This document discusses uterine fibroids and adenomyosis. Uterine fibroids are benign tumors of the myometrium that are common in women of reproductive age. They are responsive to hormones and often cause symptoms like menorrhagia, pain, and infertility. Adenomyosis is a condition where endometrial tissue is present in the myometrium, causing symptoms like menorrhagia and dysmenorrhea. Both conditions are evaluated using ultrasound, CT, and MRI. Ultrasound can detect fibroids and features suggestive of adenomyosis. MRI is best for diagnosing and characterizing adenomyosis by detecting thickening of the junctional zone. Treatment involves managing symptoms, while complications may include
hysteroscopy is a procedure with a very rare incidence of major side effects . a thorough knowledge of how to tackle them is must for anyone practicing hysteroscopy......
DEBATE - SHORT CERVIX - OS TIGHTNING BY DR SHASHWAT JANIDR SHASHWAT JANI
This document discusses cervical cerclage, a surgical procedure used to treat and prevent preterm birth. It provides guidelines on when cervical cerclage is indicated based on history of prior preterm births or short cervical length on ultrasound. Major professional organizations like ACOG, RCOG, and SOGC recommend offering cervical cerclage to women with a history of late second trimester losses or prior preterm births before 34 weeks who currently have a short cervix. Cerclage placement can reduce the risks of preterm birth, low birthweight, and perinatal mortality.
1. Tubal anastomosis or IVF-ET must be considered based on factors like age, tubal damage extent, cost, and patient preference.
2. IVF-ET has a higher per-cycle success rate while tubal anastomosis has a higher cumulative success rate and may be more cost-effective.
3. Both have risks and neither is clearly superior, so options should be discussed individually to help couples feel they explored all options.
This document discusses infection as a cause of preterm birth (PTB). It notes that local or systemic infection is a major cause, especially of early PTB between 26-34 weeks of gestation. Screening and treatment of infection-related conditions like bacterial vaginosis (BV) in early pregnancy may help prevent PTB. While some antibiotic studies show a reduction in PTB, results are conflicting. Overall, antibiotics should be considered for women found to have abnormal vaginal microflora early in pregnancy, targeting organisms associated with PTB such as those causing BV. Treatment choice and timing may depend on individual factors.
The document discusses guidelines for induction of labor including:
1) Common reasons for induction of labor and risks/benefits that should be discussed with patients. Patients should be informed of alternative options if they decline induction.
2) What to discuss at the 38 week visit including membrane sweeps and the timing of induction between 41-42 weeks or for other reasons like preterm rupture of membranes.
3) Methods of induction including membrane sweeps, pharmacological agents like prostaglandins, amniotomy, and Foley catheter placement. Risks of induction like uterine hyperstimulation and failed induction are also addressed.
Adherent placenta occurs when there is a defect in the decidua basalis, Resulting in an abnormal invasion of the placenta directly into the substance of the uterus
This document provides guidance on managing eclampsia, an obstetric emergency characterized by seizures in pregnancy. It outlines the immediate steps to take, including stabilizing the airway, breathing and circulation. It recommends administering magnesium sulfate to control seizures, with loading and maintenance dosing protocols. It also provides guidance on controlling blood pressure with antihypertensive drugs like labetolol and nifedipine. The subsequent management involves ongoing monitoring, preventing further seizures and making decisions about delivery. The overall message is that eclampsia requires rapid response and skilled management to prevent complications for both mother and baby.
This document discusses uterine fibroids and adenomyosis. Uterine fibroids are benign tumors of the myometrium that are common in women of reproductive age. They are responsive to hormones and often cause symptoms like menorrhagia, pain, and infertility. Adenomyosis is a condition where endometrial tissue is present in the myometrium, causing symptoms like menorrhagia and dysmenorrhea. Both conditions are evaluated using ultrasound, CT, and MRI. Ultrasound can detect fibroids and features suggestive of adenomyosis. MRI is best for diagnosing and characterizing adenomyosis by detecting thickening of the junctional zone. Treatment involves managing symptoms, while complications may include
hysteroscopy is a procedure with a very rare incidence of major side effects . a thorough knowledge of how to tackle them is must for anyone practicing hysteroscopy......
DEBATE - SHORT CERVIX - OS TIGHTNING BY DR SHASHWAT JANIDR SHASHWAT JANI
This document discusses cervical cerclage, a surgical procedure used to treat and prevent preterm birth. It provides guidelines on when cervical cerclage is indicated based on history of prior preterm births or short cervical length on ultrasound. Major professional organizations like ACOG, RCOG, and SOGC recommend offering cervical cerclage to women with a history of late second trimester losses or prior preterm births before 34 weeks who currently have a short cervix. Cerclage placement can reduce the risks of preterm birth, low birthweight, and perinatal mortality.
1. Tubal anastomosis or IVF-ET must be considered based on factors like age, tubal damage extent, cost, and patient preference.
2. IVF-ET has a higher per-cycle success rate while tubal anastomosis has a higher cumulative success rate and may be more cost-effective.
3. Both have risks and neither is clearly superior, so options should be discussed individually to help couples feel they explored all options.
This document discusses infection as a cause of preterm birth (PTB). It notes that local or systemic infection is a major cause, especially of early PTB between 26-34 weeks of gestation. Screening and treatment of infection-related conditions like bacterial vaginosis (BV) in early pregnancy may help prevent PTB. While some antibiotic studies show a reduction in PTB, results are conflicting. Overall, antibiotics should be considered for women found to have abnormal vaginal microflora early in pregnancy, targeting organisms associated with PTB such as those causing BV. Treatment choice and timing may depend on individual factors.
The document discusses guidelines for induction of labor including:
1) Common reasons for induction of labor and risks/benefits that should be discussed with patients. Patients should be informed of alternative options if they decline induction.
2) What to discuss at the 38 week visit including membrane sweeps and the timing of induction between 41-42 weeks or for other reasons like preterm rupture of membranes.
3) Methods of induction including membrane sweeps, pharmacological agents like prostaglandins, amniotomy, and Foley catheter placement. Risks of induction like uterine hyperstimulation and failed induction are also addressed.
Adherent placenta occurs when there is a defect in the decidua basalis, Resulting in an abnormal invasion of the placenta directly into the substance of the uterus
This document provides guidance on managing eclampsia, an obstetric emergency characterized by seizures in pregnancy. It outlines the immediate steps to take, including stabilizing the airway, breathing and circulation. It recommends administering magnesium sulfate to control seizures, with loading and maintenance dosing protocols. It also provides guidance on controlling blood pressure with antihypertensive drugs like labetolol and nifedipine. The subsequent management involves ongoing monitoring, preventing further seizures and making decisions about delivery. The overall message is that eclampsia requires rapid response and skilled management to prevent complications for both mother and baby.
The document discusses various challenges in diagnosing premature rupture of membranes (PROM). Current diagnostic methods like nitrazine tests, ferning tests, ultrasound and amniotic dye infusion are inaccurate or invasive. There is a need for an easy and accurate diagnostic test to correctly identify PROM and prevent misdiagnoses that can harm both mother and baby. Research into proteins in amniotic fluid showed promise but failed to produce a reliable diagnostic due to variability between patients. The problems of inaccurate or difficult testing for PROM remain unresolved.
This document discusses obstetric anal sphincter injuries (OASIS), including its prevalence, risk factors, prevention strategies, and consequences of missed diagnoses. OASIS occurs in 0.5-2.5% of vaginal deliveries and can lead to fecal incontinence and long-term pelvic floor issues. Risk factors include midline episiotomy, prolonged second stage of labor, forceps delivery, and nulliparity. Prevention strategies focus on modifiable factors like restrictive episiotomy, perineal protection, warm compresses, and positions during delivery. Proper diagnosis and repair are also important to reduce short and long-term morbidity. Training and documentation are crucial to prevent missed
Baloon tamponade in management of postpartum haemorrhageAboubakr Elnashar
Uterine balloon tamponade is an effective treatment for postpartum haemorrhage when standard medical treatments have failed. Various balloon devices can be inserted into the uterine cavity and inflated to exert pressure and stop bleeding. Balloons are made of materials like condoms, Foley catheters, or purpose-built devices. When inflated, they work by applying pressure against the uterine walls to compress blood vessels and control bleeding. Balloon tamponade is a minimally invasive option that can prevent the need for hysterectomy in many cases by controlling bleeding without surgery.
This document defines vaginismus and discusses its diagnosis and treatment. It begins by defining vaginismus and tracing the evolution of its definition. It notes that vaginismus is characterized by involuntary contraction of pelvic floor muscles that interfere with penetration. The document discusses prevalence, types, potential causes, diagnosis through history and examination, and classification. It outlines treatment approaches including exploration of underlying phobias or beliefs, sex education, muscle relaxation exercises, and systematic vaginal desensitization using graduated insertion of trainers under controlled relaxation. The goal of treatment is to help women gain control of pelvic floor muscles and replace pain with pleasure through a multidisciplinary approach.
An episiotomy is a surgically planned incision made in the perineum and posterior vaginal wall during the second stage of labor to prevent severe tearing and assist with delivery when needed. There are different types of episiotomies including median, mediolateral, and lateral incisions, with mediolateral being the most commonly performed. Potential complications of episiotomies include rectal involvement, bleeding, infection, wound disruption, pain during sex, and scar issues.
The document discusses several causes of late pregnancy bleeding including placenta previa, abruptio placentae, and retained placenta. Placenta previa occurs when the placenta implants in the lower uterine segment, potentially causing painless bleeding. Abruptio placentae involves premature separation of a normally implanted placenta, which can lead to abdominal pain and concealed bleeding. Retained placenta after delivery requires manual removal or potential transfusion and shock management if heavy bleeding occurs.
ESHRE Guideline on Recurrent Pregnancy Loss (RPL)Sujoy Dasgupta
Dr Sujoy Dasgupta invited to deliver a lecture on "RPL- ESHRE Guideline" in the Annual Conference of RCOG (Royal College of Obstetricians and Gynaecologists) IRC (International Representative Committee) India East held on 20-21 May, 2023
MANAGEMENT OF COMPLICATIONS OF HYSTEROSCOPY BY DR SHASHWAT JANIDR SHASHWAT JANI
This document provides information from Dr. Shashwat Jani regarding hysteroscopic procedures. It discusses complications rates from studies that found rates between 0.13-2% for diagnostic and 0.95-4.5% for operative hysteroscopies. Major complications like perforation and hemorrhage occur in less than 1% of cases. The document outlines risks from patient positioning like nerve injuries and describes entry-related risks such as cervical laceration and perforation. It provides guidance on managing complications like uterine perforation.
Management of Suboptimally dated pregnancy. Aboubakr Elnashar Aboubakr Elnashar
This document provides recommendations for managing pregnancies where the estimated due date is uncertain due to a lack of early ultrasound examination. It recommends that:
1. The timing of any indicated delivery should be based on the best clinical estimate of gestational age, balancing maternal and newborn risks.
2. Elective deliveries are not recommended without risks sufficient to warrant delivery, to avoid unnecessary neonatal morbidity if the pregnancy is earlier than estimated.
3. Antenatal corticosteroids and fetal surveillance may be considered based on best gestational age estimate, but amniocentesis is not recommended routinely for decision making.
This document discusses intrahepatic cholestasis of pregnancy (IHCP), a cholestatic disorder characterized by pruritus in the second or third trimester, elevated liver enzymes and bile acids, and relief of symptoms after delivery. IHCP has genetic and hormonal risk factors and can cause adverse pregnancy outcomes like preterm birth and stillbirth. Treatment involves ursodeoxycholic acid and early induction of labor between 37-38 weeks to prevent complications. Monitoring of liver enzymes is important until 10 days postpartum.
This document summarizes a presentation given by Dr. Rajni Singh on vaginal hysterectomy techniques. Key points include:
- Vaginal hysterectomy is the safest and most cost-effective surgical route for conditions like fibroids and abnormal bleeding, with less complications and faster recovery compared to abdominal hysterectomy.
- Evaluation of pelvic support and anatomy is important prior to the surgery.
- Techniques like bladder dissection, use of curved scissors and hemostatic systems like Ligasure can aid in performing a bloodless procedure.
- Post-operative care includes catheter removal after 12 hours and discharge usually within 24-36 hours. Potential complications include vault hematoma, infections and urinary tract injuries
Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide, accounting for 34% of deaths in developing countries. PPH is defined as blood loss of 500ml or more following a vaginal birth or 1000ml or more following a caesarean section. Early identification of at-risk patients and active management of the third stage of labour can help prevent PPH. Diagnosis involves communication, resuscitation with fluids and blood products, monitoring, and investigating the cause of bleeding. Treatment focuses on bimanual compression, uterotonic drugs, surgical haemostasis procedures if conservative measures fail, and consideration of recombinant factor VII.
Colposcopy nstrumentation and principles on how to do 22Tariq Mohammed
This document discusses the principles and procedures of colposcopy examinations. It begins by defining a colposcope and its main uses. The most common reason for referral is abnormal cervical screening tests indicating possible precancerous lesions. During the exam, the cervix is examined under magnification with saline, acetic acid, and Lugol's iodine to identify any abnormal white lesions that could indicate precancer or cancer. The document outlines the proper colposcopy instrumentation, examination steps including the principles behind using acetic acid and Lugol's iodine, how to interpret the results, and the importance of thoroughly documenting findings.
This document discusses the history and uses of electro surgery in gynecology. It begins with the early history of heat therapy and progresses to modern developments. Key points covered include the basics of electricity used, types of currents and waveforms, effects on tissue, and specific applications in gynecology like treating cervical lesions, tubal sterilization, endometriosis, and fibroids. Proper use and safety precautions are also emphasized.
This document discusses appendicitis during pregnancy. It covers the epidemiology, anatomical changes, pathophysiology, complications, diagnosis, differential diagnosis, and surgery of appendicitis in pregnant patients. The key points are that appendicitis occurs in about 1 in 1500 pregnancies, symptoms can be more difficult to diagnose due to pregnancy-related changes, ultrasound and CT scan are used for diagnosis but have limitations during late pregnancy, and prompt surgical treatment is indicated to prevent complications of perforation for both the mother and fetus.
This document discusses ureteric injuries that can occur during obstetric and gynecological surgeries and procedures for urinary diversions. It covers the anatomy of the ureters, risk factors for injury, types of injuries, prevention strategies, management approaches, and specific procedures like ileal conduits and continent urinary diversions. Nursing considerations are also outlined for preoperative teaching, postoperative care and monitoring, and potential complications from various urinary diversion surgeries.
PHYSIOLOGY OF LABOUR PAIN AND LABOUR ANALGESIA [Autosaved] [Autosaved].pptxKeerthy Unnikrishnan
This document discusses physiology of labour pain and various analgesia techniques. It describes the components and pathways of visceral and somatic labour pain. Non-pharmacological techniques like water immersion, hypnosis, acupuncture, TENS and Lamaze are summarized. Pharmacological analgesics including opioids like fentanyl, remifentanil and non-opioids like nalbuphine are outlined. Regional analgesia techniques such as epidural analgesia are also mentioned. Newer advances in analgesia including patient controlled analgesia are briefly covered.
The document discusses various challenges in diagnosing premature rupture of membranes (PROM). Current diagnostic methods like nitrazine tests, ferning tests, ultrasound and amniotic dye infusion are inaccurate or invasive. There is a need for an easy and accurate diagnostic test to correctly identify PROM and prevent misdiagnoses that can harm both mother and baby. Research into proteins in amniotic fluid showed promise but failed to produce a reliable diagnostic due to variability between patients. The problems of inaccurate or difficult testing for PROM remain unresolved.
This document discusses obstetric anal sphincter injuries (OASIS), including its prevalence, risk factors, prevention strategies, and consequences of missed diagnoses. OASIS occurs in 0.5-2.5% of vaginal deliveries and can lead to fecal incontinence and long-term pelvic floor issues. Risk factors include midline episiotomy, prolonged second stage of labor, forceps delivery, and nulliparity. Prevention strategies focus on modifiable factors like restrictive episiotomy, perineal protection, warm compresses, and positions during delivery. Proper diagnosis and repair are also important to reduce short and long-term morbidity. Training and documentation are crucial to prevent missed
Baloon tamponade in management of postpartum haemorrhageAboubakr Elnashar
Uterine balloon tamponade is an effective treatment for postpartum haemorrhage when standard medical treatments have failed. Various balloon devices can be inserted into the uterine cavity and inflated to exert pressure and stop bleeding. Balloons are made of materials like condoms, Foley catheters, or purpose-built devices. When inflated, they work by applying pressure against the uterine walls to compress blood vessels and control bleeding. Balloon tamponade is a minimally invasive option that can prevent the need for hysterectomy in many cases by controlling bleeding without surgery.
This document defines vaginismus and discusses its diagnosis and treatment. It begins by defining vaginismus and tracing the evolution of its definition. It notes that vaginismus is characterized by involuntary contraction of pelvic floor muscles that interfere with penetration. The document discusses prevalence, types, potential causes, diagnosis through history and examination, and classification. It outlines treatment approaches including exploration of underlying phobias or beliefs, sex education, muscle relaxation exercises, and systematic vaginal desensitization using graduated insertion of trainers under controlled relaxation. The goal of treatment is to help women gain control of pelvic floor muscles and replace pain with pleasure through a multidisciplinary approach.
An episiotomy is a surgically planned incision made in the perineum and posterior vaginal wall during the second stage of labor to prevent severe tearing and assist with delivery when needed. There are different types of episiotomies including median, mediolateral, and lateral incisions, with mediolateral being the most commonly performed. Potential complications of episiotomies include rectal involvement, bleeding, infection, wound disruption, pain during sex, and scar issues.
The document discusses several causes of late pregnancy bleeding including placenta previa, abruptio placentae, and retained placenta. Placenta previa occurs when the placenta implants in the lower uterine segment, potentially causing painless bleeding. Abruptio placentae involves premature separation of a normally implanted placenta, which can lead to abdominal pain and concealed bleeding. Retained placenta after delivery requires manual removal or potential transfusion and shock management if heavy bleeding occurs.
ESHRE Guideline on Recurrent Pregnancy Loss (RPL)Sujoy Dasgupta
Dr Sujoy Dasgupta invited to deliver a lecture on "RPL- ESHRE Guideline" in the Annual Conference of RCOG (Royal College of Obstetricians and Gynaecologists) IRC (International Representative Committee) India East held on 20-21 May, 2023
MANAGEMENT OF COMPLICATIONS OF HYSTEROSCOPY BY DR SHASHWAT JANIDR SHASHWAT JANI
This document provides information from Dr. Shashwat Jani regarding hysteroscopic procedures. It discusses complications rates from studies that found rates between 0.13-2% for diagnostic and 0.95-4.5% for operative hysteroscopies. Major complications like perforation and hemorrhage occur in less than 1% of cases. The document outlines risks from patient positioning like nerve injuries and describes entry-related risks such as cervical laceration and perforation. It provides guidance on managing complications like uterine perforation.
Management of Suboptimally dated pregnancy. Aboubakr Elnashar Aboubakr Elnashar
This document provides recommendations for managing pregnancies where the estimated due date is uncertain due to a lack of early ultrasound examination. It recommends that:
1. The timing of any indicated delivery should be based on the best clinical estimate of gestational age, balancing maternal and newborn risks.
2. Elective deliveries are not recommended without risks sufficient to warrant delivery, to avoid unnecessary neonatal morbidity if the pregnancy is earlier than estimated.
3. Antenatal corticosteroids and fetal surveillance may be considered based on best gestational age estimate, but amniocentesis is not recommended routinely for decision making.
This document discusses intrahepatic cholestasis of pregnancy (IHCP), a cholestatic disorder characterized by pruritus in the second or third trimester, elevated liver enzymes and bile acids, and relief of symptoms after delivery. IHCP has genetic and hormonal risk factors and can cause adverse pregnancy outcomes like preterm birth and stillbirth. Treatment involves ursodeoxycholic acid and early induction of labor between 37-38 weeks to prevent complications. Monitoring of liver enzymes is important until 10 days postpartum.
This document summarizes a presentation given by Dr. Rajni Singh on vaginal hysterectomy techniques. Key points include:
- Vaginal hysterectomy is the safest and most cost-effective surgical route for conditions like fibroids and abnormal bleeding, with less complications and faster recovery compared to abdominal hysterectomy.
- Evaluation of pelvic support and anatomy is important prior to the surgery.
- Techniques like bladder dissection, use of curved scissors and hemostatic systems like Ligasure can aid in performing a bloodless procedure.
- Post-operative care includes catheter removal after 12 hours and discharge usually within 24-36 hours. Potential complications include vault hematoma, infections and urinary tract injuries
Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide, accounting for 34% of deaths in developing countries. PPH is defined as blood loss of 500ml or more following a vaginal birth or 1000ml or more following a caesarean section. Early identification of at-risk patients and active management of the third stage of labour can help prevent PPH. Diagnosis involves communication, resuscitation with fluids and blood products, monitoring, and investigating the cause of bleeding. Treatment focuses on bimanual compression, uterotonic drugs, surgical haemostasis procedures if conservative measures fail, and consideration of recombinant factor VII.
Colposcopy nstrumentation and principles on how to do 22Tariq Mohammed
This document discusses the principles and procedures of colposcopy examinations. It begins by defining a colposcope and its main uses. The most common reason for referral is abnormal cervical screening tests indicating possible precancerous lesions. During the exam, the cervix is examined under magnification with saline, acetic acid, and Lugol's iodine to identify any abnormal white lesions that could indicate precancer or cancer. The document outlines the proper colposcopy instrumentation, examination steps including the principles behind using acetic acid and Lugol's iodine, how to interpret the results, and the importance of thoroughly documenting findings.
This document discusses the history and uses of electro surgery in gynecology. It begins with the early history of heat therapy and progresses to modern developments. Key points covered include the basics of electricity used, types of currents and waveforms, effects on tissue, and specific applications in gynecology like treating cervical lesions, tubal sterilization, endometriosis, and fibroids. Proper use and safety precautions are also emphasized.
This document discusses appendicitis during pregnancy. It covers the epidemiology, anatomical changes, pathophysiology, complications, diagnosis, differential diagnosis, and surgery of appendicitis in pregnant patients. The key points are that appendicitis occurs in about 1 in 1500 pregnancies, symptoms can be more difficult to diagnose due to pregnancy-related changes, ultrasound and CT scan are used for diagnosis but have limitations during late pregnancy, and prompt surgical treatment is indicated to prevent complications of perforation for both the mother and fetus.
This document discusses ureteric injuries that can occur during obstetric and gynecological surgeries and procedures for urinary diversions. It covers the anatomy of the ureters, risk factors for injury, types of injuries, prevention strategies, management approaches, and specific procedures like ileal conduits and continent urinary diversions. Nursing considerations are also outlined for preoperative teaching, postoperative care and monitoring, and potential complications from various urinary diversion surgeries.
PHYSIOLOGY OF LABOUR PAIN AND LABOUR ANALGESIA [Autosaved] [Autosaved].pptxKeerthy Unnikrishnan
This document discusses physiology of labour pain and various analgesia techniques. It describes the components and pathways of visceral and somatic labour pain. Non-pharmacological techniques like water immersion, hypnosis, acupuncture, TENS and Lamaze are summarized. Pharmacological analgesics including opioids like fentanyl, remifentanil and non-opioids like nalbuphine are outlined. Regional analgesia techniques such as epidural analgesia are also mentioned. Newer advances in analgesia including patient controlled analgesia are briefly covered.
Üriner İnkontinansta Değerlendirme, Tanı Testleri ve Yönetim-Prof. Dr. Omer L...Omer Lutfi Tapisiz
Her iki kadından biri (%50) hayatlarının bir döneminde üriner inkontinansı deneyimlemektedir. Kadınlarda semptomatik üriner inkontinans görülme sıklığı %25-61 arasında değişmekte olup bu oran >65 yaş olan kadınlarda yüzde ellinin üzerine çıkmaktadır. Görüldüğü üzere kadınlarda üriner inkontinans; hayat kalitesini ciddi derecede etkileyen, sık görülen bir toplum sağlığı sorunudur.
Bu sunumda kadınlarda üriner inkontinansta değerlendirme, tanı testleri ve yönetim konusu her yönü ile ele alınacaktır. Prof. Dr. Omer Lutfi TAPISIZ
2. Cinsel Yolla Bulaşan Hastalıklar
(CYBH)
Acil Servis’te (AS) tanınmaları neden önemli?
Hastanın sağlığını ve gelecekteki doğurganlığını
korumak
Cinsel temasta bulunduğu kişileri korumak
Beraberinde HIV enfeksiyonu sık görüldüğünden
bu tanıyı da koyabilmek
DR.ŞENOL ARDIÇ - KEAH ACİL TIP - 20.9.2011 2
3. Cinsel Yolla Bulaşan Hastalıklar
(CYBH)
CYBH’ın tanı ve tedavi protokolleri devamlı
değişmektedir. Hazırlanan en güncel
guideline’lar;
CDC (Centers for Disease Control)’in
The Morbidity and Mortality Weekly Report ’
tan elde edilebilir..
DR.ŞENOL ARDIÇ - KEAH ACİL TIP - 20.9.2011 3
4. Cinsel Yolla Bulaşan Hastalıklar (CYBH)
TANI
Şüphe etmek tanının ilk adımı
Çoğunluğu belirgin semptomlarla gelse de
dizüri ve karın ağrısı gibi silik
semptomlarla da gelebilirler
Bir çalışmada; AS’den İYE diye taburcu
edilen hastaların %50’sinde ≥1 CYBH
kültürü (+) bulunmuş
DR.ŞENOL ARDIÇ - KEAH ACİL TIP - 20.9.2011 4
5. Cinsel Yolla Bulaşan Hastalıklar (CYBH)
HİKAYE
Cinsel aktivite ve önceki CYBH hikayesi
Gebelik ve cinsel istismar hikayesi
DR.ŞENOL ARDIÇ - KEAH ACİL TIP - 20.9.2011 5
6. Cinsel Yolla Bulaşan Hastalıklar (CYBH)
FİZİK MUAYENE
Genital muayene
Penis sünnet derisi, sünnetsizlerde geriye
doğru çekilerek içinin de incelenmesi
Gonore ve Klamidya Kültürleri alınması
DR.ŞENOL ARDIÇ - KEAH ACİL TIP - 20.9.2011 6
20. Lezyonsuz CYBH
GONORE-TANI
Seçici bir media üzerinde yapılan servikal yada
üretral kültürler altın standart (%80-90 sens)
Üretral yaymanın gram boyaması
(erkekte sens ve spec, kadında değil)
Dissemine gonokoksemi tanısında kan, lezyon,
eklem kültürleri sadece %20-50 (+)
DR.ŞENOL ARDIÇ - KEAH ACİL TIP - 20.9.2011 20
