The document discusses antenatal care provided by midwives to pregnant women. Antenatal care aims to monitor pregnancy progress and fetal development, identify risks, and discover early complications through regular checkups and assessments. Initial assessments involve a physical exam, medical history, and establishing a trusting relationship. Follow up appointments typically occur every 4 weeks until week 28, then every 2 weeks until delivery. Physical exams include abdominal palpation to determine fetal size, position, and heart rate starting at 25 weeks. Proper antenatal care helps ensure healthy pregnancies and deliveries.
Oligohydramnios by dr alka mukherjee dr apurva mukherjee nagpur m.s.alka mukherjee
• Oligohydramnios refers to amniotic fluid volume that is less than expected for gestational age. It is typically diagnosed by ultrasound examination and may be described qualitatively (eg, reduced amniotic fluid volume) or quantitatively (eg, amniotic fluid index ≤5 cm, single deepest pocket <2 cm).
• Oligohydramnios may be idiopathic or have a maternal, fetal, or placental cause The fetal prognosis depends on several factors, including the underlying cause, the severity (reduced versus no amniotic fluid), and the gestational age at which oligohydramnios occurs. Because an adequate volume of amniotic fluid is critical to normal fetal movement and lung development and for cushioning the fetus and umbilical cord from uterine compression, pregnancies complicated by oligohydramnios from any cause are at risk for fetal deformation, pulmonary hypoplasia, and umbilical cord compression.
• Oligohydramnios is associated with an increased risk for fetal or neonatal death, which may be related to the underlying cause of the reduced amniotic fluid volume or due to sequelae of the reduced amniotic fluid volume.
• This topic will discuss issues related to oligohydramnios. Methods of amniotic fluid volume assessment are reviewed separately.
• Oligohydramnios occurs when the amniotic fluid is < 5th centile for gestational age.
• The most common causes are premature rupture of membranes (often missed by the mother) and placental insufficiency, however structural abnormalities such as renal agenesis should be considered.
• Prognosis is linked to gestation at diagnosis and likely development of pulmonary hypoplasia and premature delivery.
• Treatment is by optimising gestation of delivery
Oligohydramnios by dr alka mukherjee dr apurva mukherjee nagpur m.s.alka mukherjee
• Oligohydramnios refers to amniotic fluid volume that is less than expected for gestational age. It is typically diagnosed by ultrasound examination and may be described qualitatively (eg, reduced amniotic fluid volume) or quantitatively (eg, amniotic fluid index ≤5 cm, single deepest pocket <2 cm).
• Oligohydramnios may be idiopathic or have a maternal, fetal, or placental cause The fetal prognosis depends on several factors, including the underlying cause, the severity (reduced versus no amniotic fluid), and the gestational age at which oligohydramnios occurs. Because an adequate volume of amniotic fluid is critical to normal fetal movement and lung development and for cushioning the fetus and umbilical cord from uterine compression, pregnancies complicated by oligohydramnios from any cause are at risk for fetal deformation, pulmonary hypoplasia, and umbilical cord compression.
• Oligohydramnios is associated with an increased risk for fetal or neonatal death, which may be related to the underlying cause of the reduced amniotic fluid volume or due to sequelae of the reduced amniotic fluid volume.
• This topic will discuss issues related to oligohydramnios. Methods of amniotic fluid volume assessment are reviewed separately.
• Oligohydramnios occurs when the amniotic fluid is < 5th centile for gestational age.
• The most common causes are premature rupture of membranes (often missed by the mother) and placental insufficiency, however structural abnormalities such as renal agenesis should be considered.
• Prognosis is linked to gestation at diagnosis and likely development of pulmonary hypoplasia and premature delivery.
• Treatment is by optimising gestation of delivery
Malpresentations are all presentations of
fetus other than vertex. Face presentation, brow presentation, shoulder presentation and breech presentation are common malpresentations.
Definition-
The destructive operations are designed to diminish the bulk of the fetus so as to facilitate easy delivery through the birth canal
types
Craniotomy
Eviceration
Decapitation
Cleidotomy
CRANIOTOMY
Definition
It is an operation to make a perforation on the fetal head to evacuate the contents followed by extraction of the fetus
DECAPITATION
Definition
It is a destructive operation whereby the fetal head is severed from the trunk and the delivery is completed with the extraction of the trunk and that of the decapitated head per vaginam
CLEIDOTOMY
Definition
The operation consist of reduction in the bulk of the shoulder girdle by division of one or both the clavicles
Indications
Dead fetus with shoulder dystocia
Procedure
The clavicles are divided by the embryotomy scissors or long straight scissors introduced under the guidance of left two fingers placed inside the vagina
Malpresentations are all presentations of
fetus other than vertex. Face presentation, brow presentation, shoulder presentation and breech presentation are common malpresentations.
Definition-
The destructive operations are designed to diminish the bulk of the fetus so as to facilitate easy delivery through the birth canal
types
Craniotomy
Eviceration
Decapitation
Cleidotomy
CRANIOTOMY
Definition
It is an operation to make a perforation on the fetal head to evacuate the contents followed by extraction of the fetus
DECAPITATION
Definition
It is a destructive operation whereby the fetal head is severed from the trunk and the delivery is completed with the extraction of the trunk and that of the decapitated head per vaginam
CLEIDOTOMY
Definition
The operation consist of reduction in the bulk of the shoulder girdle by division of one or both the clavicles
Indications
Dead fetus with shoulder dystocia
Procedure
The clavicles are divided by the embryotomy scissors or long straight scissors introduced under the guidance of left two fingers placed inside the vagina
Overview
While it takes nine months to grow a full-term baby, labor and delivery occurs in a matter of days or even hours. However, it’s the process of labor and delivery that tends to occupy the minds of expectant parents the most.
Read on if you have questions and concerns around the signs and length of labor, and how to manage pain.
Signs of labor
Labor has started or is coming soon if you experience symptoms such as:
increased pressure in the uterus
a change of energy levels
a bloody mucus discharge
Real labor has most likely arrived when contractions become regular and are painful.
Braxton Hicks contractions
Many women experience irregular contractions sometime after 20 weeks of pregnancy. Known as Braxton Hicks contractions, they’re typically painless. At most, they’re uncomfortable and are irregular.
Braxton Hicks contractions can sometimes be triggered by an increase in either mother or baby’s activity, or a full bladder. No one fully understands the role Braxton Hicks contractions play in pregnancy.
They may promote blood flow, help maintain uterine health during the pregnancy, or prepare the uterus for childbirth.
Braxton Hicks contractions don’t cause the cervix to dilate. Painful or regular contractions aren’t likely to be Braxton Hicks. Instead, they’re the type of contractions that should lead you to call your doctor.
ADMISSION OF A WOMAN IN LABOUR and It's management 2.pptchikondindalama42
This File Explain more about Admission of woman in Labor and it's Management, this is very useful in Labor Ward and other people who like reading information
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Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Immunity to Veterinary parasitic infections power point presentation
Antenatal care
1. Antenatal care
• Antenatal care refers to care given to a pregnant
woman from the time conception is confirmed
until the beginning of labour. The midwife should
provide a woman-centred approach to the care
of the woman and her family by sharing
information with the woman to help her make
informed choices about her care.
2. Antenatal care aims
• provide effective antenatal care
• monitor the progress of pregnancy and fetal
development
• the midwife critically evaluates the physical,
psychological and sociological effects of pregnancy on
the woman and her family
• discuss the initial assessment visit, define its objectives
and consider the significance of the different
components of the woman's history taken by the
midwife.
• describe the physical examination and psychological
support of the woman at the initial assessment and
during subsequent visits
• Discover early pregnancy complication
4. Objectives for the initial assessment
• To assess levels of health by taking a detailed history
and to offer appropriate screening tests
• To ascertain baseline recordings of blood pressure,
urinalysis,
• To identify risk factors by taking accurate details of past
and present midwifery, obstetric, medical, family and
personal history
• To provide an opportunity for the woman to express and
discuss any concerns
• To give public health advice
• To build a trusting relationship with pregnant women
5. Abdominal examination & pelvic
examination
• In the initial presentation, full physical examination
should be done.
• Abdominal & pelvic examination remains important exam
for pregnant women because it is the easiest method of
fetal monitoring.
6. • Abdominal examination is carried out from 25
weeks' gestation to establish and affirm that fetal
growth is consistent with gestational age during
the pregnancy.
• The specific aims are to:
• • observe the signs of pregnancy
• • assess fetal size and growth
• • auscultate the fetal heart when indicated
• • locate fetal parts
• • detect any deviation from normal.
7. • 1- Inspection
– Size of the uterus: assess
• If the length & breadth are both increased multiple
pregnancies, polyhydramnios
• If the length is increased only large baby
– Shape of the uterus: length should be larger than broad
this indicates longitudinal lie. But if the uterus is low and
broad indicates transverse fetus lie.
– Fetal movement
– Contour of the abdomen: full bladder may be visible
in late pregnancy. Umbilicus may become everted
– Skin changes: look for stretch marks, linea nigra, scars
that indicates previous surgeries
Methods of examination
8. Methods of examination
• 2- Palpation (A): by Leopold maneuver-4
maneuvers
– Palpate the fundus (to determine if it contains breech,
head)
• By gentle pressure:
– if soft consistency/ indefinite outline breech
– If hard, smooth, well defined head
• Move your fingertips over the fetal mass to
determine mobility and sixe
– If can’t move independent from the body
breech
– If moves freely between fingertips head
9.
10. Essential definitions that you should know to
understand the physical examination
findings:
• The presentation:
is the part of the
fetus in the lower
pole of the uterus
overlying the pelvic
brim (cephalic,
breech)
11. • The lie of the fetus: is the relation of the
long axis of the fetus to the uterus (could
be longitudinal, oblique or transverse. only
longitudinal lie is normal)
12. • The attitude: is the posture of the fetus
(flexion, deflexion, extension)
13. • The position: of
the baby in relation
to the presenting
part of the mother’s
pelvis. It is
expressed
according to the
denominator which
is :
• occiput in vertex
presentation
• sacrum in breech
presentation
• mentum in face
presentation
14. Station & engagement
Station: is the relation
of the presenting part
to the ischial spine. If
the presenting part is
at the level of ischial
spine, station =0
Engagement: the
descent of the
biparietal diameter
through pelvic brim. If
the head is at the
level of ischial spine
the head must be
engaged.
15. Method of abdominal exam
• Lateral Palpation (B): (determine the position of
the fetal back and small parts)
• Hands are placed on each side of the umbilicus.
The fetal spine will palpate as firm, flat and
linear. The fetal extremities are palpable by their
varying contour and movements. The purpose of
this maneuver is to determine whether the fetal
back is left or right.
16.
17. Method of abdominal exam
• Pelvic palpation (C): 2 maneuvers
• Grasp the lower poles of the uterus between fingers
and thumbs and comment of the size, flexion and
mobility of the head.
• To determine the position of the vertex presentation:
try to palpate the prominences (occiput @ the same
side of the back & sincipital @ the opposite side of the
back)
18. Pawlik's manoeuvre, where the midwife grasps the lower pole of the uterus
between her fingers and thumb, which should be spread wide enough apart to
accommodate the fetal head
19. Method of abdominal exam
• 3- Auscultation: help assess
fetal well being
Auscult the whole abdomen
trying to locate the point of
maximum intensity
20. After you examine a pregnant women
you should answer the following
questions
1. What is the fundal
height?
It is estimated by
centimeters from
upper border of the
fundus to the pubis
symphasis by taping
measure. The
height of the fundus
correlates well with
the gestational age
especially during the
weeks of
pregnancy.
21. After you examine a pregnant women you
should answer the following questions
2. lie of the fetus: only longitudinal lie is normal
3. Attitude: normally it is full flexion and every fetal
joint is flexed.
4. presentation: normally cephalic
5. position: according to the dominator
6. Is the vertex engaged?
