Obstetrics deals with pregnancy, childbirth, and the postnatal period. Key terms include gestation, which is the duration of pregnancy, and trimesters, which divide pregnancy into three stages. Complications can include preterm birth before 37 weeks, post-term birth after 42 weeks, and pregnancy-induced high blood pressure conditions like preeclampsia. Delivery methods include normal spontaneous vaginal delivery and Cesarean section.
This topic contains detailed description about labour, its definition, date of onset of labour, calculations of date of delivery, causes of onset of labour, physiology of normal labour, and events, clinical course and management of each stages of labour.
This topic contains detailed description regarding Normal puerperium, it's definition, duration, phases, involution of uterus and other pelvic organs, lochia, general physiological changes of puerperium, lactation, management of normal puerperium, management of ailments and postnatal care.
Hydatidiform Mole (HM) is a rare mass or growth that forms inside the uterus at the beginning of a pregnancy. It is a type of gestational trophoblastic disease (GTD).
When a normal sperm cell fertilizes one of these oocytes, the resulting embryo has only one set of chromosomes. Because the embryo has no genes from the mother, the pregnancy cannot develop normally, resulting in a hydatidiform mole.
Series of events that takes place in the genital organ in an effort to expel the viable products of conception out of the womb through the vagina into the outer world is called labour.
there are four stages of labour.
This topic contains detailed description about labour, its definition, date of onset of labour, calculations of date of delivery, causes of onset of labour, physiology of normal labour, and events, clinical course and management of each stages of labour.
This topic contains detailed description regarding Normal puerperium, it's definition, duration, phases, involution of uterus and other pelvic organs, lochia, general physiological changes of puerperium, lactation, management of normal puerperium, management of ailments and postnatal care.
Hydatidiform Mole (HM) is a rare mass or growth that forms inside the uterus at the beginning of a pregnancy. It is a type of gestational trophoblastic disease (GTD).
When a normal sperm cell fertilizes one of these oocytes, the resulting embryo has only one set of chromosomes. Because the embryo has no genes from the mother, the pregnancy cannot develop normally, resulting in a hydatidiform mole.
Series of events that takes place in the genital organ in an effort to expel the viable products of conception out of the womb through the vagina into the outer world is called labour.
there are four stages of labour.
physiology of labor includes the contraction and retraction of the muscles of uterus. I hope this presentation will help the persons of concerned subject.
It explains the mechanism of normal labour to medical and para-medical staff.It also puts light on principle movements underlying mechanism of normal labour with pictures.Thank You Like an share it to the maximum.
The second stage of labor begins when the cervix is completely dilated (open), and ends with the birth of your baby. Contractions push the baby down the birth canal, and you may feel intense pressure, similar to an urge to have a bowel movement. Your health care provider may ask you to push with each contraction.
physiology of labor includes the contraction and retraction of the muscles of uterus. I hope this presentation will help the persons of concerned subject.
It explains the mechanism of normal labour to medical and para-medical staff.It also puts light on principle movements underlying mechanism of normal labour with pictures.Thank You Like an share it to the maximum.
The second stage of labor begins when the cervix is completely dilated (open), and ends with the birth of your baby. Contractions push the baby down the birth canal, and you may feel intense pressure, similar to an urge to have a bowel movement. Your health care provider may ask you to push with each contraction.
There are two common tenets of operations: "hell is other people's software," and "better software is produced by those forced to operate it." In this session I'll take a fly-by-tour of two pieces of software that were built from the ground up for operability from the hard-earned teachings of their inoperable predecessors: a distributed datastore replacing PostgreSQL, and a message queue replacing RabbitMQ.
We'll discuss specific design aspects that increase resiliency in the event of failure and observability at all times.
Optimizing the Upstreaming Workflow: Flexibly Scale Storage for Seismic Proce...Avere Systems
Of all the applications in the oil and gas industry's upstream workflow, those involved in seismic processing place the greatest demand on storage. Pre-stack and post-stack migration, velocity modeling, and other processing steps are challenging even the highest performance NAS systems. In this Webinar, we discuss meeting these demands with accelerated performance, reduced cost, and a streamlined workflow.
Google Analytics vs. Omniture Comparative GuideJimmy Jay
Google Analytics Vs Omniture Comparative Guide is a clear way to differentiate between two available web analytics applications. This guide is based on the basic as well as complex features of both the platforms.
USMLE GENERAL EMBRYOLOGY 020 Anatomical basis of delivery (Normal - C.S.).pdfAHMED ASHOUR
Normal vaginal labor refers to the process of childbirth where the baby is delivered through the vagina without the need for surgical intervention such as a cesarean section.
During normal vaginal labor, the cervix dilates and effaces, allowing the baby to pass through the birth canal.
Cesarean sections, often referred to as C- sections, are surgical procedures used to deliver a baby when vaginal delivery is not possible or not safe for the mother or the baby.
1.1 Define and use correctly all of the key terms
1.2 Describe the signs of true labour and distinguish between true and false labour
1.3 Explain to the mother how to recognise the onset of true labour
1.4 Describe the characteristic features and mechanisms of the four stages of labour
1.5 Describe the seven cardinal movements made by the baby as it descends the birth canal in a normal labour
Parturition, commonly known as childbirth or labor, is a natural and complex process through which a pregnant mammal gives birth to her offspring. This transformative event marks the culmination of the pregnancy journey, as the developing fetus is ready to transition from the safety of the mother's womb to the outside world. It is a remarkable phenomenon that involves intricate hormonal, physiological, and behavioral changes in both the mother and the fetus. In this essay, we will delve into the fascinating process of parturition, exploring its stages, hormonal influences, and the significance of this event in the continuation of species.
Parturition is a highly regulated process orchestrated by the intricate interplay of hormones. During pregnancy, the uterus provides a nurturing environment for the developing fetus, surrounded by the amniotic fluid. As the pregnancy reaches full term, the fetus secretes a hormone called cortisol, which stimulates the placenta to produce another hormone called prostaglandins. Prostaglandins play a crucial role in softening and thinning the cervix, the lower part of the uterus, preparing it for dilation. Additionally, the secretion of oxytocin, commonly referred to as the "love hormone" due to its role in bonding and social behavior, increases in response to fetal cortisol levels. Oxytocin triggers uterine contractions, initiating the labor process.
Parturition can be divided into three distinct stages: the latent phase, the active phase, and the placental phase. The latent phase is often the longest and least intense, characterized by irregular contractions that help in the gradual dilation and effacement of the cervix. During this phase, the expectant mother may experience a release of the mucus plug, known as the "show," indicating the progress of the cervical changes.
The active phase marks the onset of more intense and regular contractions. Oxytocin levels surge, and the contractions become stronger, more prolonged, and closer together. This stage leads to rapid cervical dilation and the eventual transition of the fetus into the birth canal. As the contractions intensify, the mother may experience increased discomfort and a strong urge to bear down and push. The amniotic sac may rupture, leading to the release of amniotic fluid, commonly referred to as the "breaking of water." This rupture also serves to facilitate the descent of the fetus.
The fetus's position and presentation are essential during childbirth. Ideally, the baby's head presents first as it is the largest and most efficient part to pass through the birth canal. In some cases, the baby may present in a breech position (feet or buttocks first) or in other less common positions, requiring additional medical attention and possibly a cesarean section.
During the active phase, the mother's body releases endorphins, which act as natural painkillers and help the mother cope with the increasing intensity of contractions.
Lecture on some therapeutic poisons based on subject of Forensic Medicine. Aspirin , Salicylate, aconite and barbiturates poisoning is beutifully explaned with treatments
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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2. Obstetrics
Obstetrics deals with the care of women's reproductive tracts
and their children during pregnancy, childbirth and the
postnatal period.
A doctor performing such practice is called Obstetrician.
3. LMP : Last Menstrual Period.
It is the time elapsed since 14 days prior to fertilization
4. EDC or EDD : The Due Date.
EDC stands for the old-fashioned "estimated date of confinement." EDD is the more
modern "Estimated Day of Delivery." The average pregnancy “gestation” is 40 weeks
or 280 days from the first day of the last menstrual period (LMP).
For a 28 day cycle, EDD is calculated by taking the LMP and adding 9 months and 7
days to it.
If the cycle is longer than 28 days, add the difference between cycle length and 28
days.
Nagele’s Rule:
• Subtract 3 months from the 1st day of the LMP
• Add 7 days
5. Gravida:
It is the number of times the mother has been pregnant, regardless of whether these
pregnancies were carried to term.
A current pregnancy, if any, is included in this count.
A nulligravida or gravida 0 is a woman who has never been pregnant.
A primigravida or gravida 1 is a woman who is pregnant for the first time or has been
pregnant one time.
A multigravida or more specifically a gravida 2 (also secundigravida), gravida 3,
and so on, is a woman who has been pregnant more than one time.
An elderly primigravida is a woman in her first pregnancy, who is at least 35 years
old.
6. Parity
It is the number of times the woman has delivered after the age of viability.
It includes the births after 24 weeks or those having weight of 500 grams.
TPAL method
Para is often recorded in 4 numbers:
• T= the number of term deliveries (after 37 weeks)
• P= the number of premature deliveries (> 20 and < 37 wk)
• A= the number of abortions (either spontaneous of therapeutic)
• L= the number of living children
There can be 4 numbers after the "P" for "para."
The first number is how many term pregnancies.
The second number is how many premature babies.
The third number is how many abortions or miscarriages
The fourth number is how many living children survive.
7. Gestation
Gestation is the carrying of an embryo or fetus inside a female
viviparous animal. Mammals during pregnancy can have one or more
gestations at the same time (multiple gestations).
The time interval of a gestation is called the gestation period.
In human obstetrics, gestational age refers to the embryonic or fetal
age plus two weeks. This is approximately the duration since the
woman's last menstrual period (LMP) began.
8. Trimester
The pregnancy is divided into 3 trimesters.
• The first one is from LMP up until 12 or 13 weeks.
• The second rimester is from 12-13 weeks until 28 weeks.
• The third trimester is from 28 weeks until delivery.
9. Preterm Birth
It is the birth of a baby between 24 and 37 weeks of gestational age.
Premature infants are at greater risk for short and long term complications,
including disabilities and impediments in growth and mental development.
10. Post term Birth
Postmaturity is when a baby has not yet been born after 42 weeks
of gestation.
Different babies will show different symptoms of postmaturity. The
most commons symptoms are dry skin, overgrown nails, creases on
the baby's palms and soles of their feet, minimal fat, a lot of hair on
their head, and either a brown, green, or yellow discoloration of
their skin. Some postmature babies will show no or little sign of
postmaturity.
11. Presentation
It refers to which anatomical part of the fetus is leading, that is, is closest to the
pelvic inlet of the birth canal just before the birth. According to the leading part,
this is identified as a cephalic, breech, or shoulder presentation.
Normal presentation is cephalic.
Malpresentation
A malpresentation is any other presentation than a vertex presentation
(with the top of the head first). It could be breech or shoulder presentation.
12. Position
It is the relationship of specific fetal denominator to maternal denominator.
It includes occipito anterior, occipito posterior, occipito transverse.
Normal position is occipito anterior.
Malposition
It is the abnormal position of the fetus in uterus. Could be occipito
posterior or occipito transverse.
13. Lie
It is the relationship of longitudinal axis of fetus to longitudinal
axis of mother’s pelvis.
It can be longitudinal, transverse or oblique.
Most common is longitudinal.
14. Variety
The relation of the given portion of the presenting part to the
anterior and/or posterior portion of mother’s pelvis.
15. Attitude
It is the relationship of different parts of fetus to each other.
Normal is flexed attitude.
16. Engagement
Engagement is said to have taken place when the widest part of
presenting part of fetus has passed successfully through the pelvic
inlet.
The number of fifths of the fetal head palpable abdominally s often
used to describe whether engagement has taken place. If more than
two fifths of fetal head is palpable abdominally, the head is not yet
engaged.
17. Moulding
It is the process which effectively reduces the diameter of fetal
skull and encourages progress of delivery through maternal pelvis
without harming the fetal brain.
It is achieved due to followinf characteristics of fetal skull:
• Ununited sutures which help the bones to move together and
overlap during delivery.
• compressible nature of bones
• Anterior and posterior fontanelles
18. Effacement
It is the process by which the cervix shortens in length as it
becomes included in the lower segment of uterus.
The cervical os cannot usually begin to dilate until effacement is
complete.
19. Episiotomy
It is a surgically planned incision on the perineum and the posterior
vaginal wall during second stage of labor.
It is also called perineotomy.
20. Crown-to-Rump Length:
Measurement from the top of the baby's head to the buttocks of the
baby.
Chadwick's sign:
Dark-blue or purple discoloration of the mucosa of the vagina and
cervix during pregnancy.
21. NSVD
Normal Spontaneous Vaginal Delivery.
SVD
Spontaneous Vaginal Delivery - same as NSVD.
Cesarean section (delivery):
Delivery of a baby through an abdominal incision rather than through the vagina.
Primary Cesarean Section
First time a mother has delivered by Cesarean.
Secondary Cesarean Section
Mother has already had a previous Cesarean delivery, and this is a repeat Cesarean birth.
22. VBAC : Vaginal Birth After Cesarean.
The mother has had a previous Cesarean delivery but has now delivered vaginally.
There is a small amount of risk (less than 1%) that the old surgical scar on the
uterus will rupture when a VBAC is attempted, so mothers who wish to attempt a
VBAC must understand the risks and sign an "informed consent" that shows they
are aware of the risks/benefits.
TOL : Trial of Labor.
If a woman has had a previous Cesarean birth and wants to have a VBAC, she is
said to be undergoing a "trial of labor" when her contractions start.
VAD : Vacuum Assisted Delivery.
The doctor applies a suction cup to the baby's head and gently draws it out, when
the mother is too tired to push effectively any more but the baby is very low in
the pelvis.
23. Miscarriage
Miscarriage is the spontaneous end of a pregnancy before 24 weeks of
gestation.
Probable signs include:
• Low back pain or abdominal pain that is dull, sharp, or cramping
• Tissue or clot-like material that passes from the vagina
• Vaginal bleeding, with or without abdominal cramps
Cause:
Most common cause is chromosomal abnormalities. Other causes include:
• progesterone deficiency
• malformed uterus
• cervical weakness
• hormonal disorders
• severe infection
24. Types:
Threatened: Patient is at the risk of miscarriage. Fetus is inside the
uterus and the cervical os is closed.
Inevitable: Associated with heavy bleeding and severe pain. Cervical os
is opening up. May be complete or incomplete.
Complete: If cervical os has opened up
Incomplete: If cervical os has not opened up completely and some
products are still inside the uterus.
Missed: Fetus has died in the uterus but has not been expelled out.
Septic: Any induced miscarriage, usually done due to social
circumstances, done by untrained professional.
Recurrent: Three or more miscarriages consecutively.
25. Stillbirth
It is the birth of a baby after the age of viability when it has no vital
functions at birth, ie no heart rate, no umbilical cord pulsation, etc.
Causes:
• bacterial infection
• chromosomal aberrations
• maternal diabetes
• high blood pressure, including preeclampsia
• maternal consumption of recreational drugs
• placental abruptions
• physical trauma
• radiation poisoning
26. Ectopic Pregnancy
An ectopic pregnancy, or eccysis, is a complication of pregnancy in which the embryo implants
outside the uterine cavity.
Most ectopic pregnancies occur in the Fallopian tube, so-called tubal pregnancies), but
implantation can also occur in the cervix, ovaries, and abdomen.
Symptoms include pain in lower abdomen, during micturition, bowel movement, vaginal bleeding.
There are four types:
Tubal Pregnancy: occurring in fallopian tube
Non-tubal Ectopic Pregnancy: occurring in ovary, cervix or are intra-abdominal.
Heterotopic Pregnancy: There may be two fertilized eggs, one outside the uterus and the
other inside.
Persistent Ectopic Pregnancy: continuation of trophoplastic growth after a
surgical intervention to remove an ectopic pregnancy.
27. Hyperemesis
Hyperemesis gravidarum (HG) is a severe form of morning sickness, with
"unrelenting, excessive pregnancy-related nausea and/or vomiting that prevents
adequate intake of food and fluids.
It may be due to adverse hormonal effects or raised levels of Human Chorionic
Gonadotropin (HCG).
Pruritis Gravidarum:
It is the itching during pregnancy.
Postnatal Blues:
Mild depression after delivery.
Postpartum Depression:
Depression after delivery.
28. Ante partum Hemorrhage
Also called prepartum hemorrhage, it is the bleeding from the vagina during
pregnancy from the 24th week gestational age to term.
It should be considered a medical emergency and medical attention should be
sought immediately.
Causes:
• Placental abruption - most common pathological cause
• Placenta previa - second most common pathological cause
• Vasa previa
• Uterine rupture
• Bleeding from the lower genital tract
• Cervical bleeding - cervicitis, cervical neoplasm, cervical polyp
• Bleeding from the vagina itself - trauma, neoplasm
• Bleeding that may be confused with vaginal bleeding eg GI bleeding,
haemorrhoids, inflammatory bowel disease, urinary tract infection
29. Postpartum Hemorrhage
It is the loss of greater than 500 ml of blood following vaginal delivery, or 1000 ml of blood following
cesarean section.
Causes:
These include uterine atony (inability of the uterus to contract), trauma (tissue tear during delivery), retained placenta,
and bleeding coagulopathy, etc.
Management:
California Maternity Quality Care Collaborative has described a 4 staged protocol for postpartum
hemorrhage:
Stage 0: normal - treated with fundal massage and oxytocin
Stage 1: more than normal bleeding - establish large-bore intravenous access, increase oxytocin,
consider use of methergine, perform fundal massage, prepare 2 units of packed red cells.
Stage 2: bleeding continues - check coagulation status, place intrauterine balloon, administer additional
uterotonics (misoprostol, carboprost tromethamine), consider: uterine artery embolization, dilatation
and curettage, and laparotomy with uterine compression stitches or hysterectomy.
Stage 3: bleeding continues - activate massive transfusion protocol, recheck laboratory tests, perform
laparotomy, consider hysterectomy.
A Cochrane review suggests that active management (use of uterotonic drugs, cord clamping and
controlled cord traction) of the third stage of labour significantly reduces severe maternal bleeding and
anemia compared to expectant management.
30. Pregnancy Induced Hypertension
It is the condition of high blood pressure during pregnancy.
It is also called Gestational hypertension.
Gestational hypertension can lead to a serious condition called preeclampsia.
Types:
Chronic Hypertension: Women who have high blood pressure ( over 140/90)
before pregnancy, early in pregnancy ( before 20 weeks), or carry it on after
delivery.
Gestational Hypertension: High blood pressure that develops after week 20 in
pregnancy and goes away after delivery.
Preeclampsia: Both chronic hypertension and gestational hypertension can lead
to this severe condition after week 20 of pregnancy. Symptoms include high
blood pressure and protein in the urine and can lead to serious complications for
both mom and baby if not treated quickly.
31. Pre-eclampsia
It is when a pregnant woman develops high blood pressure and protein in the urine after the 20th
week of pregnancy.
Causes:
Blood vessel problems
Diet
Genes
Obesity
Being older than age 35
History of diabetes, high blood pressure, or kidney disease
Symptoms:
Symptoms of preeclampsia can include:
Swelling of the hands and face/eyes (edema)
Sudden weight gain over 1-2 days, more than 2 pounds a week
Headache
Belly pain on the right side, below the ribs. Pain may also be felt in the right shoulder
Irritability
Decreased urine output, not urinating very often
Nausea and vomiting
Vision changes
32. Eclampsia
It is an acute and life-threatening complication of pregnancy, is characterized by the
appearance of tonic-clonic seizures, which are not due to preexisting or organic brain
disorders, usually in a patient who has developed pre-eclampsia.
Pre-eclampsia and eclampsia are collectively called Hypertensive disorder of
pregnancy and toxemia of pregnancy.
Symptoms:
Typically patients show signs of pregnancy-induced hypertension and proteinuria prior
to the onset of the hallmark of eclampsia, the eclamptic convulsion. Other cerebral
signs may precede the convulsion such as nausea, vomiting, headaches, and cortical
blindness. In addition, with the advancement of the pathophysiological process, other
organ symptoms may be present including abdominal pain, liver failure, signs of the
HELLP syndrome, pulmonary oedema, and oliguria. The fetus may already have been
compromised by intrauterine growth retardation, and with the toxemic changes during
eclampsia may suffer fetal distress. Placental bleeding and placental abruption may
occur.
33. TORCH Syndrome
TORCH complex (also known as STORCH, TORCHES or the TORCH infections) is a
medical acronym for a set of perinatal infections. It is spelled as:
T – Toxoplasmosis / Toxoplasma gondii
O – Other infections (see below)
R – Rubella
C – Cytomegalovirus
H – Herpes simplex virus 2
The "other agents" included under O are Coxsackievirus, Syphilis, Varicella-Zoster Virus,
HIV, and Parvovirus B19.
Hepatitis B may also be included among "other agents", but the hepatitis B virus is a large
virus and does not cross the placenta, hence it cannot infect the fetus.
The acronym has also been listed as TORCHES, for TOxoplasmosis, Rubella,
Cytomegalovirus, HErpes simplex, Syphilis.
34. Maternal Mortality
It is the death of a woman while pregnant or within 42 days after termination of pregnancy
irrespective of the site and duration.
It can be:
Direct: death due to pregnancy, labour, puerperium or management of complications
Indirect: death due to a pre-existing condition in the pregnant lady that is aggravated by
pregnancy.
Incidental: death in spite of the lady being normal and healthy
Maternal Mortality Rate
It is the ratio of the number of maternal deaths per 100,000 live births
from any cause related to or aggravated by pregnancy or its management,
excluding accidental or incidental causes.
According to WHO, MMR in world average per 100,000 is 400.
35. Neonatal Death
Number of deaths during the first 28 completed days of
life per 1,000 live births in a given year or period.
It is taken per 1000 live births.
Neonatal deaths may be subdivided into early neonatal
deaths, occurring during the first seven days of life, and
late neonatal deaths, occurring after the seventh day but
before the 28 completed days of life.
36. Perinatal Death
It is the death of the baby around birth and includes stillbirth and neonatal death.
It includes the time from 24 weeks (before birth) to 28 days after birth.
Perinatal Mortality Rate
It is the number of perinatal deaths per 1,000 total births.
The WHO has not published contemporary data.