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.
This document defines cephalopelvic disproportion and describes factors that can influence pelvic size. It discusses various types of contracted pelves, including developmental, metabolic, and traumatic causes. Methods for diagnosing a contracted pelvis are provided, including history, examination, and pelvimetry techniques. Degrees of disproportion and contracted pelvis are defined based on pelvic measurements.
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
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.
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.
Contracted pelvis (diagnosis and treatment)fidaey48
The document summarizes the contracted pelvis, including its etiology, diagnosis, mechanisms of labor, and management. A contracted pelvis is defined as having one or more main diameters reduced below normal. Causes include developmental issues, metabolic diseases like rickets, trauma, and tumors. Diagnosis involves history, examination, and pelvimetry. Management depends on the degree of disproportion, with minor cases attempting vaginal delivery, moderate cases getting a trial of labor followed by c-section if needed, and severe cases proceeding directly to c-section.
This document defines cephalopelvic disproportion and describes factors that can influence pelvic size. It discusses various types of contracted pelves, including developmental, metabolic, and traumatic causes. Methods for diagnosing a contracted pelvis are provided, including history, examination, and pelvimetry techniques. Degrees of disproportion and contracted pelvis are defined based on pelvic measurements.
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
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.
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.
Contracted pelvis (diagnosis and treatment)fidaey48
The document summarizes the contracted pelvis, including its etiology, diagnosis, mechanisms of labor, and management. A contracted pelvis is defined as having one or more main diameters reduced below normal. Causes include developmental issues, metabolic diseases like rickets, trauma, and tumors. Diagnosis involves history, examination, and pelvimetry. Management depends on the degree of disproportion, with minor cases attempting vaginal delivery, moderate cases getting a trial of labor followed by c-section if needed, and severe cases proceeding directly to c-section.
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.
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 developmental dysplasia of the hip (DDH), also known as congenital hip dysplasia. DDH ranges from shallow acetabulum to complete hip dislocation. It is more common in females and breech babies. Clinical signs include leg length discrepancy, limited hip abduction, and Trendelenberg gait. Ultrasound is the best initial imaging method, using the alpha and beta angles to assess acetabular depth and femoral head position. X-rays become more useful after age 4-7 months as ossification centers appear. Early diagnosis and treatment are important to prevent long-term complications of DDH like osteoarthritis.
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,
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
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.
This document discusses cephalopelvic disproportion (CPD) and contracted pelvis. It defines CPD as a disparity between the fetal head and the mother's pelvis. Contracted pelvis occurs when one or more pelvic diameters is reduced below normal. The document describes various classifications of contracted pelvis and discusses diagnosis, effects, and management approaches for CPD and contracted pelvis which may include a trial of labor or cesarean section depending on the degree of disproportion. Complications of CPD can include maternal and fetal injuries as well as increased morbidity and mortality.
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.
Anorectal malformations (ARMs) are birth defects affecting the development of the rectum and anus. They occur due to abnormal development during fetal growth. ARMs can range from mild defects like fistulas to more severe defects like cloaca. Diagnostic tests like X-rays and ultrasound are used to classify the defect and identify associated issues. Surgical intervention is needed to correct the defect, often using staged procedures like colostomy followed later by posterior sagittal anorectoplasty. Nursing care focuses on pre-and post-operative stabilization, wound care, and supporting bowel function and continence development.
This document discusses developmental dysplasia of the hip (DDH), which refers to dysplasia of the hip joint that develops during fetal life or infancy. It can range from shallow acetabulum to complete hip dislocation. DDH is more common in females and risk factors include breech presentation and family history. Treatment depends on age, with Pavlik harness used in infants under 6 months and hip spica casting for older infants and children under 2 years. The goal of treatment is to reduce the femoral head in the acetabulum and allow normal hip joint development.
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.
This document discusses developmental dysplasia of the hip (DDH), including its etiology, presentation, diagnosis and treatment. Key points include:
- DDH is a spectrum of hip disorders presenting at different ages, including subluxation, acetabular dysplasia and dislocation.
- Risk factors include ligamentous laxity, breech positioning, and postnatal positioning with hips in extension.
- Clinical diagnosis involves the Ortolani and Barlow tests for instability in infants. Imaging includes ultrasound and x-rays.
- Left untreated, DDH can progress from instability to dislocation and eventual osteoarthritis. Treatment aims to prevent this progression.
1. Developmental dysplasia of the hip (DDH) refers to dysplasia or dislocation of the hip joint that develops during fetal life or infancy. It can range from shallow acetabulum to partial or complete dislocation.
2. Risk factors include female sex, breech presentation, family history, and swaddling practices that restrict hip movement. Screening involves clinical examination and ultrasound of newborns and infants.
3. Treatment depends on age and severity but aims to reduce the femoral head and maintain the reduction to allow for normal hip development. Options include Pavlik harness, hip spica casting, and surgery.
1. Developmental dysplasia of the hip (DDH) refers to dysplasia or dislocation of the hip joint that develops during fetal life or infancy. It can range from shallow acetabulum to partial or complete dislocation.
2. Risk factors include female sex, breech presentation, family history, and swaddling practices that restrict hip movement. Screening involves clinical tests and ultrasound imaging to detect abnormalities.
3. Treatment depends on age and severity but generally aims to reduce the femoral head and maintain the reduction through devices like Pavlik harness or hip spica casting. Surgical intervention may be needed for older patients or failed non-surgical treatment.
1. Developmental dysplasia of the hip (DDH) refers to dysplasia or dislocation of the hip joint that develops during fetal life or infancy. It can range from shallow acetabulum to partial or complete dislocation.
2. Risk factors include female sex, breech presentation, family history, and swaddling practices that restrict hip movement. Screening involves clinical examination and ultrasound of newborns and infants.
3. Treatment depends on age and severity but aims to reduce the femoral head and maintain the reduction to allow for normal hip development. Options include Pavlik harness, hip spica casting, and surgery.
Breech presentation occurs when the fetus is positioned so that the buttocks or feet present first at the pelvic inlet during labor. It is classified as complete or incomplete based on flexion of the hips and legs. An assisted vaginal breech delivery may be attempted for uncomplicated breech presentations, following principles such as avoiding pulling and keeping the fetal back anterior. External cephalic version can be attempted to convert breech to cephalic presentation. Elective cesarean section is recommended for complicated breech presentations or if version fails.
This document discusses several congenital genital defects including cryptorchidism, hypospadias, chordee, micropenis, and others. It provides details on the embryological development of the genitals. For hypospadias, it describes the condition as an abnormal urethral opening on the ventral penis and notes increasing rates. Surgical correction aims to widen the meatus, correct curvature, and reconstruct the urethra. Techniques discussed include TIP urethroplasty and flap procedures. Complications can include fistula, stenosis, and stricture.
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.
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 developmental dysplasia of the hip (DDH), also known as congenital hip dysplasia. DDH ranges from shallow acetabulum to complete hip dislocation. It is more common in females and breech babies. Clinical signs include leg length discrepancy, limited hip abduction, and Trendelenberg gait. Ultrasound is the best initial imaging method, using the alpha and beta angles to assess acetabular depth and femoral head position. X-rays become more useful after age 4-7 months as ossification centers appear. Early diagnosis and treatment are important to prevent long-term complications of DDH like osteoarthritis.
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,
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
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.
This document discusses cephalopelvic disproportion (CPD) and contracted pelvis. It defines CPD as a disparity between the fetal head and the mother's pelvis. Contracted pelvis occurs when one or more pelvic diameters is reduced below normal. The document describes various classifications of contracted pelvis and discusses diagnosis, effects, and management approaches for CPD and contracted pelvis which may include a trial of labor or cesarean section depending on the degree of disproportion. Complications of CPD can include maternal and fetal injuries as well as increased morbidity and mortality.
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.
Anorectal malformations (ARMs) are birth defects affecting the development of the rectum and anus. They occur due to abnormal development during fetal growth. ARMs can range from mild defects like fistulas to more severe defects like cloaca. Diagnostic tests like X-rays and ultrasound are used to classify the defect and identify associated issues. Surgical intervention is needed to correct the defect, often using staged procedures like colostomy followed later by posterior sagittal anorectoplasty. Nursing care focuses on pre-and post-operative stabilization, wound care, and supporting bowel function and continence development.
This document discusses developmental dysplasia of the hip (DDH), which refers to dysplasia of the hip joint that develops during fetal life or infancy. It can range from shallow acetabulum to complete hip dislocation. DDH is more common in females and risk factors include breech presentation and family history. Treatment depends on age, with Pavlik harness used in infants under 6 months and hip spica casting for older infants and children under 2 years. The goal of treatment is to reduce the femoral head in the acetabulum and allow normal hip joint development.
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.
This document discusses developmental dysplasia of the hip (DDH), including its etiology, presentation, diagnosis and treatment. Key points include:
- DDH is a spectrum of hip disorders presenting at different ages, including subluxation, acetabular dysplasia and dislocation.
- Risk factors include ligamentous laxity, breech positioning, and postnatal positioning with hips in extension.
- Clinical diagnosis involves the Ortolani and Barlow tests for instability in infants. Imaging includes ultrasound and x-rays.
- Left untreated, DDH can progress from instability to dislocation and eventual osteoarthritis. Treatment aims to prevent this progression.
1. Developmental dysplasia of the hip (DDH) refers to dysplasia or dislocation of the hip joint that develops during fetal life or infancy. It can range from shallow acetabulum to partial or complete dislocation.
2. Risk factors include female sex, breech presentation, family history, and swaddling practices that restrict hip movement. Screening involves clinical examination and ultrasound of newborns and infants.
3. Treatment depends on age and severity but aims to reduce the femoral head and maintain the reduction to allow for normal hip development. Options include Pavlik harness, hip spica casting, and surgery.
1. Developmental dysplasia of the hip (DDH) refers to dysplasia or dislocation of the hip joint that develops during fetal life or infancy. It can range from shallow acetabulum to partial or complete dislocation.
2. Risk factors include female sex, breech presentation, family history, and swaddling practices that restrict hip movement. Screening involves clinical tests and ultrasound imaging to detect abnormalities.
3. Treatment depends on age and severity but generally aims to reduce the femoral head and maintain the reduction through devices like Pavlik harness or hip spica casting. Surgical intervention may be needed for older patients or failed non-surgical treatment.
1. Developmental dysplasia of the hip (DDH) refers to dysplasia or dislocation of the hip joint that develops during fetal life or infancy. It can range from shallow acetabulum to partial or complete dislocation.
2. Risk factors include female sex, breech presentation, family history, and swaddling practices that restrict hip movement. Screening involves clinical examination and ultrasound of newborns and infants.
3. Treatment depends on age and severity but aims to reduce the femoral head and maintain the reduction to allow for normal hip development. Options include Pavlik harness, hip spica casting, and surgery.
Breech presentation occurs when the fetus is positioned so that the buttocks or feet present first at the pelvic inlet during labor. It is classified as complete or incomplete based on flexion of the hips and legs. An assisted vaginal breech delivery may be attempted for uncomplicated breech presentations, following principles such as avoiding pulling and keeping the fetal back anterior. External cephalic version can be attempted to convert breech to cephalic presentation. Elective cesarean section is recommended for complicated breech presentations or if version fails.
This document discusses several congenital genital defects including cryptorchidism, hypospadias, chordee, micropenis, and others. It provides details on the embryological development of the genitals. For hypospadias, it describes the condition as an abnormal urethral opening on the ventral penis and notes increasing rates. Surgical correction aims to widen the meatus, correct curvature, and reconstruct the urethra. Techniques discussed include TIP urethroplasty and flap procedures. Complications can include fistula, stenosis, and stricture.
This document discusses perinatal infections, providing details on several pathogens that can cause congenital infections including Toxoplasma gondii, rubella virus, cytomegalovirus, herpes simplex virus, and Treponema pallidum (syphilis). It describes the transmission, signs/symptoms, diagnosis, and treatment of infections caused by each pathogen. Key points include that primary maternal infection with toxoplasmosis, rubella virus, or herpes is highest risk for fetal transmission and infection earlier in pregnancy leads to worse outcomes. Diagnosis involves pathogen detection and serologic testing, while treatment focuses on antimicrobials and supportive care of the newborn.
complex and shoulder presentation&cord prolapse and presentation.pptxIslamSaeed19
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help boost feelings of calmness, happiness and focus.
Perinatal infections can cause significant morbidity and mortality if not properly diagnosed and treated. Some important perinatal infections discussed in the document include toxoplasmosis, rubella, cytomegalovirus, herpes simplex virus, and syphilis. For each infection, the document outlines the causative agent, route of transmission, signs and symptoms in both the mother and infant, diagnostic testing, and treatment recommendations. Preventing transmission requires screening, counseling, and treatment as indicated for at-risk mothers and newborns.
This document discusses shoulder, complex, and cord presentations. It defines each type of presentation and provides information on incidence, etiology, diagnosis, and management. Shoulder presentation occurs when the fetus is transverse or oblique, with the scapula acting as the denominator. Complex presentations involve a cephalic or breech presentation with prolapse of one or both limbs. Cord presentation is when the umbilical cord is below the presenting part, while cord prolapse is when the cord descends through the cervix into the vagina. The document outlines the specific considerations and approaches for managing each type of presentation depending on factors such as cervical dilation, fetal condition, and presentation.
power point vaccination during pregnancy3faa.pptIslamSaeed19
This document discusses vaccines recommended during pregnancy and postpartum. It describes the types of vaccines including live attenuated, inactivated, toxoid, subunit, and conjugate vaccines. It recommends the influenza, tetanus, diphtheria, pertussis, and measles-mumps-rubella vaccines during pregnancy to protect both mother and baby. Maternal immunization against influenza has been shown to reduce flu illness in mothers and increase newborn immunity. The tetanus, diphtheria, pertussis vaccine protects against these diseases and aims to pass protection to infants who are most at risk.
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.
PHA Covid vaccination training slides Programme for childbearing women FINAL ...IslamSaeed19
The document provides information on COVID-19 vaccination for pregnant women, breastfeeding women, and women planning pregnancy. It discusses that COVID-19 vaccination is recommended and safe for these groups as the vaccines are non-live. While clinical trials have not been conducted in pregnancy, emerging real-world data on over 120,000 doses in the US have not found any safety signals. The risks and benefits of vaccination should be discussed between the woman and her clinician.
Tubo-ovarian abscesses are collections of pus in the fallopian tubes or ovaries that can develop from pelvic infections. They require prompt diagnosis and treatment with intravenous antibiotics and sometimes surgery. The article reviews the diagnosis and management of tubo-ovarian abscesses, noting that ultrasound is useful for diagnosis but CT scan may be needed for complex cases, and that treatment involves IV antibiotics with surgery sometimes needed for drainage if the patient does not improve within 48 hours of starting antibiotics.
This document provides guidelines on the management of various fetal malpresentations and positions during labor and delivery. It discusses:
1) Face, brow, shoulder, breech and compound presentations including diagnostic landmarks and management recommendations which are usually cesarean section if fetus is alive or destructive operations if fetus is dead.
2) Breech presentation classifications (complete, frank, footling), risks, and management options of planned vaginal delivery or elective c-section for uncomplicated breeches.
3) Occiput posterior position diagnosis and management of attempting external cephalic version or short/long rotations to convert to occiput anterior for vaginal delivery.
This document provides an overview of wound healing, its functions, stages, mechanisms, factors affecting it, and complications.
A wound is a break in the integrity of the skin or tissues, which may be associated with disruption of the structure and function.
Healing is the body’s response to injury in an attempt to restore normal structure and functions.
Healing can occur in two ways: Regeneration and Repair
There are 4 phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This document also describes the mechanism of wound healing. Factors that affect healing include infection, uncontrolled diabetes, poor nutrition, age, anemia, the presence of foreign bodies, etc.
Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
This presentation was provided by Racquel Jemison, Ph.D., Christina MacLaughlin, Ph.D., and Paulomi Majumder. Ph.D., all of the American Chemical Society, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
A Visual Guide to 1 Samuel | A Tale of Two HeartsSteve Thomason
These slides walk through the story of 1 Samuel. Samuel is the last judge of Israel. The people reject God and want a king. Saul is anointed as the first king, but he is not a good king. David, the shepherd boy is anointed and Saul is envious of him. David shows honor while Saul continues to self destruct.
Leveraging Generative AI to Drive Nonprofit InnovationTechSoup
In this webinar, participants learned how to utilize Generative AI to streamline operations and elevate member engagement. Amazon Web Service experts provided a customer specific use cases and dived into low/no-code tools that are quick and easy to deploy through Amazon Web Service (AWS.)
Andreas Schleicher presents PISA 2022 Volume III - Creative Thinking - 18 Jun...EduSkills OECD
Andreas Schleicher, Director of Education and Skills at the OECD presents at the launch of PISA 2022 Volume III - Creative Minds, Creative Schools on 18 June 2024.
Elevate Your Nonprofit's Online Presence_ A Guide to Effective SEO Strategies...TechSoup
Whether you're new to SEO or looking to refine your existing strategies, this webinar will provide you with actionable insights and practical tips to elevate your nonprofit's online presence.
2. Contracted Pelvis
www.freelivedoctor.com
• Definition:
• 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:
www.freelivedoctor.com
* 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. Aetiology of Contracted Pelvis
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a.Causes in the pelvis
• Developmental (congenital):
> Small gynaecoid pelvis (generally contracted pelvis).
>Small android pelvis.
>Small anthropoid pelvis
> Small platypelloid pelvis (simple flat pelvis).
>Naegele’s pelvis: absence of one sacral ala
>Robert’s pelvis: absence of both sacral alae.
>High assimilation pelvis: The sacrum is composed of 6
vertebrae.
>Low assimilation pelvis: The sacrum is composed of 4
vertebrae.
>Split pelvis: splitted symphysis pubis.
5. Aetiology of Contracted Pelvis
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• a.Causes in the pelvis
• Metabolic:
> Rickets.
> Osteomalacia (triradiate pelvic brim).
• Traumatic: as fractures.
• Neoplastic: as osteoma.
6. Aetiology of Contracted Pelvis
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b.Causes in the spine
* Lumbar kyphosis.
* Lumbar scoliosis.
* Spondylolisthesis: The 5th lumbar vertebra
with the above vertebral column is pushed
forward while the promontory is pushed
backwards and the tip of the sacrum is pushed
forwards leading to outlet contraction.
7. Aetiology of Contracted Pelvis
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c.Causes in the lower limbs
* Dislocation of one or both femurs.
* Atrophy of one or both lower limbs.
>N.B. oblique or asymmetric pelvis: one oblique
diameter is obviously shorter than the other. This
can be found in:
* Naegele’s pelvis.
* Scoliotic pelvis.
* Diseases, fracture or tumours affecting one side.
8. Diagnosis of Contracted Pelvis
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• 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.
9. Diagnosis of Contracted Pelvis
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•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.
10. Diagnosis of Contracted Pelvis
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•Examination
General examination:
>Manifestations of rickets as:
* square head,
*rosary beads in the costal ridges.
* pigeon chest,
* Harrison’s sulcus and bow legs.
> 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.
11. Diagnosis of Contracted Pelvis
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Abdominal examination:
Nonengagement of the head: in the last 3-4
weeks in primigravida.
Pendulous abdomen: in a primigravida.
Malpresentations: are more common.
12. Diagnosis of Contracted Pelvis
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• Pelvimetry: It is assessment of the pelvic
diameters and capacity done at 38-39 weeks. It
includes:
1.Clinical pelvimetry:
A.Internal pelvimetry for:
> inlet,
>cavity, and
> outlet.
B.External pelvimetry for:
> inlet and
>outlet.
13. Diagnosis of Contracted Pelvis
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• Pelvimetry:
2.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 use.)
14. Internal pelvimetry
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Internal pelvimetry (is done through vaginal examination):
1. The inlet:
a.Palpation of the forepelvis (pelvic brim):
b. The index and middle fingers are moved along the pelvic
brim. Note whether it is round or angulated, causing the
fingers to dip into a V-shaped depression behind the
symphysis.
c. Diagonal conjugate: >Try to palpate the sacral promontory
to measure the diagonal conjugate. Normally, it is 12.5 cm
and cannot be reached. If it is felt the pelvis is considered
contracted and the true conjugate can be calculated by
subtracting 1.5 cm from the diagonal conjugate .This
assessment is not done if the head is engaged.
15. Internal pelvimetry
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2.The cavity:
a.Height, thickness and inclination of the symphysis.
b. Shape and inclination of the sacrum.
c. Side walls: >To determine whether it is straight,
convergent or divergent starting from the pelvic
brim down to the base of ischial spines in the
direction of the base of the ischial tuberosity.
Then relation between the index and middle
finger of the base of ischial spines and the thumb
of the other hand on the ischial tuberosity
isdetected. If the thumb is medial the side wall is
convergent and if lateral it is divergent.
16. Internal pelvimetry
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• 2.The cavity:
• d.Ischial spines:
> Whether it is blunt (difficult to identify at all),
prominent (easily felt but not large) or very
prominent (large and encroaching on the mid-
plane).
>The ischial spines can be located by following
the sacrospinous ligament to its lateral end.
17. Internal pelvimetry
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2.The cavity:
e. Interspinous diameter: By using the 2
examining fingers, if both spines can be
touched simultaneously, the interspinous
diameter is £ 9.5 cm i.e. inadequate for an
average-sized baby.
f. Sacrosciatic notch:> If the sacrospinous
ligament is two and half fingers, the
sacrosciatic notch is considered adequate.
18. Internal pelvimetry
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3.The outlet:
a. Subpubic angle:> Normally, it admits 2 fingers.
b.Bituberous diameter:>Normally, it admits the
closed fist of the hand (4 knuckle).
c.Mobility of the coccyx:> by pressing firmly on it
while an external hand on it can determine its
mobility.
d. Anteroposterior diameter of the outlet:> from
the tip of the sacrum to the inferior edge of
the symphysis.
19. Data Finding
Forepelvis (pelvic brim) Round.
Diagonal conjugate ³ 11.5 cm.
Symphysis . Average thickness, parallel to sacrum.
Sacrum Hollow, average inclination
Side walls Straight.
Ischial spines Blunt.
Interspinous diameter ³ 10.0 cm.
Sacrosciatic notch 2.5 -3 finger - breadths.
Subpubic angle 2finger - breadths.
Bituberous diameter 4 knuckles (> 8.0 cm).
Coccyx Mobile.
Anterposterior diameter of outlet ³ 11.0 cm.
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20. External pelvimetry
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• It is of little value as it measures diameters of the
false pelvis.
• Thom’s, Jarcho’s or crossing pelvimeter can be
used for external pelvimetry.
* Interspinous diameter (25cm): between the
anterior superior iliac spines.
* Intercrestal diameter (28 cm): between the most
far points on the outer borders of the iliac crests.
* External conjugate (20 cm).
* Bituberous diameter: can be measured by
pelvimeter.
21. Radiological pelvimetry
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It is indicated mainly in borderline pelvic contraction.
*Lateral view: The patient stands with the X-ray tube on
one side and the film cassette on the opposite side.
> It is the most important view as it shows the
anteroposterior diameters of the pelvis, angle of
inclination of the brim, width of sacrosciatic notch,
curvature of the sacrum and cephalo-pelvic
relationship.
* Inlet view: The patient sits on the film cassette and
leans backwards so that the plane of the pelvic brim
becomes parallel to the film.
* Outlet view: The patient sits on the film cassette and
leans forwards.
22. Cephalometry
* Ultrasonography: is the safe accurate and easy
method and can detect:
The biparietal diameter (BPD)
The occipito-frontal diameter.
The circumference of the head.
* Radiology (X-ray): is difficult to interpret.
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23. Cephalopelvic disproportion tests
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• 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.
24. Cephalopelvic disproportion tests
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(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.
25. Degrees of Disproportion
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1.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.
2.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.
3. Marked disproportion (2nd degree disproportion):
>The head overrides the anterior surface of the
symphysis. Vaginal delivery cannot occur.
26. Degrees of Contracted Pelvis
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1. Minor degree: The true conjugate is 9-10 cm. It
corresponds to minor disproportion.
2.Moderate degree: The true conjugate is 8-9 cm. It
corresponds to moderate disproportion.
3.Severe degree: The true conjugate is 6-8 cm. It
corresponds to marked disproportion.
4.Extreme degree: The true conjugate is less than 6
cm. Vaginal delivery is impossible even after
craniotomy asthe bimastoid diameter (7.5 cm) is
not crushed.
27. Mechanism of Labour in Contracted
Pelvis
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• The Flat Rachitic Pelvis:Characters
1. Inlet: reduced antero-posterior diameter.
2. The pelvic inclination: is exaggerated due to
increased lumbar lordosis.
3.The sacrum has the following characters:
> The promontory is pushed forwards so the tip
is pushed backwards.
>Diminished or obliterated concavity.
> Bent at the middle may be present.
28. Mechanism of Labour in Contracted
Pelvis
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The Flat Rachitic Pelvis
• Characters
4.The outlet has the following characters:
> Increased antero-posterior diameter.
> Increased bituberous diameter.
5. The interspinous equal the intercrestal
diameter.
29. Mechanism of labour:
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• a.Engagement: with the sagittal suture in the
transverse diameter.
• b.Asynclitism with anterior parietal bone
presentation so that the shorter subparietal
supraparietal diameter (9cm) is passed instead of
the biparietal (9.5cm) in the narrow true
conjugate.
• c. Lateral displacement of the head so that the
bitemporal diameter is passed through the
narrow true conjugate
30. Mechanism of labour:
d. Deflexion of the head as the descent of the
occiput is resisted by the lateral pelvic wall .
e.Correction of the asynclitism and deflexion
with further descent of the head.
f. Rotation of the occiput 2/8 circle anteriorly
and the head is delivered easily due to wide
outlet.
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32. Simple Flat Pelvis
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• Mechanism of labour:
• The process passes as flat rachitic pelvis till
the mid cavity where internal rotation and
further descent cannot occur due to
persistence of flattening of the pelvis and
contracted outlet. So deep transverse arrest is
common and vaginal delivery is obstructed.
33. Contracted Outlet (Funnel Pelvis)
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• Characters:
* The pelvic capacity is diminished from the
inlet to the outlet.
* Subpubic angle is acute.
* Convergent side walls.
* Bituberous diameter is 8 cm or less.
34. Contracted Outlet (Funnel Pelvis)
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Causes:
* Android pelvis.
* Anthropoid pelvis.
* Osteomalacia.
* High assimilation pelvis.
* Spondylolisthesis.
* Oblique pelvis.
* 20% of generally contracted pelvis.
35. Mechanism of labour:
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* Normal descent and engagement as the pelvic inlet is
normal.
*Extreme flexion and moulding of the head at the level of
the jutting ischial spines.
*Because of the narrow subpubic angle, the head is
pushed backwards with more liability to perineal tears.
* In case of occipito-posterior, the funnel pelvis
interferes with long anterior rotation so persistent
occipito-posterior and deep transverse arrest are
common. The face to pubis position is more favourable
as it brings the short bitemporal diameter in the
narrow subpubic angle.
36. Management:
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• It depends on Thom’s dictum:
* If the sum of bituberous + posterior sagittal is >15
cm and bituberous diameter is >8cm: vaginal
delivery is allowed with episiotomy and low
forceps.
* If the Thom’s dictum is <15 cm or the bituberous
diameter is <8cm: caesarean section is
performed.
* Symphysiotomy: may be done in distant areas
with no facilities for C.S. and the foetus is living.
37. Management of Contracted Pelvis
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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
ofcontracted pelvis): caesarean section.
38. Trial of Labour
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• 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.
39. Procedure:
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* 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
40. Suitable cases for trial of labour:
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* Young primigravida of good health.
* Moderate disproportion.
* Vertex presentation.
* No outlet contractions.
* Average sized baby.
41. Termination of trial of labour:
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* 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.
42. Indications of caesarean section in
contracted pelvis
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* 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.
43. Complications of Contracted Pelvis
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• Maternal:
During pregnancy:
> Incarcerated retroverted gravid uterus.
> Malpresentations.
> Pendulous abdomen.
> Nonengagement.
> Pyelonephritis especially in high assimilation
pelvis due to more compression of the ureter.
44. Complications of Contracted Pelvis
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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.