This document provides an overview of current issues in perinatology and preterm birth. It discusses definitions and common causes of preterm birth such as spontaneous preterm labor and preterm premature rupture of membranes. Risk factors for preterm birth include multiple gestations, preeclampsia, and maternal medical conditions. Complications of prematurity are also reviewed such as respiratory distress syndrome and intraventricular hemorrhage. Current tocolytic medications for inhibiting preterm labor are described including beta-agonists, calcium channel blockers, nitric oxide donors, and oxytocin receptor antagonists. The efficacy, maternal and fetal effects, dosing, and contraindications of specific medications like ritodrin and nifed
This document provides an overview of current issues in perinatology and preterm birth. It discusses definitions and common causes of preterm birth such as spontaneous preterm labor and preterm premature rupture of membranes. Risk factors for preterm birth include multiple gestations, preeclampsia, and maternal medical conditions. Complications of prematurity are also reviewed such as respiratory distress syndrome and intraventricular hemorrhage. Current tocolytic medications for inhibiting preterm labor are described including beta-agonists, calcium channel blockers, nitric oxide donors, and oxytocin receptor antagonists. The efficacy, maternal and fetal effects, dosing, and contraindications of specific medications like ritodrin and nifed
Mamatoto Resource & Birth Center, located in Trinidad, provides real choice for women who want to experience a completely natural and supportive birthing experience.
Chapter 15 Teachback (Pregnancy and Preparing for Birth)ginaabcg
This document provides information about pregnancy and preparing for birth. It discusses the physical and emotional changes that occur during pregnancy. Physically, organs adapt to support the growing fetus and hormonal changes occur. Emotionally, a woman's identity and self-confidence transform as she prepares to become a mother. The document also outlines various aspects of prenatal care, such as regular checkups, tests, and considerations for high-risk pregnancies. Additionally, it covers choices for birth settings, pain management options, and preparing to breastfeed. The overall message is that learning about the pregnancy and birth process helps women feel more confident in their abilities.
Planned caesarean section versus planned vaginal birth for breech presentation at term was studied in a randomized multicentre trial. The study found that for women with a breech baby close to their due date, a planned c-section is safer than planned vaginal delivery and results in fewer serious complications for the baby. The trial was conducted across 121 medical centers and involved over 3,000 women with breech babies at term to compare outcomes of planned c-section versus planned vaginal delivery.
Integrated Science M3 Fertilization, Pregnancy and birtheLearningJa
This document discusses fertilization, implantation, pregnancy, and birth. It is divided into two parts. Part A covers fertilization, which occurs when an egg is fertilized by sperm in the fallopian tubes. Implantation occurs when the fertilized egg attaches to the uterus. Part B discusses the changes that occur during pregnancy, including development of the fetus and functions of the placenta. It also outlines the stages of birth.
Fertilization occurs when a sperm fuses with an ovum in the Fallopian tube. Pregnancy is the development of the zygote as it travels down the Fallopian tube and implants in the uterus. The placenta then forms to nourish the growing embryo, now called a fetus. Over 40 weeks of gestation, the fetus develops fully within the amniotic sac until birth.
1. Fertilization occurs through the acrosomal reaction and fusion of the egg and sperm membranes, allowing entry of a single sperm.
2. This triggers the fast block to polyspermy within 1/10th of a second and the cortical reaction, which changes the egg cytoplasm and hardens membranes to prevent multiple fertilization.
3. Pregnancy is divided into three trimesters. The first trimester involves rapid development and differentiation of the embryo. The placenta forms and the embryo implants in the uterine wall.
The document discusses the phylum Cnidaria, including corals. It notes that corals are colonies of tiny polyps that can reproduce both asexually through budding and sexually by releasing gametes. Corals secrete calcium carbonate skeletons and have complex life cycles involving larval and polyp stages. They are found in tropical oceans where they form important reef ecosystems.
The document describes the three stages of labour: 1) dilation of the cervix where contractions slowly open the cervix over hours, 2) expulsion where powerful contractions push the baby through the birth canal in minutes to hours, and 3) delivery of the placenta a few minutes after birth. It provides details of the progression and key events of each stage, such as full cervical dilation marking the end of the first stage and clamping of the umbilical cord at the end of the third stage.
(1) Rigor mortis occurs several hours after death as muscles contract and become rigid due to loss of ATP.
(2) Toward the end of pregnancy, hormonal and mechanical changes cause the uterus to develop strong contractions that expel the baby. Hormonal changes include increasing estrogen and oxytocin levels.
(3) Labor contractions are initially weak but grow stronger through positive feedback as the cervix is stretched, further stimulating contractions. Strong, regular contractions combined with abdominal muscle contractions expel the baby.
This presentation outlines the vocabulary associated with livestock reproduction, specifically during pregnancy. It also outlines a human's developmental milestones in the womb.
3. Klasik uterin insizyon
Alt segment (Kerr)
insizyon*
Alt segment vertikal
T / J İnsizyonları
4. Prof. John Martin Munro Kerr
(1868–1960)
İskoç obstetrisyen
Glasgow Üniversitesi
5. Aşırı preterm
Alt segment miyom(lar)
Alt segment adezyon(lar)
Diğer teknik zorluklar
Previa, transvers duruş ± oligohidroamniyoz
“Postmortem” sezaryen
Sorun: Ruptur riskinde artış
6. Kanama
Enfeksiyon
Organ zedelenmeleri (örn, mesane)
Anesteziye bağlı
◦ Genel
◦ Rejyonel
Bebekte
◦ Solunum sıkıntısı (Yaş akciğer)
◦ Astım, diyabet (?)
7. >3500-3800 g TFA bebek (BPD >100 mm)*
Habitus bozukluğu: Hiperekstansiyon
Prematür fetüs < 1500 g (2500 g)?*
Ayak / Kordon prezente
Eşlik eden komplikasyonlar: Preeklampsi vb
Pelvik darlık
* 28-34 hft
8. Makat geliş fetüste boynun
hiperektansiyonu, spinal
kord travması ve fetal kayıp
riski ile ilişkilidir.
9. 1998-2003: %21
2003-2008: %37
İlk doğum: %45
Kent: %42
Kırsal: %24
Doğu Anadolu: %16
Diğer bölgeler > %40
En yüksek eğitim + refah düzeyi: %60 (x3)
Kaynak: TNSA 2008
10. Makat geliş / Çoğul gebeliklerde tercih
YÜT artışı
Fetal distres tanısında artış (elektr. monit.)
Stres inkontinansa karşı koruma
Kadınlarda ağrı korkusu / estetik hususlar
Medikolegal sorunlar
Yardımcı personel yetersizliği
Analjezi / Anestezi alt yapı yetersizliği
Toplum baskısı / Moda (!)
Endikasyonsuz sezaryende artış
11. Sezaryen doğumun avantajları
Pelvik rölaksasyon için önleyici
Doğumun zamanlanması
İstenmeyen etkiler
Anne ölüm oranında artış (x3)
Nedbeli uterus
Ameliyat, anestezi komplikasyonları
Bebekte kısa-uzun dönem akciğer sorunları
Bebekte immünolojik sorunlar: tip 1 DM riski (?)
Anne-bebek bağlanmasında sorunlar
Batın / Uterus içi adezyonlar – KPA, vb.
12. Forseps doğum
Vakum ekstraksiyonu
AMAÇ: Vajinal doğuma yardımcı olmak ve/veya
hızlandırmak
13. Kafa en büyük çap
Yüksek Pelvik girimde
Orta (Mid-forseps) Spina – Girim arası
Aşağı (low) Spina – (+2) arası
Çıkımda Baş perinede
Modern obstetride çoğunlukla çıkımda
Diğer durumlarda sezaryen
23. Forseps ile benzer
OP pozisyonda
kullanılabilir
Büyük (ön) fontanel
üzerine uygulanmamalı
Multiparda silinme iyi (%80
ve üzeri) ise 8-9 cm
açıklıkta uygulanabilir
24. Forseps ile benzer
Daha az deneyim
gerektirme (?)
İKK riskinde artış (?)
Yüz felci – nadir
Maternal
laserasyonlar
Stres inkontinans
25.
26. Forseps ve vakum, doğumun 2. evresinin
hızlandırılması gerektiği durumlarda
kullanılabilir.
Her 2 yöntem de benzer uygulama şartları ve
komplikasyon oranlarına sahip gözükmekte.
Koşullara uyulur ve deneyimli operatör
tarafından uygulanırsa acil sezaryenden daha
güvenlidir.
Model / senaryo eğitimlerine önem
verilmelidir.
