This document discusses induction of labour, which is defined as artificially stimulating uterine contractions before the onset of natural labour. It outlines the goals, indications, methods, and nursing responsibilities for labour induction. The main methods discussed are medical induction using prostaglandins or oxytocin, and surgical induction through membrane stripping or artificial rupture of membranes. The nursing responsibilities involve properly administering induction medications and procedures, monitoring the woman and fetus during labour induction, and providing general care and support to the woman and newborn.
Oligohydramnios is defined as a reduction in amniotic fluid volume below 500 ml, and in rare cases there may be a complete absence of fluid known as anhydramnios. It occurs in approximately 1 in 750 pregnancies and can be caused by placental insufficiency, urinary tract malformations in the fetus, or post-term pregnancy. Ultrasound is used to diagnose oligohydramnios and identify any fetal anomalies, growth problems, or the fetal presentation. Complications include pulmonary hypoplasia if the fluid is needed for lung development, abnormal fetal development due to compression, and abnormal fetal presentations. Management depends on if it occurs post-term, in which case
Contracted pelvis, also known as pelvic disproportion, occurs when the essential diameters of the pelvis are shortened, altering the normal mechanism of labor. It can be caused by developmental, metabolic, traumatic or other factors. Pelvises are classified based on degree of contraction and pelvic architecture. Diagnosis involves history, physical exam including internal and external pelvimetry, and sometimes radiological imaging. An internal pelvimetry exam evaluates the inlet, cavity, and outlet to determine pelvic adequacy for vaginal delivery.
This document discusses fetal positioning and presentations during labor and delivery. It begins by defining non-vertex presentations including breech, face, brow, transverse, and compound. It then discusses the causes of non-vertex presentations and describes the different positions including occiput posterior. The document provides details on assessing various positions through abdominal and vaginal exams. It concludes by outlining the management of different non-vertex positions, including allowing natural rotation, augmentation of labor, operative vaginal delivery, or caesarean section if needed.
This document discusses forceps delivery, which is an assisted birth using obstetric forceps to extract the fetal head when the mother is unable to deliver the baby on her own. It describes the different types of forceps used based on how far the baby's head has descended in the birth canal, including high, mid, low, rotational, and outlet forceps. The indications for a forceps delivery include maternal conditions like exhaustion or fetal distress. Criteria that must be met first include a fully dilated cervix. Complications can be maternal like vaginal lacerations or postpartum hemorrhage, or fetal like bruising, hemorrhage, or asphyxia.
This document provides an overview of preterm labor and abnormal uterine action. It begins by defining preterm labor as labor starting between 24-28 weeks and before 37 weeks of pregnancy. The prevalence of preterm labor is reported to range between 5-10%. Risk factors for preterm labor are then discussed, along with potential maternal and fetal complications. Diagnosis and management of preterm labor focuses on preventing onset, arresting labor if possible, and providing appropriate neonatal care. The document then discusses various types of abnormal uterine action including hypertonic, hypotonic, dyscoordinate, and tonic contractions. Causes, signs, and management are described for each type. Cervical dystocia is also reviewed, distinguishing between primary
This document discusses induction of labour, which is defined as artificially stimulating uterine contractions before the onset of natural labour. It outlines the goals, indications, methods, and nursing responsibilities for labour induction. The main methods discussed are medical induction using prostaglandins or oxytocin, and surgical induction through membrane stripping or artificial rupture of membranes. The nursing responsibilities involve properly administering induction medications and procedures, monitoring the woman and fetus during labour induction, and providing general care and support to the woman and newborn.
Oligohydramnios is defined as a reduction in amniotic fluid volume below 500 ml, and in rare cases there may be a complete absence of fluid known as anhydramnios. It occurs in approximately 1 in 750 pregnancies and can be caused by placental insufficiency, urinary tract malformations in the fetus, or post-term pregnancy. Ultrasound is used to diagnose oligohydramnios and identify any fetal anomalies, growth problems, or the fetal presentation. Complications include pulmonary hypoplasia if the fluid is needed for lung development, abnormal fetal development due to compression, and abnormal fetal presentations. Management depends on if it occurs post-term, in which case
Contracted pelvis, also known as pelvic disproportion, occurs when the essential diameters of the pelvis are shortened, altering the normal mechanism of labor. It can be caused by developmental, metabolic, traumatic or other factors. Pelvises are classified based on degree of contraction and pelvic architecture. Diagnosis involves history, physical exam including internal and external pelvimetry, and sometimes radiological imaging. An internal pelvimetry exam evaluates the inlet, cavity, and outlet to determine pelvic adequacy for vaginal delivery.
This document discusses fetal positioning and presentations during labor and delivery. It begins by defining non-vertex presentations including breech, face, brow, transverse, and compound. It then discusses the causes of non-vertex presentations and describes the different positions including occiput posterior. The document provides details on assessing various positions through abdominal and vaginal exams. It concludes by outlining the management of different non-vertex positions, including allowing natural rotation, augmentation of labor, operative vaginal delivery, or caesarean section if needed.
This document discusses forceps delivery, which is an assisted birth using obstetric forceps to extract the fetal head when the mother is unable to deliver the baby on her own. It describes the different types of forceps used based on how far the baby's head has descended in the birth canal, including high, mid, low, rotational, and outlet forceps. The indications for a forceps delivery include maternal conditions like exhaustion or fetal distress. Criteria that must be met first include a fully dilated cervix. Complications can be maternal like vaginal lacerations or postpartum hemorrhage, or fetal like bruising, hemorrhage, or asphyxia.
This document provides an overview of preterm labor and abnormal uterine action. It begins by defining preterm labor as labor starting between 24-28 weeks and before 37 weeks of pregnancy. The prevalence of preterm labor is reported to range between 5-10%. Risk factors for preterm labor are then discussed, along with potential maternal and fetal complications. Diagnosis and management of preterm labor focuses on preventing onset, arresting labor if possible, and providing appropriate neonatal care. The document then discusses various types of abnormal uterine action including hypertonic, hypotonic, dyscoordinate, and tonic contractions. Causes, signs, and management are described for each type. Cervical dystocia is also reviewed, distinguishing between primary
The first stage of normal labour begins with the onset of true labour pains and ends with full dilatation of the cervix. For primi-gravida women this stage typically takes 12 hours, and for multi-gravida women it takes around 6 hours. Nursing care during this stage includes admission assessment, perineal care, monitoring contractions and vital signs, allowing rest and ambulation as tolerated, and shifting the patient to the delivery table once full dilatation is reached. Evidence shows that practices like ambulation during labour, support from a companion, and restricted vaginal exams and enemas can help make the first stage of labour safer and more comfortable.
BIRTH INJURIES IN NEWBORN: Definition of birth injuries , statistics, etiology, classification of birth injuries , head injuries: cephalhematoma and Caput succedaneum, skull fractures
, nerve injuries: erb's palsy and klumpke's palsy, bone injuries: clavicular and long bone fracture , intra-abdominal and soft tissue injuries, management and prevention of birth injuries
Puerperal infection is an infection of the genital tract that occurs after delivery. It is commonly caused by bacteria like Doderlein bacillus. Risk factors include prolonged rupture of membranes, traumatic delivery, and anemia. Symptoms range from local infection to sepsis. Diagnosis involves examinations, tests, and cultures to identify the site and cause of infection. Treatment involves antibiotics, surgery if needed to drain abscesses, and supportive care. Prevention focuses on clean delivery techniques, prompt repair of lacerations, and prophylactic antibiotics in high risk cases.
A midwife must ensure the baby is adequately fed and help the mother develop breastfeeding skills. They must understand common breast conditions like inverted or flat nipples that can affect feeding, as well as complications like engorgement, cracked nipples, and mastitis that can arise after delivery. Mastitis is an inflammation of the breast that causes fever, pain, and swelling and is usually treated with antibiotics and analgesics while suspending breastfeeding on the affected breast.
A placenta examination is performed after delivery to ensure the entire placenta and membranes have been expelled. It checks that the placenta is of normal size, shape, consistency and weight, and detects any abnormalities. The examination also evaluates the umbilical cord length and number of blood vessels. Key tools used include a bowl, weighing scale, and measuring tape. The placenta develops during pregnancy to support fetal growth and development through respiratory, alimentary, excretory and other vital functions.
The document discusses complications that can occur during the third stage of labour, which include postpartum haemorrhage, retention of placenta, uterine inversion, obstetric shock, and pulmonary embolism. Postpartum haemorrhage is defined as bleeding over 500cc after delivery and can be caused by uterine atony, trauma, retained tissues, or coagulation disorders. Retention of placenta may occur if the placenta is not fully separated or adhered to the uterus. Uterine inversion involves the uterus turning inside out, and can be caused by fundal pressure or a relaxed uterus. Obstetric shock is low blood pressure caused by blood loss, trauma, air embol
This document presents a presentation on minor disorders of newborns and their management. It defines a newborn as an infant from birth to 28 days old. Minor disorders are physical conditions that cause disturbances to normal functioning. The document discusses 12 common minor disorders including oral thrush, ophthalmia neonatorum, omphalitis, neonatal mastitis, nasopharyngitis, excessive crying, abdominal distension, constipation, diarrhea, pain, vomiting, and physiological jaundice. For each disorder, it describes symptoms and provides recommendations for management and treatment. The overall document aims to educate about minor health issues in newborns and appropriate care responses.
This document discusses the relationship between the fetus and the pelvis during childbirth. It describes the lie or orientation of the fetus, the presenting part of the fetus that engages the pelvis, and the position and attitude of the fetal head. The key points are:
- The fetus most commonly lies longitudinally in the uterus with the head engaging the pelvis (cephalic presentation).
- The position describes the location of the presenting part, such as the occiput, in relation to maternal pelvic quadrants.
- The attitude refers to the flexion or extension of fetal parts. Flexion is most common with the head flexed forward onto the chest.
- Moulding, or shifting of fetal
This topic contains definition, instruments, indications, contraindications, prerequisites, advantages, procedure, complications and hazards of ventouse or vaccum delivery.
This presentation contain:
Normal neonate;
Physiological adaptation;
Initial & Daily assessment
Essential newborn care; Thermal control,
Breast feeding, presentation of infections
Immunization
Minor disorders of newborn and its management
Levels of neonatal care (level I, II, & III)
At primary, secondary and tertiary levels
Maintenance of Reports and Records
1. The document discusses various injuries that can occur to the birth canal during childbirth, including classifications, causes, symptoms, diagnosis, and management.
2. Injuries include perineal tears, cervical and vaginal lacerations, hematomas, and complete uterine rupture. Causes may include obstructed labor, instrumentation, or congenital factors.
3. Diagnosis involves investigations like ultrasound and symptoms like pain, bleeding, and shock. Management depends on the type of injury but may include suturing lacerations, draining hematomas, or laparotomy for severe injuries like uterine rupture.
This document discusses placental and umbilical cord abnormalities. It begins by describing normal placental anatomy and development. It then covers various types of placental anomalies including abnormalities of form, position, relationships to cord/membranes, and diseases. Umbilical cord abnormalities such as short/long length, knots, torsion, and single umbilical artery are also reviewed. In summary, the document provides an overview of common placental and umbilical cord abnormalities for Mrs. Savita presented by Nikita Sharma.
The document discusses the female pelvis and contracted pelvis. It defines an anatomically contracted pelvis and discusses factors that can influence pelvis size and shape such as development, nutrition, trauma, and diseases. Common causes of contracted pelvis include nutritional deficiencies, diseases or injuries of pelvic bones, and certain developmental defects. A contracted pelvis can affect pregnancy and labor by increasing risks of malpresentations, prolonged labor, obstructed labor, and maternal and fetal complications. Management depends on the degree of disproportion and may include a trial of vaginal delivery or cesarean section.
Labour is the process by which the fetus and placenta are expelled from the uterus through the birth canal. It involves involuntary uterine contractions that cause effacement and dilation of the cervix, allowing the fetus to descend and be delivered. Normal labour has three stages - the first stage involves cervical dilation, the second stage is expulsion of the fetus, and the third stage is expulsion of the placenta. Multiple factors influence the progress of labour, including the size and position of the fetus, strength of uterine contractions, and psychological state of the mother.
Definition-
The destructive operations are designed to diminish the bulk of the fetus so as to facilitate easy delivery through the birth canal
types
Craniotomy
Eviceration
Decapitation
Cleidotomy
CRANIOTOMY
Definition
It is an operation to make a perforation on the fetal head to evacuate the contents followed by extraction of the fetus
DECAPITATION
Definition
It is a destructive operation whereby the fetal head is severed from the trunk and the delivery is completed with the extraction of the trunk and that of the decapitated head per vaginam
CLEIDOTOMY
Definition
The operation consist of reduction in the bulk of the shoulder girdle by division of one or both the clavicles
Indications
Dead fetus with shoulder dystocia
Procedure
The clavicles are divided by the embryotomy scissors or long straight scissors introduced under the guidance of left two fingers placed inside the vagina
VACUUM DELIVERY - OBSTETRICS AND GYNAECOLOGY-
DEALS WITH THE DELIVERY OF HUMAN BABY BY VACUUM IN SPECIAL OBSTETRIC CONDITIONS.
VACUUM is an instrumental device designed to assist delivery by creating a vacuum between it and the fetal scalp.
This document discusses common minor disorders that can occur during pregnancy and their management. It covers disorders of the digestive system like nausea, constipation, and heartburn. Musculoskeletal issues like backache, leg cramps, and round ligament pain are also addressed. Circulatory changes such as varicose veins, hemorrhoids, and ankle edema are described. The document provides treatment recommendations for each condition and identifies disorders that require immediate medical attention, such as vaginal bleeding or reduced fetal movement.
Cephalopelvic disproportion (CPD) is a pregnancy complication that may interferes with vaginal delivery; making it dangerous or impossible and requires caeserean section.
Cephalopelvic disproportion (CPD) occurs when the baby's head is too large to pass through the mother's pelvis during birth. It can be caused by a large baby, abnormal fetal positioning, a contracted pelvis, or an abnormally shaped pelvis. A contracted pelvis has one or more diameters reduced below normal size. Complications of CPD include prolonged labor, obstructed labor, ruptured uterus, and fetal injuries like skull fracture or brain damage. Management depends on the degree of disproportion and may include a trial of vaginal delivery or cesarean section.
The first stage of normal labour begins with the onset of true labour pains and ends with full dilatation of the cervix. For primi-gravida women this stage typically takes 12 hours, and for multi-gravida women it takes around 6 hours. Nursing care during this stage includes admission assessment, perineal care, monitoring contractions and vital signs, allowing rest and ambulation as tolerated, and shifting the patient to the delivery table once full dilatation is reached. Evidence shows that practices like ambulation during labour, support from a companion, and restricted vaginal exams and enemas can help make the first stage of labour safer and more comfortable.
BIRTH INJURIES IN NEWBORN: Definition of birth injuries , statistics, etiology, classification of birth injuries , head injuries: cephalhematoma and Caput succedaneum, skull fractures
, nerve injuries: erb's palsy and klumpke's palsy, bone injuries: clavicular and long bone fracture , intra-abdominal and soft tissue injuries, management and prevention of birth injuries
Puerperal infection is an infection of the genital tract that occurs after delivery. It is commonly caused by bacteria like Doderlein bacillus. Risk factors include prolonged rupture of membranes, traumatic delivery, and anemia. Symptoms range from local infection to sepsis. Diagnosis involves examinations, tests, and cultures to identify the site and cause of infection. Treatment involves antibiotics, surgery if needed to drain abscesses, and supportive care. Prevention focuses on clean delivery techniques, prompt repair of lacerations, and prophylactic antibiotics in high risk cases.
A midwife must ensure the baby is adequately fed and help the mother develop breastfeeding skills. They must understand common breast conditions like inverted or flat nipples that can affect feeding, as well as complications like engorgement, cracked nipples, and mastitis that can arise after delivery. Mastitis is an inflammation of the breast that causes fever, pain, and swelling and is usually treated with antibiotics and analgesics while suspending breastfeeding on the affected breast.
A placenta examination is performed after delivery to ensure the entire placenta and membranes have been expelled. It checks that the placenta is of normal size, shape, consistency and weight, and detects any abnormalities. The examination also evaluates the umbilical cord length and number of blood vessels. Key tools used include a bowl, weighing scale, and measuring tape. The placenta develops during pregnancy to support fetal growth and development through respiratory, alimentary, excretory and other vital functions.
The document discusses complications that can occur during the third stage of labour, which include postpartum haemorrhage, retention of placenta, uterine inversion, obstetric shock, and pulmonary embolism. Postpartum haemorrhage is defined as bleeding over 500cc after delivery and can be caused by uterine atony, trauma, retained tissues, or coagulation disorders. Retention of placenta may occur if the placenta is not fully separated or adhered to the uterus. Uterine inversion involves the uterus turning inside out, and can be caused by fundal pressure or a relaxed uterus. Obstetric shock is low blood pressure caused by blood loss, trauma, air embol
This document presents a presentation on minor disorders of newborns and their management. It defines a newborn as an infant from birth to 28 days old. Minor disorders are physical conditions that cause disturbances to normal functioning. The document discusses 12 common minor disorders including oral thrush, ophthalmia neonatorum, omphalitis, neonatal mastitis, nasopharyngitis, excessive crying, abdominal distension, constipation, diarrhea, pain, vomiting, and physiological jaundice. For each disorder, it describes symptoms and provides recommendations for management and treatment. The overall document aims to educate about minor health issues in newborns and appropriate care responses.
This document discusses the relationship between the fetus and the pelvis during childbirth. It describes the lie or orientation of the fetus, the presenting part of the fetus that engages the pelvis, and the position and attitude of the fetal head. The key points are:
- The fetus most commonly lies longitudinally in the uterus with the head engaging the pelvis (cephalic presentation).
- The position describes the location of the presenting part, such as the occiput, in relation to maternal pelvic quadrants.
- The attitude refers to the flexion or extension of fetal parts. Flexion is most common with the head flexed forward onto the chest.
- Moulding, or shifting of fetal
This topic contains definition, instruments, indications, contraindications, prerequisites, advantages, procedure, complications and hazards of ventouse or vaccum delivery.
This presentation contain:
Normal neonate;
Physiological adaptation;
Initial & Daily assessment
Essential newborn care; Thermal control,
Breast feeding, presentation of infections
Immunization
Minor disorders of newborn and its management
Levels of neonatal care (level I, II, & III)
At primary, secondary and tertiary levels
Maintenance of Reports and Records
1. The document discusses various injuries that can occur to the birth canal during childbirth, including classifications, causes, symptoms, diagnosis, and management.
2. Injuries include perineal tears, cervical and vaginal lacerations, hematomas, and complete uterine rupture. Causes may include obstructed labor, instrumentation, or congenital factors.
3. Diagnosis involves investigations like ultrasound and symptoms like pain, bleeding, and shock. Management depends on the type of injury but may include suturing lacerations, draining hematomas, or laparotomy for severe injuries like uterine rupture.
This document discusses placental and umbilical cord abnormalities. It begins by describing normal placental anatomy and development. It then covers various types of placental anomalies including abnormalities of form, position, relationships to cord/membranes, and diseases. Umbilical cord abnormalities such as short/long length, knots, torsion, and single umbilical artery are also reviewed. In summary, the document provides an overview of common placental and umbilical cord abnormalities for Mrs. Savita presented by Nikita Sharma.
The document discusses the female pelvis and contracted pelvis. It defines an anatomically contracted pelvis and discusses factors that can influence pelvis size and shape such as development, nutrition, trauma, and diseases. Common causes of contracted pelvis include nutritional deficiencies, diseases or injuries of pelvic bones, and certain developmental defects. A contracted pelvis can affect pregnancy and labor by increasing risks of malpresentations, prolonged labor, obstructed labor, and maternal and fetal complications. Management depends on the degree of disproportion and may include a trial of vaginal delivery or cesarean section.
Labour is the process by which the fetus and placenta are expelled from the uterus through the birth canal. It involves involuntary uterine contractions that cause effacement and dilation of the cervix, allowing the fetus to descend and be delivered. Normal labour has three stages - the first stage involves cervical dilation, the second stage is expulsion of the fetus, and the third stage is expulsion of the placenta. Multiple factors influence the progress of labour, including the size and position of the fetus, strength of uterine contractions, and psychological state of the mother.
Definition-
The destructive operations are designed to diminish the bulk of the fetus so as to facilitate easy delivery through the birth canal
types
Craniotomy
Eviceration
Decapitation
Cleidotomy
CRANIOTOMY
Definition
It is an operation to make a perforation on the fetal head to evacuate the contents followed by extraction of the fetus
DECAPITATION
Definition
It is a destructive operation whereby the fetal head is severed from the trunk and the delivery is completed with the extraction of the trunk and that of the decapitated head per vaginam
CLEIDOTOMY
Definition
The operation consist of reduction in the bulk of the shoulder girdle by division of one or both the clavicles
Indications
Dead fetus with shoulder dystocia
Procedure
The clavicles are divided by the embryotomy scissors or long straight scissors introduced under the guidance of left two fingers placed inside the vagina
VACUUM DELIVERY - OBSTETRICS AND GYNAECOLOGY-
DEALS WITH THE DELIVERY OF HUMAN BABY BY VACUUM IN SPECIAL OBSTETRIC CONDITIONS.
VACUUM is an instrumental device designed to assist delivery by creating a vacuum between it and the fetal scalp.
This document discusses common minor disorders that can occur during pregnancy and their management. It covers disorders of the digestive system like nausea, constipation, and heartburn. Musculoskeletal issues like backache, leg cramps, and round ligament pain are also addressed. Circulatory changes such as varicose veins, hemorrhoids, and ankle edema are described. The document provides treatment recommendations for each condition and identifies disorders that require immediate medical attention, such as vaginal bleeding or reduced fetal movement.
Cephalopelvic disproportion (CPD) is a pregnancy complication that may interferes with vaginal delivery; making it dangerous or impossible and requires caeserean section.
Cephalopelvic disproportion (CPD) occurs when the baby's head is too large to pass through the mother's pelvis during birth. It can be caused by a large baby, abnormal fetal positioning, a contracted pelvis, or an abnormally shaped pelvis. A contracted pelvis has one or more diameters reduced below normal size. Complications of CPD include prolonged labor, obstructed labor, ruptured uterus, and fetal injuries like skull fracture or brain damage. Management depends on the degree of disproportion and may include a trial of vaginal delivery or cesarean section.
This document discusses cephalopelvic disproportion (CPD) which occurs when the baby's head is too large to pass through the mother's pelvis during birth. CPD can be caused by a large baby, an abnormal fetal position, a contracted pelvis, or an abnormally shaped pelvis. A contracted pelvis has one or more diameters that are smaller than normal. Causes include developmental factors, malnutrition, trauma, infections, or tumors. Evaluation involves history, examination, pelvimetry (internal and external measurement of the pelvis), and cephalometry (measurement of the baby's head). Management depends on the degree of disproportion and may include a trial of labor, caesarean section, or
Prolonged labour – cpd, fetal malposition andArsenic Halcyon
1) Prolonged labor is defined as labor exceeding 18 hours for the first and second stages combined. It can be caused by cephalopelvic disproportion (CPD) where the fetal head is too large for the maternal pelvis.
2) CPD can be absolute due to a permanently contracted pelvis or relative due to fetal malpositions or malpresentations. Management depends on the degree of disproportion and may include a trial of labor or cesarean section.
3) Careful monitoring during labor is important when there is suspected CPD to detect complications early and intervene if needed to deliver the baby safely.
1) Cephalo-pelvic disproportion (CPD) occurs when the fetal head is too large to fit through the mother's pelvis, while a contracted pelvis has diameters smaller than normal.
2) Causes of contracted pelvis include nutritional deficiencies, injuries, diseases, and developmental defects. Contracted pelvises are classified based on architecture (e.g. flat) and degree of contraction.
3) Diagnosis involves history, examination, and pelvimetry. Management depends on degree of disproportion, and may include induction, trial of labor, or cesarean section. Complications can arise from prolonged labor. Close monitoring is needed during labor for those with CPD or contracted pel
This document discusses cephalopelvic disproportion (CPD) and contracted pelvis. It defines each condition and describes the causes, classifications, diagnosis and management. CPD occurs when the fetal head is too large to fit through the mother's pelvis. Contracted pelvis occurs when one or more pelvic diameters is reduced by at least 1 cm below normal. Causes include nutritional deficiencies, injuries, or developmental defects. Contracted pelvises are classified by type of distortion or degree of contraction. Diagnosis involves history, exam, and pelvimetry. Management depends on severity, and may include trial of labor, induction, or cesarean section. Complications of CPD can be fetal distress,
This document provides information on contracted pelvis, including its definition, causes, diagnosis, and management. A contracted pelvis is one where one or more pelvic diameters is reduced below normal. Causes can be developmental, metabolic like rickets, or due to trauma or tumors. Diagnosis involves history, examination, internal and external pelvimetry. Management depends on the degree of disproportion and may include a trial of labor, caesarean section, or symphysiotomy. Different types of contracted pelvis shape labor mechanisms, for example a flat pelvis causes asynclitism and lateral displacement of the head.
The document discusses contracted pelvis, including its definition, causes, diagnosis, and assessment. It defines a contracted pelvis as one where one or more pelvic diameters is reduced below normal. Causes can include developmental factors, malnutrition, diseases like rickets, and trauma. Diagnosis involves history, examination of the pelvis and spine, and pelvimetry to measure pelvic diameters internally and through imaging. Degrees of disproportion and contracted pelvis are classified from minor to severe based on reduction in the true conjugate diameter.
The document discusses the pelvis and cephalopelvic disproportion (CPD). It defines the false pelvis and true pelvis, and lists the normal diameters of the pelvic inlet, cavity, and outlet. It describes a contracted pelvis as having one or more diameters reduced by 1 cm or more below normal. Causes of a contracted pelvis include developmental factors, trauma, infections, tumors, and metabolic bone diseases. Degrees of CPD range from minor to extreme. Management depends on the degree of disproportion and may include a trial of vaginal delivery, cesarean section, or craniotomy. Complications can affect both mother and fetus.
The document discusses the pelvis and cephalopelvic disproportion (CPD). It defines the false pelvis and true pelvis, and lists the normal diameters of the pelvic inlet, cavity, and outlet. It describes a contracted pelvis as having one or more diameters reduced by 1 cm or more below normal. Causes of a contracted pelvis include developmental factors, trauma, infections, tumors, and metabolic bone diseases. Degrees of CPD range from minor to extreme. Management depends on the degree of disproportion and may include a trial of vaginal delivery, cesarean section, or craniotomy. Complications can affect both mother and fetus.
A contracted pelvis is one where the pelvic diameters are reduced below normal limits, potentially interfering with labor. Causes include developmental factors, malnutrition, trauma, and diseases affecting the bones. Diagnosis involves history, examination assessing pelvic and spinal abnormalities, and pelvimetry to measure diameters. In labor, the fetus's head may pass through a contracted pelvis via molding, asynclitic descent, or an altered rotation pattern depending on the type of contraction. Management ranges from a trial of vaginal delivery for minor issues to cesarean section for more severe disproportion.
Anorectal malformations are birth defects where the anus and rectum do not develop properly. They occur in about 1 in 4,000 live births. The document discusses the various types of anorectal malformations including rectoperineal fistula, rectourethral fistula, and imperforate anus without fistula. It covers the embryology, classification systems, clinical features, investigations, and surgical management protocols for repairing defects in both male and female newborns. The posterior sagittal anorectoplasty technique is emphasized as the standard approach for repair.
Contracted pelvis, or cephalopelvic disproportion (CPD), occurs when the baby's head is too large to pass through the mother's pelvis during birth. CPD can be caused by a large baby, a small pelvis, or abnormal fetal positioning. A contracted pelvis may result from developmental factors, malnutrition, trauma, or diseases affecting bone development like rickets. Complications of CPD include prolonged labor, obstructed labor, rupture of the uterus, maternal and fetal injury, and increased risk of c-section. Management depends on the degree of disproportion, with c-section recommended for severe or extreme disproportion.
1. Anorectal malformations are congenital anomalies of the anus and rectum that occur in approximately 1 in 5,000 live births.
2. The document describes various classifications of anorectal malformations and discusses the embryological development of the condition.
3. Key surgical procedures for repair of anorectal malformations are described, including colostomy, posterior sagittal anorectoplasty, and pull-through operations. The repair approaches are discussed depending on the specific type of malformation.
This document discusses contracted pelvis (CPD), also known as cephalopelvic disproportion (CPD), which refers to a mismatch between the fetal head size and the mother's pelvis. It defines CPD, describes the causes and classifications. It outlines the diagnostic process including history, examination and pelvimetry. Management options are discussed including trial of labor, induction, cesarean section. Complications of CPD like shoulder dystocia are also summarized. Finally, it provides an abstract of a journal article on using fetal pelvic index to predict CPD.
1. Anorectal malformations occur due to abnormal development of the cloaca during early embryonic development.
2. Imperforate anus is when the anus is either absent or abnormally located and is often associated with anomalies of the sacrum, genitourinary tract, and other systems.
3. Classification and treatment of imperforate anus depends on the specific type of defect and presence of any associated abnormalities.
Abnormal labour process and management for nursing studentsbrownmunde108
This document discusses abnormal labor including cephalo pelvic disproportion (CPD) and contracted pelvis. It defines CPD as a disparity between the fetal head size and the mother's pelvis size. CPD is assessed using the Muller-Kerr method where the head is pushed into the pelvis and overlapping is observed. Contracted pelvis refers to a pelvis with reduced diameters and is classified based on type and degree of contraction. Management of CPD and contracted pelvis may include trial of labor, induction, or cesarean section depending on the severity. Complications of abnormal labor can arise during each stage of labor.
Hypospadias is a birth defect where the opening of the urethra is on the underside of the penis instead of at the tip. It occurs in around 4 in 1,000 male births. The cause is unknown but may involve deficient androgen stimulation during penis development in the womb. Treatment involves surgery to reposition the urethral opening, with the ideal age being 6-12 months. Surgical techniques vary depending on the location and severity of the hypospadias.
This document provides information on hysterosalpingography (HSG) procedures, including equipment used, indications, contraindications, timing, normal findings, and various abnormal findings. It lists conditions that can be evaluated with HSG such as infertility, congenital uterine anomalies, recurrent miscarriage, abnormal bleeding, and uterine masses. Potential risks including pain, bleeding, infection, and allergic reaction are noted. Images demonstrate normal uterine anatomy and various uterine anomalies detectable on HSG.
CPR combines chest compressions and rescue breathing to manually circulate blood to vital organs until emergency medical services arrive. It is used when someone is unresponsive and not breathing or if they do not have a pulse. The key steps of CPR are RAP (check for responsiveness, activate EMS, and position on back) followed by ABCD (check airway, breathing, circulation, and disability). Chest compressions should be performed at a rate of 30 compressions to 2 breaths until help arrives or the victim recovers. Even with successful CPR, most victims will not survive without additional advanced cardiac life support treatments like defibrillation and drugs.
Simran presented a seminar on uterine fibroids to Professor Bhupinder Kaur. Uterine fibroids are non-cancerous growths that develop from the muscles of the uterus. They are very common, affecting up to 80% of women by age 50. Fibroids can cause heavy bleeding, pain, and fertility problems. Diagnosis involves ultrasound or MRI. Treatment options include medication, surgery to remove fibroids (myomectomy), or complete hysterectomy. Nursing care focuses on managing pain and bleeding pre-and post-operatively, and educating patients.
This document provides information about birth control and family planning methods. It discusses the risks of pregnancy compared to risks of birth control. Various birth control methods are described, including hormonal (pill, injection, implant), barrier (condom, diaphragm), IUD, fertility awareness, and permanent sterilization. Specific methods like the pill, injection, and IUD are explained in more detail regarding how they work, effectiveness rates, side effects, and proper use. Emergency contraception and natural family planning methods are also covered. Quality of care indicators and clients' rights to information and choice are outlined.
This document provides information on various diagnostic tests including a complete blood count, serum electrolytes, liver function tests, lipid profile, blood glucose levels, urine tests, sputum culture, and radiologic procedures. It describes what each test measures, normal ranges, and conditions they can help screen for or diagnose. A complete blood count provides counts and percentages of red blood cells, white blood cells, platelets, and can screen for many disorders. Serum electrolytes commonly measure sodium, potassium, and chloride levels which can be abnormal in cases of fluid imbalance, kidney disease, or other conditions. Liver function tests evaluate liver health through measures of bilirubin and liver enzymes. A lipid profile assesses cholesterol and triglyceride levels
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Versio
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
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
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
2. Contracted Pelvis
Anatomical definition: It is a pelvis in which one or
more of its diameters is reduced below the normal by
one or more centimeters.
Obstetric definition: It is a pelvis in which one or more
of its diameters is reduced so that it interferes with the
normal mechanism of labour.
3. Factors influencing the size and shape of the pelvis
Developmental factor: hereditary or congenital.
Racial factor.
Nutritional factor: malnutrition results in small pelvis.
Sexual factor: as excessive androgen may produce
android pelvis.
Metabolic factor: as rickets and osteomalacia.
Trauma, diseases or tumours of the bony pelvis, legs or
spines. .
4. Diagnosis of Contracted Pelvis
History
Rickets: is expected if there is a history of delayed
walking and dentition.
Trauma or diseases: of the pelvis, spines or lower
limbs.
Bad obstetric history: e.g. prolonged labour ended by;
difficult forceps,
caesarean section or
still birth
5. Examination
Examination
General examination:
Gait: abnormal gait suggesting abnormalities in the
pelvis, spines or lower limbs.
Stature: women with less than 150 cm height usually
have contracted pelvis.
Spines and lower limbs: may have a disease or lesion.
6. Contd..
Manifestations of rickets as:
square head,
rosary beads in the costal ridges.
pigeon chest,
Harrison’s sulcus and bow legs.
7. Contd..
Dystocia dystrophia syndrome: the woman is
short,
stocky,
subfertile,
has android pelvis and
masculine hair distribution,
with history of delayed menarche.
This woman is more exposed to occipito-posterior
position and dystocia.
8. Contd..
Abdominal examination:
Nonengagement of the head: in the last 3-4 weeks in
primigravida.
Pendulous abdomen: in a primigravida.
Malpresentations: are more common
9.
10. Pelvimetry
It is assessment of the pelvic diameters and capacity done
at 38-39 weeks. It includes:
Clinical pelvimetry:
Internal pelvimetry for:
inlet,
cavity, and
outlet.
External pelvimetry for:
inlet and
outlet.
11.
12. Contd..
Imaging pelvimetry:
X-ray.
Computerised tomography (CT).
Magnetic resonance imaging (MRI) .
N.B. CT and MRI are recent and accurate but expensive
and not always available so they are not in common
13.
Data Finding
Forepelvis (pelvic brim)
Diagonal conjugate
Symphysis
Sacrum
Side walls
Ischial spines
Interspinous diameter
Sacrosciatic notch
Subpubic angle
Bituberous diameter
Coccyx
Anterposterior diameter of
outlet
Round.
11.5 cm.
Average thickness, parallel to
sacrum.
Hollow, average inclination.
Straight.
Blunt.
10.0 cm.
2.5 -3 finger - breadths.
2finger - breadths.
4 knuckles (> 8.0 cm).
Mobile.
11.0 cm.
14. Cephalopelvic disproportion tests
These are done to detect contracted inlet if the head is
not engaged in the last 3-4 weeks in a primigravida.
(1) Pinard’s method:
The patient evacuates her bladder and rectum.
The patient is placed in semi-sitting position to bring
the foetal axis perpendicular to the brim.
The left hand pushes the head downwards and
backwards into the pelvis while the fingers of the right
hand are put on the symphysis to detect disproportion.
15. Contd..
(2) Muller - Kerr’s method:
It is more valuable in detection of the degree of
disproportion.
The patient evacuates her bladder and rectum.
The patient is placed in the dorsal position.
The left hand pushes the head into the pelvis and
vaginal examination is done by the right hand while its
thumb is placed over the symphysis to detect
disproportion.
16. Degrees of Disproportion
Minor disproportion:
The anterior surface of the head is in line with the posterior
surface of the symphysis. During labour the head is engaged
due to moulding and vaginal delivery can be achieved.
Moderate disproportion (1st degree disproportion):
The anterior surface of the head is in line with the anterior
surface of the symphysis. Vaginal delivery may or may not
occur.
Marked disproportion (2nd degree disproportion):
The head overrides the anterior surface of the symphysis.
Vaginal delivery cannot occur.
17. Degrees of Contracted Pelvis
Minor degree: The true conjugate is 9-10 cm. It
corresponds to minor disproportion.
Moderate degree: The true conjugate is 8-9 cm. It
corresponds to moderate disproportion.
18. Contd…
Severe degree: The true conjugate is 6-8 cm. It
corresponds to marked disproportion.
Extreme degree: The true conjugate is less than 6 cm.
Vaginal delivery is impossible even after craniotomy as
the bimastoid diameter (7.5 cm) is not crushed
19. Management of Contracted Pelvis
It depends mainly on the degree of disproportion.
Minor disproportion (minor degree of contracted
pelvis): vaginal delivery.
Moderate disproportion (moderate degree of
contracted pelvis): trial labour, if failed ® caesarean
section.
Marked disproportion (severe or extreme degree of
contracted pelvis): caesarean section.
20. Contd..
Trial of Labour
It is a clinical test for the factors that cannot be
determined before start of labour as:
Efficiency of uterine contractions.
Moulding of the head.
Yielding of the pelvis and soft tissues.
21. Procedure:
Trial is carried out in a hospital where facilities for C.S is
available.
Adequate analgesia.
Nothing by mouth.
Avoid premature rupture of membranes by:
rest in bed,
avoid high enema,
minimise vaginal examinations.
The patient is left for 2 hours in the 2nd stage with good
uterine contractions under close supervision to the mother
and foetus.
22. Suitable cases for trial of labour:
Young primigravida of good health.
Moderate disproportion.
Vertex presentation.
No outlet contractions.
Average sized baby.
Termination of trial of labour:
Vaginal delivery:
either spontaneously or by forceps if the head is engaged.
Caesarean section if:
failed trial of labour i.e. the head did not engage or
complications occur during trial as foetal distress or
prolapsed pulsating cord before full cervical dilatation.
23. Indications of caesarean section in contracted
pelvis
Moderate disproportion if trial of labour is
contraindicated or failed.
Marked disproportion.
Extreme disproportion whether the foetus is living or
dead.
Contracted outlet.
Contracted pelvis with other indications as;
elderly primigravida,
malpresentations, or
placenta praevia.
24. Complications of Contracted Pelvis
Maternal:
During pregnancy:
Incarcerated retroverted gravid uterus.
Malpresentations.
Pendulous abdomen.
Nonengagement.
Pyelonephritis especially in high assimilation pelvis due to
more compression of the ureter.
25. Contd..
During labour:
Inertia, slow cervical dilatation and prolonged labour.
Premature rupture of membranes and cord prolapse.
Obstructed labour and rupture uterus.
Necrotic genito-urinary fistula.
Injury to pelvic joints or nerves from difficult forceps delivery.
Postpartum haemorrhage.
Foetal:
Intracranial haemorrhage.
Asphyxia.
Fracture skull.
Nerve injuries.
Intra-amniotic infection.