This document summarizes the key physical changes that occur during pregnancy across three trimesters. In the first trimester, women experience symptoms like amenorrhea, morning sickness, and breast tenderness. The uterus grows from the size of a hen's egg at 6 weeks to a cricket ball by 8 weeks. In the second trimester, quickening often occurs around 18 weeks, and the fundus rises out of the pelvis. Braxton Hicks contractions begin. In the third trimester, the uterus is cylindrical, lightening may happen, and striae become prominent. Fetal assessment includes position, presentation and growth monitoring.
Cervical Erosion
Dr. Yashika
Definition
Cervical erosion is a condition where the squamous epithelium of the ectocervix is replaced by columnar epithelium which is continuous with endocervix.
Aetiology
Congenital
Acquired
Clinical features
Symptoms :
Vaginal discharge
Contact bleeding
Associated cervicitis
SIGNS :
Diagnosis
Ectropion
Early carcinoma
Primary Lesion (Chancre)
Tubercular ulcer
Management
Pregnancy
Pill user
Persistent ectopy
what is endometriosis? Theories in endometriosis, sites of endometriosis. types and clinical presentation. signs and symptoms.
Investigations :TVS, CA125
laparoscopic findings
chocolate cyst and extrapelvic endometriosis.
Classification of endometiosis
Diffential diagnosis
Management :of asymptomatic and symptomatic cases
drugs and minimally invasive surgery
surgey and preventive measures in endometiosis.
Gestational age is a key piece of data used by healthcare providers to determine the timing of various screening tests and assessments of the fetus and mother throughout pregnancy. Gestational age may be assessed at any time during pregnancy, and several modes of assessment exist, each requiring different equipment or skills and with varying degrees of accuracy. Obtaining more accurate estimates of gestational age through better diagnostic approaches may initiate more prompt medical management of a pregnant patient.
Cervical Erosion
Dr. Yashika
Definition
Cervical erosion is a condition where the squamous epithelium of the ectocervix is replaced by columnar epithelium which is continuous with endocervix.
Aetiology
Congenital
Acquired
Clinical features
Symptoms :
Vaginal discharge
Contact bleeding
Associated cervicitis
SIGNS :
Diagnosis
Ectropion
Early carcinoma
Primary Lesion (Chancre)
Tubercular ulcer
Management
Pregnancy
Pill user
Persistent ectopy
what is endometriosis? Theories in endometriosis, sites of endometriosis. types and clinical presentation. signs and symptoms.
Investigations :TVS, CA125
laparoscopic findings
chocolate cyst and extrapelvic endometriosis.
Classification of endometiosis
Diffential diagnosis
Management :of asymptomatic and symptomatic cases
drugs and minimally invasive surgery
surgey and preventive measures in endometiosis.
Gestational age is a key piece of data used by healthcare providers to determine the timing of various screening tests and assessments of the fetus and mother throughout pregnancy. Gestational age may be assessed at any time during pregnancy, and several modes of assessment exist, each requiring different equipment or skills and with varying degrees of accuracy. Obtaining more accurate estimates of gestational age through better diagnostic approaches may initiate more prompt medical management of a pregnant patient.
Signs and Symptoms, Investigations-UPT and USG helps to diagnose pregnancy. A midwife can diagnose pregnancy by physical examination of signs and symptoms.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
5. BREAST DISCOMFORT
feeling of fullness and pricking
sensation at 6-8th week. Increased size
of the breast due to the hormones
estrogen and progesteron
FATIGUE
due to increase physiological
changes in cardiovascular system.
Complaints of sleepiness and
declination of work
6. FREQUENCY OF MICTURATION
1. resting of the uterus over bladder
2. Congestion of bladder mucosa
3. Change in maternal osmoregulation
FEELING OF WARMTH AND
SWEATING
Complaint of feverish and excessive
sweating due to altered circulation in the
skin
7. 6th week- breast enlarged, painful and tensed
8th week- bluish surface vein are visible due to increased
vasularity
8th-12th week- montgomey’s tubercle develop. Development of
primary areola. Colostrum secretion can expressed
from nipple on 3rd month
8. until 12th week uterus remains in the pelvic organ.
Soft uterine fundus can be felt at the hypogastrium just at the
superior border of symphysis pubis just felt as suprapubic bulge
Fundus is not felt at early pregnancy
9. Otherwise known as
jacquemier’s sign
At 8th week of pregnancy
Due to local vascular congestion
Apart from bluish discolouration
the vaginal wall become
softened copious non irritating
mucoid discharge appear at 6th
week
10. Seen early as 6th week and due to
increased vascularity
11. Size, shape and consistency
6th week- size of hen egg
8th week- size of cricket ball
12th week- size of fetal head
Pyriform shape of non pregnant uterus become globular at
12th week
As pregnancy advances symmetry is restored and the
uterus feel soft and elastic
12. PISKACEK’S SIGN
Blastocyst usually implant laterally resulting in
asymmetrical growth of the uterus with the area of
implantation being softer than the rest
HEGAR’S SIGN
Demonstrted between 6-10th week.
Upper part of the body of the uterus
is enlarged by the growing fetus,
lower part of the body is empty and
extremely soft
13. PALMER’S SIGN
Regular and rhythmic uterine contraction can
be elicited during bimanual examination as
early as 4-8 weeks
14.
15.
16.
17.
18. It is more sensitive and can detect beta subunit of hCG
upto 0.002IU/ml in the serum. It can detect pregnancy
early as 8-9 days after ovulation
Uses sandwich technique to detect whole hCG molecule
21. Subjective symptoms
Nausea, vomiting and frequency of micturation usually
subside
Amenorrhea continue
Quickening- fluttering sensation felt by the mother for
active movement for the first time it is usually felt at 18
week and 2 week early in multi gravidae
Progressive enlargement of lower abdomen
22. Objective sign
Pigmentation over forehead and
cheek appear at about 24th week
•Formation of secondary areola
around primary areola
•Prominent veins
•Colostrum become thick and
yellowish by 16th week
23. Intermittent painless contraction can be elicited by placing a
palm on uterus at irregular intervals of 10-20 mins from 16th
week followed by relaxation.
BRAXTON HICKS CONTRACTION
24.
25. ENLARGEMENT OF UTERUS
12th week- at symphysis pubis
14th week- 2.5 cm above symphysis
pubis
16th week- 5cm above symphysis
pubis
20th week- 2.5 cm below the
umbilicus
24th week- at the level of umbilicus
28th week- at the lower one third
distance from umbilicus and ensiform
cartilage
27. AUSCULTATING FETAL HEART SOUND
FHS can be detected between 18-20 weeks. The sound resembles
the tick of a watch under a pillow. Rate varies from 110-160 beats
per minute
28.
29.
30. Bluish discolouration of the vulva, vagina and cervix more
evident
INTERNAL BALLOTMENT
Elicited between 12-28th week. On dorsal position
of woman two fingers are placed on anterior
vaginal fornixes in front of the cervix while other
hand is placed firmly on the uterus fundus
The fetal head or the buttocks may be felt resting
on the internal fingers when the internal finger
tape the fetal pole
31.
32.
33. Lightening felt by women after 38 week.
This is due to drooping down of uterine
fundus due to liquor amino absorption and
descent of fetal head
Due to fetal head
pressure effect on
urinary bladder
34. Chloasma and breast signs are more prominent
Colostrum can be expressed
Edema of dorsum of feet and ankle
Linea nigra become more prominent
Pink linear stretch mark (striae gravidarum) become visible
on sides and front of lower abdominal skin striae albicans
(silvery white appearance) in subsequent pregnancy
Shape of the uterus is cylindrical upto 38th week
35. ENLARGEMENT OF UTERUS
At 28th week- uterus fundus reaches lower
one-third distance between umbilicus and
ensiform cartilage
At 32nd week- fundus occupies lower two
third of the later space.
At 36th week- fundus reaches near the
subcoastal arch
At 38th week- fundus reaches the subcoastal
arch below ensiform cartilage
At 40th week- fundus sinks below 36th week
but lies above 32 week. This is called
shelving of uterine fundus
36. Braxton hicks contraction comes more regularly
during last two weeks of the pregnancy
Fetal movements are easily felt and fetal parts are
palpated to determine the presentation, position and lie
External ballotment can be elicited
37. ULTRASONOGRAPHY
o Estimation of fetal weight
oAssessment of amniotic fluid volume
oAssessment of placenta
oGestational sac is identified by BPD, HC, CC, FL
oIdentification of fetal anomalies
