery and outlines the cardinal movements of labor. It discusses assessing and monitoring labor through the stages including fetal wellbeing, maternal wellbeing, and labor progress using a partogram. It covers managing each stage of labor including the first stage of dilation, the second stage of delivery, and the third stage of delivery of the placenta. Key points like positioning, pushing techniques, and care of the newborn are summarized.
Unstable lie
This document discusses unstable lie and version in pregnancy. It defines unstable lie as a condition where the fetal presentation constantly changes beyond 36 weeks of pregnancy when it should have stabilized. Causes include factors that prevent the presenting part from remaining fixed in the lower uterus. Complications include cord entanglement and increased risk of perinatal death. External cephalic version can be attempted to correct the malpresentation if there are no contraindications. Hospitalization is recommended at 37 weeks to monitor for premature rupture of membranes or cord prolapse. Elective c-section is often required, especially if complicating factors are present.
Shoulder dystocia
Shoulder dystocia is when the fetal shoulders become lodged at the maternal pelvis after delivery of the head, occurring in 0.2-2% of births. Risk factors include maternal diabetes, obesity, macrosomia, and prior shoulder dystocia. Management involves calling for help, applying suprapubic pressure and the McRoberts maneuver to widen the pelvis, and rotating the shoulders using maneuvers like Woods screw or Rubin. If unsuccessful, procedures include delivering the posterior arm or rarely symphysiotomy. Fetal risks are brachial plexus injury, fractures, and hypoxic brain injury. Maternal risks include perineal tears and postpartum hemorrhage. Prevention focuses
Inversion Of Uterus
Uterine inversion occurs when the uterus turns inside out, most commonly during the third stage of labor due to excessive traction on the umbilical cord or fundal pressure. It can be incomplete, with just the fundus inverted, or complete, with the entire uterus emerging from the vagina or outside the body. Symptoms include hemorrhage, abdominal pain, and shock. Treatment involves immediate manual repositioning of the uterus if diagnosed early, or the O'Sullivan hydrostatic method using saline if delayed. Prevention relies on avoiding excessive fundal pressure or cord traction during delivery of the placenta.
Midwifery cervical dystocia
Cervical dystocia occurs when the cervix fails to dilate during labor despite contractions. There are two types: primary occurs in first births and is caused by excessive fibrous tissue or spasmic muscles; secondary results from scarring or rigidity from previous operations or diseases. Results include the cervix becoming thinned but applied to the head, contractions become ineffective, and the anterior lip may edematize. Management depends on safety of vaginal delivery and how low the head is - it may include manually pushing the head up during contractions, traction, or Duhrssen's incisions followed by ventouse or forceps.
Retained placenta
A retained placenta occurs when the placenta is not expelled from the uterus within 30 minutes of childbirth. Risk factors include previous retained placentas, uterine injuries or surgeries, preterm births, induced labor, and multiple pregnancies. Causes can include failure of the placenta to separate fully from the uterine wall or abnormal placenta attachments like placenta accreta. Treatment involves controlled cord traction, manual removal in the operating room if needed, or hysterectomy for deeply embedded placentas. Complications can be life-threatening bleeding, infections, or shock if not properly managed.
BENIGN LESIONS OF UTERUS
Uterine polyps and fibroids are common benign uterine tumors. Uterine polyps can be endometrial, fibroid, adenomyomatous, or placental in origin. They typically present with menorrhagia, metrorrhagia, or postmenopausal bleeding. Diagnosis is usually made by ultrasound, and polyps can be removed by D&C or hysteroscopy. Fibroids are the most common benign tumors in women. They are estrogen dependent and present with heavy menstrual bleeding, infertility, pain, or an abdominal mass. Treatment involves medical therapy, myomectomy or hysterectomy depending on symptoms. Adenomyosis involves endometrial tissue within the myometrial
Inversion of the uterus
Uterine inversion is a rare complication where the uterus turns inside out, and can be partial or complete. It occurs in around 1 in 20,000 deliveries and is usually acute and complete. There are three degrees - first involves dimpling of the fundus, second passes through the cervix into the vagina, and third is complete outside the vulva. Treatment involves urgent manual replacement or hydrostatic replacement under anesthesia to prevent shock, hemorrhage, infection and other complications. Proper management of the third stage of labor can prevent induced inversions.
Shoulder Dystocia
Shoulder dystocia occurs when a baby's shoulders become lodged inside the mother's pelvis during childbirth, making normal vaginal delivery difficult or impossible. The document discusses risk factors for shoulder dystocia such as obesity, gestational diabetes, macrosomia, and previous shoulder dystocia. It recommends calling for help, performing an episiotomy, applying suprapubic pressure, and using maneuvers like McRobert's and Wood's screw to increase the pelvic space or change the baby's position for delivery. Complications can include maternal injuries and fetal nerve injuries, fractures or birth asphyxia if not resolved quickly.
Normal labour and its physiology
This presentation contains :-
1.Introduction of normal labour
2. Definiation of normal labour
3.Criteria of normal labour
4. Physiology of normal labour
5. Pathophysiology of labor
6.Estrogen
7. Prostaglandin
8. Oxytocin
9. True labor and false labor difference
10. Uterine contraction in labor
11. Stages of labour
12. Management of 1 st stage
13. management of 2 nd stage
14. mamagement of 3 rd stage of labor
15. Cervix dilation
16. Friedman's curve
17. Fetal skull
18. Diameter of fetal skull
19. Sutures in fetal head
20. Moulding
21. Mechanism of labour
Intrauterine death
Intrauterine fetal death refers to babies with no signs of life in utero after 24 completed weeks of gestation or weighing over 500g. The document discusses the definition, incidence, impacts, causes, diagnosis, investigations, labour and birth process, complications, lactation, postmortem examination, legal issues, psychological aspects, and follow up considerations for intrauterine fetal death. The overall goal is to provide compassionate care for the health of the mother and support for her and her partner during this difficult time.
Epilepsy in pregnancy
Seizures during pregnancy can cause: Slowing of the fetal heart rate. Decreased oxygen to the fetus. Fetal injury, premature separation of the placenta from the uterus (placental abruption) or miscarriage due to trauma, such as a fall, during a seizure
Presentation on Adherent placenta by Dr. Laxmi Shrikhande
Adherent placenta occurs when there is a defect in the decidua basalis, Resulting in an abnormal invasion of the placenta directly into the substance of the uterus
Abruptio placentae
Placental abruption occurs when the placenta detaches from the uterus prior to delivery of the baby. It can lead to significant maternal and neonatal morbidity and mortality. Risk factors include hypertension, smoking, and prior abruption. Symptoms may include vaginal bleeding, abdominal pain, and changes in fetal heart rate. Ultrasound can show a retroplacental hematoma. Management involves monitoring, administering medications to help the baby's lungs/brain if preterm, and delivery depending on gestational age and stability of the mother and baby. Women with a history of abruption have a higher risk of recurrence.
IUGR
Intrauterine Growth Restriction (IUGR) is defined as failure of the fetus to reach growth potential and is associated with increased morbidity and mortality. It affects 3-10% of pregnancies and increases perinatal mortality rate by 5-20 times. Causes include fetal, placental and maternal factors like infections, structural anomalies, vascular diseases, nutritional deficiencies, and thrombophilias. Diagnosis involves assessing risk factors, fetal measurements and Doppler ultrasound. Management focuses on treating underlying causes, fetal monitoring, timing of delivery and neonatal care. Complications include stillbirth, fetal distress, hypoglycemia and long term risks of metabolic and neurological disorders. Prognosis depends on gestational age and prematurity, with increased
obstetrics- malpositions and malpresentations
This document discusses abnormal fetal positions and presentations that can occur during labor, including occiput posterior, face, brow, and shoulder presentations. It provides details on the diagnosis, mechanisms of labor, complications, and management for each presentation. The key points are:
1) Occiput posterior positions are usually diagnosed by vaginal exam and have higher risks of prolonged labor and operative delivery; manual rotation or vacuum extraction can be attempted for deep transverse arrest.
2) Face and brow presentations engage the pelvis with the chin/mentum and forehead, respectively, increasing risks; mentoanterior positions usually rotate anteriorly while mentoposterior often require c-section.
3) Shoulder presentations have no mechanism of
Jijin 140725134811-phpapp01
This document describes occiput posterior positions, including definitions, causes, diagnosis, and management. It discusses three occiput posterior positions: right occiput posterior, left occiput posterior, and direct occiput posterior. Causes include pelvic shape and fetal factors like deflexion. Diagnosis involves abdominal and vaginal exams. Management depends on whether rotation occurs, including allowing labor, rotation procedures, instrumental delivery, or c-section for non-rotation or other complications.
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Cervical incompetence
This document discusses cervical incompetence, also known as cervical insufficiency. It defines cervical incompetence as the inability of the uterine cervix to retain a pregnancy in the absence of contractions or labor during the second trimester. The document outlines the causes, diagnosis, and management of cervical incompetence, with a focus on cervical cerclage procedures like the McDonald and Shirodkar techniques. Cervical cerclage involves surgically placing a suture around the cervix to reinforce it and prevent painless dilation during pregnancy.
Instrumental vaginaldelivery...
This document provides information on instrumental vaginal delivery. It begins by defining instrumental delivery as using an instrument like forceps or vacuum extractor to assist with vaginal birth. It then discusses the indications and contraindications for both vacuum extraction and forceps delivery. For vacuum extraction, it describes the types of cups used, application technique, and potential complications. For forceps delivery it discusses the history and types of forceps, parts of the forceps, and the technique for low forceps application. The document emphasizes that modern obstetrics favors low forceps delivery over other higher forms of instrumental delivery due to lower risks of morbidity and mortality.
Intrauterine growth retardation (IUGR)
1) Intrauterine growth restriction (IUGR) refers to babies whose birth weight is below the 10th percentile for gestational age. It can affect preterm, term, or post-term babies.
2) The incidence of IUGR is about 3-10% in developed countries. IUGR babies have an increased risk of perinatal mortality and morbidity that progressively increases as birth weight percentile decreases.
3) IUGR can be symmetrical, affecting growth uniformly, or asymmetrical, where the head is larger than the abdomen indicating preferential shunting of nutrients to the brain. Causes include placental insufficiency, infections, and genetic/structural abnormalities.
Shoulder dystocia
Shoulder dystocia occurs when the baby's shoulders become stuck after delivery of the head. It has a low incidence rate of 0.2-1% and risk factors include fetal macrosomia, obesity, diabetes and others. Diagnosis is made when normal maneuvers by the midwife fail to deliver the baby. Management involves calling for help, clearing the baby's airways, and performing maneuvers like McRoberts and Rubin's to rotate the shoulders and decrease their diameter in order to allow delivery. More invasive maneuvers like cleidotomy may be needed if these fail to deliver the anterior shoulder.
3 malpresentations.warda (3)- FACE PRESENTATION
Face presentations occur when the fetal chin is the presenting part instead of the vertex. They are classified into four positions based on the position of the chin. Mentoanterior positions are more common and favorable than mentoposterior positions. Labor is usually prolonged in face presentations due to delayed engagement and lack of molding of the facial bones. Management depends on the position, with mentoanterior positions usually allowing vaginal delivery while mentoposterior positions often requiring assistance. Brow presentations are the rarest type and usually do not have a defined mechanism of labor.
Management of normal labour
This document provides information on the management of normal labor. It defines labor and delivery and outlines the cardinal movements of labor. It discusses assessing and monitoring labor through the stages including fetal wellbeing, maternal wellbeing, and labor progress using a partogram. It covers managing each stage of labor including the first stage of dilation, the second stage of delivery, and the third stage of delivery of the placenta. Key points like positioning, pushing techniques, and care of the newborn are summarized.
Unstable lie
This document discusses unstable lie and version in pregnancy. It defines unstable lie as a condition where the fetal presentation constantly changes beyond 36 weeks of pregnancy when it should have stabilized. Causes include factors that prevent the presenting part from remaining fixed in the lower uterus. Complications include cord entanglement and increased risk of perinatal death. External cephalic version can be attempted to correct the malpresentation if there are no contraindications. Hospitalization is recommended at 37 weeks to monitor for premature rupture of membranes or cord prolapse. Elective c-section is often required, especially if complicating factors are present.
Shoulder dystocia
Shoulder dystocia is when the fetal shoulders become lodged at the maternal pelvis after delivery of the head, occurring in 0.2-2% of births. Risk factors include maternal diabetes, obesity, macrosomia, and prior shoulder dystocia. Management involves calling for help, applying suprapubic pressure and the McRoberts maneuver to widen the pelvis, and rotating the shoulders using maneuvers like Woods screw or Rubin. If unsuccessful, procedures include delivering the posterior arm or rarely symphysiotomy. Fetal risks are brachial plexus injury, fractures, and hypoxic brain injury. Maternal risks include perineal tears and postpartum hemorrhage. Prevention focuses
Inversion Of Uterus
Uterine inversion occurs when the uterus turns inside out, most commonly during the third stage of labor due to excessive traction on the umbilical cord or fundal pressure. It can be incomplete, with just the fundus inverted, or complete, with the entire uterus emerging from the vagina or outside the body. Symptoms include hemorrhage, abdominal pain, and shock. Treatment involves immediate manual repositioning of the uterus if diagnosed early, or the O'Sullivan hydrostatic method using saline if delayed. Prevention relies on avoiding excessive fundal pressure or cord traction during delivery of the placenta.
Midwifery cervical dystocia
Cervical dystocia occurs when the cervix fails to dilate during labor despite contractions. There are two types: primary occurs in first births and is caused by excessive fibrous tissue or spasmic muscles; secondary results from scarring or rigidity from previous operations or diseases. Results include the cervix becoming thinned but applied to the head, contractions become ineffective, and the anterior lip may edematize. Management depends on safety of vaginal delivery and how low the head is - it may include manually pushing the head up during contractions, traction, or Duhrssen's incisions followed by ventouse or forceps.
Retained placenta
A retained placenta occurs when the placenta is not expelled from the uterus within 30 minutes of childbirth. Risk factors include previous retained placentas, uterine injuries or surgeries, preterm births, induced labor, and multiple pregnancies. Causes can include failure of the placenta to separate fully from the uterine wall or abnormal placenta attachments like placenta accreta. Treatment involves controlled cord traction, manual removal in the operating room if needed, or hysterectomy for deeply embedded placentas. Complications can be life-threatening bleeding, infections, or shock if not properly managed.
BENIGN LESIONS OF UTERUS
Uterine polyps and fibroids are common benign uterine tumors. Uterine polyps can be endometrial, fibroid, adenomyomatous, or placental in origin. They typically present with menorrhagia, metrorrhagia, or postmenopausal bleeding. Diagnosis is usually made by ultrasound, and polyps can be removed by D&C or hysteroscopy. Fibroids are the most common benign tumors in women. They are estrogen dependent and present with heavy menstrual bleeding, infertility, pain, or an abdominal mass. Treatment involves medical therapy, myomectomy or hysterectomy depending on symptoms. Adenomyosis involves endometrial tissue within the myometrial
Inversion of the uterus
Uterine inversion is a rare complication where the uterus turns inside out, and can be partial or complete. It occurs in around 1 in 20,000 deliveries and is usually acute and complete. There are three degrees - first involves dimpling of the fundus, second passes through the cervix into the vagina, and third is complete outside the vulva. Treatment involves urgent manual replacement or hydrostatic replacement under anesthesia to prevent shock, hemorrhage, infection and other complications. Proper management of the third stage of labor can prevent induced inversions.
Shoulder Dystocia
Shoulder dystocia occurs when a baby's shoulders become lodged inside the mother's pelvis during childbirth, making normal vaginal delivery difficult or impossible. The document discusses risk factors for shoulder dystocia such as obesity, gestational diabetes, macrosomia, and previous shoulder dystocia. It recommends calling for help, performing an episiotomy, applying suprapubic pressure, and using maneuvers like McRobert's and Wood's screw to increase the pelvic space or change the baby's position for delivery. Complications can include maternal injuries and fetal nerve injuries, fractures or birth asphyxia if not resolved quickly.
Normal labour and its physiology
This presentation contains :-
1.Introduction of normal labour
2. Definiation of normal labour
3.Criteria of normal labour
4. Physiology of normal labour
5. Pathophysiology of labor
6.Estrogen
7. Prostaglandin
8. Oxytocin
9. True labor and false labor difference
10. Uterine contraction in labor
11. Stages of labour
12. Management of 1 st stage
13. management of 2 nd stage
14. mamagement of 3 rd stage of labor
15. Cervix dilation
16. Friedman's curve
17. Fetal skull
18. Diameter of fetal skull
19. Sutures in fetal head
20. Moulding
21. Mechanism of labour
Intrauterine death
Intrauterine fetal death refers to babies with no signs of life in utero after 24 completed weeks of gestation or weighing over 500g. The document discusses the definition, incidence, impacts, causes, diagnosis, investigations, labour and birth process, complications, lactation, postmortem examination, legal issues, psychological aspects, and follow up considerations for intrauterine fetal death. The overall goal is to provide compassionate care for the health of the mother and support for her and her partner during this difficult time.
Epilepsy in pregnancy
Seizures during pregnancy can cause: Slowing of the fetal heart rate. Decreased oxygen to the fetus. Fetal injury, premature separation of the placenta from the uterus (placental abruption) or miscarriage due to trauma, such as a fall, during a seizure
Presentation on Adherent placenta by Dr. Laxmi Shrikhande
Adherent placenta occurs when there is a defect in the decidua basalis, Resulting in an abnormal invasion of the placenta directly into the substance of the uterus
Abruptio placentae
Placental abruption occurs when the placenta detaches from the uterus prior to delivery of the baby. It can lead to significant maternal and neonatal morbidity and mortality. Risk factors include hypertension, smoking, and prior abruption. Symptoms may include vaginal bleeding, abdominal pain, and changes in fetal heart rate. Ultrasound can show a retroplacental hematoma. Management involves monitoring, administering medications to help the baby's lungs/brain if preterm, and delivery depending on gestational age and stability of the mother and baby. Women with a history of abruption have a higher risk of recurrence.
IUGR
Intrauterine Growth Restriction (IUGR) is defined as failure of the fetus to reach growth potential and is associated with increased morbidity and mortality. It affects 3-10% of pregnancies and increases perinatal mortality rate by 5-20 times. Causes include fetal, placental and maternal factors like infections, structural anomalies, vascular diseases, nutritional deficiencies, and thrombophilias. Diagnosis involves assessing risk factors, fetal measurements and Doppler ultrasound. Management focuses on treating underlying causes, fetal monitoring, timing of delivery and neonatal care. Complications include stillbirth, fetal distress, hypoglycemia and long term risks of metabolic and neurological disorders. Prognosis depends on gestational age and prematurity, with increased
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Presentation on Adherent placenta by Dr. Laxmi Shrikhande
Presentation on Adherent placenta by Dr. Laxmi Shrikhande
Similar to Android pelvis
obstetrics- malpositions and malpresentations
This document discusses abnormal fetal positions and presentations that can occur during labor, including occiput posterior, face, brow, and shoulder presentations. It provides details on the diagnosis, mechanisms of labor, complications, and management for each presentation. The key points are:
1) Occiput posterior positions are usually diagnosed by vaginal exam and have higher risks of prolonged labor and operative delivery; manual rotation or vacuum extraction can be attempted for deep transverse arrest.
2) Face and brow presentations engage the pelvis with the chin/mentum and forehead, respectively, increasing risks; mentoanterior positions usually rotate anteriorly while mentoposterior often require c-section.
3) Shoulder presentations have no mechanism of
Jijin 140725134811-phpapp01
This document describes occiput posterior positions, including definitions, causes, diagnosis, and management. It discusses three occiput posterior positions: right occiput posterior, left occiput posterior, and direct occiput posterior. Causes include pelvic shape and fetal factors like deflexion. Diagnosis involves abdominal and vaginal exams. Management depends on whether rotation occurs, including allowing labor, rotation procedures, instrumental delivery, or c-section for non-rotation or other complications.
ABNORMAL LABOUR PPT.pptx
This document discusses abnormal labor and dystocia. It defines abnormal labor as difficult labor characterized by abnormal slow progression due to problems with the passenger (fetus size/position), pelvis (size/shape), or power (uterine contractility). Specific causes of abnormal labor discussed include cephalopelvic disproportion (CPD), obstructed labor, shoulder dystocia, breech presentation, and fetal malpositions. The signs, risks, and management of these complications are described. Obstructed labor is defined as cessation of labor progression despite adequate contractions due to mechanical obstruction, and can lead to maternal death if not properly managed.
Contracted pelvis
Contracted pelvis
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complications
management
Malpresentation & Malpositioning
Fetal malpositioning & malpresentation can pose a serious threat to maternal & fetal well being. The document discusses the risks, complication, and management of some of the common malpresentation & malpositioning.
Difficult c section
THIS WAS PRESENTED AT SAFOG MOGS "SMART CONFERENCE "IN MUMBAI
PREPARED WITH HELP OF DR SUCHITRA PANDIT,DR CN PURANDARE AND DR ALPESH GANDHI.....VIDEOS CAN BE SEEN AT U TUBE
cpd & cp.pptx
CPD, or cephalopelvic disproportion, occurs when the fetal head is too large to pass through the mother's pelvis during labor. It can be caused by a large baby, abnormal fetal position, or a contracted pelvis. A contracted pelvis is a permanent deformity where one or more pelvic diameters are smaller than normal, which can cause dystocia or difficult labor. Clinical methods like abdominal palpation and Munro-Kerr-Muller are used to assess CPD, but imaging like X-ray or MRI can provide more accurate measurements. While elective c-section is preferred for severe CPD, a trial of vaginal delivery may be attempted for mild cases in a hospital
Obg contracted pelvis and other pelvic deformations
Contracted pelvis gynecological condition for bsc nursing and msc nursing students
Management of genital prolapse
The document discusses various methods for managing pelvic organ prolapse, including preventive measures, conservative treatments like pessary use, and different surgical procedures for correcting prolapse of the anterior vaginal wall, posterior vaginal wall, uterus, and vaginal vault depending on factors like patient age and desire for future fertility or menstruation. Conservative options have limitations while surgery aims to relieve symptoms, restore anatomy, and sexual function with various procedures for different types and degrees of prolapse.
Mellss obg y3 breech
Support the baby’s back with one hand
Apply pressure over the sacrum with other
hand to flex the head
Obstetrician:
Apply pressure over the fetal abdomen to
flex the head
Rotate the shoulders anteriorly
Apply gentle traction to deliver anterior
shoulder
Rotate the trunk posteriorly to deliver
posterior shoulder
Apply gentle traction and pressure over
the abdomen to deliver the head in flexion
Resuscitation if required
Breech Extraction
Indications:
Cord prolapse
Extended legs
Arrest of descent
malpositionandmalpresentations-160108183858.pdf
This document discusses abnormal fetal positions during childbirth including breech, face, brow, and transverse presentations. It notes that factors like multiparity, multiple fetuses, abnormal amniotic fluid levels, uterine abnormalities, placenta previa, or prematurity can contribute to abnormal positions. Occiput posterior is the most common non-vertex position and can cause prolonged labor due to the longer rotation required. The document provides details on assessing and managing different abnormal positions, including allowing progress, augmentation, operative vaginal delivery, or c-section depending on the position and other factors.
Malposition and malpresentations
This document discusses fetal positioning and presentations during labor and delivery. It begins by defining non-vertex presentations including breech, face, brow, transverse, and compound. It then discusses the causes of non-vertex presentations and describes the different positions including occiput posterior. The document provides details on assessing various positions through abdominal and vaginal exams. It concludes by outlining the management of different non-vertex positions, including allowing natural rotation, augmentation of labor, operative vaginal delivery, or caesarean section if needed.
Caesarian section.ppt
A caesarian section is a surgical procedure to deliver a baby through an incision in the mother's abdomen and uterus. It can be done as an elective or emergency procedure. The procedure involves preparing the mother, making an incision in the abdomen and uterus, extracting the baby and placenta, closing the incisions, and recovering the mother from anesthesia. Indications for a c-section include previous scarring, fetal distress, malpresentation, or maternal complications like pre-eclampsia. Complications can include hemorrhage, injuries to the baby or mother, infection, or issues with blood clots.
Malpresentation & malposition.pptx
This document discusses different abnormal fetal positions that can occur during labor, including shoulder, face, brow, occipito-transverse, and occipito-posterior positions. It provides details on the diagnosis and management of each position. The key points are:
1. Abnormal fetal positions include shoulder, face, brow, occipito-transverse, and occipito-posterior presentations.
2. Diagnosis is made through physical examination, ultrasound, and vaginal examination to determine the presenting part of the fetus.
3. Management depends on the specific position but may include external cephalic version, forceps delivery, caesarean section, or expectant management and allowing the
BREECH PRESENTATION obstetrics and gynacology mbbs final year
BREECH PRESENTATION obstetrics and gynacology mbbs final year
presentation , pregnancy
final year mbbs
normal labor
breech labor complications
management
BREECH
tdmc kerala
L32 Abnormal labor
This document discusses abnormal labor, which includes any deviations from normal spontaneous labor of a singleton fetus in cephalic presentation at term. Abnormal labor can occur due to poor progress, fetal compromise, malpresentation, multiple gestation, uterine scar, or induction of labor. Poor progress is defined as less than 2 cm dilation in 4 hours and can be caused by dysfunctional uterine contractions, cephalic-pelvic disproportion, or malpresentation. Malpresentations include abnormal lie, face/brow presentations, breech presentation, and compound presentations. Management depends on identifying the underlying cause based on the 3 Ps - powers (uterine contractions), passages (maternal pelvis), and passenger (fetus).
occipitoposteriorposition.pptx
This document discusses malpositions during labor, specifically occipito-posterior position. It defines malposition as any position other than flexed occipito-anterior. Occipito-posterior position occurs when the occiput is placed posteriorly over the sacrum. It describes the types, incidence, causes, diagnosis, and management of occipito-posterior position. Management may involve expectant monitoring, assisted vaginal delivery techniques like manual rotation or vacuum extraction, or cesarean section if labor is not progressing.
CPD cephalo pelvi. .pptx
This document discusses contracted pelvis (CPD), also known as cephalopelvic disproportion (CPD), which refers to a mismatch between the fetal head size and the mother's pelvis. It defines CPD, describes the causes and classifications. It outlines the diagnostic process including history, examination and pelvimetry. Management options are discussed including trial of labor, induction, cesarean section. Complications of CPD like shoulder dystocia are also summarized. Finally, it provides an abstract of a journal article on using fetal pelvic index to predict CPD.
Malpresentation illi(2)
This document discusses various fetal malpresentations and malpositions that can occur during labor and delivery. It defines malpresentation as a non-vertex presentation such as breech, brow, or transverse lie, and malposition as positions other than occiput anterior. Common presentations and positions are described along with their diagnosis, management, and potential complications. Breech presentation management includes external cephalic version, spontaneous version, or caesarean section depending on gestational age and other risk factors. Vaginal breech delivery techniques like Pinard's maneuver and Burns Marshall method are outlined. Face presentations are also summarized.
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Obg contracted pelvis and other pelvic deformations
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Android pelvis
- 1. ANDROID PELVIS PRESANTER: DR Arshwi MODERATOR: DR SAUMYA
- 2. Introduction Aetiology Diagnosis Mechanism of labour Management complication
- 5. This type of pelvis is in tall women with narrow hips and in African women. heart-shaped brim and is quite narrow in front. In this pelvis babies lie with their back against their mothers’ back and may experience longer labour
- 6. women take an active role during their labour and need to squat and move around as much as possible.
- 7. INLET Shape: triangular Ant. & post. Segment: narrow/ short Sacrum: SA <90⁰ inclined forward & straight CAVITY Narrow & deep sacrosciatic joint Convergent : side walls OUTLET Prominent : ischial spines Long and straight : pubic arch Narrow: subpubic angle Short: bituberous diameter FEATURES
- 8. INLET Position : OL/ oblique OP Transverse /oblique diameter of engagement with delayed & difficult engagement CAVITY Internal rotation :difficult ant rotation Doesnt occurs early above ischial spine,chance of arrest OULET Delivery: difficult with increase chance of perineal injuy OBSTETRIC OUTCOME
- 9. HISTORY Bad obstetric history- prolonged labour leads to: *difficult forceps *CS *Still birth *Early neonatal death *Late neurological symptoms Evidence of maternal injuries(complete perineal tear) PHYSICAL EXAMINATION: Tall stature DIAGNOSIS
- 10. *Dystocia dystrophia syndrome: Short , Stockily built, Bull neck, Broad shoulders Short thigh ,Obese, Male distribution of hairs Delayed menarche Sub fertile having dys-menorrhea / oligo-menorrhea /irregular periods Increase incidence of pre-eclampsia,tendency of postmaturity ,android type of pelvis *OP position is common *During labor inertia is common
- 11. *tendency of deep transverse arrest or outlet dystocia.... *Chance of lactation failure ABDOMINAL EXAMINATION: Inspection :pendulous abdomen in primi Obstetrical : may be malpresentation in primigravidae non engagement of head :in last 3 to 4 weeks in primigravidae Pelvimetry: bimanual /radio-pelvimetry/CT/MRI
- 12. Timing: Procedure:Empty the bladder, Position: Aseptic precautions Features to be noted: Cervix , Station ,Engagement if not then CPD Elasticity of perineal muscle Steps: CLINICAL PELVIMETRY
- 18. X-RAY CT.. MRI
- 19. Depending on severity MANAGEMENT OF CPD • ECSMAJOR • TRIAL LABOR • ECS BRDELINE • Vertex NVD • OTHER* ECS MINOR
- 21. Metarnal : During pregnancy Mal presentation Pendulous abdomen Non engagement Pylonephritis.... COMPLICATON
- 22. During labour inertia , slow cervical dilatation & prolong labour Premature rupture of membrane & cord prolapse Obstructed labour & rupture uterus Necrotic genito urinary fistula Injury to pelvic joints & nerves from difficult forceps delivery PPH
- 23. Fetal: IC haemorrhage Asphyxia Nerve injury Fracture of skull Intra amniotic infection
- 24. D C DUTTA’S textbook of obstetrics 7th edition Source for pictures : internet REFERENCE
- 25. THANK YOU