Antepartum haemorrhage s
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Antepartum haemorrhage (APH) is bleeding from the genital tract between 28 weeks of pregnancy and the onset of labor. Placenta previa and placenta abruption are major causes of APH. Placenta previa occurs when the placenta is implanted in the lower uterine segment or covers all or part of the cervical os. It can be diagnosed by ultrasound and treated with caesarean section. Complications of APH include maternal and fetal mortality due to factors like pre-existing anemia, transport difficulties, and inadequate medical care.
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Ante partum haemorrhage by dr wyo
This document discusses antepartum hemorrhage (APH), or bleeding from the female genital tract between 20-28 weeks of pregnancy until delivery. It defines the different types of APH such as simple or complicated, and describes the main causes - placenta previa, abruptio placentae, and vasa previa. Risk factors, signs and symptoms, investigations, and management are outlined for each condition. Complications for both mother and baby are also noted. The key is to assess the ABCs, monitor the fetus, provide supportive care or intervention as needed depending on the etiology and severity of bleeding.
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A woman's gestational period typically lasts 40 weeks. Common first trimester symptoms include morning sickness and mood swings. Another major risk in the first trimester besides miscarriage is an ectopic pregnancy where the embryo attaches outside the uterus. A pregnant woman's plasma and blood volume typically increases by 20% during pregnancy. Labor may be induced if a woman has not given birth by 40-41 weeks.
Shoulder dystocia
Shoulder dystocia is an obstetric emergency that occurs when the baby's anterior shoulder becomes trapped behind the pubic bone during childbirth after delivery of the head. Risk factors include previous shoulder dystocia, large baby size (macrosomia), diabetes, and certain complications during labor like prolonged pushing. Diagnosis involves difficulty delivering the baby's head or shoulders with normal traction. Management begins by calling for help and stopping pushing, and uses maneuvers like McRoberts position and suprapubic pressure to widen the pelvis and disimpact the shoulder. If these fail, internal maneuvers are attempted to rotate the baby before considering more extreme options. Complications can include maternal and fetal injuries.
Uterine abnormalities
This document defines and classifies uterine abnormalities, or mullerian duct anomalies. It describes 7 classes of anomalies resulting from abnormal development of the mullerian ducts during embryogenesis. Class 1 involves complete or partial mullerian agenesis. Classes 2 through 5 involve various degrees of failure of the mullerian ducts to fully fuse, resulting in anomalies like a unicornuate, didelphys, bicornuate, or septate uterus. Class 6 is an arcuate uterus and Class 7 involves DES exposure in utero causing a T-shaped uterus. Symptoms may include pain or infertility. Diagnosis involves imaging tests. Treatment depends on symptoms but may involve surgery to correct the anomaly
Antepartum hemorrhage
Antepartum hemorrhage (APH) is bleeding from or within the genital tract after 24 weeks of gestation. The most common causes are placenta previa and abruptio placentae. Placenta previa is the implantation of the placenta in the lower uterine segment, often causing painless bleeding. Abruptio placentae is the premature separation of a normally implanted placenta, which can cause abdominal pain, shock, and fetal distress. Diagnosis involves history, examination, ultrasound, and tests. Conservative management is used for mild cases while termination is indicated for heavy bleeding, fetal distress, or gestational age of 37 weeks or more. Close monitoring during hospitalization and until
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This document discusses antepartum hemorrhage (APH), or bleeding from the female genital tract between 20-28 weeks of pregnancy until delivery. It defines the different types of APH such as simple or complicated, and describes the main causes - placenta previa, abruptio placentae, and vasa previa. Risk factors, signs and symptoms, investigations, and management are outlined for each condition. Complications for both mother and baby are also noted. The key is to assess the ABCs, monitor the fetus, provide supportive care or intervention as needed depending on the etiology and severity of bleeding.
antepartum-haemorrhage
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A woman's gestational period typically lasts 40 weeks. Common first trimester symptoms include morning sickness and mood swings. Another major risk in the first trimester besides miscarriage is an ectopic pregnancy where the embryo attaches outside the uterus. A pregnant woman's plasma and blood volume typically increases by 20% during pregnancy. Labor may be induced if a woman has not given birth by 40-41 weeks.
Shoulder dystocia
Shoulder dystocia is an obstetric emergency that occurs when the baby's anterior shoulder becomes trapped behind the pubic bone during childbirth after delivery of the head. Risk factors include previous shoulder dystocia, large baby size (macrosomia), diabetes, and certain complications during labor like prolonged pushing. Diagnosis involves difficulty delivering the baby's head or shoulders with normal traction. Management begins by calling for help and stopping pushing, and uses maneuvers like McRoberts position and suprapubic pressure to widen the pelvis and disimpact the shoulder. If these fail, internal maneuvers are attempted to rotate the baby before considering more extreme options. Complications can include maternal and fetal injuries.
Uterine abnormalities
This document defines and classifies uterine abnormalities, or mullerian duct anomalies. It describes 7 classes of anomalies resulting from abnormal development of the mullerian ducts during embryogenesis. Class 1 involves complete or partial mullerian agenesis. Classes 2 through 5 involve various degrees of failure of the mullerian ducts to fully fuse, resulting in anomalies like a unicornuate, didelphys, bicornuate, or septate uterus. Class 6 is an arcuate uterus and Class 7 involves DES exposure in utero causing a T-shaped uterus. Symptoms may include pain or infertility. Diagnosis involves imaging tests. Treatment depends on symptoms but may involve surgery to correct the anomaly
Antepartum hemorrhage
Antepartum hemorrhage (APH) is bleeding from or within the genital tract after 24 weeks of gestation. The most common causes are placenta previa and abruptio placentae. Placenta previa is the implantation of the placenta in the lower uterine segment, often causing painless bleeding. Abruptio placentae is the premature separation of a normally implanted placenta, which can cause abdominal pain, shock, and fetal distress. Diagnosis involves history, examination, ultrasound, and tests. Conservative management is used for mild cases while termination is indicated for heavy bleeding, fetal distress, or gestational age of 37 weeks or more. Close monitoring during hospitalization and until
Uterine Inversion 2018
Uterine inversion occurs when the uterus turns inside out, most commonly during delivery from excessive cord traction or fundal pressure. It can range from the fundus inverting into the cervix to the entire uterus prolapsing outside the body. Prompt diagnosis and management is needed to prevent shock. The uterus must be manually or surgically replaced before detaching the placenta to avoid hemorrhage. Prevention involves controlled cord traction and avoiding fundal pressure until the placenta separates naturally.
version
Version is a procedure to manually alter the presentation of the fetus for delivery. There are three main types: external cephalic version, internal podalic version, and bipolar version. External cephalic version involves abdominal manipulation to convert a breech or transverse lie into a cephalic presentation. It has indications such as breech presentation or transverse/oblique lie between 32-36 weeks, and contraindications include multiple pregnancy or conditions that require a cesarean. Internal podalic version converts the presentation from transverse or cephalic to a footling breech via intrauterine and abdominal maneuvers when external version has failed or for specific conditions. It carries risks of uterine rupture and fetal injury or death
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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.
Shoulder presentation
This document defines and discusses abnormal fetal positions and presentations that can occur during labor, including breech, face, brow, shoulder, transverse lie, and compound presentations. It provides the definitions, incidence rates, causes, diagnostic techniques, and management approaches for each atypical presentation. Key points covered include the different types of breech, face, brow, and shoulder positions, mechanisms of labor for each, and when external cephalic version, assisted vaginal delivery, or cesarean section are recommended.
Management of ectopic pregnancy
An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, usually in the fallopian tubes. Ectopic pregnancies are not viable and can be life-threatening due to potential internal bleeding. The vast majority of ectopic pregnancies implant in the fallopian tubes. Diagnosis involves transvaginal ultrasound and beta-hCG level testing. Treatment options include medical management with methotrexate or surgical intervention like laparoscopy or laparotomy. The goal of treatment is to remove the ectopic pregnancy safely while preserving the ability to conceive in the future.
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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.
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Version
Version is a procedure to change the fetal lie or presentation. There are two main types: external cephalic version and internal podalic version. External cephalic version is done externally without anesthesia to flex the fetus and rotate the head into a vertex presentation. Internal podalic version requires anesthesia and is done when the cervix is dilated to grasp the fetal foot and bring the breech into position for delivery. Potential maternal complications include shock, bleeding, and infection, while fetal risks include asphyxia and complications of breech delivery.
How to approch a case of bleeding in early pregnancy with case illustration
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Obstructed labor and uterine rupture
This document discusses obstructed labor and uterine rupture. It defines obstructed labor as when the fetus cannot progress through the birth canal despite strong contractions due to an insurmountable barrier. Causes include cephalopelvic disproportion and pelvic abnormalities. Uterine rupture is a full thickness tear of the uterus, which can occur in women with prior uterine scars. Risk factors, signs and symptoms, management including emergency surgery, and complications are described for both conditions. Prevention focuses on antenatal care, monitoring labor, and avoiding risky practices like fundal pressure.
Obstructed labour
This topic contains definition, incidence, causes, effect on mother and fetus, clinical features, prevention, management of Obstructed labour.
Puerperal genital haematomas
This document discusses puerperal genital haematomas. It begins by stating they are relatively uncommon but can cause serious morbidity or mortality if not properly diagnosed. It then covers the incidence, types, risk factors, presentation, investigations, and management of these haematomas. The types include infralevator, vulval, vulvovaginal, paravaginal, and supralevator haematomas. Risk factors include episiotomy, instrumental delivery, and primiparity. Management involves resuscitation, conservative measures like antibiotics and ice for small haematomas, and surgery or arterial embolization for larger cases.
Episiotomy
This document discusses episiotomy, which is an incision made in the perineum during childbirth to widen the vaginal opening. It can help prevent tearing and complications. The two main types are median and mediolateral episiotomies. Median episiotomies involve a midline incision while mediolateral incisions extend laterally towards the ischial tuberosity. Episiotomies are usually performed when the vaginal opening is distended during crowning to prevent stretching injuries. They are sutured closed after delivery.
uterine abnormality
This document discusses uterine abnormalities, including their definition, classification, incidence, etiology, diagnostic measures, complications, and management. Uterine abnormalities result from abnormal development of the Mullerian ducts during embryogenesis and range in symptoms from amenorrhea and infertility to normal functioning depending on the defect. The American Fertility Society classification includes 7 classes of abnormalities: hypoplastic/agenetic uterus, unicornuate uterus, didelphus uterus, bicornuate uterus, septate uterus, arcuate uterus, and DES-related anomalies. Complications can include infertility, pregnancy loss, uterine rupture, and malpresentations. Diagnosis involves physical examination, ultrasound, and hysteroscopy. Surgical
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Aph
Antepartum haemorrhage (APH), or bleeding during pregnancy, can be caused by placenta praevia or abruption. Placenta praevia occurs when the placenta implants in the lower uterine segment, potentially causing bleeding as the cervix dilates. Abruption occurs when the placenta prematurely separates from the uterine wall, and bleeding severity is classified from mild to severe. APH is considered an obstetric emergency treated initially with IV fluids and monitoring, with management depending on gestational age and bleeding severity, and potentially involving delivery.
Antepartum haemorrhage
This document discusses antepartum haemorrhage (APH), defined as bleeding from or into the genital tract occurring from 22 weeks of pregnancy until birth. APH complicates 3-5% of pregnancies and is a leading cause of perinatal and maternal mortality. The main causes of APH are placenta praevia, abruptio placentae, vasa praevia, and local cervical/vaginal bleeding. Management involves stabilizing the mother, assessing fetal wellbeing, investigating the cause, and planning for delivery depending on gestational age and the condition of the mother and fetus.
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Uterine Inversion 2018
Uterine inversion occurs when the uterus turns inside out, most commonly during delivery from excessive cord traction or fundal pressure. It can range from the fundus inverting into the cervix to the entire uterus prolapsing outside the body. Prompt diagnosis and management is needed to prevent shock. The uterus must be manually or surgically replaced before detaching the placenta to avoid hemorrhage. Prevention involves controlled cord traction and avoiding fundal pressure until the placenta separates naturally.
version
Version is a procedure to manually alter the presentation of the fetus for delivery. There are three main types: external cephalic version, internal podalic version, and bipolar version. External cephalic version involves abdominal manipulation to convert a breech or transverse lie into a cephalic presentation. It has indications such as breech presentation or transverse/oblique lie between 32-36 weeks, and contraindications include multiple pregnancy or conditions that require a cesarean. Internal podalic version converts the presentation from transverse or cephalic to a footling breech via intrauterine and abdominal maneuvers when external version has failed or for specific conditions. It carries risks of uterine rupture and fetal injury or death
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Caesarean section is a surgical procedure to deliver babies through incisions in the abdominal wall and uterus. The incidence of caesarean sections has steadily increased in recent decades due to improved safety and identification of risk factors. There are two main types - elective and emergency. Lower segment transverse incisions heal faster than classical incisions in the upper uterine segment. Post-operative care involves monitoring vitals, administering antibiotics and analgesics, encouraging early mobilization while avoiding complications like hemorrhage, infection, and thrombosis.
Deep transverse arrest
This document discusses occiput posterior position, its definition, causes, diagnosis, and management. It defines occiput posterior position as the fetal head descending into the pelvis with the sagittal suture in the transverse plane. Causes include pelvic abnormalities and fetal positioning. Diagnosis involves vaginal examination to feel head position. Management includes careful assessment, cesarean for modern obstetrics, or manual rotation and assisted delivery if vaginal is possible. Manual rotation involves inserting the hand into the vagina to rotate the fetal head to the occiput anterior position, and can be done with the whole or half hand.
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.
Shoulder presentation
This document defines and discusses abnormal fetal positions and presentations that can occur during labor, including breech, face, brow, shoulder, transverse lie, and compound presentations. It provides the definitions, incidence rates, causes, diagnostic techniques, and management approaches for each atypical presentation. Key points covered include the different types of breech, face, brow, and shoulder positions, mechanisms of labor for each, and when external cephalic version, assisted vaginal delivery, or cesarean section are recommended.
Management of ectopic pregnancy
An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, usually in the fallopian tubes. Ectopic pregnancies are not viable and can be life-threatening due to potential internal bleeding. The vast majority of ectopic pregnancies implant in the fallopian tubes. Diagnosis involves transvaginal ultrasound and beta-hCG level testing. Treatment options include medical management with methotrexate or surgical intervention like laparoscopy or laparotomy. The goal of treatment is to remove the ectopic pregnancy safely while preserving the ability to conceive in the future.
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obstetrics emergencies are really devastating condition so some knowledge toward it will help to reduce maternal mortality.
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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.
Hydatidiform (vesicular) mole
A hydatidiform mole is a benign tumor of the placenta that can develop after conception. It occurs more frequently in Asian women and women over age 45. A complete mole contains no embryo and results from fertilization by a sperm that duplicates the paternal chromosomes. A partial mole contains some normal placental tissue but also abnormal molar areas, resulting from fertilization by two sperm. Diagnosis is based on an elevated hCG level and ultrasound findings, and treatment involves surgical evacuation of the uterus. Follow up hCG testing is needed to monitor for choriocarcinoma, a rare type of cancer that can develop after a molar pregnancy.
Version
Version is a procedure to change the fetal lie or presentation. There are two main types: external cephalic version and internal podalic version. External cephalic version is done externally without anesthesia to flex the fetus and rotate the head into a vertex presentation. Internal podalic version requires anesthesia and is done when the cervix is dilated to grasp the fetal foot and bring the breech into position for delivery. Potential maternal complications include shock, bleeding, and infection, while fetal risks include asphyxia and complications of breech delivery.
How to approch a case of bleeding in early pregnancy with case illustration
How to approch a case of bleeding in early pregnancy with case illustrationFaculty of Medicine,Zagazig University,EGYPT
Undergraduate course lectures in Obstetrics&Gynecology .Prepared by DR Manal Behery.Faculty of Medicine,Zagazig UniversityPost term pregnancy
Post-term or post-maturity pregnancy is defined as a pregnancy continuing beyond 42 completed weeks of gestation. The average incidence is about 10%. Post-term pregnancies carry increased risks for both mother and baby, including macrosomia, placental insufficiency, meconium aspiration syndrome, hypoglycemia, and stillbirth. Diagnosis involves confirming gestational age through menstrual history, clinical examination, and ultrasound. Management may involve induction of labor or continued monitoring, depending on fetal well-being as assessed by tests like biophysical profile and nonstress test. Preventing post-term pregnancy involves accurate dating using early ultrasound and monitoring pregnancies at risk of going past 42 weeks.
Obstructed labor and uterine rupture
This document discusses obstructed labor and uterine rupture. It defines obstructed labor as when the fetus cannot progress through the birth canal despite strong contractions due to an insurmountable barrier. Causes include cephalopelvic disproportion and pelvic abnormalities. Uterine rupture is a full thickness tear of the uterus, which can occur in women with prior uterine scars. Risk factors, signs and symptoms, management including emergency surgery, and complications are described for both conditions. Prevention focuses on antenatal care, monitoring labor, and avoiding risky practices like fundal pressure.
Obstructed labour
This topic contains definition, incidence, causes, effect on mother and fetus, clinical features, prevention, management of Obstructed labour.
Puerperal genital haematomas
This document discusses puerperal genital haematomas. It begins by stating they are relatively uncommon but can cause serious morbidity or mortality if not properly diagnosed. It then covers the incidence, types, risk factors, presentation, investigations, and management of these haematomas. The types include infralevator, vulval, vulvovaginal, paravaginal, and supralevator haematomas. Risk factors include episiotomy, instrumental delivery, and primiparity. Management involves resuscitation, conservative measures like antibiotics and ice for small haematomas, and surgery or arterial embolization for larger cases.
Episiotomy
This document discusses episiotomy, which is an incision made in the perineum during childbirth to widen the vaginal opening. It can help prevent tearing and complications. The two main types are median and mediolateral episiotomies. Median episiotomies involve a midline incision while mediolateral incisions extend laterally towards the ischial tuberosity. Episiotomies are usually performed when the vaginal opening is distended during crowning to prevent stretching injuries. They are sutured closed after delivery.
uterine abnormality
This document discusses uterine abnormalities, including their definition, classification, incidence, etiology, diagnostic measures, complications, and management. Uterine abnormalities result from abnormal development of the Mullerian ducts during embryogenesis and range in symptoms from amenorrhea and infertility to normal functioning depending on the defect. The American Fertility Society classification includes 7 classes of abnormalities: hypoplastic/agenetic uterus, unicornuate uterus, didelphus uterus, bicornuate uterus, septate uterus, arcuate uterus, and DES-related anomalies. Complications can include infertility, pregnancy loss, uterine rupture, and malpresentations. Diagnosis involves physical examination, ultrasound, and hysteroscopy. Surgical
Retained placenta
Retained placenta can be defined as lack of placental expulsion within 30 minutes of delivery of an infant. it is more common in preterm. Retained Placenta can lead to massive PPH and increase maternal morbidity and mortality.
REDUCED FETAL MOVEMENTS - HOW TO PROCEED BY DR SHASHWAT JANI
Dr. Shashwat Jani provides a summary of the optimal management of women who experience reduced fetal movements (RFM). The document discusses evaluating these women to exclude fetal death or compromise and identify pregnancies at risk. It recommends confirming fetal heart tone with Doppler, performing a cardiotocography if over 28 weeks, and considering ultrasound to check amniotic fluid and fetal growth if concerns remain. For persistent RFM, monitoring with biophysical profiles and ultrasounds twice weekly is suggested before 37 weeks, and labor induction after 37 weeks if the cervix is favorable.
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How to approch a case of bleeding in early pregnancy with case illustration
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Aph
Antepartum haemorrhage (APH), or bleeding during pregnancy, can be caused by placenta praevia or abruption. Placenta praevia occurs when the placenta implants in the lower uterine segment, potentially causing bleeding as the cervix dilates. Abruption occurs when the placenta prematurely separates from the uterine wall, and bleeding severity is classified from mild to severe. APH is considered an obstetric emergency treated initially with IV fluids and monitoring, with management depending on gestational age and bleeding severity, and potentially involving delivery.
Antepartum haemorrhage
This document discusses antepartum haemorrhage (APH), defined as bleeding from or into the genital tract occurring from 22 weeks of pregnancy until birth. APH complicates 3-5% of pregnancies and is a leading cause of perinatal and maternal mortality. The main causes of APH are placenta praevia, abruptio placentae, vasa praevia, and local cervical/vaginal bleeding. Management involves stabilizing the mother, assessing fetal wellbeing, investigating the cause, and planning for delivery depending on gestational age and the condition of the mother and fetus.
Bleeding in late px
Antepartum hemorrhage (APH) refers to bleeding from the genital tract between 28 weeks of gestation until delivery. The main causes are placenta previa, where the placenta covers part or all of the cervix, and placental abruption, where the placenta separates prematurely from the uterus. APH can cause shock in the mother from blood loss and fetal hypoxia, and risks include stillbirth, neonatal death, or long term health issues for both mother and baby if not properly managed. Treatment depends on the amount of bleeding, condition of the mother and fetus, placental location, and gestational age, ranging from bed rest and monitoring to emergency c-section.
ABNORMALITY IN STRUCTURE OF UTERUS
This document summarizes a seminar on abnormalities in uterine structure. It discusses how uterine malformations occur due to abnormal development of the Müllerian ducts during embryogenesis. Specifically, it explains that a bicornuate uterus is formed when the Müllerian ducts incompletely fuse at the fundus level, resulting in two separate uterine cavities connected by a single cervix and vagina. It also mentions that DES exposure in the 1940s-1970s has been linked to Müllerian duct abnormalities.
Bleeding in late pregnancy (antepartum haemorrhage)
This document discusses antepartum haemorrhage, or bleeding in late pregnancy. It defines antepartum haemorrhage as bleeding from the genital tract after 28 weeks of pregnancy until the end of the second stage of labour. Bleeding is classified as either placental site bleeding (62% of cases) or non-placental site bleeding (28% of cases). Placental site bleeding includes conditions like placenta praevia, abruptio placentae, and marginal separation. Placenta praevia is defined as a placenta that is partially or totally attached to the lower uterine segment, and it discusses the degrees of placenta praevia from first to fourth
Antepartum haemorhage
Antepartum haemorrhage (APH) refers to bleeding from the vagina during pregnancy after 24 weeks of gestation until delivery. The main causes of APH are placental abnormalities like placenta previa or abruption, as well as genital tract infections or trauma. Management involves resuscitation, monitoring for fetal distress, and delivery depending on the severity of bleeding and gestational age. Outcomes can be poor if APH is severe or left untreated, with risks of maternal and fetal death.
Pregnancy Complications
Complications of pregnancy are health problems that occur during pregnancy. They can involve the mother's health, the baby's health, or both. Here are some complications which a woman may face during pregnancy.
Medical Complications in Pregnancy
This document discusses various medical conditions that can complicate pregnancy, including diabetes mellitus, gestational diabetes, urinary tract infections, tuberculosis, thyroid disorders, and pulmonary disorders. It provides definitions, classifications, diagnostic criteria, management guidelines, and effects on pregnancy for each condition. Key points include screening and treatment recommendations for diabetes, criteria for diagnosing overt diabetes versus gestational diabetes, management of urinary tract infections and tuberculosis with antibiotics, and use of antithyroid medications like propylthiouracil to treat Graves disease during pregnancy.
Medical Complications In Pregnancy
The document discusses various medical conditions that can complicate pregnancy, including diabetes mellitus and thyroid disorders. It provides definitions and classifications for gestational diabetes and overt/pregestational diabetes. It describes screening, diagnosis and management of gestational diabetes. It also discusses the effects and management of overt diabetes during pregnancy as well as normal thyroid changes and hyperthyroidism/Grave's disease in pregnancy.
Aph Antepartum hemorrhage
The document discusses two conditions that can cause bleeding in late pregnancy - abruptio placenta and placenta previa. Abruptio placenta involves the separation of the placenta from the uterus prior to delivery and common risk factors include hypertension and trauma. Placenta previa occurs when the placenta implants in the lower uterine segment over the cervical os. Management of both conditions involves monitoring for maternal and fetal stability and either emergency c-section or planned c-section depending on gestational age and severity of bleeding. Complications can include disseminated intravascular coagulation for abruptio placenta or placenta accreta if placenta previa occurs over a previous c-section
Placenta Praevia
Placenta Praevia is one of the major causes of antepartum haemorrhage, discussed in its entirety here. Ref:D.C Dutta's textbook of obstetrics.
Pregnancy Complications.ppt
Gestational diabetes is a type of diabetes that occurs during pregnancy where the mother's pancreas cannot produce enough insulin to regulate blood sugar levels. It can lead to complications for both mother and baby if not controlled, such as high birth weight, shoulder dystocia, hypoglycemia, and preeclampsia. Preeclampsia is defined as high blood pressure and excess protein in the urine after 20 weeks of pregnancy and is a leading cause of maternal and infant illness and death globally. The only cure for preeclampsia is delivery of the baby.
antepartum haemorrhage
This document discusses the causes, presentation, risk factors, complications, and management of antepartum haemorrhage (APH), which is vaginal bleeding after 22 weeks of pregnancy until birth. The main causes of APH are placenta praevia (20%), abruptio placentae (30%), and undetermined causes (45%). Evaluation involves history, examination, ultrasound, and monitoring maternal and fetal stability. Management depends on the cause but may include continuous fetal monitoring, intravenous fluids and blood products, augmentation of labour, or cesarean section for delivery.
Antepartum hemorrhage
This document discusses antepartum haemorrhage and placenta previa. It defines both conditions and discusses their causes, risk factors, diagnosis using ultrasound, and management. Placenta previa, when part or all of the placenta lies in the lower uterine segment over or near the cervical os, accounts for about 31% of antepartum haemorrhage cases. Transvaginal ultrasound is the preferred method for diagnosing and monitoring placenta previa. Conservative management is recommended for stable patients under 37 weeks. For patients at or near term, caesarean section is usually required if the placenta overlaps or is within 20mm of the internal os.
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Bleeding in late pregnancy (antepartum haemorrhage)
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OBSTETRIC HAEMORRHAGE.pptx
This document discusses various causes of obstetric haemorrhage including placenta praevia, abruptio placentae, uterine rupture, and vasa previa. It provides details on the definition, risk factors, clinical presentation, diagnosis, and management of each condition. Placenta praevia is defined as a placenta implanted in the lower uterus and is a leading cause of late pregnancy bleeding. Abruptio placentae is the premature detachment of a normally situated placenta before delivery. Uterine rupture is a complete separation of the uterine wall while vasa previa occurs when fetal vessels traverse the membranes over the cervical os. Immediate surgical intervention is often required to treat bleeding
2pj06waht1sezzvi07jh-140623140730-phpapp02.pdf
This document discusses the management of preterm labor in cases of placenta previa and abruption placentae. It describes placenta previa as when the placenta is located over or near the internal os, and notes four degrees. For placenta previa, the expectant approach aims to continue the pregnancy for lung maturity using bed rest and monitoring. For abruption placentae, which is premature separation of a normally situated placenta, the active approach is indicated due to risks of further separation and fetal death, with immediate delivery by vaginal or cesarean delivery for severe cases.
management of placenta previa
This document discusses the management of preterm labor in cases of placenta previa and abruption placentae. It describes placenta previa as when the placenta is located over or near the internal os, and notes four degrees. For placenta previa, the expectant management using Macafee-Johnson's regime aims to continue the pregnancy for lung maturity up to 37 weeks without risking maternal health. For abruption placentae, where the placenta prematurely separates, active management through immediate delivery is usually indicated due to risks of further separation and fetal death. Lower segment c-section is often used for placenta previa, while vaginal delivery may be possible if the
Antepartum hemorrhage
This document discusses antepartum hemorrhage (APH), specifically placenta previa and placental abruption. It defines APH as bleeding from or into the genital tract after 28 weeks of pregnancy but before birth. Placenta previa is when the placenta implants over the lower uterine segment or cervical os, while placental abruption is the premature separation of a normally implanted placenta. Both can cause painless vaginal bleeding and are medical emergencies. The document outlines risk factors, clinical features, diagnosis, potential complications, and management approaches for each condition.
Obstetric bleeding
ECTOPIC PREGNANCY. An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, usually in the fallopian tubes. Risk factors include previous pelvic inflammatory disease or use of an intrauterine device. Clinical presentation includes amenorrhea, abdominal pain, and vaginal bleeding. Diagnosis is made through pregnancy tests, ultrasound, and clinical examination. Treatment options include surgery such as salpingectomy or salpingotomy. Conservative treatment with methotrexate may also be used. Complications can include hemorrhage and shock.
Antepartum haemorrhage
This document discusses various causes of antepartum hemorrhage (APH), including placenta previa, abruption placentae, and vasa previa. Placenta previa, where the placenta implants in the lower uterine segment, accounts for about one-third of APH cases. Risk factors include advancing maternal age, multiparity, prior cesarean delivery, and smoking. Management depends on gestational age and severity of bleeding, ranging from bed rest to cesarean delivery. Abruptio placentae is the premature separation of a normally implanted placenta and can cause concealed or revealed bleeding. It is associated with increased risks of fetal and maternal complications. Vasa previa
APH lecture.ppt ad it's surgical management
This document discusses antepartum haemorrhage (APH), defined as bleeding from the genital tract between 28 weeks of pregnancy and onset of labor. The main causes of APH discussed are placenta praevia, placental abruption, local causes, and undetermined origin. Placenta praevia is when the placenta implants in the lower uterine segment, and is classified into four grades based on how close it is to the cervix. Placental abruption is the premature separation of a normally implanted placenta, which can lead to hemorrhage, fetal hypoxia, and maternal shock. Management of placenta praevia and abruption focus on early delivery, usually by
APH(Antepartum Hemorrhage)& PPH(Postpartum hemorrhage).pptx
Antepartum hemorrhage (APH) is bleeding from the genital tract during pregnancy before labor. It affects 4% of pregnancies and can cause complications for both mother and fetus. The main causes are placenta previa, placental abruption, and local infections. Management depends on severity, with minor bleeding monitored but major bleeding requiring delivery to stabilize the mother or fetus. Expediting delivery preserves the health of both.
OBSTETRIC EMERGENCIES.pptx
Obstetric emergencies are life-threatening conditions that can affect pregnant women and their babies. Examples include antepartum hemorrhage (APH), obstructed labor, preeclampsia, and postpartum hemorrhage. APH refers to bleeding from the vagina after 28 weeks of gestation but before birth. Placenta previa, where the placenta covers all or part of the cervix, is a common cause of APH. Risk factors for placenta previa include advanced maternal age, smoking, and prior cesarean sections. Management of placenta previa depends on severity but may include bed rest, monitoring, blood transfusions, and ultimately delivery by cesare
najmi placenta previa final 4.pdf
This document discusses placenta previa and placenta accreta spectrum. It begins with definitions of placenta previa as implantation of the placenta over the internal cervical os. It describes placenta accreta spectrum from accreta where the placenta attaches to the myometrium without decidua, to increta with invasion into the myometrium, and percreta with invasion through the myometrium. Risk factors include placenta previa, cesarean sections, advanced maternal age, and previous uterine surgeries. Ultrasound is the main diagnostic tool but MRI can also be used. Management involves multidisciplinary care, conservative approaches when possible
Obstetric Emergencies_065207.pptx
An obstetric emergency document discusses ectopic pregnancy, spontaneous abortion, antepartum haemorrhage, postpartum haemorrhage, and secondary postpartum haemorrhage. It defines these conditions, outlines their causes, risk factors, types, clinical findings, management, and importance. Ectopic pregnancy and postpartum haemorrhage are leading causes of maternal morbidity and mortality. Timely diagnosis and management are essential to prevent complications and reduce mortality from obstetric haemorrhages.
APH.pptx
This document defines and describes antepartum hemorrhage (APH), which is bleeding from or into the genital tract between 28 weeks of pregnancy and birth. The main causes of APH are placental bleeding (70%), unexplained causes (25%), and extraplacental causes (5%). Two major extraplacental causes are placenta previa and abruptio placenta. Placenta previa is when the placenta implants over or near the cervical os. Risk factors include previous placenta previa, multiparity, fibroids, and smoking. Abruptio placenta is the premature separation of a normally implanted placenta, which can be revealed or concealed. It is
Antepartum hemorrhage
The document discusses bleeding in late pregnancy or antepartum hemorrhage, which occurs within the third trimester and is a serious complication associated with maternal and fetal risks. The most common causes of antepartum hemorrhage are placenta previa, placenta abruption, and vasa previa. It provides details on the definition, incidence, causes, diagnosis, management, complications and nursing care for each of these conditions.
BLEEDING DISORDERS IN LATE PREGNANCY-Renjini.R....pptx
1) Placenta previa is a condition where the placenta implants in the lower uterine segment, either partially or fully covering the cervix. This can cause bleeding in the second half of pregnancy.
2) Diagnosis is usually made using ultrasound and confirmed during delivery. Management depends on gestational age and involves either expectant monitoring with bed rest or active management through delivery, usually by caesarean section.
3) Complications of placenta previa include bleeding, preterm birth, fetal distress, and increased risk of postpartum hemorrhage. Prognosis has improved due to early diagnosis, availability of blood transfusions, and caesarean delivery when needed.
Gynecology 5th year, 7th lecture (Dr. Muhabat Salih Saeid)
1. Ectopic pregnancy occurs when a fertilized egg implants outside of the uterus, most commonly in the fallopian tubes. It is a leading cause of maternal mortality.
2. Risk factors include a history of pelvic inflammatory disease, previous ectopic pregnancy, or tubal ligation. Symptoms include abdominal pain, vaginal bleeding, and amenorrhea.
3. Diagnosis involves using ultrasound to locate the pregnancy and measuring serum hCG levels. If the pregnancy cannot be located, hCG levels will help determine if the pregnancy is intrauterine or ectopic.
Aph
This document discusses antepartum hemorrhage (APH), which is bleeding during pregnancy after 24 weeks of gestation. It describes the main causes of APH as placental abnormalities like placenta previa, placenta abruption, and vasa previa. Placenta previa is when the placenta implants in the lower uterine segment or over the cervical os. Risk factors include previous c-sections and advanced maternal age. Diagnosis is usually by ultrasound and digital exams are avoided due to risk of bleeding. Management depends on severity but often involves admission, monitoring, and eventual c-section delivery. The document contrasts the presentations and management of placenta previa versus placenta abruption.
placenta Previa (APHge).pdf
Antepartum hemorrhage (APH) is defined as bleeding from or into the genital tract, occurring from 24+0 weeks of pregnancy and before the birth of the baby. The most important causes of APH are placenta praevia and placental abruption
Obg seminar
This document discusses bleeding disorders in late pregnancy such as antepartum haemorrhage and its causes including placenta previa and abruption placentae. It describes the diagnosis, management and nursing considerations for women experiencing bleeding in the second half of pregnancy. Complications for both mother and baby are explained. The prognosis is generally good when cases are diagnosed early and properly managed in well-equipped hospitals with blood transfusion facilities and skilled practitioners.
7c9a4939-6417-49a7-b59b-9fd5d6488627-151028203353-lva1-app6891 (1).pptx
Placenta previa is an abnormal implantation of the placenta in the lower uterus near or over the cervical os. Risk factors include prior c-sections and advanced maternal age. A client with placenta previa may present with painless vaginal bleeding. Ultrasound is used to diagnose placenta previa. Management involves expectant care like bed rest or active management with cesarean delivery.
APH.pptx
This document defines and discusses placenta previa and abruption placentae, two causes of antepartum hemorrhage (APH). Placenta previa occurs when the placenta implants in the lower uterine segment, covering all or part of the cervical os. It can be graded based on the extent of coverage. Abruptio placentae is the premature separation of a normally implanted placenta, which can manifest as revealed, concealed, or mixed bleeding. Both conditions are evaluated based on symptoms, abdominal and vaginal examination findings, ultrasound localization of the placenta, and management involves expectant treatment, induction/acceleration of labor, or cesarean section depending on gestational age and
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APH(Antepartum Hemorrhage)& PPH(Postpartum hemorrhage).pptx
APH(Antepartum Hemorrhage)& PPH(Postpartum hemorrhage).pptx
BLEEDING DISORDERS IN LATE PREGNANCY-Renjini.R....pptx
BLEEDING DISORDERS IN LATE PREGNANCY-Renjini.R....pptx
Gynecology 5th year, 7th lecture (Dr. Muhabat Salih Saeid)
Gynecology 5th year, 7th lecture (Dr. Muhabat Salih Saeid)
7c9a4939-6417-49a7-b59b-9fd5d6488627-151028203353-lva1-app6891 (1).pptx
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Antepartum haemorrhage s
- 1. 1 ANTEPARTUM HAEMORRHAGE (APH) DR HENRY A.A. UGBOMA (JP)
- 2. 2 Antepartum haemoharrage is bleeding from the genital tract between the 28th week of pregnancy and the onset of labour. Causes: Placenta previa and placenta abruption are the major cause of (APH) but most common causes are undetermined. Diseases of the lower genital tract contribute to (APH).
- 3. 33 Complications:Complications: • Maternal and fetal mortality may result from APH due to: • Pre-existing anaemia. • Transport difficulties. • Restricted medical facilities. • Inadequate resuscitation of mother. • Inexperience of junior medical staff. • Delay in seeking assistance of more experienced doctors. • Delay in response by senior medical staff.
- 4. 4 Placenta praevia A condition where the placenta is implanted wholly or in part in the lower uterine segment. There are four different grades of placenta praevia. The placenta reaches the lower uterine segment but does not reach the internal cervical os. The placenta reaches the edge of the cervix but does not cover it.. The placenta covers the cervix but does not at full cervical dilatation. The placenta covers the cervix and remains so at full cervical dilatation. Placenta praevia can also be grouped as major or minor degrees. The major degrees are 2B, 3 and 4 while the minor degrees are 1 and 2A. The ‘A’ and ‘B’ stands for anterior and posterior sites respectively.
- 5. 55 CausesCauses • This is unclear. There are accepted associations like: • Older multiparous women. • Multiple pregnancies. • Previous caesarean sections, other previous uterine damage, include dilatation and curettage, spontaneous abortion and evacuation of uterus for retained products of conception.
- 6. 6 Clinical presentation: Presentation of APH. Fetal malposition in late pregnancy. Asymptomatic placenta praevia by routine ultrasound examination. Bleeding in placenta praevia is usually painless and unprovoked. In abdominal examination, the uterus is soft and non tender. The fetal heart rate is usually normal. There is unusually high head presenting or a malpresentation. Vaginal examination is contraindicated.
- 7. 77 Investigations:Investigations: FBCFBC UrinalysisUrinalysis Ultrasonography.Ultrasonography. MRI.MRI.
- 8. 8 TreatmentTreatment In minor degree placenta praevia, vaginalIn minor degree placenta praevia, vaginal deliveries are allowed. In cases where bleeding isdeliveries are allowed. In cases where bleeding is severe, emergency caesarean section is done.severe, emergency caesarean section is done. Delivery for major degree placenta praevia is byDelivery for major degree placenta praevia is by caesarean section. Patient is admitted into thecaesarean section. Patient is admitted into the ward. About 4-6 units of blood are grouped andward. About 4-6 units of blood are grouped and cross matched for her.cross matched for her. Blood transfusion is given to these patients toBlood transfusion is given to these patients to replace losses from intermittent bleeds untilreplace losses from intermittent bleeds until delivery is carried out.delivery is carried out.
- 9. 9 Thanks ……Thanks …… Any questions?Any questions?
- 10. 9 Thanks ……Thanks …… Any questions?Any questions?