Placenta praevia is a condition where the placenta is implanted in the lower uterine segment, either partially or completely covering the internal cervical os. There are four types depending on the degree of coverage of the cervical os. Risk factors include multiparity, increased maternal age, smoking, and history of uterine scarring. Symptoms include painless vaginal bleeding unrelated to activity. Management depends on gestational age and stability of the mother and fetus, ranging from bed rest to cesarean delivery. Nursing care focuses on monitoring for signs of decreased cardiac output or tissue perfusion due to blood loss, and providing education and support to address the mother's fears.
Hydatidiform Mole (HM) is a rare mass or growth that forms inside the uterus at the beginning of a pregnancy. It is a type of gestational trophoblastic disease (GTD).
When a normal sperm cell fertilizes one of these oocytes, the resulting embryo has only one set of chromosomes. Because the embryo has no genes from the mother, the pregnancy cannot develop normally, resulting in a hydatidiform mole.
Hydatidiform Mole (HM) is a rare mass or growth that forms inside the uterus at the beginning of a pregnancy. It is a type of gestational trophoblastic disease (GTD).
When a normal sperm cell fertilizes one of these oocytes, the resulting embryo has only one set of chromosomes. Because the embryo has no genes from the mother, the pregnancy cannot develop normally, resulting in a hydatidiform mole.
It is a composite graphical recording of cervical dilatation and descent of head against duration of labour in hours.
It also gives information about fetal and maternal condition that are all recorded on single sheet of paper.
It is a composite graphical recording of cervical dilatation and descent of head against duration of labour in hours.
It also gives information about fetal and maternal condition that are all recorded on single sheet of paper.
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
2. DEFINITION
• The placenta is implanted partially or
completely over the lower uterine segment
(over or adjacent to the internal os ) it is called
Placenta Praevia.
D.C.Dutta
3. DEFINITION
• In Placenta Praevia the placenta is implanted
in the lower uterine segment such that is
completely or partially cover the cervix or is
close enough to the cervix to cause bleeding
when the cervix dilated or the lower uterine
segment effaces.
(Hull and Resnik, 2009)
4.
5. INCIDENCE
• In 80% cases it is found in multiparous
women.
• The incidence is increased beyond the age of
35, with high birth order pregnancies and in
multiple pregnancy.
• The incidences approximately 4-5 per
thousand pregnancies.
6. RISK FACTORS
• Multiparity
• Increased maternal age
• Higher altitude
• History of previous scar in the uterus.
• Smoking
7. TYPES
There are four types of placenta praevia
depending upon the degree of extension of
placenta to the lower segment.
• Type 1 (Low lying)
• Type 2 (Marginal)
• Type 3 ( Incomplete or partial central )
• Type 4 ( Central or total)
8.
9. CONTD..
Type 1 (Low lying) :
The major part of placenta is attached to
the upper segment and only the lower
margin encroaches onto the lower
segment but not to the os.
10. CONTD…
Type 2 (Marginal) :
The placenta reaches
the margin of internal
os but does not cover
it.
11. CONTD…
Type 3 ( Incomplete or partial central ) :
The placenta covers the internal os partially
( cover the internal os when closed but does
not entirely do so when fully dilated)
12. CONTD…
Type 4 ( Central or total) :
The placenta completely covers the internal
os even after it is fully dilated.
15. CONTD…
Signs:
• General condition and anaemia are
proportionate to the visible blood loss
Abdominal examination: the size of the uterus
• Uterus feels relaxed and soft.
• The head is floating in contrast to the period of
gestation.
• Fetal heart sound is usually present.
24. PREVENTION
To minimize the risks , the following guidelines are
useful.
• Adequate antenatal care
• Significance of warning haemorrhage
At Home –
• Put the patient on bed .
• Abdominal examination
• Vaginal examination must not be done.
Transfer To Hospital
• Admission To Hospital
25. IMMEDIATE ATTENTION
• To ensure an adequate blood supply to a
women and fetus place the women
immediately on bed rest in a side lying
position.
• A large bore IV cannula is cited and
infusion of normal saline
• Gentle abdominal palpation
26. Scheme Of Management
All APH patients are to be admitted
General and abdominal examination
Clinical assessment of blood loss
Resuscitation if necessary
Localisation of placenta
• Expectant management Active interference
27. Expectant management
The expectant treatment is carried upto 37 weeks.
Aim: The aim is to continue pregnancy for fetal
maturity without compromising the maternal
health.
Indications:
• No active bleeding
• Patient stable haemo-dynamically
• FHS- good
• CTG- reactive fetus
28. CONTD…
Interventions:
• Bed rest
• Periodic inspection of vulvul pads
• Supplementary haematinics if patient is
anaemic
• Use of tocolytics.
• Rh immunoglobulins to all Rh negative
women.
30. CONTD…
Active management
Vaginal delivery Caesarean delivery
Placental edge is within 2 cm from the
internal os: in this case no internal
examination is performed and caesarean
section is considered as the best choice.
31. CONTD…
Placental edge is 2-3 cm away from the internal cervical os:
Internal examination in OT
ARM with or without oxytocin
Satisfactory progress of labour bleeding continues
& no labour initiation
vaginal delivery caesarean delivery
32. NURSING MANAGEMENT
Nursing Diagnosis
Decreased cardiac output related to blood loss
as manifested by increase in heart rate.
Interventions:
• Monitor Vital Signs
• Provide adequate rest &
• reposition client
• Encourage relaxation techniques
• Elevate Hb of the client
•
33. Ineffective tissue perfusion related to
decrease in Hb in blood as manifested
by dyspnea.
Interventions:
• Monitor Vital Signs.
• Encourage quiet & restful environment.
• Encourage use of relaxation techniques.
• Provide supplemental oxygen to the client
as prescribed by the physician.
34. Deficient fluid volume related to Blood
Loss as manifested by vital signs
changes.
Interventions:
• Monitor Vital Signs
• Monitor FHR.
• Initiate IV fluids as ordered by the
physician.
• Place the patient in left lateral position.
35. Fear related to outcome of pregnancy as
manifested by facial expressions of the
mother.
Nursing Interventions
• Assess fetal heart sounds.
• Allow the mother to share her feelings.
• Answer the mother’s questions honestly.
• Include the mother in the planning of the
care plan for both the mother and the baby.
36. Bibliography
• Perry, Hockenberry, Lowdermilk et al. Maternal Child
Nursing Care. Elsevier. 5th
edition; 326-329
• Cunningham, Leveno, Bloom et al. Williams Obstetrics. Mc
graw Hill Education. 24th
edition; 801-807
• D.C.Dutta’s . Textbook of Obstetrics. New central Book
Agency(P) Ltd. 7th
edition; 241-250
• Renu mishra.IAN DONALD’S Practical Obstetric
problems. Wolters kluwer. 7th
edition ; 315-320
• Adele pillitteri. Maternal and child health nursing. Walters
kluwer. 7th
edition;562-565.