The document discusses obstetric emergencies, which are life-threatening medical conditions that occur during pregnancy, labor, or delivery that endanger the health of the mother and baby. It defines obstetric emergencies and describes various types including complications of pregnancy like ectopic pregnancy and preeclampsia, as well as emergencies during labor like shoulder dystocia. Signs and symptoms, methods of diagnosis, and treatment approaches for different types of obstetric emergencies are also outlined.
Definition-
The destructive operations are designed to diminish the bulk of the fetus so as to facilitate easy delivery through the birth canal
types
Craniotomy
Eviceration
Decapitation
Cleidotomy
CRANIOTOMY
Definition
It is an operation to make a perforation on the fetal head to evacuate the contents followed by extraction of the fetus
DECAPITATION
Definition
It is a destructive operation whereby the fetal head is severed from the trunk and the delivery is completed with the extraction of the trunk and that of the decapitated head per vaginam
CLEIDOTOMY
Definition
The operation consist of reduction in the bulk of the shoulder girdle by division of one or both the clavicles
Indications
Dead fetus with shoulder dystocia
Procedure
The clavicles are divided by the embryotomy scissors or long straight scissors introduced under the guidance of left two fingers placed inside the vagina
Definition-
The destructive operations are designed to diminish the bulk of the fetus so as to facilitate easy delivery through the birth canal
types
Craniotomy
Eviceration
Decapitation
Cleidotomy
CRANIOTOMY
Definition
It is an operation to make a perforation on the fetal head to evacuate the contents followed by extraction of the fetus
DECAPITATION
Definition
It is a destructive operation whereby the fetal head is severed from the trunk and the delivery is completed with the extraction of the trunk and that of the decapitated head per vaginam
CLEIDOTOMY
Definition
The operation consist of reduction in the bulk of the shoulder girdle by division of one or both the clavicles
Indications
Dead fetus with shoulder dystocia
Procedure
The clavicles are divided by the embryotomy scissors or long straight scissors introduced under the guidance of left two fingers placed inside the vagina
This ppt is made by Mr. arkab khan pathan under guidance of Mrs. RAKHI GOAR. this ppt contain the detail and all the lecture notes of HEG.
THANK YOU.
Arkab khan
Many women experience some minor disorders during pregnancy.
Every system of the body may be affected during pregnancy. These disorders, however , are not minor to the pregnant woman.
This ppt is made by Mr. arkab khan pathan under guidance of Mrs. RAKHI GOAR. this ppt contain the detail and all the lecture notes of HEG.
THANK YOU.
Arkab khan
Many women experience some minor disorders during pregnancy.
Every system of the body may be affected during pregnancy. These disorders, however , are not minor to the pregnant woman.
Emergencies that occur in pregnancy or during or after labor and delivery.
main emergencies are
Ectopic Pregnancy
Uterine Inversion
Obstetrical Shock
Cord Prolepses
Amniotic Fluid Embolism
Postpartum Hemorrhage
Placental abruption is premature separation of placenta from the uterus/ in other words separates before childbirth.
It occurs most commonly around 25 weeks of pregnancy characterized by vaginal bleeding, lower abdominal pain, and dangerously low blood pressure
Approach to maternal collapse and cardiac arrest.pptxKTD Priyadarshani
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
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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
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
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Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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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.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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3. SPECIFIC OBJECTIVES:
DEFINE OBSTETRIC EMERGENCIES
DESCRIBE THE VARIOUS TYPES OF OBSTETRIC
EMERGENCIES
ENLIST THE CAUSES OF OBSTETRIC EMERGENCIES
DESCRIBE THE SIGNS AND SYMPTOMS OF OBSTETRIC
EMERGENCIES
ENLIST THE VARIOUS INVESTIGATIONS FOR THE
DIAGNOSIS OF OBSTETRIC EMERGENCIES
DISCUSS THE TREATMENT OF VARIOUS TYPES OF
OBSTETRIC EMERGENCIES
EXPLAIN THE PREVENTION OF OBSTETRIC
EMERGENCIES
4.
5. Introduction
An emergency is a situation that poses an immediate risk to health, life,
property or environment. Most emergencies require urgent intervention
to prevent the worsening of the situation, although in some situations,
mitigation may not be possible and agencies may only be able to offer
palliative care for the aftermath.
One such kind of emergency is obstetric emergency. Obstetrical
emergencies may also occur during active labour, & after delivery
(postpartum). The first principal of dealing with obstetric emergencies
are the same as for any emergency (see to the airway, breathing &
circulation) but remember that in obstetrics there are two patients; the
fetus is very vulnerable to maternal hypoxia. There are a number of
illnesses and disorder of pregnancy that can threaten the well-being of
both mother and child.
7. Types of obstetric emergencies
1)obstetric emergencies of pregnancy
•Ectopic pregnancy
An ectopic, or tubal, pregnancy occurs when the fertilized
egg implants itself in the fallopian tube rather than the
uterine wall. If the pregnancy is not terminated at an early
stage, the fallopian tube will rupture, causing internal
hemorrhaging and
potentially resulting in permanent infertility.
8.
9. •Placental abruption
Also called abruptio placenta, placental abruption
occurs when the placenta separates from the uterus
prematurely, causing bleeding and contractions . If
over 50% of the placenta separates
both the fetus and mother are at risk.
10.
11. •Placenta previa
When the placenta attaches to the mouth of the
uterus and
partially or completely blocks the cervix, the position
is termed placenta previa
(or low-lying placenta). Placentaprevia can result in
premature bleeding and possible postpartum hemor
rhage.
12.
13. •Preeclampsia / eclampsia
Preeclampsia (toxemia) or pregnancy
induced high blood
pressure causes severe edema(swelling due to
water retention) and can impair kidney and liver
function. The condition occurs in approximately 5%
of all
United States pregnancies. If it
progresses to eclampsia, toxemia is potentially
fatal for mother and child.
14.
15. •Premature rupture of membranes
Premature rupture of membranes is the breaking
of the bag ofwaters (amniotic fluid)before
contractions or labor begins. Thesituation is only
considered an emergency if the break occurs
before thirty-seven weeks and results
in significant leakage ofamniotic fluid and/or
infection of the amniotic sac.
16.
17. 2)obstetric emergencies
during labour & delivery
•Amniotic fluid embolism
A rare but frequently fatal complication of labor, this
condition occurs when amniotic fluid embolizes from the
amniotic sac andthrough the veins of the uterus and into
the circulatory system of the mother. The fetal cells
present in the fluid then blockor clogthe pulmonary artery
, resulting in heartattack. This complication can also
happen during pregnancy, but usually occurs in the
presence of strong contractions.
18.
19. •Inversion or rupture of uterus
During labor, a weak spot in the uterus (such as a
scar or a uterine wall that is thinned by a
multiple pregnancy) may tear,resulting in a uterine
rupture. In certain circumstances, a portion of the
placenta may stay attached to thewall and will pull
theuterus out with it during delivery. This is called
uterine inversion.
20.
21. •Placenta accreta
Placenta accreta occurs when the
placenta is implanted too
deeply into the uterine wall, and will not
detach during
the latestages of childbirth, resulting in
uncontrolled bleeding.
22.
23. •Prolapsed umbilical cord
A prolapse of the umbilical cord occurs w
hen the cord is pushed down into the
cervix or vagina. If thecord becomes com
pressed, the oxygen supply to the fetus
could be diminished, resulting in brain
damage or possible death.
24.
25. •Shoulder dystocia
Shoulder dystocia occurs when the baby'
s shoulder(s) becomes wedged in the
birth canal after the head has been
delivered.
````Vasa previa `````
‘’’cord polapse’’’
29. Obstetrical emergencies can be caused by a
number of factors, including-
•Stress
•Trauma
•Genetic and other variables
In some cases, past medical history, including
previous pregnancies & deliveries, may help an
obstetrician anticipate the possibility of
complications.
Causes of obstetrical emergencies
30. Signs and symptoms of an obstetrical emergency include, but are n
ot limited to:
•Diminished fetal activity. In the late third
trimester, fewer than ten movements in a two
hour period may indicate that the fetus is in distress.
•Abnormal bleeding. During pregnancy, brown or white to pink
vaginal discharge is normal, bright red blood or blood containing
large clots is not. After delivery, continual blood loss of
over 500 ml indicates hemorrhage.
•Leaking amniotic fluid. Amniotic fluid is straw-
colored and may easily be confused with urine
leakage, but can be differentiated by its slightly sweet odor.
Signs and symptoms of obstetrical emergencies
31. •Severe abdominal pain. Stomach or lower back pain can
indicate preeclampsia or an undiagnosed ectopic pregnancy.
Postpartum
stomach pain can be a sign of infection or hemorrhage.
•Contractions. Regular contractions before 37 weeks of
gestation can signal the onset of preterm labor due to obstetr
ical complications.
•Abrupt and rapid increase in blood pressure. Hypertension
is one of the first signs of toxemia
•Edema. Sudden and significant swelling of hands and feet
caused by fluid retention from toxemia.
•Unpleasant smelling vaginal discharge. A thick, malodorous
discharge from the vagina can indicate a postpartum infection
.
32. •Fever. Fever may indicate an active infection.
•Loss of consciousness. Shock due to blood
loss (hemorrhage) or amniotic embolism can
precipitate a loss of consciousness in the
mother.
•Blurred vision and headaches. Vision
problems and headache are possible symptoms
of preeclampsia.
33. Diagnosis of obstetrical emergencies
Diagnosis of an obstetrical emergency typically takes place in a
hospital or other urgent care facility.
Diagnosis includes:-
•Medical history
•General physical examination
•Pelvic examination
•Mother’s vital sign taken - If preeclampsia is suspected, BP may be
monitored over a period of time.
•Fetal heartbeat assessed with a Doppler stethoscope
•Blood & urine tests
•Abdominal sonography
•Biophysical profile (BPP) may also be performed to evaluate the
health of the fetus.
34. Treatment
1)Obstetrical emergencies of pregnancy
•Ectopic pregnancy - Treatment of an ectopic
pregnancy is laparoscopic surgical removal of the fertilize
d ovum. If the fallopian tube hasburst or been damaged, f
urther surgery will be necessary.
•Placental abruption - In mild cases of placental
abruption, bed rest may prevent further separation of the
placenta and stem bleeding.If a significant abruption (over
50%) occurs, the fetus may have to be delivered immedia
tely and a blood transfusion may be required.
35. •Placenta previa-
Hospitalization or highly restricted athome bed rest is usually
recommended if placenta previa is
diagnosed after thetwentieth week of pregnancy. If the fetus is at
least 36 weeks old and the lungs are mature, a cesarean
section is performed to deliver the baby.
Preeclampsia / Eclampsia -
Treatment of preeclampsia depends upon the age of the fetus
and the acuteness of the condition. A woman
near full term that has only mild toxemia
may have labor induced to deliver the child as soon as possible.
Severe preeclampsia in a woman
36. •near term also calls for immediate delivery of the child, as this
is the only known cure for the condition.However, if the fetus is
under 28weeks, the mother
may be hospitalized and steroids may be administered to try to
hasten lung development in the fetus. If the life of the
mother or fetus appears to be in danger, the baby is delivered i
mmediately, usually by cesarean section.
•Premature rupture of membrane-
If PROM occurs before 37 weeks and/or results in significant le
akage of amniotic
fluid, a course of intravenous antibiotics is started. A culture of
the
cervix may be taken to analyze for the presence of bacterial infe
ction. Ifthe fetus is close to term, labor is typically induced if co
ntractions do not start within 24 hours of rupture.
37. 2)Obstetrical emergencies during labour & delivery
•Amniotic fluid embolism -
The stress of contractions can cause this complication, whic
h has a high mortality rate. Administering
steroids to the mother and delivering the fetus as soon as p
ossible is the standard treatment.
•Inversion or rupture of uterus -
An inverted uterus is either manually or surgical replaced t
o the proper position. A ruptured uterus
is repaired if possible, although if the damage is extreme, a
hysterectomy (removal of the uterus) may be performed. A
blood transfusion
may be required in either case if hemorrhaging occurs.
38. • Placenta accreta -
Women who experience placenta accreta will typically n
eed to have their placenta surgically removed after deliv
ery. Hysterectomy is necessary in some cases.
• Prolapsed umbilical cord -
Saline may be infused into the vagina to relieve the com
pression. If the cord has prolapsed out the vaginal
opening, it may be replaced, but immediate delivery by
cesarean section is usually indicated.
39. Shoulder dystocia -
The mother is usually positioned with her knees to he
r chest, known as the McRoberts maneuver, in an effo
rt tofree the child's shoulder. An episiotomy is also pe
rformed to widen the vaginal opening. If the shoulder
cannot be dislodged from the pelvis,the baby's clavic
le (collarbone) may have to be broken to complete the
delivery before a lack of oxygen causes brain damage
to the infant.
40. 3)Obstetrical emergencies postpartum
•Postpartum hemorrhage or infection -
The source of the hemorrhage is determined, and blood transfusio
n and IV fluids are given
as necessary. Oxytocic drugs may be administered to encourage co
ntraction of the uterus. Retained placenta is a frequent cause of
persistent bleeding, and surgical removal of the remaining fragmen
ts (curettage) may be required. Surgical repair of lacerations to the
birthcanal or uterus may be required. Drugs that encourage coagu
lation (clotting) of the blood may be administered to stem the ble
eding.
Infrequently, hysterectomy is required.In cases of infection, a cour
se of intravenous antibiotics is prescribed. Most postpartum infect
ions occur in the endometrium, or lining of theuterus, and may be
also caused by a piece of retained placenta. If this is the case, it will
also require surgical removal.
41. Prevention
•Proper prenatal care is the best prevention for
obstetrical emergencies.
•When complications of pregnancy do arise, pregnant
women who see their Ob/GYN on a regular basis are
more likely to get an early diagnosis, & with it, the best
chances for fast & effective treatment.
•In addition, eating right & taking prenatal vitamins and
supplements as recommended by a physician will also
contribute to the health of both mother & child.