Moniliasis(Candida vaginitis)
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Candida vaginitis is caused by the fungus Candida albicans. It presents with intense vulvovaginal discharge, dyspareunia, and a thick, curdy white discharge on examination that resembles cottage cheese and adheres to the vaginal walls. Diagnosis is made via wet smear, and treatment involves removing predisposing factors as well as using local and oral antifungal creams, ointments, pessaries, or single dose therapies like fluconazole or itraconazole.
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Fibroids
Uterine fibroids are benign tumors that arise from the smooth muscle cells of the uterus. They are the most common pelvic tumor in women. Fibroids can be classified based on their location within the uterus as submucosal, intramural, subserosal, or cervical. Symptoms depend on the size and location of fibroids and include heavy menstrual bleeding, pelvic pressure or pain, and reproductive complications like infertility. Diagnosis involves history, physical exam, pelvic ultrasound, and sometimes additional imaging like MRI.
Cervicitis.pptx
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Urinary tract infections (UTIs) are more common during pregnancy due to anatomical and physiological changes that cause incomplete bladder emptying and a less acidic urine. There are different types of UTIs including asymptomatic bacteriuria, acute cystitis, and pyelonephritis. Common symptoms are urges to urinate, painful urination, and fever. Left untreated, UTIs can cause serious complications for both mother and baby like preterm labor. Diagnosis involves urine and blood tests and treatment consists of hospitalization, IV fluids and antibiotics. Prevention focuses on drinking fluids, urinating frequently, and good genital hygiene.
Cervical erosion
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
Placenta previa
Placenta previa is a condition in which the placenta lies very low in the uterus and covers all or part of the cervix. The cervix is the opening to the uterus that sits at the top of the vagina. Placenta previa happens in about 1 in 200 pregnancies.
Placenta praevia risk factors include a previous delivery, age older than 35 and a history of previous surgeries, such as a caesarean section (C-section) or uterine fibroid removal.
The main symptom is bright red vaginal bleeding without pain during the second-half of pregnancy. The condition can also cause severe bleeding before or during delivery.
Limited physical activity is recommended. A C-section is often required in severe cases.
Complications of puerperium
This document summarizes common complications that can occur during the puerperium period after childbirth. These include puerperal pyrexia (fever) which can be caused by infections in the genital tract, breast, respiratory tract, or urinary tract. Other causes include wound infections or thrombophlebitis. Problems with breastfeeding may also occur such as engorgement, cracked nipples, mastitis or breast abscess. Coagulation disorders can increase the risk of thromboembolism, which is a leading cause of maternal mortality. Finally, psychiatric disorders like postpartum blues, anxiety, depression or psychosis may develop during this time.
Uterine prolapse
Uterine prolapse occurs when the uterus descends from its normal position due to weakened pelvic muscles and tissues. It is often caused by pregnancy, childbirth, obesity, menopause, or chronic conditions like coughing or constipation. Symptoms range from a feeling of heaviness to organs protruding from the vagina. Treatment options include pelvic floor exercises, pessaries, hormone therapy, and surgery to repair damaged tissues or remove the uterus. Surgical risks include infection, incontinence, and prolapse recurrence.
Caesarean section
Caesarean section is the delivery of a baby through surgical incisions in the mother's abdomen and uterus. It can be performed as an emergency procedure if there are threats to the mother or baby, or electively if there are risk factors present but no urgency. The most common reasons for C-section are prior C-section, non-progressing labor, abnormal fetal position, and fetal distress. Regional anesthesia is preferred to allow the mother to experience childbirth while remaining safe. The surgery involves making incisions in the abdomen and lower uterine segment to deliver the baby and placenta, followed by closure of the incisions. Complications can include hemorrhage, infection, and injury to nearby organs, but with
Recommended
Fibroids
Uterine fibroids are benign tumors that arise from the smooth muscle cells of the uterus. They are the most common pelvic tumor in women. Fibroids can be classified based on their location within the uterus as submucosal, intramural, subserosal, or cervical. Symptoms depend on the size and location of fibroids and include heavy menstrual bleeding, pelvic pressure or pain, and reproductive complications like infertility. Diagnosis involves history, physical exam, pelvic ultrasound, and sometimes additional imaging like MRI.
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this lecture involves full, simple and easy description of cervicitis
including acute and chronic cervicitis and the major causes for it as Neisseria gonorrhea and chlamydia trachomatous
also chronic infection and ectopy
urinary tract infection during pregnancy
Urinary tract infections (UTIs) are more common during pregnancy due to anatomical and physiological changes that cause incomplete bladder emptying and a less acidic urine. There are different types of UTIs including asymptomatic bacteriuria, acute cystitis, and pyelonephritis. Common symptoms are urges to urinate, painful urination, and fever. Left untreated, UTIs can cause serious complications for both mother and baby like preterm labor. Diagnosis involves urine and blood tests and treatment consists of hospitalization, IV fluids and antibiotics. Prevention focuses on drinking fluids, urinating frequently, and good genital hygiene.
Cervical erosion
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
Placenta previa
Placenta previa is a condition in which the placenta lies very low in the uterus and covers all or part of the cervix. The cervix is the opening to the uterus that sits at the top of the vagina. Placenta previa happens in about 1 in 200 pregnancies.
Placenta praevia risk factors include a previous delivery, age older than 35 and a history of previous surgeries, such as a caesarean section (C-section) or uterine fibroid removal.
The main symptom is bright red vaginal bleeding without pain during the second-half of pregnancy. The condition can also cause severe bleeding before or during delivery.
Limited physical activity is recommended. A C-section is often required in severe cases.
Complications of puerperium
This document summarizes common complications that can occur during the puerperium period after childbirth. These include puerperal pyrexia (fever) which can be caused by infections in the genital tract, breast, respiratory tract, or urinary tract. Other causes include wound infections or thrombophlebitis. Problems with breastfeeding may also occur such as engorgement, cracked nipples, mastitis or breast abscess. Coagulation disorders can increase the risk of thromboembolism, which is a leading cause of maternal mortality. Finally, psychiatric disorders like postpartum blues, anxiety, depression or psychosis may develop during this time.
Uterine prolapse
Uterine prolapse occurs when the uterus descends from its normal position due to weakened pelvic muscles and tissues. It is often caused by pregnancy, childbirth, obesity, menopause, or chronic conditions like coughing or constipation. Symptoms range from a feeling of heaviness to organs protruding from the vagina. Treatment options include pelvic floor exercises, pessaries, hormone therapy, and surgery to repair damaged tissues or remove the uterus. Surgical risks include infection, incontinence, and prolapse recurrence.
Caesarean section
Caesarean section is the delivery of a baby through surgical incisions in the mother's abdomen and uterus. It can be performed as an emergency procedure if there are threats to the mother or baby, or electively if there are risk factors present but no urgency. The most common reasons for C-section are prior C-section, non-progressing labor, abnormal fetal position, and fetal distress. Regional anesthesia is preferred to allow the mother to experience childbirth while remaining safe. The surgery involves making incisions in the abdomen and lower uterine segment to deliver the baby and placenta, followed by closure of the incisions. Complications can include hemorrhage, infection, and injury to nearby organs, but with
Cervical erison
Cervical ectropion is a common condition caused by hormonal changes that results in cells normally found inside the cervix appearing on the outside of the cervix. It can cause symptoms like bleeding or discharge but is not harmful. While cervical ectropion may require treatment if symptoms are severe, it usually resolves on its own without intervention by stopping oral contraceptives or resolving hormonal changes during pregnancy. Treatment options include cryotherapy or electrocautery to remove the ectopic cells. Routine cervical screening should continue to monitor for any abnormal cell changes.
BARTHOLINS.pptx
Bartholin's glands are paired oval-shaped glands located on each side of the vaginal opening that produce lubricating secretions. Bartholin's gland infection, or Bartholinitis, can be caused by various bacteria and may result in complete resolution, recurrence, abscess formation, or cyst formation. A Bartholin's abscess is an infection of one of the glands that causes severe pain and swelling. Treatment involves antibiotics, sitz baths, and draining the abscess. A Bartholin's cyst is a fluid-filled sac that can cause discomfort and dyspareunia, and treatment is marsupialization to remove the cyst.
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This document discusses septic abortion, which occurs when an abortion is complicated by infection in the uterus or its contents. It defines septic abortion and outlines its causes, clinical presentation, investigations, management, and complications. Septic abortion is most commonly associated with illegal or unsafe induced abortions where proper aseptic techniques are not followed. Management involves controlling the infection with antibiotics, removing the source of infection, and providing supportive care. Treatment is based on clinical grading of the infection from Grade I (localized) to Grade III (generalized peritonitis or septic shock), with more aggressive management needed for higher grades.
mastitis.pdf
Mastitis is inflammation of the breast tissue that can be caused by an engorged breast or a blocked duct.
Vulvitis
Vulvitis is irritation or inflammation of the vulva, the skin outside the vagina. It causes symptoms like itching, redness, swelling, soreness, and pain during sex. Vulvitis can be caused by infections, irritants like soaps or tight clothing, medications, douching, or poor hygiene. Diagnosis involves examining the vulva and testing for infections. Treatment depends on the underlying cause but may include anti-fungal or antibiotic creams, hydrocortisone cream for allergies, or estrogen cream for post-menopausal women. Preventing vulvitis involves keeping the vulva clean, dry, and cool and avoiding irritants.
Injuries to the birth canal
it contains a presentation on injuries that occur during baby birth
summary:
Maternal injuries following childbirth process are quite common.
VULVA
PERINEUM
RISK FACTORS FOR THIRD DEGREE PERINEL TEAR
REPAIR OF COMPLETE PERINEAL TEAR
VAGINA
CERVIX
PELVIC HEMATOMA
DIAGNOSIS OF RUPTURE UTERUS
Hydatidiform (vesicular) mole
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Pelvic inflammatory disease ppt
Pelvic inflammatory disease (PID) is an inflammatory condition of the pelvic cavity that is usually caused by bacteria, viruses, or other microbes. It commonly affects sexually active young women and can cause long-term complications like infertility or ectopic pregnancy if left untreated. Symptoms include lower abdominal pain and vaginal discharge. Treatment involves antibiotics, bed rest, and care of any sexual partners. Nursing care focuses on monitoring, education, and supporting patients through treatment.
Management of ectopic pregnancy
An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, usually in the fallopian tubes. Ectopic pregnancies are not viable and can be life-threatening due to potential internal bleeding. The vast majority of ectopic pregnancies implant in the fallopian tubes. Diagnosis involves transvaginal ultrasound and beta-hCG level testing. Treatment options include medical management with methotrexate or surgical intervention like laparoscopy or laparotomy. The goal of treatment is to remove the ectopic pregnancy safely while preserving the ability to conceive in the future.
Breech presentation
Breech presentation refers to when the fetus is in a longitudinal lie with its buttocks as the lowest part. The document discusses the different types of breech presentations as well as their incidence, classifications, positions, etiology, diagnosis, and management both during pregnancy and delivery. Management during pregnancy includes attempting external cephalic version after 36 weeks to convert the fetus to head-first position. Management during delivery depends on factors such as gestational age and fetal/maternal conditions, and may involve vaginal delivery with assistance, total breech extraction, or cesarean section to avoid risks to the mother and fetus.
20.Pelvic Inflammatory Disease
Pelvic inflammatory disease (PID) is an inflammatory condition of the female upper genital tract that can involve the endometrium, fallopian tubes, and pelvic tissue. It is usually caused by bacteria like Neisseria gonorrhoeae and Chlamydia trachomatis transmitted sexually. Left untreated, PID can lead to long-term complications like infertility or ectopic pregnancy. Treatment involves antibiotics, with hospitalization sometimes needed for severe or unresponsive cases. Prompt treatment is important to prevent permanent damage.
Abnormal puerperium
This topic contains detail information about all abnormalities during puerperium like puerperial pyrexia, sepsis, subinvolution, breast complications, urinary complications, puerperal venous thrombosis, pulmonary embolism, obstetric palsies, puerperal emergencies, psychiatric disroders, perinatal management
Breech presentation
This document discusses breech presentation, including its definition, types, diagnosis, and management. Some key points:
- Breech presentation is when the buttocks or lower limbs present first. It occurs in 3.5% of term deliveries and up to 25% of preterm deliveries.
- Types include complete breech, frank breech, and footling breech. Diagnosis is made through inspection, palpation, auscultation, and ultrasound.
- Management options are external cephalic version, vaginal delivery for some cases, or caesarean section which is recommended for complicated breeches or large babies. Vaginal delivery carries risks of complications for
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Vital signs, urine analysis, blood tests and ultrasounds were conducted to investigate a patient's condition. Tests included renal and liver function as well as a 24-hour urine creatinine. The conclusion was that eclampsia is a common complication associated with high mortality and morbidity for both mother and baby, so antenatal care needs to be strengthened to detect pre-eclampsia early and prevent eclampsia, and in-hospital management should be optimized to prevent further seizures and complications.
Shoulder dystocia
Shoulder dystocia occurs when the baby's shoulders become stuck after delivery of the head. It has a low incidence rate of 0.2-1% and risk factors include fetal macrosomia, obesity, diabetes and others. Diagnosis is made when normal maneuvers by the midwife fail to deliver the baby. Management involves calling for help, clearing the baby's airways, and performing maneuvers like McRoberts and Rubin's to rotate the shoulders and decrease their diameter in order to allow delivery. More invasive maneuvers like cleidotomy may be needed if these fail to deliver the anterior shoulder.
ABNORMAL LABOUR
Definitions
Stages and Phases of Normal Labour
Abnormal Patterns of Labour
Classification of Abnormal Labour/Dystocia
Diagnosis and Management of Abnormal Labour
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This document discusses polyhydramnios, or excessive amniotic fluid, during pregnancy. It defines polyhydramnios as an amniotic fluid index greater than 25 cm or a single vertical pocket over 8 cm. Common causes include fetal anomalies, placental tumors, multiple pregnancies, and maternal diabetes. Chronic polyhydramnios presents with abdominal swelling while acute cases are rarer and can be caused by twin-twin transfusion syndrome or large placental tumors. Ultrasound is used to diagnose and complications for both mother and baby must be monitored and managed.
Vaginitis
Vaginitis is an inflammation of the vagina that affects about 1 in 3 women during their reproductive years. It is often caused by infections like bacterial vaginosis, trichomoniasis, or a yeast infection. Symptoms include burning and itching outside the vagina along with a white, lumpy discharge. Doctors diagnose vaginitis by examining a sample of vaginal discharge under a microscope. Treatment depends on the specific type but generally involves oral or topical medications.
Pelvic inflammatory disease (PID)
Pelvic inflammatory disease (PID) is an inflammatory condition of the pelvic cavity that is usually caused by bacteria like gonorrhea and chlamydia. It begins with cervicitis and can spread to the uterus, fallopian tubes, ovaries, and pelvic peritoneum. Risk factors include young age, multiple sexual partners, history of STDs, and procedures like IUD insertion. Symptoms include lower abdominal pain and vaginal discharge. Diagnosis involves history, exam noting cervical motion tenderness, and tests. Treatment is hospitalization, IV antibiotics, and educating partners to prevent reinfection. Complications can include infertility, ectopic pregnancy, and chronic pelvic pain.
database.pptx
1) The document discusses various databases related to Ayurveda including literature databases containing Samhitas and other Ayurvedic texts, manuscript databases, herbal databases containing information on medicinal plants from sources like the Flora of India and the Wealth of India series, the Traditional Knowledge Digital Library, clinical trials registry, Cochrane library, and dissertation repository Shodhganga.
2) It also mentions databases containing information on Ayurvedic pharmaceutical companies and their products, the national pharmacovigilance program and database, patent databases, gemological and minerals databases, and mobile apps databases.
3) Several national organizations that maintain important Ayurveda databases are discussed, including the National Institute of
uterine fibroid.pptx
Uterine fibroids are benign tumors that develop in the uterus. They are composed of smooth muscle and connective tissue and are the most common tumors found in females. The highest prevalence occurs in women between ages 35-45. While the exact cause is unclear, genetic and hormonal factors likely play a role. Fibroids can be asymptomatic but may cause heavy periods, pelvic pain, infertility, or pregnancy complications. Diagnosis involves ultrasound, MRI, or other imaging. Treatment options include medication, myomectomy (surgical removal of fibroids), hysterectomy (removal of the uterus), or embolization (blocking the blood supply).
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Cervical erison
Cervical ectropion is a common condition caused by hormonal changes that results in cells normally found inside the cervix appearing on the outside of the cervix. It can cause symptoms like bleeding or discharge but is not harmful. While cervical ectropion may require treatment if symptoms are severe, it usually resolves on its own without intervention by stopping oral contraceptives or resolving hormonal changes during pregnancy. Treatment options include cryotherapy or electrocautery to remove the ectopic cells. Routine cervical screening should continue to monitor for any abnormal cell changes.
BARTHOLINS.pptx
Bartholin's glands are paired oval-shaped glands located on each side of the vaginal opening that produce lubricating secretions. Bartholin's gland infection, or Bartholinitis, can be caused by various bacteria and may result in complete resolution, recurrence, abscess formation, or cyst formation. A Bartholin's abscess is an infection of one of the glands that causes severe pain and swelling. Treatment involves antibiotics, sitz baths, and draining the abscess. A Bartholin's cyst is a fluid-filled sac that can cause discomfort and dyspareunia, and treatment is marsupialization to remove the cyst.
Septic Abortion
This document discusses septic abortion, which occurs when an abortion is complicated by infection in the uterus or its contents. It defines septic abortion and outlines its causes, clinical presentation, investigations, management, and complications. Septic abortion is most commonly associated with illegal or unsafe induced abortions where proper aseptic techniques are not followed. Management involves controlling the infection with antibiotics, removing the source of infection, and providing supportive care. Treatment is based on clinical grading of the infection from Grade I (localized) to Grade III (generalized peritonitis or septic shock), with more aggressive management needed for higher grades.
mastitis.pdf
Mastitis is inflammation of the breast tissue that can be caused by an engorged breast or a blocked duct.
Vulvitis
Vulvitis is irritation or inflammation of the vulva, the skin outside the vagina. It causes symptoms like itching, redness, swelling, soreness, and pain during sex. Vulvitis can be caused by infections, irritants like soaps or tight clothing, medications, douching, or poor hygiene. Diagnosis involves examining the vulva and testing for infections. Treatment depends on the underlying cause but may include anti-fungal or antibiotic creams, hydrocortisone cream for allergies, or estrogen cream for post-menopausal women. Preventing vulvitis involves keeping the vulva clean, dry, and cool and avoiding irritants.
Injuries to the birth canal
it contains a presentation on injuries that occur during baby birth
summary:
Maternal injuries following childbirth process are quite common.
VULVA
PERINEUM
RISK FACTORS FOR THIRD DEGREE PERINEL TEAR
REPAIR OF COMPLETE PERINEAL TEAR
VAGINA
CERVIX
PELVIC HEMATOMA
DIAGNOSIS OF RUPTURE UTERUS
Hydatidiform (vesicular) mole
A hydatidiform mole is a benign tumor of the placenta that can develop after conception. It occurs more frequently in Asian women and women over age 45. A complete mole contains no embryo and results from fertilization by a sperm that duplicates the paternal chromosomes. A partial mole contains some normal placental tissue but also abnormal molar areas, resulting from fertilization by two sperm. Diagnosis is based on an elevated hCG level and ultrasound findings, and treatment involves surgical evacuation of the uterus. Follow up hCG testing is needed to monitor for choriocarcinoma, a rare type of cancer that can develop after a molar pregnancy.
Pelvic inflammatory disease ppt
Pelvic inflammatory disease (PID) is an inflammatory condition of the pelvic cavity that is usually caused by bacteria, viruses, or other microbes. It commonly affects sexually active young women and can cause long-term complications like infertility or ectopic pregnancy if left untreated. Symptoms include lower abdominal pain and vaginal discharge. Treatment involves antibiotics, bed rest, and care of any sexual partners. Nursing care focuses on monitoring, education, and supporting patients through treatment.
Management of ectopic pregnancy
An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, usually in the fallopian tubes. Ectopic pregnancies are not viable and can be life-threatening due to potential internal bleeding. The vast majority of ectopic pregnancies implant in the fallopian tubes. Diagnosis involves transvaginal ultrasound and beta-hCG level testing. Treatment options include medical management with methotrexate or surgical intervention like laparoscopy or laparotomy. The goal of treatment is to remove the ectopic pregnancy safely while preserving the ability to conceive in the future.
Breech presentation
Breech presentation refers to when the fetus is in a longitudinal lie with its buttocks as the lowest part. The document discusses the different types of breech presentations as well as their incidence, classifications, positions, etiology, diagnosis, and management both during pregnancy and delivery. Management during pregnancy includes attempting external cephalic version after 36 weeks to convert the fetus to head-first position. Management during delivery depends on factors such as gestational age and fetal/maternal conditions, and may involve vaginal delivery with assistance, total breech extraction, or cesarean section to avoid risks to the mother and fetus.
20.Pelvic Inflammatory Disease
Pelvic inflammatory disease (PID) is an inflammatory condition of the female upper genital tract that can involve the endometrium, fallopian tubes, and pelvic tissue. It is usually caused by bacteria like Neisseria gonorrhoeae and Chlamydia trachomatis transmitted sexually. Left untreated, PID can lead to long-term complications like infertility or ectopic pregnancy. Treatment involves antibiotics, with hospitalization sometimes needed for severe or unresponsive cases. Prompt treatment is important to prevent permanent damage.
Abnormal puerperium
This topic contains detail information about all abnormalities during puerperium like puerperial pyrexia, sepsis, subinvolution, breast complications, urinary complications, puerperal venous thrombosis, pulmonary embolism, obstetric palsies, puerperal emergencies, psychiatric disroders, perinatal management
Breech presentation
This document discusses breech presentation, including its definition, types, diagnosis, and management. Some key points:
- Breech presentation is when the buttocks or lower limbs present first. It occurs in 3.5% of term deliveries and up to 25% of preterm deliveries.
- Types include complete breech, frank breech, and footling breech. Diagnosis is made through inspection, palpation, auscultation, and ultrasound.
- Management options are external cephalic version, vaginal delivery for some cases, or caesarean section which is recommended for complicated breeches or large babies. Vaginal delivery carries risks of complications for
Pregnancy induced hypertension
This presentation incudes a description of pregnancy induce hypertension, it's risk factor, medical as well as nursing management.
Eclampsia ppt
Vital signs, urine analysis, blood tests and ultrasounds were conducted to investigate a patient's condition. Tests included renal and liver function as well as a 24-hour urine creatinine. The conclusion was that eclampsia is a common complication associated with high mortality and morbidity for both mother and baby, so antenatal care needs to be strengthened to detect pre-eclampsia early and prevent eclampsia, and in-hospital management should be optimized to prevent further seizures and complications.
Shoulder dystocia
Shoulder dystocia occurs when the baby's shoulders become stuck after delivery of the head. It has a low incidence rate of 0.2-1% and risk factors include fetal macrosomia, obesity, diabetes and others. Diagnosis is made when normal maneuvers by the midwife fail to deliver the baby. Management involves calling for help, clearing the baby's airways, and performing maneuvers like McRoberts and Rubin's to rotate the shoulders and decrease their diameter in order to allow delivery. More invasive maneuvers like cleidotomy may be needed if these fail to deliver the anterior shoulder.
ABNORMAL LABOUR
Definitions
Stages and Phases of Normal Labour
Abnormal Patterns of Labour
Classification of Abnormal Labour/Dystocia
Diagnosis and Management of Abnormal Labour
Polyhydramnios
This document discusses polyhydramnios, or excessive amniotic fluid, during pregnancy. It defines polyhydramnios as an amniotic fluid index greater than 25 cm or a single vertical pocket over 8 cm. Common causes include fetal anomalies, placental tumors, multiple pregnancies, and maternal diabetes. Chronic polyhydramnios presents with abdominal swelling while acute cases are rarer and can be caused by twin-twin transfusion syndrome or large placental tumors. Ultrasound is used to diagnose and complications for both mother and baby must be monitored and managed.
Vaginitis
Vaginitis is an inflammation of the vagina that affects about 1 in 3 women during their reproductive years. It is often caused by infections like bacterial vaginosis, trichomoniasis, or a yeast infection. Symptoms include burning and itching outside the vagina along with a white, lumpy discharge. Doctors diagnose vaginitis by examining a sample of vaginal discharge under a microscope. Treatment depends on the specific type but generally involves oral or topical medications.
Pelvic inflammatory disease (PID)
Pelvic inflammatory disease (PID) is an inflammatory condition of the pelvic cavity that is usually caused by bacteria like gonorrhea and chlamydia. It begins with cervicitis and can spread to the uterus, fallopian tubes, ovaries, and pelvic peritoneum. Risk factors include young age, multiple sexual partners, history of STDs, and procedures like IUD insertion. Symptoms include lower abdominal pain and vaginal discharge. Diagnosis involves history, exam noting cervical motion tenderness, and tests. Treatment is hospitalization, IV antibiotics, and educating partners to prevent reinfection. Complications can include infertility, ectopic pregnancy, and chronic pelvic pain.
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1) The document discusses various databases related to Ayurveda including literature databases containing Samhitas and other Ayurvedic texts, manuscript databases, herbal databases containing information on medicinal plants from sources like the Flora of India and the Wealth of India series, the Traditional Knowledge Digital Library, clinical trials registry, Cochrane library, and dissertation repository Shodhganga.
2) It also mentions databases containing information on Ayurvedic pharmaceutical companies and their products, the national pharmacovigilance program and database, patent databases, gemological and minerals databases, and mobile apps databases.
3) Several national organizations that maintain important Ayurveda databases are discussed, including the National Institute of
uterine fibroid.pptx
Uterine fibroids are benign tumors that develop in the uterus. They are composed of smooth muscle and connective tissue and are the most common tumors found in females. The highest prevalence occurs in women between ages 35-45. While the exact cause is unclear, genetic and hormonal factors likely play a role. Fibroids can be asymptomatic but may cause heavy periods, pelvic pain, infertility, or pregnancy complications. Diagnosis involves ultrasound, MRI, or other imaging. Treatment options include medication, myomectomy (surgical removal of fibroids), hysterectomy (removal of the uterus), or embolization (blocking the blood supply).
Trichomonas vaginitis.pptx
Introduction
Causative agent : Trichomonas vaginalis
Transmission : Sexual contact
Incubation period : 3 – 28 days.
Clinical features
Sudden profuse and offensive vaginal discharge.
Severe irritation and itching around introitus.
Dysuria and increased frequency of urine.
Examination:
Thin, greenish yellow frothy offensive vaginal discharge.
Inflammed vulva
Vaginal examination may be painful.
Diagnosis:
Culture of discharge :
Diamonds TYM or Feinberg
Whittington medium.
Treatment:
DOC : Metronidazole
200mg TDS x 1 week.
Tinidazole
syphilis.pptx
Introduction
Causative agent : Treponema pallidium
Transmission : Abraded skin / mucosal surface.
Spreads through direct contact.
Incubation period : 9 -90 days.
Clinical features
Phases of syphilis :
Primary syphilis
Lesion / Chancre : Single/ Multiple
Site : Labia, fourchette, anus, cervix or
nipples.
Small papule gets eroded into an ulcer. The margins of ulcer are raised and floor is smooth and shiny.
Healing of primary chancre takes place in 1-8 weeks.
Secondary Syphilis
Secondary syphilis is evident in form of Condyloma lata in vulva.
Condyloma lata : coarse, flat topped, moist, necrotic lesions.
Maculopapular rashes : Palms and soles.
Alopecia, lymphadenopathy, mucosal ulcers.
Latent Syphilis
Quiescence phase.
Duration : 2 -20 years.
Tertiary Syphilis
Progression of tertiary syphilis occurs only in condition of untreated syphilis.
Damages CNS, CVS, Musculoskeletal system.
Cranial nerve palsies III, VI, VII and VIII.
Gummatous ulcer : deep punched ulcer with rolled out margins. Painless with moist leather base.
Diagnosis
History of exposure.
Identification of organism.
Serological test
VDRL (Venereal disease research laboratory)
TPHA (Treponoma pallidum haemagglutination)
EIA (Enzyme immunoassay)
FTA (Fluorescent treponomal Antibody)
TPI (Treponoma pallidum immobilisation)
Treatment
Benzathine penicillin IM
Tetracycline 500 mg
Doxycycline 100 mg
Serological test should be performed 1, 3, 6 and 12
month after treatment of syphilis.
pruritis vulvae.pptx
Pruritis vulvae
Etiology:
1. Vaginal discharge : Trichomonas vaginalis, Candida albicans
2. Local skin lesion: Psoriasis, Dermatitis
3. Vulvar infection: Fungal, Viral, Parasitic, STD
4. Medical disorders: Glycosuria
5. Deficiency: Fe, Folic acid, Vit B12 Vit A
6. Psychosomatic causes
Investigations
Age of onset
Intensity of itching
Duration
Vaginal discharge
Contraceptive practice
Allergy- nylon, soap, detergent.
DM
Liver disorder
Thyroid
Hematological disorder
Special Investigations
Microscopic examination: Vaginal discharge / vulval scarping
Urine examination: Sugar, Protein and pus cells.
Blood examination: CBC, Thyroid profile, Glucose, LFT, RFT
Stool examination: Ova, Parasite, Cyst.
Treatment
Maintain local hygiene.
Loose fitting clothing
Local topical application: antibiotics/ clobetasol propionate
Treat specific disease
Surgery: Neoplasia invasion
POP.pptx
Pelvic organ prolapse
Pelvic Organ Prolapse
Most common gynaecological problem.
Amongst parous women.
A form of hernia.
Anatomy of Uterus
Anteversion and anteflexion position.
Lies between rectum and bladder.
Cervix pierces the vagina at the right angle to the axis of vagina.
Supports of Uterus
Uterus is held in position by 3 tier support system.
Upper tier
Middle tier
Inferior tier.
Upper tier
Primarily, maintains the uterus in anteverted position.
The structures responsible are:
Endopelvic fascia.
Round ligaments.
Broad ligaments.
Middle tier
Constitutes the strongest support of uterus.
Responsible structures are:
Pericervical ring.
Pelvic cellular tissues.
Inferior tier
Indirect support of uterus.
Responsible structures are pelvic floor muscles including:
Levator ani
Endopelvic fascia
Levator plate
Perineal body
Urogenital diaphragm
Anatomical Factors
Gravitational stress.
Parturition stress.
Pelvic floor weakness.
Inherent weakness of supporting structures.
Acquired Predisposing Factors
Trauma of vaginal delivery causing injury :
Ligaments
Endopelvic fascia
Levator muscle
Perineal body
Pudendal nerve and muscle damage due to
repeated child birth.
Congenital Predisposing Factors
Inborn weakness of supporting structure.
Aggravating factors
Post menopausal atrophy
Poor collagen tissue repair with age.
Increased intra abdominal pressure.
Occupational hazards
Asthenia
Obesity
Fibroid/Polyp
Clinical Degrees Of Uterine Prolapse
Symptoms
Feeling of something coming out per vaginum.
Backache or dragging pain in pelvis
Dyspareunia
Urinary symptoms
Bowel symptoms
Clinical examination
Inspection and palpation.
General examination.
Pelvic examination
Uterine prolapse
Management of Prolapse
Preventive
Conservative
Surgery
Preventive Measures
Pelvic floor exercise during puerperium.
Avoid strenuous activities.
Avoiding prolonged cough.
Avoiding constipation.
Avoiding heavy weight lifting.
Avoiding future pregnancy too early.
Conservative Management
Indications :
Asymptomatic women
Mild degree prolapse
POP in early pregnancy
Treatment :
Oestrogen replacement therapy.
Kegel exercise
Pessary treatment
Surgical Management of Prolapse
Restorative
Extirpative
Obliterative
pid.pptx
Definition
PID is a disease of the upper genital tract.
It is a spectrum of infection and inflammation of the upper genital tract organs typically involving the uterus (endometrium), fallopian tubes, ovaries, pelvic peritoneum and surrounding structures.
Epidemiology
Occurs both in the developed and developing
countries.
85 per cent are spontaneous infection in sexually active females of reproductive age.
The remaining 15 per cent follow procedures, which favors the organisms to ascend up.
Two-thirds are restricted to young women of less than 25 years and the remaining one-third limited among 30 years or older.
Risk factors
Menstruating teenagers.
Multiple sexual partners.
Absence of contraceptive pill use.
Previous history of acute PID.
IUD users.
Area with high prevalence of sexually transmitted diseases.
Protective factors
Contraceptive practice
Barrier methods
Oral steroidal contraceptives
Monogamy / Vasectomy
Others
Pregnancy
Menopause
Vaccines
CLINICAL FEATURES
Bilateral lower abdominal and pelvic pain dull in nature.
Fever, lassitude and headache.
Irregular and excessive vaginal bleeding .
Abnormal vaginal discharge (purulent or copious)
Nausea and vomiting.
Dyspareunia.
Pain and discomfort in the right hypochondrium.
Signs
Temperature >38.3°C.
Abdominal palpation
(1) Tenderness on both the quadrants of lower abdomen.
(2) The liver may be enlarged and tender.
Vaginal examination
(1) Abnormal vaginal discharge (purulent).
(2) Congested external urethral meatus or openings of Bartholin’s ducts through which pus may be seen escaping out on pressure.
(3) Speculum examination shows congested cervix with purulent discharge from the canal.
Clinical diagnostic criteria of PID (CDC-2006)
Minimum Criteria
Lower abdominal tenderness.
Adnexal tenderness.
Cervical motion tenderness.
Additional Criteria
Oral temperature > 38.3°C.
Mucopurulent cervical or vaginal discharge.
Raised C-reactive protein and/or ESR.
Definitive Criteria
Histopathologic evidence of endometritis on biopsy.
Imaging study (TVS/MRI) evidence of tubo-ovarian complex.
Laparoscopic evidence of PID
Investigations
Identification of organisms
Blood: Leucocyte count shows leucocytosis to more than 10,000 per cu mm and an elevated ESR value of more than 15 mm per hour.
Laparoscopy
Complications Of Pid
Immediate
Pelvic peritonitis or even generalized
Septicemia
Late
Dyspareunia
Infertility
Chronic pelvic inflammation
Formation of adhesions or hydrosalpinx or pyosalpinx and tubo-ovarian abscess.
Chronic pelvic pain and ill health.
Ambulatory Management Of Acute PID (CDC-2006)
Patient should have oral therapy for 14 days
Regimen A
Levofloxacin 500 mg (or, ofloxacin 400 mg) PO
Metronidazole 500 PO bid
Regimen B
Ceftriaxone 250 mg IM single dose
Doxycycline 100 mg PO BID with or without
Metronidazole 500 mg PO BID for 14
hsg.pptx
Hysterosalpingography (HSG)
Hystero + Salpingo + Graphy
HSG is a radiological procedure done to assess the interior anatomy of the uterine cavity and the shape and patency of the fallopian tubes.
It is a radiographic study using fluorescent dye to visualise the anatomy of uterus and fallopian tubes.
Indications:
Assessment of tubal patency.
Detection of uterine malformation.
Diagnosis of cervical incompetence.
Detection of translocated IUD.
Diagnosis of uterine synechiae.
Diagnosis of uterine fibroid , uterine polyp.
Diagnosis of abdominal pregnancy.
Uterine Malformation
Steps of operation
The patient is asked to remain empty bladder.
Operation is done under general anaesthesia.
The patient is placed in lithotomy position.
Local antiseptic cleaning is done.
Posterior vaginal speculum is introduced.
Anterior lip of cervix is grasped with Allis tissue forcep.
HSG cannula is fitted with a syringe containing radio opaque dye. About 5- 10 ml of dye is slowly introduced.
The passage of the dye is observed by using X-ray intensifier and a video display unit.
Two radiographic X-rays are taken. First one to show the filling of uterine cavity and other one 10-15 mins after the completion of procedure.
Timing of procedure :
HSG is done between D6 and D10 of cycle.
Antibiotics are given one day prior the procedure up to 5 days.
Contrast media
Complications
Peritoneal irritation.
Pelvic pain.
Vasovagal attack.
Intravasation of dye into the venous or lymphatic channels.
Flaring up of pelvic infections.
endo.pptx
Definition
Presence of functioning endometrium (glands and stroma) in sites other than uterine mucosa is called endometriosis.
It is a benign but it is locally invasive.
Prevalence
The real one is due to delayed marriage, postponement of first conception and adoption of small family norm.
The apparent one is due to increased use of diagnostic laparoscopy as well as hightened awareness of this disease complex amongst the gynecologists
Sites
Abdominal: Usually confined to the abdominal structures below the level of umbilicus.
Extra-abdominal: Common sites are abdominal scar of hysterotomy, cesarean section, tubectomy and myomectomy, umbilicus, episiotomy scar, vagina and cervix.
Remote
Pathology
Naked Eye Appearance: The appearance of the lesion depends on the organs involved, extent of lesion and reaction of the surrounding tissues.
Pelvic endometriosis: Small black dots, called ‘powder burns’ seen on the uterosacral ligaments and pouch of Douglas.
Fibrosis and scarring
Symptoms
Dysmenorrhea (70%)
Abnormal menstruation (20%)
Infertility (40–60%)
Dyspareunia (20–40%)
Chronic Pelvic Pain
Abdominal Pain
Urinary— frequency, dysuria, back pain or even hematuria.
Sigmoid colon and rectum—painful defecation (dyschezia), diarrhea, constipation, rectal bleeding or even melena.
Chronic fatigue, perimenstrual symptoms (bowel, bladder).
Hemoptysis (rarely), chest pain.
Surgical scars—cyclical pain and bleeding.
Examination
Abdominal palpation
A mass may be felt in the lower abdomen arising from the enlarged tubo-ovarian mass due to endometriotic adhesions. The mass is tender with restricted mobility.
Pelvic Examination
Pelvic tenderness, nodules in the pouch of Douglas, nodular feel of the uterosacral ligaments, fixed uterus or unilateral or bilateral adnexal mass of varying sizes
Diagnosis
Bichemical parameters:
Serum CA 125
Monocyte Chemotactic Protein (MCP-1)
Imaging:
TVS - ovarian endometriomas
Endorectal USG - Rectosigmoid endometriosis
MRI - deep infiltrating endometriosis.
Colonoscopy, rectosigmoidoscopy and cystoscopy
Differential Diagnosis
Chronic pelvic infection / symptomatic endometriosis. Laparoscopy is helpful in actual diagnosis.
Ovarian endometrioma / benign ovarian tumor / malignant ovarian.
Ultrasonography or Laparoscopy
Rupture of the chocolate cyst / torsion or rupture of the ovarian tumour, disturbed ectopic pregnancy, appendicitis or diverticulitis.
Complications
Endocrinopathy
Rupture of chocolate cyst
Infection of chocolate cyst
Obstructive features:
Intestinal obstruction
Ureteral obstruction → hydroureter
hydronephrosis → renal infection
Endocrinopathy in Endometriosis
Corpus luteum insufficiency
Luteolysis due to ↑ PGF.
Luteinized unruptured follicle (LUF)
Anovulation
Elevated prolactin level
Double LH peak.
Staging
Endometrios is should be staged appropriately.
To predict prognosis.
To choose therapy.
To evaluate the treatment protocol.
The stage is determined by adding specific points given to each.
contraception.pptx
Contraception
Contraception is defined as the intentional prevention of conception through the use of various devices, sexual practices, chemicals, drugs or surgical procedures.
The preventive methods to help women avoid unwanted pregnancies are called contraceptive methods.
Need for contraception
• To avoid unwanted pregnancies.
• To regulate the timing of pregnancy.
• To regulate the interval between pregnancy.
Ideal Contraceptive
• Safe
• Effective
• Acceptable
• Reversible
• Inexpensive
• Long lasting
• Requires little or no medical supervision
Contraceptive methods
Spacing methods
Natural
Barrier
IUDs
Emergency contraception
Terminal methods
Male fertilisation
Female fertilisation
Natural Methods
Coitus inteyrruptus / withdrawal
Rhythm Method
Lactational Amenorrhoea
Barrier Methods
Mechanical
Male : Condom
Female : Condom, Diaphragm, Cervical cap
Chemical
Creams - Deleen
Jelly – Koromex, Volpar paste
Foam tablets – Aerosol foams, Chlorimin T or Contab
Combination
Combined use of Chemical and Mechanical methods.
Male condom
• Most commonly known and used contraceptive.
• Better known in India as NIRODH.
Female condom
Femidom
Diaphragm
Spermicides
Spermicides are surface active agents which attach
themselves to spermatozoa and kill them.
Available in various forms like
Intrauterine Contraceptive Devices
Cu T200
T shaped device Polyethylene frame.
215 mm2 surface area of Cu wire.
Contains 124 mg of copper
Cu is lost at the rate of 50 µg/day.
Polyethylene monofilament tied at vertical stem.
Cu is radio opaque so additionally barium is
incorporated in the device.
Supplied in a sterilised sealed packet.
Lifetime 4 years.
Cu T 380A
380 mm square surface area of copper wire.
Replacement 10 years.
Multiload Cu 250
60-100 ug/day
Replacement 3 years
Multiload - 375
Mode of action
Biochemical and histological changes in endometrium.
Increased tubal motility.
Endometrial inflammatory response.
Prevents implantation.
Contraindication for insertion of IUCD
Presence of pelvic infection
Genital tract bleeding (undiagnosed)
Suspected pregnancy
Uterine fibroid
Severe dysmenorrhoea
Ectopic pregnancy history
Caesarean section
Cu allergy
Time of insertion
Interval
2-3 days after menstrual phase.
During lactational amenorrhoea.
Postabortal
Done immediately following termination of pregnancy.
Postpartum
After 6 weeks of delivery.
Postplacental delivery
Post delivery of placenta.
Method of Insertion
Preliminary steps:
History taking and examination
Patient is informed and consent is obtained.
Insertion is done in OPD aseptic conditions.
Placement of device in inserter.
Steps of operation
The patient is asked to remain empty bladder.
The patient is placed in lithotomy position.
Local antiseptic cleaning is done.
Posterior vaginal speculum is introduced.
Anterior lip of cervix is grasped with Allis tissue forcep.
The device is placed in the inserter and introduced through cervical
Lgv (Lymphogranuloma Venereum)
Lymphogranuloma Venereum
Dr. Yashika
Causative agent : Chlamydia trachomatis
Incubation period: 3-30 days
Clinical features :
Initial phase:
Painless papule, pustule or ulcer in vulva, urethra,
rectum or cervix.
Involved inguinal nodes feels rubbery.
Acute lumphangitis and lymphadenitis.
Necrosed glands and abscess formation.
Rupture of abscess occurs within 7-15 days.
Sinus and fistula formation.
Intense fibrosis with lymphatic drainage.
Secondary phase : Painful adenopathy.
Classical clinical sign:
Groove sign
A depression between the groups of inflammed nodes.
Complication:
Vulval elephantiasis
Perineal scarring
Rectal stricture
Sinus and fistula formation.
Diagnosis
Culture and isolation
Detection of LGV
Treatment:
Doxycycline 100 mg BID x 21days.
Azithromycin 1 gm PO weekly x 3 weeks
Abscess aspiration
Leucorrhoea
Leucorrhoea
Dr. Yashika
Abnormal Vaginal Discharge
Frequent complaint.
Discharge may vary from excess to normal.
Discharge may be blood-stained / contaminated with urine or stool.
Characteristics of normal vaginal fluid
Nature - watery
Colour - white
Odour - Odourless
pH - 4.0
Microscopically - Squamous epithelial cells,
Leucorrhoea
Leucorrhoea is defined as excessive normal vaginal discharge.
Features of vaginal discharge in leucorrhoea :
Excess secretion.
Non purulent
Non offensive
Non irritant
Never causes pruritis.
Etiology :
Physiological excess
Cervical causes
Vaginal causes
Physiologic excess
Puberty
Menstrual Cycle
Pregnancy
Sexual excitement
Cervical causes:
Cervicitis
Cervical ectopy
Cervical polyp
Treatment
General health improvement
Surgical treatment of cervical factors
Pill users are asked to stop pill immediately
Local hygiene
Hysterectomy
HYSTERECTOMY
Hysterectomy
Hysterectomy
Term origin:
hyster + ectomy
uterus surgical removal
Definition:
Hysterectomy is defined as the surgical removal of uterus.
Routes for Hysterectomy
Abdominal Hysterectomy
Vaginal Hysterectomy
Laparoscopic Hysterectomy
Caesarean Hysterectomy
Types of Hysterectomy
Total Hysterectomy
Removal of entire uterus.
Subtotal Hysterectomy
Removal of body or corpus leaves behind the cervix.
Panhysterectomy / Hysterectomy with bilateral salpingo oophorectomy
Removal of uterus along with tubes and ovaries of
both sides.
Indications
Hsv Herpes Genitalis
Herpes Genitalis
Dr. Yashika
Introduction
Causative organism : Herpes Simplex virus type 1 and 2
Transmission : Orogenital contact
Incubation period : 2 – 14 days.
Clinical features:
First attack with 7 days of sexual contact.
Red painful inflammatory area around clitoris, labia, vestibule, vagina, cervix and perineum.
Appearance of multiple vesicles which progress into ulcers then heals up by crusting
Lymphadenopathy
Fever, malaise and headache.
Diagnosis:
Virus tissue culture and isolation
ELISA
Fluorescent method
PCR test
Treatment
Specific treatment is yet to b explored.
Acyclovir 200 mg 5 times x 5days.
Saline water bath.
Hsg
Hysterosalpingography
Dr. Yashika
Hysterosalpingography (HSG)
Hystero + Salpingo + Graphy
HSG is a radiological procedure done to assess the interior anatomy of the uterine cavity and the shape and patency of the fallopian tubes.
It is a radiographic study using fluorescent dye to visualise the anatomy of uterus and fallopian tubes.
Indications:
Assessment of tubal patency.
Detection of uterine malformation.
Diagnosis of cervical incompetence.
Detection of translocated IUD.
Diagnosis of uterine synechiae.
Diagnosis of uterine fibroid , uterine polyp.
Diagnosis of abdominal pregnancy.
Uterine Malformation
Steps of operation
The patient is asked to remain empty bladder.
Operation is done under general anaesthesia.
The patient is placed in lithotomy position.
Local antiseptic cleaning is done.
Posterior vaginal speculum is introduced.
Anterior lip of cervix is grasped with Allis tissue forcep.
HSG cannula is fitted with a syringe containing radio opaque dye. About 5- 10 ml of dye is slowly introduced.
The passage of the dye is observed by using X-ray intensifier and a video display unit.
Two radiographic X-rays are taken. First one to show the filling of uterine cavity and other one 10-15 mins after the completion of procedure.
Timing of procedure :
HSG is done between D6 and D10 of cycle.
Antibiotics are given one day prior the procedure up to 5 days.
Contrast media
Complications
Peritoneal irritation.
Pelvic pain.
Vasovagal attack.
Intravasation of dye into the venous or lymphatic channels.
Flaring up of pelvic infections.
Human Immunodeficiency Virus - Acquired Immuno Deficiency Disease
AIDS
Dr. Yashika
Introduction
Causative agent : Human Immunodeficiency Viruses (HIV)
HIV belongs to retrovirus family (double stranded RNA).
Mode of transmission
Sexual intercourse
IV drug abusers
Blood transfusion
Use of contaminated needles
Breastfeeding
Perinatal transmission
Immunopathogenesis
Immunological Markers
CD4 T lymphocyte count
RT-PCR
Raised P-24 antigen titre
Raised serum β2 microglobulin
Clinical Presentation
Development of Ab marks the stage of seroconversion aka flu-like syndrome.
Acute infection syndrome characterized by fever, skin rash, arthralgia, lymphadenopathy and diarrhoea. This is called seroconversion illness lasts upto 2-3 weeks and gets resolved itself spontaneously.
Gynaecological Symptoms
Infections of genital tract.
Neoplasm of genital tract.
Menstrual abnormalities.
Fertility and pregnancy are not affected.
Diagnosis
Detection of IgG antibody.
ELISA
Western blot
PCR
Treatment
Gonorrhoea
GONORRHOEA
Dr. Yashika
Introduction
Causative agent : Neisseria gonorrhoea (gram negative diplococcus).
Incubation period : 3-7 days.
Site of invasion : columnar and transitional epithelium of the genitourinary tract.
Primary sites of infection : endocervix, urethra and Bartholins gland.
Other sites of infection : Oropharynx, anorectal and conjuctiva.
Clinical features :
Local:
Excessive irritant vaginal discharge
Dysuria
Acute unilateral pain
Swelling over labia.
Pharyngeal infection
Intermenstrual bleeding.
Rectal discomfort.
Signs :
Swollen labia and inflammed.
Mucopurulent vaginal discharge.
Speculum examination reveals congested endocervix.
Distant symptoms :
Perihepatitis
Septicaemia
Complications:
PID
Infertility
Ectopic pregnancy
Chronic pelvic pain
Tubo ovarian mass
Bartholins gland abscess.
Diagnosis
Nucleic acid amplification test (NAAT)
urine culture
Drug sensitivity test.
Treatment
Adequate therapy for gonococcal infection.
To treat both the partner simultaneously.
To avoid multiple sex partner.
To use condom till free from disease.
Dilatation and Insufflation
Dilatation and Insufflation
Dr. Yashika
Dilatation and Insufflation (D&I)
Also known as Rubin’s test.
Operation for dilatation of cervix and insufflation of air (CO2) in to the uterine cavity to know the patency of fallopian tubes.
Indications of D&I
Investigation for fertility.
Following tuboplasty.
Contraindication : Pelvic infections.
Steps of operation
The patient is asked to remain empty bladder.
Operation is done under general anaesthesia.
The patient is placed in lithotomic position
Local antiseptic cleaning is done.
Posterior vaginal speculum is introduced.
Anterior lip of cervix is grasped with Allis tissue forceps.
7. Uterine sound is introduced to confirm the position and to note the length of cervical canal.
Cervical canal is dilated with graduated dilators.
After the desired dilatation, the insufflation cannula is introduced into the cervical canal.
10. Air is introduced in the uterus and the hissing sound is auscultated over the flanks.
Test
Positive Test:
An audible hissing sound on the flanks due to exit of air.
Patient complains of shoulder painon sitting.
Negative Test:
No hissing sound over the flanks.
Complications
Complications
Cervical biopsy
Cervix Anatomy
Lowermost part of uterus
Cylindrical shape
Diameter and length are 2.5 cm.
Parts Supravaginal
Infravaginal
Extends from histological internal os to anatomical external os.
Nulliparous - Pin hole cervix
Parous - Bilateral slit
Cervical Biopsy
Punch Biopsy
Wedge Biopsy
Ring Biopsy
Whole of squamo-columnar junction area of the cervix is excised with a special knife.
The tissue is subjected to serial section to detect cervical intraepithelial neoplasia (CIN) or early invasive carcinoma.
Cone Biopsy - Conization
Complications
Thank you
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Moniliasis(Candida vaginitis)
- 2. Introduction: Causative agent: Candida albicans (Gram positive fungus) Clinical features: Intense vulvovaginal discharge Dyspareunia
- 3. On examination: • Thick, curdy white discharge. • Cottage cheese type flakes discharge often adherent to the vaginal wall. • Red swollen vulva. • Tender PV examination.
- 5. Treatment: • Removal of predisposing factors. • Local anti fungal prep. • Creams, ointments, pessary. • Single dose oral therapy • Fluconazole/ itraconazole
- 6. Thank you