The document discusses induction of labour, including its definition, mechanisms, indications, contraindications, methods, and complications. Some key points include:
- Induction of labour is the artificial initiation of labour prior to its spontaneous onset.
- Common methods include membrane sweeping, amniotomy, prostaglandins like misoprostol and dinoprostone, and oxytocin administration.
- Indications include post-term pregnancy, pre-eclampsia, diabetes, and fetal growth restriction. Contraindications include malpresentations and previous uterine scarring.
- Factors like maternal and fetal well-being as well as cervical status via Bishop score are assessed prior to induction.
- Comp
For difficult vaginal delivery,forceps delivery,vacuum application are done to assist the vaginal delivery.Many types of forceps are there divided in 3 categories.
For difficult vaginal delivery,forceps delivery,vacuum application are done to assist the vaginal delivery.Many types of forceps are there divided in 3 categories.
Uterus Transplantation Utx (obstetric and gynecology) D.A.B.M
Is the surgical procedure whereby a healthy uterus is transplanted into an organism of which the uterus is absent or diseased.
As part of normal mammalian sexual reproduction, a diseased or absent uterus does not allow normal embryonic implantation, effectively rendering the female infertile.
This phenomenon is known as Absolute Uterine Factor Infertility (AUFI).
Uterine transplant is a potential treatment for this form of infertility.
Uterus is a dynamic, complex organ. It is hugely blood-flow dependent.
More than 116,000 Number of men, women and children on the national transplant waiting list as of August 2017.
33,611 transplants were performed in 2016.
20 people die each day waiting for a transplant.
every 10 minutes another person is added to the waiting list.
VACUUM DELIVERY - OBSTETRICS AND GYNAECOLOGY-
DEALS WITH THE DELIVERY OF HUMAN BABY BY VACUUM IN SPECIAL OBSTETRIC CONDITIONS.
VACUUM is an instrumental device designed to assist delivery by creating a vacuum between it and the fetal scalp.
Labour induction
Induction of labour
Guidelines on induction of labour
Guidelines on labour induction
induction of labour is not risk free
prostaglandins for induction of labour
Bishop score
Cervical ripening techniques
mechanical and pharmacological induction of labour
Post dates induction
options for cervical ripening
oral vs. vaginal misoprostol
advantages diadvantages and techniques for induction of labour
gynecology & obstetrics
Labour induction methods
review of guidelines for labour induction
Uterus Transplantation Utx (obstetric and gynecology) D.A.B.M
Is the surgical procedure whereby a healthy uterus is transplanted into an organism of which the uterus is absent or diseased.
As part of normal mammalian sexual reproduction, a diseased or absent uterus does not allow normal embryonic implantation, effectively rendering the female infertile.
This phenomenon is known as Absolute Uterine Factor Infertility (AUFI).
Uterine transplant is a potential treatment for this form of infertility.
Uterus is a dynamic, complex organ. It is hugely blood-flow dependent.
More than 116,000 Number of men, women and children on the national transplant waiting list as of August 2017.
33,611 transplants were performed in 2016.
20 people die each day waiting for a transplant.
every 10 minutes another person is added to the waiting list.
VACUUM DELIVERY - OBSTETRICS AND GYNAECOLOGY-
DEALS WITH THE DELIVERY OF HUMAN BABY BY VACUUM IN SPECIAL OBSTETRIC CONDITIONS.
VACUUM is an instrumental device designed to assist delivery by creating a vacuum between it and the fetal scalp.
Labour induction
Induction of labour
Guidelines on induction of labour
Guidelines on labour induction
induction of labour is not risk free
prostaglandins for induction of labour
Bishop score
Cervical ripening techniques
mechanical and pharmacological induction of labour
Post dates induction
options for cervical ripening
oral vs. vaginal misoprostol
advantages diadvantages and techniques for induction of labour
gynecology & obstetrics
Labour induction methods
review of guidelines for labour induction
Series of events that takes place in the genital organ in an effort to expel the viable products of conception out of the womb through the vagina into the outer world is called labour.
there are four stages of labour.
Optimising Delivery Of 1kg Fetus - Special Considerations.pptxNiranjan Chavan
After an uncomplicated vaginal birth in a health facility, healthy mothers and newborns should receive care in the facility for at least 24 hours after birth.
Pre-labor rupture of membranes (PROM), previously known as premature rupture of membranes, is breakage of the amniotic sac before the onset of labor.
Women usually experience a painless gush or a steady leakage of fluid from the vagina.
If it occurs before 37 weeks it is known as PPROM (‘preterm’ prelabour rupture of membranes) otherwise it is known as term PROM.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
6. Time, place & preparation
• Time of induction: Preferably early morning
• Place of induction: where facility for
intervention and fetal monitoring is available
• Preparation of Patient : Enema may be given
to patients prior to induction
9. Contraindications of induction of
labor
• Contracted pelvis and CPD
• Malpresentations
• Previous classical caesarean section &
hysterotomy
• Uteroplacental factors: unexplained
vaginal bleeding,vasa previa,placenta
previa
• Cord presentation,cord prolapse
• Active genital herpes infection,HIV
• Pelvic tumor
10. Factors to assess prior to
induction
Maternal
To confirm the
indication
Exclude the
contraindicatn
Assess Bishop
score
Assess pelvic
adequacy
Fetal
Ensure fetal
gestn age
Ensure fetal
presentation
Confirm fetal
well being
14. • Misoprostol (a prostaglandin E1 analogue) has several potential
advantages: it is stable at room temperature, it is relatively
inexpensive and it can be given via several routes (oral, vaginal,
sublingual, buccal). These properties make misoprostol an ideal
agent for induction of labour, particularly in settings where the
use of prostaglandin E2 is not possible owing to lack of
availability, facilities for storage, or financial constraints.
• Since the use of a powerful uterotonic such as misoprostol can
lead to adverse maternal and perinatal effects, it is important
to review the effectiveness and the side-effects of misoprostol
use in cervical priming and induction of labour. This commentary
evaluates three Cochrane reviews that sought to determine the
effectiveness and safety of misoprostol administered orally (3),
buccally (sublingually) (4), or vaginally (5) for third-trimester
cervical ripening and induction of labour.
15. Membrane sweeping
• Its possible only if the
cervix has ripened to allow
the passage of one finger.
• Insertion of a gloved
finger through the cervix
and it’s rotation against
the wall of the uterus.
• Its strips off the chorionic
membrane from the
underlying decidua
releases PGS
• Placenta previa should be
excluded, Accidental
amniotomy is a
disadvantage.
16. Amniotomy
• AROMstretching of the cervix & separation
of the membranes release of Prostaglandins
• Depends on the state of the cervix and station
of the presenting part
• ADV:High success rate and chance to see the
amniotic fluid
• DIS: cannot be applied in an unfavourable
cervix, possibility of cord prolapse
18. Prostaglandins
• Chemistry:PG is a carboxylic
acid synthetised from
arachidonic acid.
• Source: menstrual fluid,
endometrium, decidua and
amniotic membrane
TYPES
• PGE1 -amnion
• PGE2-amnion
• PGF2-decidua and myometrium
• PGI2-myometrium
19. Mechanism of action
• It causes change in the
myometrial cell memb
permeablity and alteration
in the membrane bound
calcium
• It also sensitises the
mometrium to the oxytocin
• PGE2 has its collagenolytic
activityalter the ground
substance of cervixcx
ripening
21. How to give Misoprostol?
• Dose of 25 micro gram every 4hrly to a
maximum of 6 doses can be given
intravaginally
• Dose of 50micro gram every 3hrs to a
maximum of 6 doses can be given orally
• Dose of 25micro gram every 2hrs can
be given orally
• Other routes of administration:
1.Buccal
2.rectal
3.sublingual
22. Oral Vs vaginal Misoprostol
ORAL
• Less effective
when compared
to vaginal PG
• Chance of fetal
distress is less
VAGINAL
• More effective when
compared to oral
route
• Chance of fetal
distress is more
23. Dinoprostone
• Vaginal gel 0.5mg can be given
intracervically.
• It can be repeated after 6 hrs for 3 – 4
doses if required
• Vaginal tab 3 mg can be given in
the posterior fornix followed by
3mg after 6-8 hrs to a maximum
dose of 6mg
• Vaginal pessary releasing
dinoprostone 10mg over 24hrs.It
is removed when cx ripening is
adequate
24. Misoprostol Vs Dinoprostone
• Cheap & cost
effective
• Stable at room temp
• Easy to administer
• Costly
• Need refrigeration
25. Advantages Disadvantages
• Misoprostol is Cheap
and has long half life
• It is stable at room
temp
• Induction-delivery
interval is short
• Failure of induction is
less
• Powerful oxytoxic
effect irrespective
of gestation
• Side eff: Vomiting,
diarrhoea
• Bronchospasm
• Hyerstimulation of
uterus
• Tachysystole
• Fetal distress
• Rupture uterus
26. Contraindications of PGs
• Bronchial asthma
• Pulmonary disease
• Previous uterine scar is
relatively
contraindicated
27. Oxytocin
• It’s a nanopeptide
synthetised in the supra
optic and paraventricular
nuclei of the hypothalamus.
• Half life of 3-4 mins and
duration of action 20 mins
• Oxytocin is used very
commonly to achieve
induction of labour.
• The objective is to produce
uterine contractions that
effectively produce cervical
change and descent of the
presenting part.
28. Mode of Action
1.It acts throgh the receptor and voltage
gated calcium channelmyometrial
contraction
2.It stimulates amniotic and decidual PG
production
Preparations
• Available in ampoules containing 5IU/ml
• Buccal tab containing 50IU/ml
• Nasal solution containing 40units/ml
Routes of administration:
• 1.I.V infusion
• Intra muscular
• Buccal tablets
• Nasal spray
29. How to give?
Maximum dose of oxytocin 5IU in 500ml of
fluid at the rate of 40drops /min
31. Oxytocin (syntocinon) should be used
with extreme caution in multiparous
women.
Oxytocin (syntocinon) should not be
started for six hours following
administration of vaginal prostaglandins
If a trial of labour is judged safe
then Oxytocin may be used.
Oxytocin should be used with caution
with a previous uterine scar.
Oxytocin should always be used in
conjunction with the partogram once in
established labour.
F
A
C
T
S
32. Advantages
• Cheaper and effective
• Easy titrable
Disadv:
.Needs refrigeration
.Effectiveness less with:
1. less Bishop score
2.IUD
3.lesser weeks of
pregnancy
33. Hazards of oxytocin
• Uterine hyperstimulation:
(Normal:3 contractions in 10 mins
each lasting for 45secs)
(>5 contractions in 10mins each
lasting for 1min)
• Water intoxication:It due to
anti diuretic action(30-
40IU/ml).Manifested by
hyponatremia,confusion,coma
and CCF
• Fetal distress
• Uterine rupture
• Hypotension
34. When to interrupt?
• When there is hyperstimulation of
uterus
• Fetal distress
• Signs of water intoxication.(Occurs
with the max dose of 100 IU in the
interval of less than 24hrs .clinically
Manifested after 24hrs)
35. Oxytocin Vs Misoprostol
• Safe,cheap and
effective
• Unstable at room
temp
• Easily titrable
• Chance of fetal
distress is less
• More effective near
term
• Less effective with
less Bishop score
and in IUD
• Tablet form is
cheap& effective
• Stable at room
temp,PGE1-unstable
• Not titrable
• Chance of fetal
distress is more
• Effective
irrespective of
gestation
36. Failed Induction Of Labor
• If Amniotomy is still
impossible after a
maximum no. of doses of
Prostaglandins have been
given or
• If the cervix remains
uneffaced and <3cm
dilated after an
Amniotomy has been
performed &
• Oxytocin has been
running for 6-8hrs with
regular contractions
• Possible Causes
1. Placental Sulfatase
deficiency
2. Lack of Essential
Cytokines
38. CONCLUSION
during Induction of Labor,
B enefits should be weighed,
R isks should be assessed,
A lternatives should be considered,
N ecessity of intervention adjudged
&
D ecision should be taken
accordingly
BUT,
INJUDICIOUS USE of Labor Inducing agents should
be avoided