Congenital Malformations of the Female genital Tract
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This document summarizes congenital malformations of the female genital tract. It describes disorders including Mayer-Rokitansky-Kuster-Hauser syndrome which is characterized by the absence of the upper vagina, cervix and uterus. It also discusses disorders of lateral fusion of the mullerian ducts which can result in abnormalities such as a uterus didelphys, bicornuate uterus or septate uterus. These abnormalities are associated with increased risks in pregnancy such as recurrent abortions or premature birth. The document outlines approaches to diagnosis and treatment of various mullerian duct anomalies.
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FOTHERGIL'S OPERATION
This document describes the Fothergill's Operation procedure for uterine prolapse. The key steps are:
1. Amputating the elongated cervix while preserving menstrual function.
2. Approximating the cardinal ligaments in front of the cervical stump using a Fothergill stitch to support the uterus.
3. Repairing any enterocele or cystocele.
The operation is indicated for 2nd or 3rd degree prolapse with vaginal wall defects. Complications can include hemorrhage, cervical stenosis, recurrence of prolapse, and bladder or fistula injuries. A modification by Shirodkar involves cutting and crossing the uterosacral ligaments in
Congenital malformations of female genital tract
This document discusses various congenital malformations of the female genital tract that can occur, including anomalies of the external genitalia, vagina, uterus, fallopian tubes, and ovaries. Some key malformations mentioned are imperforate hymen, transverse vaginal septum, bicornuate and septate uteri, elongated or absent fallopian tubes, and streak gonads. The causes are often genetic in origin. Clinical features may include infertility, dyspareunia, abnormal bleeding, recurrent miscarriage, and obstructed labor. Treatment depends on the specific anomaly but may involve surgical correction or resection.
Retained placenta
Retained placenta is defined as the inability to expel the placenta from the uterus or birth canal over 30 minutes after childbirth. There are three phases of normal placental delivery that can be disrupted: separation from the uterine wall, descent into the lower uterine segment and vagina, and expulsion. Retained placenta can be caused by poor uterine contractions, an atonic uterus, multiple pregnancy, prolonged labor, or a large placental surface area. Management depends on the type and severity of the retention, and may include expectant management, controlled cord traction, or manual removal of the placenta. Complications can include hemorrhage, shock, and puerperal sepsis.
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
Purandares cervicopexy
Uterine prolapse (also called descensus or procidentia) means the uterus has descended from its normal position in the pelvis farther down into the vagina.Cervicopexy is fertility conserving surgical management of prolapse.
Difficult lscs
LSCS is the most common obstetric procedure but it can be very difficult to manage in cases of previous LSCS, low lying placenta, and PPH. please check out the youtube links to the videos embedded in this PPT.
ADHESIOLYSIS DURING LSCS https://youtu.be/2Hv80v3yu20
BLADDER DISSECTION https://youtu.be/6qsaTJ1yRUY
RECTUS SHEATH ADHESIOLYSIS https://youtu.be/SryJHjuGsME
VECTIS IN FLOATING HEAD DURING LSCS https://youtu.be/3PECperU8Cw
BREECH DELIVERY https://youtu.be/i-LcmTNNVvU
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CONJOINT TWINS https://youtu.be/KLR7D6wkf38
LSCS IN PLACENTA PREVIA https://youtu.be/dNKQwt4KhVY
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This document discusses cephalopelvic disproportion (CPD) and contracted pelvis. It defines CPD as a disparity between the fetal head and the mother's pelvis. Contracted pelvis occurs when one or more pelvic diameters is reduced below normal. The document describes various classifications of contracted pelvis and discusses diagnosis, effects, and management approaches for CPD and contracted pelvis which may include a trial of labor or cesarean section depending on the degree of disproportion. Complications of CPD can include maternal and fetal injuries as well as increased morbidity and mortality.
Recommended
FOTHERGIL'S OPERATION
This document describes the Fothergill's Operation procedure for uterine prolapse. The key steps are:
1. Amputating the elongated cervix while preserving menstrual function.
2. Approximating the cardinal ligaments in front of the cervical stump using a Fothergill stitch to support the uterus.
3. Repairing any enterocele or cystocele.
The operation is indicated for 2nd or 3rd degree prolapse with vaginal wall defects. Complications can include hemorrhage, cervical stenosis, recurrence of prolapse, and bladder or fistula injuries. A modification by Shirodkar involves cutting and crossing the uterosacral ligaments in
Congenital malformations of female genital tract
This document discusses various congenital malformations of the female genital tract that can occur, including anomalies of the external genitalia, vagina, uterus, fallopian tubes, and ovaries. Some key malformations mentioned are imperforate hymen, transverse vaginal septum, bicornuate and septate uteri, elongated or absent fallopian tubes, and streak gonads. The causes are often genetic in origin. Clinical features may include infertility, dyspareunia, abnormal bleeding, recurrent miscarriage, and obstructed labor. Treatment depends on the specific anomaly but may involve surgical correction or resection.
Retained placenta
Retained placenta is defined as the inability to expel the placenta from the uterus or birth canal over 30 minutes after childbirth. There are three phases of normal placental delivery that can be disrupted: separation from the uterine wall, descent into the lower uterine segment and vagina, and expulsion. Retained placenta can be caused by poor uterine contractions, an atonic uterus, multiple pregnancy, prolonged labor, or a large placental surface area. Management depends on the type and severity of the retention, and may include expectant management, controlled cord traction, or manual removal of the placenta. Complications can include hemorrhage, shock, and puerperal sepsis.
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
Purandares cervicopexy
Uterine prolapse (also called descensus or procidentia) means the uterus has descended from its normal position in the pelvis farther down into the vagina.Cervicopexy is fertility conserving surgical management of prolapse.
Difficult lscs
LSCS is the most common obstetric procedure but it can be very difficult to manage in cases of previous LSCS, low lying placenta, and PPH. please check out the youtube links to the videos embedded in this PPT.
ADHESIOLYSIS DURING LSCS https://youtu.be/2Hv80v3yu20
BLADDER DISSECTION https://youtu.be/6qsaTJ1yRUY
RECTUS SHEATH ADHESIOLYSIS https://youtu.be/SryJHjuGsME
VECTIS IN FLOATING HEAD DURING LSCS https://youtu.be/3PECperU8Cw
BREECH DELIVERY https://youtu.be/i-LcmTNNVvU
TRANSVERSE LIE WITH IUFD https://youtu.be/hG28uqpkdpU
CONJOINT TWINS https://youtu.be/KLR7D6wkf38
LSCS IN PLACENTA PREVIA https://youtu.be/dNKQwt4KhVY
SYSTEMATIC PELVIC DEVASCULARISATION https://youtu.be/UwSH6V6GBVw
Diagnosis of pregnancy
This document discusses the diagnosis of pregnancy through various signs and symptoms presented in the three trimesters of pregnancy. It outlines the normal duration of gestation and describes common symptoms seen in each trimester such as cessation of menstruation, breast changes, nausea, and fetal movements. Diagnostic tests like urine and blood tests for hCG and ultrasound are mentioned. Common physical exam findings for each trimester including uterine size, fetal heart tone auscultation, and fundal height are summarized.
Cpd & contracted pelvis
This document discusses cephalopelvic disproportion (CPD) and contracted pelvis. It defines CPD as a disparity between the fetal head and the mother's pelvis. Contracted pelvis occurs when one or more pelvic diameters is reduced below normal. The document describes various classifications of contracted pelvis and discusses diagnosis, effects, and management approaches for CPD and contracted pelvis which may include a trial of labor or cesarean section depending on the degree of disproportion. Complications of CPD can include maternal and fetal injuries as well as increased morbidity and mortality.
Abdominal Pain in Pregnancy
Abdominal pain in pregnancy can have many potential causes including obstetric, gynecological, surgical, and medical issues. A thorough history and physical exam is important to determine the cause, which may include conditions like preterm labor, placental abruption, appendicitis, or ectopic pregnancy. Based on the findings, appropriate investigations like urine tests, ultrasound, and fetal monitoring can help make the diagnosis. Management is tailored to the specific cause but the priority is always the health and safety of the mother and baby.
Caesarean section
The document discusses Caesarean section (CS), including its history, types, indications, contraindications, technique, and complications. It defines CS as the delivery of the fetus through an incision in the abdominal wall and uterine wall. The document outlines various types of CS according to timing, gestational age, and uterine incision. It provides detailed lists of maternal, fetal, and fetomaternal indications and contraindications for performing a CS. The step-by-step technique for performing a CS is also described. Potential intra-operative, early postoperative, and long-term complications are discussed.
Caesarean section - indications and types
Caesarean section is the removal of a child through an incision in the abdominal wall of an intact uterus. The incidence of caesarean sections has increased worldwide in the last 25 years, mainly due to repeat caesareans, dystocia, and fetal distress. Indications for caesarean section include maternal factors like previous c-sections, fetal distress, and fetal-maternal factors. The most common type is a lower segment caesarean section (LSCS) which involves a transverse incision in the lower uterine segment. While caesarean section can be life-saving, it carries more risks than a planned vaginal delivery.
Bartholian cyst
A Bartholin's cyst is a fluid-filled sac within the Bartholin's gland of the vagina. Bartholin's cysts typically occur in nulliparous women of child-bearing age and other risk factors include a personal history of Bartholin's cyst, being sexually active, or a history of vulval surgery. Bartholin's cysts can cause vulvar pain, dyspareunia, and may rupture spontaneously, relieving pain. Treatment options include incision and drainage with placement of a Word catheter or marsupialization to prevent reaccumulation of fluid.
Breech 2021
Contact Me
Telegram: https://t.me/OBGYN_Note_Book Or https://t.me/Hanybal2021
Facebook: https://www.facebook.com/obgyn.books
Slideshare: https://www.slideshare.net/bjlomsecond
Youtube: https://www.youtube.com/channel/UCXyr7omX-DZ8cTixpQeYvcQ/videos
Email: bjlomsecond@gmail.com
Post date and induction of labor
This document discusses post-term pregnancy and induction of labor. It defines post-term pregnancy as exceeding 42 weeks of gestation and notes risks increase beyond this point. It reviews changes that occur in the amniotic fluid, placenta, and fetus with prolonged pregnancy. Methods of assessing amniotic fluid volume and signs of fetal distress are described. The document outlines indications and contraindications for labor induction as well as prerequisites and Bishop's score for assessing cervical ripening. Finally, it reviews several natural, mechanical, surgical and pharmacological methods used to induce labor.
Amniotomy by dr alka mukherjee dr apurva mukherjee nagpur m.s. india
There are four main reasons for performing an amniotomy:
1. To induce labor or augment uterine activity, despite evidence showing lack of effectiveness. A 2013 Cochrane Review concluded, that "the evidence showed no shortening of the length of first stage of labour and a possible increase in caesarean section. Routine amniotomy is not recommended as part of standard labour management and care."[2] Another Cochrane Review could not draw any conclusions about the effectiveness of using amnioitomy as a means of induction when comparing amniotomy alone vs. expected management or amniotomy alone vs. oxytocin alone.[3]
2. To enable the doctor or midwife to monitor the baby's heartbeat internally. A scalp electrode is placed against the baby's head and an ECG of the baby's heart beat can be directly recorded. This provides a much more reliable indication of the fetal well being than external monitoring alone. Internal fetal monitoring is often performed if there is a complication such as maternal disease, or if there is fetal distress or if the mother is being induced.
3. To check the color of the fluid. If there is a suspicion of the presence of meconium (the contents of the baby's bowel), certain preparations must be made. Suctioning must be set up and more personnel are required to be in attendance.
4. To avoid having the baby aspirate the contents of the amniotic sac at the moment of birth. Most often, the amniotic sac will break of its own accord, most often by the beginning of the second stage of labor. If it remains intact, it is sure to break with maternal pushing efforts. But in a rare case, the baby can be born with an intact bag that must be quickly broken to allow the baby to breathe.
Difficult c section
THIS WAS PRESENTED AT SAFOG MOGS "SMART CONFERENCE "IN MUMBAI
PREPARED WITH HELP OF DR SUCHITRA PANDIT,DR CN PURANDARE AND DR ALPESH GANDHI.....VIDEOS CAN BE SEEN AT U TUBE
Female sterilisation
This document discusses female sterilization procedures including timing, guidelines, surgical approaches, counseling requirements, and complications. It describes minilaparotomy, laparoscopic sterilization, and vaginal tubal ligation methods. Timing options include postpartum, interval, or postabortal sterilization. Counseling must cover permanence, risks, and potential for failure or reversal. Surgical risks include infection, bleeding, and injury to nearby organs. Laparoscopy is preferred for interval sterilization due to lower risk of complications compared to minilaparotomy.
Vaginal Hysterectomy
Vaginal hysterectomy is a procedure to remove the uterus through the vagina. It has advantages over abdominal hysterectomy like earlier recovery, less pain, and lower morbidity. The key steps involve exposing and clamping the uterine vessels and ligaments, then removing the uterus. The vaginal cuff and pelvic floor are repaired with sutures to prevent prolapse. Post-operative care involves bladder drainage, antibiotics, pain relief, and monitoring for potential complications like bleeding or infection.
Prolonged labour
Labour is considered prolonged if it lasts more than 12 hours. It can be caused by issues with the passageway (pelvis), passenger (baby), powers (contractions), or psyche (mental state). Prolonged labour risks maternal and fetal complications if neglected. Close monitoring is needed to detect obstruction early. Treatment depends on fetal viability but may include resuscitating the mother, controlling infection, relieving obstruction via c-section, and post-delivery care like antibiotics and bladder drainage. Abnormal uterine contractions can also prolong labour and are treated with oxytocin.
Cervical dystocia
Cervical dystocia failure causes,primary cervical dystocia, Secondary cervical dystocia and its management
Female sterilisation
This document provides information about female sterilization procedures. It discusses:
1. The anatomy of the fallopian tubes and their physiological functions.
2. The criteria for patient selection including age, number of children, prior sterilization history, and mental capacity.
3. Details of the counseling process and common surgical techniques like Pomeroy's and Uchida methods.
4. Post-operative care and potential complications. Hysteroscopic methods like Essure coils are also summarized.
Malpresentation & Malpositioning
Fetal malpositioning & malpresentation can pose a serious threat to maternal & fetal well being. The document discusses the risks, complication, and management of some of the common malpresentation & malpositioning.
Surgical Management of Postpartum Hemorrhage
Dr. Rakhi Gajbhiye is a director of Mauli Women's Hospital in Nagpur, India. She has published 9 papers in journals and contributed a chapter to a book on hysteroscopy. She is a member of several medical organizations and delivers talks at conferences.
The document discusses various surgical interventions for postpartum hemorrhage (PPH) when medical or mechanical methods have failed. It describes compression sutures like the B-Lynch suture and Hayman suture, as well as ligation of the uterine, ovarian, and internal iliac vessels. Hysterectomy is mentioned as a last resort. Complications of compression sutures and the procedures for
Cervical stitches
Cervical insufficiency, also known as cervical incompetence, is a condition where the cervix is unable to retain a pregnancy at term due to a functional or structural defect. It is characterized by painless dilatation of the cervix resulting in premature rupture of membranes and delivery, usually occurring in the second or third trimester. Cervical cerclage procedures aim to surgically suture the cervix closed to prevent premature opening. There are several techniques for cervical cerclage placement depending on the location and indication, including McDonald, Shirodkar, emergency/rescue cerclages, and pessary or balloon alternatives. Cerclage procedures can be done through the vagina or abdomen depending
secondary postpartum hemorrhage
1. Secondary postpartum hemorrhage (PPH) is defined as excessive or fresh bleeding from the vagina between 24 hours and 12 weeks after childbirth.
2. Causes of secondary PPH include retained placenta, infection, trauma, uterine abnormalities, and coagulation disorders.
3. Assessment involves vital signs, uterine size, cervical examination, and lab tests. Conservative management includes antibiotics, uterotonic drugs, and surgical intervention if bleeding continues.
4. For unstable patients, resuscitation is prioritized with IV fluids, blood products, and treating the underlying cause. Hysterectomy may be required in some severe cases.
Umbilical cord prolapse
This document provides information on umbilical cord prolapse, including its definition, risk factors, objectives in management, and emergency procedures. It defines overt and occult prolapse and lists factors like multiple pregnancy, high presenting part, and uterine abnormalities that can predispose to prolapse. The key objectives in management are prompt diagnosis, immediate action to relieve cord compression, and emergency delivery to optimize neonatal outcome. Emergency procedures include positioning the woman to elevate the presenting part, calling for help, and preparing for an emergency caesarean section with a multidisciplinary teamwork approach.
Dystocia
Dystocia refers to difficult or slow labor progress that may be caused by abnormalities of the passageway (mother's pelvis), passenger (baby), or powers (uterine contractions). There are two main types of uterine dysfunction that can cause dystocia: hypotonic dysfunction where contractions are insufficient and hypertonic dysfunction where contractions are incoordinated. Labor patterns are considered abnormal if the active phase of dilation progresses less than 1 cm/hr for nulliparous women or 1.5 cm/hr for multiparous women. Arrest disorders occur when dilation or descent stops progressing for over 2 hours. Precipitous labor is extremely rapid labor and delivery caused by abnormally low resistance in the birth canal
Pelvic Organ Prolapse
Vaginal prolapse is a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel, or the vagina itself may begin to prolapse, or fall out of their normal positions.
Placenta accreta .Prof.S. Roshdy
This document provides an overview of placenta accreta spectrum (PAS) disorders, including definitions, epidemiology, pathogenesis, clinical presentation, prenatal diagnosis, and management. PAS disorders describe abnormal placentation that can range from superficial to deep invasion of the placenta into the uterine wall. Risk factors include placenta previa, cesarean sections, and uterine surgeries. Prenatal ultrasound and MRI can detect signs such as placental lacunae and vascular abnormalities. Left untreated, PAS disorders can lead to life-threatening hemorrhage.
Mullerian anomalies
This document discusses Mullerian anomalies/defects, which range from agenesis to duplication of the tubes, uterus, cervix and upper vagina. It covers the classification system used (AFS), incidence, etiology, genetics, embryogenesis, clinical features, diagnosis using imaging modalies like HSG, USG and MRI, and management of various anomalies like unicornuate uterus, didelphys, bicornuate, septate and arcuate uterus. Complications in reproduction from each anomaly and outcomes of treatments like metroplasty are also summarized. Diethylstilbestrol exposure related abnormalities are briefly discussed.
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Caesarean section
The document discusses Caesarean section (CS), including its history, types, indications, contraindications, technique, and complications. It defines CS as the delivery of the fetus through an incision in the abdominal wall and uterine wall. The document outlines various types of CS according to timing, gestational age, and uterine incision. It provides detailed lists of maternal, fetal, and fetomaternal indications and contraindications for performing a CS. The step-by-step technique for performing a CS is also described. Potential intra-operative, early postoperative, and long-term complications are discussed.
Caesarean section - indications and types
Caesarean section is the removal of a child through an incision in the abdominal wall of an intact uterus. The incidence of caesarean sections has increased worldwide in the last 25 years, mainly due to repeat caesareans, dystocia, and fetal distress. Indications for caesarean section include maternal factors like previous c-sections, fetal distress, and fetal-maternal factors. The most common type is a lower segment caesarean section (LSCS) which involves a transverse incision in the lower uterine segment. While caesarean section can be life-saving, it carries more risks than a planned vaginal delivery.
Bartholian cyst
A Bartholin's cyst is a fluid-filled sac within the Bartholin's gland of the vagina. Bartholin's cysts typically occur in nulliparous women of child-bearing age and other risk factors include a personal history of Bartholin's cyst, being sexually active, or a history of vulval surgery. Bartholin's cysts can cause vulvar pain, dyspareunia, and may rupture spontaneously, relieving pain. Treatment options include incision and drainage with placement of a Word catheter or marsupialization to prevent reaccumulation of fluid.
Breech 2021
Contact Me
Telegram: https://t.me/OBGYN_Note_Book Or https://t.me/Hanybal2021
Facebook: https://www.facebook.com/obgyn.books
Slideshare: https://www.slideshare.net/bjlomsecond
Youtube: https://www.youtube.com/channel/UCXyr7omX-DZ8cTixpQeYvcQ/videos
Email: bjlomsecond@gmail.com
Post date and induction of labor
This document discusses post-term pregnancy and induction of labor. It defines post-term pregnancy as exceeding 42 weeks of gestation and notes risks increase beyond this point. It reviews changes that occur in the amniotic fluid, placenta, and fetus with prolonged pregnancy. Methods of assessing amniotic fluid volume and signs of fetal distress are described. The document outlines indications and contraindications for labor induction as well as prerequisites and Bishop's score for assessing cervical ripening. Finally, it reviews several natural, mechanical, surgical and pharmacological methods used to induce labor.
Amniotomy by dr alka mukherjee dr apurva mukherjee nagpur m.s. india
There are four main reasons for performing an amniotomy:
1. To induce labor or augment uterine activity, despite evidence showing lack of effectiveness. A 2013 Cochrane Review concluded, that "the evidence showed no shortening of the length of first stage of labour and a possible increase in caesarean section. Routine amniotomy is not recommended as part of standard labour management and care."[2] Another Cochrane Review could not draw any conclusions about the effectiveness of using amnioitomy as a means of induction when comparing amniotomy alone vs. expected management or amniotomy alone vs. oxytocin alone.[3]
2. To enable the doctor or midwife to monitor the baby's heartbeat internally. A scalp electrode is placed against the baby's head and an ECG of the baby's heart beat can be directly recorded. This provides a much more reliable indication of the fetal well being than external monitoring alone. Internal fetal monitoring is often performed if there is a complication such as maternal disease, or if there is fetal distress or if the mother is being induced.
3. To check the color of the fluid. If there is a suspicion of the presence of meconium (the contents of the baby's bowel), certain preparations must be made. Suctioning must be set up and more personnel are required to be in attendance.
4. To avoid having the baby aspirate the contents of the amniotic sac at the moment of birth. Most often, the amniotic sac will break of its own accord, most often by the beginning of the second stage of labor. If it remains intact, it is sure to break with maternal pushing efforts. But in a rare case, the baby can be born with an intact bag that must be quickly broken to allow the baby to breathe.
Difficult c section
THIS WAS PRESENTED AT SAFOG MOGS "SMART CONFERENCE "IN MUMBAI
PREPARED WITH HELP OF DR SUCHITRA PANDIT,DR CN PURANDARE AND DR ALPESH GANDHI.....VIDEOS CAN BE SEEN AT U TUBE
Female sterilisation
This document discusses female sterilization procedures including timing, guidelines, surgical approaches, counseling requirements, and complications. It describes minilaparotomy, laparoscopic sterilization, and vaginal tubal ligation methods. Timing options include postpartum, interval, or postabortal sterilization. Counseling must cover permanence, risks, and potential for failure or reversal. Surgical risks include infection, bleeding, and injury to nearby organs. Laparoscopy is preferred for interval sterilization due to lower risk of complications compared to minilaparotomy.
Vaginal Hysterectomy
Vaginal hysterectomy is a procedure to remove the uterus through the vagina. It has advantages over abdominal hysterectomy like earlier recovery, less pain, and lower morbidity. The key steps involve exposing and clamping the uterine vessels and ligaments, then removing the uterus. The vaginal cuff and pelvic floor are repaired with sutures to prevent prolapse. Post-operative care involves bladder drainage, antibiotics, pain relief, and monitoring for potential complications like bleeding or infection.
Prolonged labour
Labour is considered prolonged if it lasts more than 12 hours. It can be caused by issues with the passageway (pelvis), passenger (baby), powers (contractions), or psyche (mental state). Prolonged labour risks maternal and fetal complications if neglected. Close monitoring is needed to detect obstruction early. Treatment depends on fetal viability but may include resuscitating the mother, controlling infection, relieving obstruction via c-section, and post-delivery care like antibiotics and bladder drainage. Abnormal uterine contractions can also prolong labour and are treated with oxytocin.
Cervical dystocia
Cervical dystocia failure causes,primary cervical dystocia, Secondary cervical dystocia and its management
Female sterilisation
This document provides information about female sterilization procedures. It discusses:
1. The anatomy of the fallopian tubes and their physiological functions.
2. The criteria for patient selection including age, number of children, prior sterilization history, and mental capacity.
3. Details of the counseling process and common surgical techniques like Pomeroy's and Uchida methods.
4. Post-operative care and potential complications. Hysteroscopic methods like Essure coils are also summarized.
Malpresentation & Malpositioning
Fetal malpositioning & malpresentation can pose a serious threat to maternal & fetal well being. The document discusses the risks, complication, and management of some of the common malpresentation & malpositioning.
Surgical Management of Postpartum Hemorrhage
Dr. Rakhi Gajbhiye is a director of Mauli Women's Hospital in Nagpur, India. She has published 9 papers in journals and contributed a chapter to a book on hysteroscopy. She is a member of several medical organizations and delivers talks at conferences.
The document discusses various surgical interventions for postpartum hemorrhage (PPH) when medical or mechanical methods have failed. It describes compression sutures like the B-Lynch suture and Hayman suture, as well as ligation of the uterine, ovarian, and internal iliac vessels. Hysterectomy is mentioned as a last resort. Complications of compression sutures and the procedures for
Cervical stitches
Cervical insufficiency, also known as cervical incompetence, is a condition where the cervix is unable to retain a pregnancy at term due to a functional or structural defect. It is characterized by painless dilatation of the cervix resulting in premature rupture of membranes and delivery, usually occurring in the second or third trimester. Cervical cerclage procedures aim to surgically suture the cervix closed to prevent premature opening. There are several techniques for cervical cerclage placement depending on the location and indication, including McDonald, Shirodkar, emergency/rescue cerclages, and pessary or balloon alternatives. Cerclage procedures can be done through the vagina or abdomen depending
secondary postpartum hemorrhage
1. Secondary postpartum hemorrhage (PPH) is defined as excessive or fresh bleeding from the vagina between 24 hours and 12 weeks after childbirth.
2. Causes of secondary PPH include retained placenta, infection, trauma, uterine abnormalities, and coagulation disorders.
3. Assessment involves vital signs, uterine size, cervical examination, and lab tests. Conservative management includes antibiotics, uterotonic drugs, and surgical intervention if bleeding continues.
4. For unstable patients, resuscitation is prioritized with IV fluids, blood products, and treating the underlying cause. Hysterectomy may be required in some severe cases.
Umbilical cord prolapse
This document provides information on umbilical cord prolapse, including its definition, risk factors, objectives in management, and emergency procedures. It defines overt and occult prolapse and lists factors like multiple pregnancy, high presenting part, and uterine abnormalities that can predispose to prolapse. The key objectives in management are prompt diagnosis, immediate action to relieve cord compression, and emergency delivery to optimize neonatal outcome. Emergency procedures include positioning the woman to elevate the presenting part, calling for help, and preparing for an emergency caesarean section with a multidisciplinary teamwork approach.
Dystocia
Dystocia refers to difficult or slow labor progress that may be caused by abnormalities of the passageway (mother's pelvis), passenger (baby), or powers (uterine contractions). There are two main types of uterine dysfunction that can cause dystocia: hypotonic dysfunction where contractions are insufficient and hypertonic dysfunction where contractions are incoordinated. Labor patterns are considered abnormal if the active phase of dilation progresses less than 1 cm/hr for nulliparous women or 1.5 cm/hr for multiparous women. Arrest disorders occur when dilation or descent stops progressing for over 2 hours. Precipitous labor is extremely rapid labor and delivery caused by abnormally low resistance in the birth canal
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Vaginal prolapse is a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel, or the vagina itself may begin to prolapse, or fall out of their normal positions.
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Amniotomy by dr alka mukherjee dr apurva mukherjee nagpur m.s. india
Amniotomy by dr alka mukherjee dr apurva mukherjee nagpur m.s. india
Similar to Congenital Malformations of the Female genital Tract
Placenta accreta .Prof.S. Roshdy
This document provides an overview of placenta accreta spectrum (PAS) disorders, including definitions, epidemiology, pathogenesis, clinical presentation, prenatal diagnosis, and management. PAS disorders describe abnormal placentation that can range from superficial to deep invasion of the placenta into the uterine wall. Risk factors include placenta previa, cesarean sections, and uterine surgeries. Prenatal ultrasound and MRI can detect signs such as placental lacunae and vascular abnormalities. Left untreated, PAS disorders can lead to life-threatening hemorrhage.
Mullerian anomalies
This document discusses Mullerian anomalies/defects, which range from agenesis to duplication of the tubes, uterus, cervix and upper vagina. It covers the classification system used (AFS), incidence, etiology, genetics, embryogenesis, clinical features, diagnosis using imaging modalies like HSG, USG and MRI, and management of various anomalies like unicornuate uterus, didelphys, bicornuate, septate and arcuate uterus. Complications in reproduction from each anomaly and outcomes of treatments like metroplasty are also summarized. Diethylstilbestrol exposure related abnormalities are briefly discussed.
Endometriosis & Adenomyosis
Endometriosis is the presence of endometrial tissue outside the uterus, most commonly found on the ovaries, pelvic peritoneum, and ligaments. It affects 6-10% of women and is a common cause of infertility and pelvic pain. Diagnosis is typically made by laparoscopy where lesions are visualized and biopsied. Treatment aims to reduce pain and fertility issues through hormonal suppression or surgery to remove lesions. Complications can include infertility, pregnancy issues, intestinal obstruction, and in rare cases, malignant transformation of lesions.
ectopic-.pptx
Word ectopic comes from the Greek word meaning "out of place". Ectopic pregnancy occurs when a fertilized egg implants outside of the uterus, most commonly in the fallopian tubes. Ultrasound is the gold standard for diagnosing ectopic pregnancies and identifying whether the pregnancy is intrauterine or extrauterine, ruptured or unruptured. Early diagnosis of ectopic pregnancy is lifesaving as it allows for elective surgery or non-surgical treatment options to be used. Common risk factors for ectopic pregnancy include previous pelvic inflammatory disease, infertility, and prior ectopic pregnancies.
How to reduce maternal morbidity and mortality in women with morbidly adheren...
This power point presentation displays definition, types, risk factors and diagnosis of morbidly adherent placenta.In addition, this presentation discusses maternal morbidity and mortality associated with MAP and practical steps to reduce these morbidity and mortality.
Anorectal Malformation.pptx
This document discusses Anorectal Malformation, including:
- It is a developmental deformity of the anorectal canal that occurs due to arrest in embryonic development around 8 weeks gestation.
- The incidence is about 1 in 500 for minor anomalies and 1 in 5000 for major anomalies, more common in males.
- It is classified based on whether the malformation is above or below the puborectalis muscle.
- Low malformations have good prognosis while high malformations require temporary colostomy and definitive surgery like PSARP.
- Nursing management includes pre-op care like NG tube and IV fluids, post-op care like wound care and dilatation.
ECTOPIC PREGNANCY-1.ppt
An ectopic (extrauterine) pregnancy occurs when a fertilized egg implants somewhere other than the uterus, most commonly in a fallopian tube. Risk factors include previous pelvic infections, infertility, or ectopic pregnancies. Symptoms include abdominal pain and vaginal bleeding. Diagnosis is made through ultrasound and beta-hCG blood tests. Treatment depends on severity but may include surgery or methotrexate injections. Complications can include infertility, infection, or even death from blood loss. Prognosis is generally good but recurrent ectopic pregnancies occur in 10-20% of cases.
Ectopic pregnancy
This document discusses ectopic pregnancy, which occurs when a fertilized egg implants outside the uterus, usually in a fallopian tube. It presents risks to a woman's health. Ectopic pregnancies are often caused by factors that delay the transit of the fertilized egg through the fallopian tubes. Diagnosis can be made through a combination of clinical history, examination, and investigations like ultrasound and blood tests. Early diagnosis through increased awareness and diagnostic tests has lowered the risks associated with ectopic pregnancies.
Ectopic pregnancy
An ectopic pregnancy occurs when a fertilized egg implants and grows outside the uterus, most commonly in the fallopian tubes. Risk factors include pelvic inflammatory disease, previous ectopic pregnancy, infertility treatments, and IUD use. Symptoms include abdominal pain, vaginal bleeding, and a positive pregnancy test. Diagnosis is often made using transvaginal ultrasound and beta-hCG levels. Treatment depends on whether the ectopic pregnancy has ruptured but may include medication with methotrexate or laparoscopic or open surgery to remove the ectopic pregnancy. The incidence of ectopic pregnancy is rising but maternal mortality is falling due to earlier diagnosis and treatment.
fetal circulation
This document summarizes common anatomic disorders of the female reproductive system, including abnormalities of the vagina, uterus, and external genitalia. It describes disorders such as imperforate hymen, various types of vaginal atresia, transverse and longitudinal vaginal septums, and Herlyn-Werner-Wunderlich syndrome. For each disorder, it discusses clinical manifestations, diagnosis using imaging and physical exam, and various surgical and conservative treatment approaches. It also covers uterine abnormalities like congenital cervical atresia, unicornuate uterus, and rudimentary uterine horns.
posterior urethral valve.. ahmed oshiba
This document discusses posterior urethral valves, a congenital abnormality affecting male newborns. It presents in about 1 in 5000 live male births and causes obstructive uropathy. Symptoms range from asymptomatic to renal failure and can include urinary retention, infection, distension. Antenatal diagnosis is now common using ultrasonography showing keyhole sign and hydronephrosis. Initial management involves catheterization and antibiotics with endoscopic valve ablation usually within days of birth. Long term risks include bladder dysfunction, reflux, hypertension and end stage renal disease in approximately 25% of cases. Close follow up is needed to monitor renal function and treat complications.
03,04 Embryology & congenital anomalies.pdf
The document summarizes female genital development from the 12th day of fertilization through birth. It describes the development of the internal and external genitalia including the ovaries, fallopian tubes, uterus, cervix, and vagina. It also discusses congenital anomalies that can occur including ambiguous genitalia, hypoplastic organs, fusion defects of the uterus, and unicornuate or rudimentary uteri. Treatment options are provided for some anomalies.
approach to patient vaginal bleeding in 2nd half of pregnancy
Vaginal bleeding in the second half of pregnancy can be caused by placenta previa, placental abruption, or uterine rupture. Placenta previa is when the placenta lies low in the uterus over or near the cervical opening, which can cause painful bleeding. Placental abruption occurs when the placenta separates prematurely from the uterine wall, commonly causing painful bleeding and contractions. Uterine rupture is a medical emergency characterized by a complete tear through the uterine wall. The document discusses these conditions in detail and presents a case study of a pregnant patient who presented with vaginal bleeding.
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.
Ano-rectal Malformations copy.pptx
This document describes various types of anorectal malformations in infants. It begins by explaining normal fetal development of the cloaca and how it divides. It then describes the various defects seen in males (rectobladder neck fistula, rectourethral fistula) and females (rectovestibular fistula, cloaca). Signs and associated anomalies are provided. Investigations like ultrasound and X-rays are outlined. Surgical techniques for repair like PSARP are also summarized.
recurrent miscarriage.pptx
Recurrent miscarriage is defined as two or more spontaneous abortions before 20 weeks of gestation. The causes are often multifactorial and idiopathic. Common causes include endocrinopathies, genetic factors, infections, inherited thrombophilia, autoimmunity, antiphospholipid antibody syndrome, uterine anomalies, and cervical incompetence. Treatment depends on the underlying cause but may include progesterone supplementation, cerclage procedures, anticoagulation therapy, surgical correction of anomalies, and lifestyle modifications. The prognosis is best when a cause can be identified and treated appropriately.
Mullarian agenesis
Müllerian agenesis, or Mayer-Rokitansky-Küster-Hauser syndrome, is a condition where women are born without a uterus and have an underdeveloped or absent vagina. It occurs in 1 in 4,500-5,000 females. Evaluation should include testing for associated kidney, skeletal, or hearing abnormalities which occur in up to 53% of cases. Primary treatment is dilation of the vagina which succeeds for 90-96% of patients. Surgery to create a neovagina is only recommended if dilation fails or is refused by the patient. Lifelong follow up is important due to risks of sexual health issues and cancer.
peripartum.pptx
- The Triple-P procedure is a three step conservative treatment to prevent significant hemorrhage and peripartum hysterectomy involving obstetricians, anesthetists and interventional radiologists.
- A sequence of conservative measures should be attempted before resorting to hysterectomy to control uterine hemorrhage. If one measure does not succeed, the next should be swiftly instituted.
- Indecisiveness in treating hemorrhage can lead to potentially fatal excessive bleeding, while delay also increases blood loss and risks from complications like coagulopathy. Timing of hysterectomy is critical to outcome - it should be neither too early nor too late.
Vault prolapse, Pelvic organ Prolapse, Supports Of Uterus
This document discusses vault prolapse, which occurs when the top of the vagina descends after a hysterectomy. It provides details on the relevant anatomy, risk factors like childbirth and aging, and surgical techniques for repair. Challenges of the vaginal and abdominal approaches are outlined. Prevention focuses on thorough preoperative evaluation and repair of all sites of damage to restore normal pelvic anatomy and support.
Caesarean scar pregnancy.ppt
This case report describes a caesarean scar ectopic pregnancy in a 28-year old woman with two previous caesarean deliveries. Ultrasound found the gestational sac located in the lower uterine segment within the region of the previous caesarean scar. 3D imaging confirmed these findings. The differential diagnosis considered cervical ectopic pregnancy and missed abortion but color Doppler showed peripheral flow around the sac, confirming a caesarean scar ectopic pregnancy. Early detection of caesarean scar ectopic pregnancies by ultrasound is important to reduce risks of complications like hemorrhage which can require emergency hysterectomy.
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How to reduce maternal morbidity and mortality in women with morbidly adheren...
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approach to patient vaginal bleeding in 2nd half of pregnancy
approach to patient vaginal bleeding in 2nd half of pregnancy
Vault prolapse, Pelvic organ Prolapse, Supports Of Uterus
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Parasitic infestations
This document summarizes various parasitic infestations and their clinical features. It discusses papular urticaria caused by sensitivity to insect antigens, scabies caused by the mite Sarcoptes scabiei, and different types of pediculosis caused by head lice, body lice, and crab lice. It also mentions other conditions like myiasis, pulicosis, tungiasis, cimicosis, blister beetle dermatitis, spider bites, demodicidosis, larva migrans, leishmaniasis, and lymphatic filariasis. For each condition, it provides details on the causative organism, clinical manifestations, distribution of lesions
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JVP - A SHORT REVIEW
The jugular venous pulse reflects right atrial pressure and is best examined in the right internal jugular vein. It normally displays three positive waves and two negative troughs related to atrial filling and emptying. Abnormalities can indicate conditions that elevate or lower right atrial pressure such as heart failure, tamponade, constriction. Specific wave changes suggest problems like tricuspid regurgitation or stenosis. The jugular venous pulse is a useful physical exam finding for cardiovascular assessment.
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Heart murmurs can be produced by turbulence in blood flow caused by abnormalities in heart valves or structures. A murmur is described by its timing in the cardiac cycle, location, intensity, quality, and radiation pattern.
A mid-systolic murmur is the most common murmur and can be caused by ventricular outflow obstructions like aortic stenosis, dilation of the aorta/pulmonary trunk, accelerated flow, or innocent murmurs from normal anatomical variations. Diastolic murmurs include early diastolic murmurs like aortic regurgitation and high-pressure pulmonary regurgitation, and mid-diastolic murmurs caused by stenosis of the mitral or tricuspid valves. Flow murmurs
Development of male and female reproductive system
The document describes the development of the male and female reproductive systems from the indifferent stage through sexual differentiation. It covers the development of the gonads (testes and ovaries), genital ducts, and external genitalia. Some key points include:
- The gonads initially develop as indifferent gonads before differentiating into testes or ovaries depending on the presence of the SRY gene on the Y chromosome.
- The genital ducts also initially develop in an indifferent stage before the mesonephric ducts develop into male structures like the epididymis and vas deferens, while the paramesonephric ducts develop into female structures like the uterus and fallopian tubes.
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Chronic Osteomyelitis
This document discusses chronic osteomyelitis, including its causes, pathology, presentations, examinations, investigations, differential diagnoses, and treatments. It can develop following acute osteomyelitis or be caused by tuberculosis or fungi. Pathology involves spread of pus within bone leading to bone death and cavities. Presentations include discharging sinuses and bone fragments. Investigations include x-rays showing bone changes and cultures of pus. Surgical treatments aim to remove dead bone and tissue. Complications include exacerbations, growth abnormalities, and fractures. It also discusses Garre's osteomyelitis and Brodie's abscess as specific types.
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The brain receives a high blood supply to meet its metabolic demands. Arterial blood reaches the brain through the internal carotid and vertebral arteries, forming the circle of Willis at the base of the brain before branching into smaller vessels. Venous blood drains from the brain into internal jugular veins. Disruption of blood flow to the brain through cerebrovascular accidents like stroke can cause rapid loss of consciousness or permanent brain damage. Cerebrospinal fluid produced by choroid plexuses circulates within ventricles and around the brain and spinal cord, carrying nutrients and waste products.
Comprehensive Overview of Medical Genetics
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This document provides an overview of localizing neurological lesions, including definitions of key terms like the central nervous system and peripheral nervous system. It describes various motor and sensory pathways in the brain and spinal cord. Conditions covered include the corticospinal system, stroke syndromes, multiple sclerosis, cerebellar syndrome, and motor neuron disease. For each, the causes, signs, investigations, and management are summarized. Clinical case scenarios are also provided to help localize neurological lesions.
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3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
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1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
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Congenital Malformations of the Female genital Tract
- 1. CONGENITAL MALFORMATIONS OF THE FEMALE GENITAL TRACT
- 2. 1-MULLERIAN AGENESIS • Mayer –Rokitansky-Kuster-Hauser syndrome • Etiology ? • Failure of mullerian duct development absence of the upper vagina, cx & uterus (uterine remanants may be found) • The ovaries & fallopian tubes are present • Normal 46XX ♀ with normal external genitalia • Pt present with 1ry amenorrhoea • 47% have associated urinary tract anomalies • 12% skeletal anomalies • Rx psychological counseling surgical - vaginoplasty - excision of uterine remanant (if it has functioning endometrium) -vaginal dilators
- 3. 2-DISORDERS OF LATERAL FUSION OF THE MULL DUCTS Incidence - 0.1-2% 4% of infertile patient 6-10% recurrent abortion patients Most pt can conceive without difficulty Incidence of : ◊ recurrent abortions ◊ premature birth ◊ fetal loss ◊ fetal malpresentation ◊ C S ◊ cx incompetence
- 4. 2-DISORDERS OF LATERAL FUSION OF THE M D CLINICAL PRESENTATION -Shortly after menarche if there is obstruction to uterine blood flow -Difficulty in intercorse longitudinal vaginal septum -Dysmenorrhea or menorrhagia -Abnormality detected on D&C -U/S, laparoscopy or laparotomy -Palpable mass -Complications of pregnancy -HSG during infertility or RFL investigations
- 5. NON OBSTRUCTIVE MALFORMATIONS OF THE MULLERIANE DUCTS
- 6. 2-DISORDERS OF LATERAL FUSION OF THE MULL DUCTS A-Uterus didelphus • Complete duplication of uterus, cx & vagina (due to failure of fusion of the two Mull ducts) • pregnancy wastage • Diagnosis HSG or at laparoscopy / laparotomy • Rx If affecting pregnancy outcome surgical correction (metroplasty) B-Bicornuate uterus • Incomplete fusion of the two Mull ducts • pregnancy wastage • Dx HSG or at laparoscopy / laparotomy • Rx If affecting pregnancy outcome surgical correction (metroplasty)
- 7. 2-DISORDERS OF LATERAL FUSION OF THE MULL DUCTS C-Septate uterus External contour of the uterus is normal but there is intrauterine septum of varying length & thickness Worst pregnancy outcome Diagnosis both HSG & laparoscopy Treatment Hysteroscopic excision of the septum D-Unicornuate uterus Due to development of only one Mull duct Almost all patients have associated single kidney Pregnancy outcome similar to pt with didelphic uteri Dx HSG or surgery Rx NO corrective surgery if pt has associated cx incompetence cx cerclage
- 8. 2-DISORDERS OF LATERAL FUSION OF THE MUL DUCTS E-Unicurnuate with rudimentary horn Noncommunicating horn 90% Present with cyclic pelvic pain , mass, ectopic pregnancy in the rud horn or endometriosis Rx surgical excision Communicating horn Present with ectopic pregnancy in the rud horn or pregnancy wastage
- 9. 3-DISORDERS OF VERTICALE FUSION OF THE MULLERIAN DUCTS A- VAGINAL SEPTUM • Faults in the junction between the Mull. Tubercle & the urogenital sinus could be very thick or thin • 85% in upper two third of the vagina • Pt present 1ry amenorrhea, hemato-colpos, mass or cyclic abdominal pain • incidence of endometriosis • Rx surgical exicision B-Cervical AGENISIS / DYSGENISIS • V rare • Difficult, unsuccessful surgical correction • Rx hysterectomy
- 11. 4-UNUSUAL CONFIGRATION OF VERTICAL/LATERAL FUSION DEFECTS • Combined lateral & verticle defects • Do not fit in other categories • EXAMPLE, double uterus with obstructed hemivagina
- 12. Double uterus with vaginal obstruction A-Complete vaginal obstruction B-Incomp vag obst C-Comp obst with comm double uterus
- 13. 5-DEFECTS OF THE EXTERNAL GENITALIA • Ambigous genitalia congenital adrenal hyperplasia hermaphrodites • Defects of the clitoris uncommon bifid clitoris hypertrophied androgen effect • IMPERFORATE HYMEN Hymen is formed at the junction of the urogenital sinus & sinovaginal bulbs Pt presents with 1ry amenorrhea with cyclic abdominal pain or hematocolpus /hematometra Rx cruciate incision
- 14. THANK YOU