Thromboembolic disorders are a leading cause of maternal mortality in developed countries. During pregnancy and postpartum, physiological changes cause a hypercoagulable state and increased risk of thrombosis compared to non-pregnant women. Common thromboembolic disorders in the postpartum period include deep vein thrombosis (DVT), pulmonary embolism (PE), and pelvic thrombophlebitis. Risk factors include age over 35, obesity, multiple pregnancies, immobility, and prior venous thromboembolism. Symptoms depend on location but may include leg pain or swelling. Diagnosis involves imaging like ultrasound, CT, or MRI. Treatment involves anticoagulants, compression stockings,
1. Venous thromboembolic diseases that can occur during pregnancy and postpartum include deep vein thrombosis, thrombophlebitis, and pulmonary embolism.
2. Risk factors for these conditions include inherited or acquired thrombophilias, previous VTE, heart disease, surgery such as C-section, age over 35, obesity, multiple pregnancy, and immobility.
3. Diagnosis involves Doppler ultrasound, venous ultrasonography, or CTPA. Treatment consists of anticoagulants like heparin or LMWH, thrombectomy, or inferior vena cava filters to prevent further embolism.
This document provides information on the stages of labor and management of the first stage of labor. It discusses the normal progression through the latent, active, and transition phases of the first stage. It also covers monitoring during labor including vital signs, contractions, and fetal heart rate. Active management of labor is described which includes interventions like amniotomy and oxytocin if progress is unsatisfactory. The nurse's role in caring for the woman in the first stage is also summarized.
Prolapse of the uterus refers to the downward displacement of the vagina and uterus. It can be congenital or acquired due to factors like childbirth, obesity, chronic coughing, and uterine fibroids. Symptoms include feeling something coming down in the vagina, backache, difficulty urinating, and incomplete bowel movements. Diagnosis involves physical examination in both dorsal and standing positions. Management includes preventative measures, conservative options like pessaries and exercises, and surgery if symptoms become worse.
Multiple pregnancies can involve more than two fetuses developing simultaneously in the uterus. The most common variety is twins, while triplets, quadruplets, and more are rare. Management of multiple pregnancies aims to monitor fetal well-being and expedite delivery of additional fetuses after the first to prevent strain from placental insufficiency. Cesarean section may be recommended depending on fetal presentation and other complications.
This document discusses polyhydramnios, or excess amniotic fluid during pregnancy. It defines polyhydramnios as more than 1500-2000 mL of amniotic fluid. Causes may include fetal anomalies, placental chorioangiomas, multiple pregnancies, and maternal conditions like diabetes. Polyhydramnios can be chronic or acute based on onset. Complications include preterm labor, malpresentation, and pregnancy-induced high blood pressure. Ultrasound is used to diagnose and assess fetal well-being. Management depends on gestational age, response to treatment, and other complications, and may involve amniocentesis, induction of labor, or termination of pregnancy.
Please find the power point on Vacuum delivery. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
This document provides information on various obstetrical emergencies presented in a seminar, including definitions, symptoms, diagnosis, management, and nursing considerations. Vasa previa is defined as blood vessels from the umbilical cord or placenta crossing the cervix without Wharton's jelly covering. Symptoms include vaginal bleeding. Diagnosis is via color Doppler and emergency c-section is required if membranes rupture. Amniotic fluid embolism causes pulmonary vasospasm and coagulopathies. Symptoms include respiratory distress and hemorrhage. Management focuses on hemodynamic support and delivery. Other emergencies discussed include obstetric shock, cord prolapse, and uterine inversion.
1. Venous thromboembolic diseases that can occur during pregnancy and postpartum include deep vein thrombosis, thrombophlebitis, and pulmonary embolism.
2. Risk factors for these conditions include inherited or acquired thrombophilias, previous VTE, heart disease, surgery such as C-section, age over 35, obesity, multiple pregnancy, and immobility.
3. Diagnosis involves Doppler ultrasound, venous ultrasonography, or CTPA. Treatment consists of anticoagulants like heparin or LMWH, thrombectomy, or inferior vena cava filters to prevent further embolism.
This document provides information on the stages of labor and management of the first stage of labor. It discusses the normal progression through the latent, active, and transition phases of the first stage. It also covers monitoring during labor including vital signs, contractions, and fetal heart rate. Active management of labor is described which includes interventions like amniotomy and oxytocin if progress is unsatisfactory. The nurse's role in caring for the woman in the first stage is also summarized.
Prolapse of the uterus refers to the downward displacement of the vagina and uterus. It can be congenital or acquired due to factors like childbirth, obesity, chronic coughing, and uterine fibroids. Symptoms include feeling something coming down in the vagina, backache, difficulty urinating, and incomplete bowel movements. Diagnosis involves physical examination in both dorsal and standing positions. Management includes preventative measures, conservative options like pessaries and exercises, and surgery if symptoms become worse.
Multiple pregnancies can involve more than two fetuses developing simultaneously in the uterus. The most common variety is twins, while triplets, quadruplets, and more are rare. Management of multiple pregnancies aims to monitor fetal well-being and expedite delivery of additional fetuses after the first to prevent strain from placental insufficiency. Cesarean section may be recommended depending on fetal presentation and other complications.
This document discusses polyhydramnios, or excess amniotic fluid during pregnancy. It defines polyhydramnios as more than 1500-2000 mL of amniotic fluid. Causes may include fetal anomalies, placental chorioangiomas, multiple pregnancies, and maternal conditions like diabetes. Polyhydramnios can be chronic or acute based on onset. Complications include preterm labor, malpresentation, and pregnancy-induced high blood pressure. Ultrasound is used to diagnose and assess fetal well-being. Management depends on gestational age, response to treatment, and other complications, and may involve amniocentesis, induction of labor, or termination of pregnancy.
Please find the power point on Vacuum delivery. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
This document provides information on various obstetrical emergencies presented in a seminar, including definitions, symptoms, diagnosis, management, and nursing considerations. Vasa previa is defined as blood vessels from the umbilical cord or placenta crossing the cervix without Wharton's jelly covering. Symptoms include vaginal bleeding. Diagnosis is via color Doppler and emergency c-section is required if membranes rupture. Amniotic fluid embolism causes pulmonary vasospasm and coagulopathies. Symptoms include respiratory distress and hemorrhage. Management focuses on hemodynamic support and delivery. Other emergencies discussed include obstetric shock, cord prolapse, and uterine inversion.
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
The TORCH complex refers to a group of perinatal infections - Toxoplasmosis, Other (syphilis, varicella, parvo virus), Rubella, Cytomegalovirus, and Herpes simplex virus type 2. These infections can cross the placenta and infect the fetus, potentially causing severe anomalies or death. Toxoplasmosis is caused by the protozoan Toxoplasma gondii which can infect fetuses during acute maternal infection via the placenta. Rubella virus infection during pregnancy increases risks of fetal anomalies, especially in the first trimester. Cytomegalovirus is a herpes virus that commonly infects fetuses, with 30
It explains the mechanism of normal labour to medical and para-medical staff.It also puts light on principle movements underlying mechanism of normal labour with pictures.Thank You Like an share it to the maximum.
This document presents a PowerPoint presentation on multiple pregnancy by Prativa Dhakal. It defines multiple pregnancy as when more than one fetus develops simultaneously in the uterus. It discusses the different types of twin pregnancies, including dizygotic and monozygotic twins. It also covers the incidence, factors influencing twinning, maternal physiological changes, diagnosis, complications, prognosis, and management of twin pregnancies. Key diagnostic tools include ultrasound and biochemical tests. Major complications discussed are preterm birth and preeclampsia. Management involves careful monitoring, interventions to prevent preterm delivery, and ensuring availability of neonatal care.
This document discusses fetal positioning and presentations during labor and delivery. It begins by defining non-vertex presentations including breech, face, brow, transverse, and compound. It then discusses the causes of non-vertex presentations and describes the different positions including occiput posterior. The document provides details on assessing various positions through abdominal and vaginal exams. It concludes by outlining the management of different non-vertex positions, including allowing natural rotation, augmentation of labor, operative vaginal delivery, or caesarean section if needed.
Puerperium is the period following childbirth during which the body tissues, specially the pelvic organs revert back approximately to the pre-pregnant state both anatomically and physiologically. puerperium begins as soon as the placenta is expelled and lasts for approximately 6 weeks when the uterus becomes regressed almost to the non-pregnant size.
This topic contains definition, meaning, classification, pathophysiology, clinical menifestations, metabolic and general changes, management of obstetrical shock
A contracted pelvis is one where the pelvic diameters are reduced below normal limits, potentially interfering with labor. Causes include developmental factors, malnutrition, trauma, and diseases affecting the bones. Diagnosis involves history, examination assessing pelvic and spinal abnormalities, and pelvimetry to measure diameters. In labor, the fetus's head may pass through a contracted pelvis via molding, asynclitic descent, or an altered rotation pattern depending on the type of contraction. Management ranges from a trial of vaginal delivery for minor issues to cesarean section for more severe disproportion.
A retained placenta occurs when the placenta is not expelled from the uterus within 30 minutes of childbirth. Risk factors include previous retained placentas, uterine injuries or surgeries, preterm births, induced labor, and multiple pregnancies. Causes can include failure of the placenta to separate fully from the uterine wall or abnormal placenta attachments like placenta accreta. Treatment involves controlled cord traction, manual removal in the operating room if needed, or hysterectomy for deeply embedded placentas. Complications can be life-threatening bleeding, infections, or shock if not properly managed.
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 document discusses the four stages of labor: 1) dilation of the cervix, 2) baby moving through the birth canal, 3) delivery of the placenta, and 4) recovery of the mother. It focuses on the second stage where the baby moves from the uterus into the vagina and is born. Key events in this stage include uterine contractions every 2-3 minutes lasting 50-60 seconds and the baby descending through the pelvis. Nursing assessments and interventions are also outlined to monitor labor progress and support the mother through each stage.
1. Subinvolution, breast engorgement, mastitis, breast abscess, and thrombophlebitis are common postpartum complications that can occur.
2. Subinvolution occurs when the involution of the uterus after delivery is impaired or delayed. Breast engorgement is swelling of the breasts due to increased blood and lymph supply before lactation begins.
3. Mastitis is an inflammation of the breast tissue that is usually caused by bacterial infection during breastfeeding. Left untreated it can develop into a breast abscess, which is a localized collection of pus in the breast that requires drainage.
The human placenta is a discoid, haemochorial organ that develops during pregnancy to connect the developing fetus to the uterine wall for nutrient/waste exchange. At term, the placenta is a circular disc about 15-20cm in diameter and 2.5cm thick that weighs around 500g. It has both a fetal side covered by amnion/umbilical cord and a rough, spongy maternal side with lobes. The placenta facilitates gas/nutrient exchange between maternal and fetal blood supplied by the umbilical cord and establishes a connection between the mother and developing fetus.
This document discusses fetal malpresentation and malposition, which refer to abnormal positions of the fetus within the uterus. Fetal malpresentation means any position other than vertex, such as breech or transverse lie. Malposition refers to positions other than occiput anterior, such as occiput posterior or occiput transverse. Types and management of different malpresentations and malpositions are described, along with risks to mother and fetus. Nursing care focuses on close monitoring for abnormal labor, supporting the mother physically and emotionally, and preparing for potential operative delivery.
An ectopic pregnancy occurs when a fertilized egg implants and grows outside the uterus, usually in one of the fallopian tubes. This is a medical emergency that requires prompt treatment to stop potentially life-threatening bleeding. Most ectopic pregnancies occur in the fallopian tubes. While the incidence of ectopic pregnancy is rising due to increased rates of pelvic inflammatory disease, early diagnosis and treatment have reduced maternal death and illness.
Thromboprophylaxis Of Venous ThromboEmbolism (VTE )In Obstetrics And Gy...muhammad al hennawy
This document discusses thromboprophylaxis for venous thromboembolism (VTE) in obstetrics and gynecology. It covers the risks of VTE associated with pregnancy, hormonal contraceptives, and various gynecological surgeries. It recommends low molecular weight heparin as the anticoagulant of choice for prophylaxis and treatment, and discusses dosing and monitoring considerations during pregnancy due to increased clearance. Monitoring tests discussed include anti-Xa levels, APTT, INR, and delivery planning when on anticoagulation.
The document discusses the development of a new drug (DR) but provides no other context or details about the drug, its intended use, results of trials, or other pertinent information needed for a useful summary. With only the acronym "DR" provided, a meaningful 3 sentence summary cannot be generated.
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
The TORCH complex refers to a group of perinatal infections - Toxoplasmosis, Other (syphilis, varicella, parvo virus), Rubella, Cytomegalovirus, and Herpes simplex virus type 2. These infections can cross the placenta and infect the fetus, potentially causing severe anomalies or death. Toxoplasmosis is caused by the protozoan Toxoplasma gondii which can infect fetuses during acute maternal infection via the placenta. Rubella virus infection during pregnancy increases risks of fetal anomalies, especially in the first trimester. Cytomegalovirus is a herpes virus that commonly infects fetuses, with 30
It explains the mechanism of normal labour to medical and para-medical staff.It also puts light on principle movements underlying mechanism of normal labour with pictures.Thank You Like an share it to the maximum.
This document presents a PowerPoint presentation on multiple pregnancy by Prativa Dhakal. It defines multiple pregnancy as when more than one fetus develops simultaneously in the uterus. It discusses the different types of twin pregnancies, including dizygotic and monozygotic twins. It also covers the incidence, factors influencing twinning, maternal physiological changes, diagnosis, complications, prognosis, and management of twin pregnancies. Key diagnostic tools include ultrasound and biochemical tests. Major complications discussed are preterm birth and preeclampsia. Management involves careful monitoring, interventions to prevent preterm delivery, and ensuring availability of neonatal care.
This document discusses fetal positioning and presentations during labor and delivery. It begins by defining non-vertex presentations including breech, face, brow, transverse, and compound. It then discusses the causes of non-vertex presentations and describes the different positions including occiput posterior. The document provides details on assessing various positions through abdominal and vaginal exams. It concludes by outlining the management of different non-vertex positions, including allowing natural rotation, augmentation of labor, operative vaginal delivery, or caesarean section if needed.
Puerperium is the period following childbirth during which the body tissues, specially the pelvic organs revert back approximately to the pre-pregnant state both anatomically and physiologically. puerperium begins as soon as the placenta is expelled and lasts for approximately 6 weeks when the uterus becomes regressed almost to the non-pregnant size.
This topic contains definition, meaning, classification, pathophysiology, clinical menifestations, metabolic and general changes, management of obstetrical shock
A contracted pelvis is one where the pelvic diameters are reduced below normal limits, potentially interfering with labor. Causes include developmental factors, malnutrition, trauma, and diseases affecting the bones. Diagnosis involves history, examination assessing pelvic and spinal abnormalities, and pelvimetry to measure diameters. In labor, the fetus's head may pass through a contracted pelvis via molding, asynclitic descent, or an altered rotation pattern depending on the type of contraction. Management ranges from a trial of vaginal delivery for minor issues to cesarean section for more severe disproportion.
A retained placenta occurs when the placenta is not expelled from the uterus within 30 minutes of childbirth. Risk factors include previous retained placentas, uterine injuries or surgeries, preterm births, induced labor, and multiple pregnancies. Causes can include failure of the placenta to separate fully from the uterine wall or abnormal placenta attachments like placenta accreta. Treatment involves controlled cord traction, manual removal in the operating room if needed, or hysterectomy for deeply embedded placentas. Complications can be life-threatening bleeding, infections, or shock if not properly managed.
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 document discusses the four stages of labor: 1) dilation of the cervix, 2) baby moving through the birth canal, 3) delivery of the placenta, and 4) recovery of the mother. It focuses on the second stage where the baby moves from the uterus into the vagina and is born. Key events in this stage include uterine contractions every 2-3 minutes lasting 50-60 seconds and the baby descending through the pelvis. Nursing assessments and interventions are also outlined to monitor labor progress and support the mother through each stage.
1. Subinvolution, breast engorgement, mastitis, breast abscess, and thrombophlebitis are common postpartum complications that can occur.
2. Subinvolution occurs when the involution of the uterus after delivery is impaired or delayed. Breast engorgement is swelling of the breasts due to increased blood and lymph supply before lactation begins.
3. Mastitis is an inflammation of the breast tissue that is usually caused by bacterial infection during breastfeeding. Left untreated it can develop into a breast abscess, which is a localized collection of pus in the breast that requires drainage.
The human placenta is a discoid, haemochorial organ that develops during pregnancy to connect the developing fetus to the uterine wall for nutrient/waste exchange. At term, the placenta is a circular disc about 15-20cm in diameter and 2.5cm thick that weighs around 500g. It has both a fetal side covered by amnion/umbilical cord and a rough, spongy maternal side with lobes. The placenta facilitates gas/nutrient exchange between maternal and fetal blood supplied by the umbilical cord and establishes a connection between the mother and developing fetus.
This document discusses fetal malpresentation and malposition, which refer to abnormal positions of the fetus within the uterus. Fetal malpresentation means any position other than vertex, such as breech or transverse lie. Malposition refers to positions other than occiput anterior, such as occiput posterior or occiput transverse. Types and management of different malpresentations and malpositions are described, along with risks to mother and fetus. Nursing care focuses on close monitoring for abnormal labor, supporting the mother physically and emotionally, and preparing for potential operative delivery.
An ectopic pregnancy occurs when a fertilized egg implants and grows outside the uterus, usually in one of the fallopian tubes. This is a medical emergency that requires prompt treatment to stop potentially life-threatening bleeding. Most ectopic pregnancies occur in the fallopian tubes. While the incidence of ectopic pregnancy is rising due to increased rates of pelvic inflammatory disease, early diagnosis and treatment have reduced maternal death and illness.
Thromboprophylaxis Of Venous ThromboEmbolism (VTE )In Obstetrics And Gy...muhammad al hennawy
This document discusses thromboprophylaxis for venous thromboembolism (VTE) in obstetrics and gynecology. It covers the risks of VTE associated with pregnancy, hormonal contraceptives, and various gynecological surgeries. It recommends low molecular weight heparin as the anticoagulant of choice for prophylaxis and treatment, and discusses dosing and monitoring considerations during pregnancy due to increased clearance. Monitoring tests discussed include anti-Xa levels, APTT, INR, and delivery planning when on anticoagulation.
The document discusses the development of a new drug (DR) but provides no other context or details about the drug, its intended use, results of trials, or other pertinent information needed for a useful summary. With only the acronym "DR" provided, a meaningful 3 sentence summary cannot be generated.
This document summarizes embolic disorders that can occur during pregnancy, including venous thromboembolism, amniotic fluid embolism, and their causes, signs/symptoms, treatment, and complications. Venous thromboembolism is caused by Virchow's triad of endothelial damage, venous stasis, and hypercoagulability during pregnancy. It can lead to deep vein thrombosis and pulmonary embolism. Amniotic fluid embolism occurs when amniotic fluid enters the mother's bloodstream and causes respiratory distress, hypotension, and disseminated intravascular coagulation. Both conditions require emergency treatment and resuscitation to address complications like renal failure and death.
This document discusses deep vein thrombosis (DVT), including risk factors, signs and symptoms, diagnostic testing, and treatment approaches. It describes how DVT usually originates in the lower extremities and can progress proximally, with the potential to cause pulmonary embolisms. Diagnosis involves a clinical prediction model, D-dimer testing, and duplex ultrasound imaging. Treatment involves anticoagulation with heparin or low molecular weight heparin followed by warfarin to prevent clot extension and embolism, along with compression stockings in some cases.
Deep vein thrombosis is a blood clot that forms in the deep veins, usually of the legs. Risk factors include prolonged bed rest, surgery, trauma, cancer, and genetic hypercoagulable states. Symptoms include leg pain, swelling, and shortness of breath. Ultrasound is commonly used for diagnosis. Treatment involves anticoagulation with heparin or warfarin to prevent pulmonary embolism complications.
It is estimated that 20% of American women and 7% of American men suffer from venous disease. Venous disease results in symptoms such as aching, fatigue, swelling, and pain in the legs which can interfere with daily living.Cosmetic issues may affect quality of life.
At least 20% of patients with venous disease will develop leg ulcers. This presentation outlines the normal anatomy and physiology of venous drainage of the extremities as well as the common venous disorders such as varicose veins and deep vein thrombosis.
Venous thromboembolism is a condition where a blood clot forms in a vein. Deep vein thrombosis is a blood clot that forms in deep leg veins and can dislodge and travel to the lungs, called a pulmonary embolism. Risk factors include prolonged bed rest, surgery, cancer, pregnancy, oral contraceptives, and genetic conditions. Diagnosis involves a clinical assessment, D-dimer blood test, and ultrasound or venography imaging of the legs. Treatment consists of blood thinners like heparin and warfarin to prevent further clotting and embolism.
Deep vein thrombosis is a blood clot that forms in the deep veins, usually of the legs. It can dislodge and travel to the lungs, causing a pulmonary embolism. Risk factors include surgery, trauma, cancer, and prolonged immobility. Symptoms may include leg pain, swelling, redness, and warmth. Diagnosis involves assessing risk factors and testing such as ultrasound, venography, MRI, or D-dimer blood test. Treatment focuses on blood thinners to prevent clot growth and embolism.
Deep vein thrombosis (DVT) formation in the legs is a common complication. Risk factors include immobility, surgery, cancer, and genetic conditions. Symptoms may include leg swelling, pain, and skin changes. Ultrasound is the primary diagnostic test. Treatment involves blood thinners like heparin, low molecular weight heparin, and warfarin to prevent clots from growing or breaking off. Compression stockings also help. Prevention focuses on early ambulation and mechanical or pharmacological prophylaxis for high risk patients. Complications include bleeding, thrombocytopenia, and post-thrombotic syndrome. Nursing care monitors for signs of clot progression or medication side effects while educating on prevention
This document discusses the clinical aspects of veins, including:
1) The anatomy of the venous system in the leg, including deep and superficial veins.
2) The physiology of venous blood flow, which is governed by arterial pressure, the calf musculovenous pump, gravity, and venous valves.
3) Common vein disorders like venous thrombosis, thrombophlebitis, and chronic venous insufficiency which can result from valve damage or reflux and cause complications like ulceration.
Deep vein thrombosis (DVT) is a blood clot that forms in a deep vein, usually in the legs. The incidence of DVT ranges from 5-9 per 10,000 people annually. Risk factors include surgery, trauma, cancer, older age, and genetic conditions. Symptoms can include leg pain and swelling. Diagnosis involves blood tests, ultrasound imaging, or CT/MRI. Treatment aims to prevent clot growth and pulmonary embolism. Initial treatment includes anticoagulants like heparin or low molecular weight heparin. Long term treatment uses oral anticoagulants like warfarin for 3-6 months.
Venous thromboembolism refers to blood clots forming in the veins, which can break off and travel to the lungs (pulmonary embolism). Deep vein thrombosis is a blood clot that forms deep in the leg veins and can progress upwards. Superficial vein thrombosis involves shallow leg veins near the skin surface. Risk factors include surgery, trauma, cancer, genetic conditions. Symptoms include leg pain/swelling. Diagnosis involves D-dimer testing and ultrasound imaging of leg veins. Treatment is blood thinners to prevent clot growth and embolism.
Deep vein thrombosis (DVT) is a blood clot that forms in the deep veins, usually of the legs. It can be asymptomatic or cause leg pain, swelling, warmth, and redness. Risk factors include prolonged bed rest, surgery, cancer, and inherited or acquired hypercoagulable states. Diagnosis involves the Wells criteria for pre-test probability followed by D-dimer testing and duplex ultrasound imaging of the legs. Treatment aims to prevent pulmonary embolism and includes bed rest, leg elevation, compression stockings, and anticoagulation medications like heparin or warfarin. Differential diagnoses include cellulitis, arthritis, and peripheral edema from other causes.
1) Deep vein thrombosis is a blood clot that forms in the deep veins, usually of the legs. It can break off and travel to the lungs, blocking blood flow (pulmonary embolism).
2) Risk factors include prolonged bed rest, surgery, cancer, and inherited or acquired hypercoagulable states. Symptoms include leg pain, swelling, warmth, and redness. Diagnosis involves a clinical evaluation along with D-dimer testing and ultrasound imaging of the legs.
3) Treatment focuses on blood thinners to prevent clot growth and reduce the risk of embolism. Left untreated, a DVT can lead to long-term leg damage or potentially fatal blockages in
This document discusses pulmonary embolism (PE), which occurs when a blood clot breaks off and travels to the lungs. It defines PE and classifies the severity. Risk factors include prolonged bed rest, surgery, cancer, and inherited or acquired hypercoagulable states. Symptoms are often nonspecific but include chest pain and difficulty breathing. PE is caused by deep vein thrombosis (DVT) in the legs traveling to the lungs. The diagnosis is challenging due to vague symptoms but is important because untreated PE can be fatal.
This document discusses venous thrombosis, which occurs when blood clots form in the veins. Three main factors that contribute to venous thrombosis are stasis of blood, injury to vessel walls, and hypercoagulability of blood. Symptoms can include leg swelling and pain. Diagnostic tests include Doppler ultrasound, duplex imaging, and contrast phlebography. Treatment involves anticoagulant drugs like heparin and warfarin. Nursing care focuses on preventing complications through leg elevation, compression stockings, and patient education about anticoagulant therapy and risk factors.
Deep vein thrombosis (DVT) is a blood clot that forms in the deep veins, usually of the legs. Virchow's triad describes the three main factors that contribute to DVT formation: venous stasis, hypercoagulability, and endothelial injury. Clinical signs of DVT include calf pain, swelling, and tenderness. Diagnosis involves a clinical prediction model like the Wells criteria along with D-dimer testing and ultrasound imaging. Treatment consists of anticoagulation with heparin or warfarin to prevent pulmonary embolism and further complications.
This document discusses hemostasis and coagulation during pregnancy. It explains that during pregnancy, several coagulation factors increase by 50% and platelet activity increases to prevent blood loss during delivery when the placenta separates from the uterine wall. Pregnancy is also considered a hypercoagulable state to quickly stop bleeding when the placenta detaches. The document further discusses thromboembolism in pregnancy, describing superficial thrombophlebitis, deep vein thrombosis, pulmonary embolism, and thrombophilias as potential risks. It provides details on signs, symptoms, and treatments for venous thromboembolism during pregnancy.
MOVEMENT OF BONES OF AXIAL AND APPENDICULAR SYSTEM.pptxTaniyaMondal6
You can find here about the Movements of Bones of Axial and Appendicular System, Range of Motion, Bones, Joint Movements in Anatomy and Physiology with the help of 3D live images for better understanding and knowledge purpose. This presentation is made considering the new medical and nursing students. explained in an easy wasy. so that you can learn some effective knowledge through this slides.
Urine Testing for Detection of presence of glucose and proteinsTaniyaMondal6
This document provides an overview of a presentation on urine testing. It defines urine analysis as the process of analyzing urine to detect abnormalities through physical, chemical and microscopic examination. The purposes listed include general health evaluation, monitoring for abnormalities or diseases of the kidneys, urinary tract or other systemic diseases. Indications and patient, environment and article preparations are outlined. Procedures described include testing urine pH with litmus paper, testing for glucose using Benedict's solution, and testing for albumin using hot and cold tests.
Definition, Importance, Purpose, Characteristics, Sources, Classification, Principles , Implementation and Enforcement, Role of a Nurse Manager regarding nursing care standards related to nursing management and administration studies.
Twin Pregnancy by Taniya Mondal (Tutor, Shova Rani Nursing College)TaniyaMondal6
A detailed case study of a twin pregnancy, study of the condition, genesis of twins, types of twins, usg ananlysis , medical, surgical and nursing management, helath education, complication
Cord prolapse by Taniya Mondal (Tutor, Shova Rani Nursing College)TaniyaMondal6
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Versio
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
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Thrombo embolic disorders in postnatal period
1.
2. “
In most parts of the world this is overshadowed by other complications of
pregnancy which amount for a much grater proportion of maternal mortality and
morbidity. In developed countries, however, as mortality from other causes has
been reduced, thromboembolism has emerged as a leading cause of maternal
death. Physiological adaptation of pregnancy involves changes in the coagulation
system, which promote coagulation system and impair fibrinolysis. A side effect of
this change is an increased risk of Thrombosis, compared with non-pregnant
women. Here, we will discuss about Thromboembolic Disorders in Post-natal
Period.
2
Introduction
4. 4
Definition
Thromboembolic Disorder is the formation of clots (Thrombus) in blood
vessels that breaks loose and carried by the blood stream to plug
another vessels.
The clot may plug a vessel in the lungs (Pulmonary Embolism),
brain (stroke), gastrointestinal tract, kidneys or legs.
5. 5
Incidence and Background
Thromboembolic disorders remains one of the main direct causes of maternal
death in UK and other developed countries.
• It is leading non-obstetrical cause of maternal mortality.
• Incidence of 0.05%-0.3%
• The risk of thromboembolism during pregnancy and the postpartum
period is 10 times grater than that for non-pregnant patients.
• Mortality rate of 15%.
• 1 in 100,000 women of childbearing age.
• 1/1000 pregnancies in women under the age of 35.
• 4/1000 pregnancies in women over the age of 35.
• Risk per day is actually greatest in the weeks following delivery.
• 10-20% of VTEs are PEs.
6. 6
• Presentation is similar to non-pregnant patients with DVT or PE.
• PTE occurs most often secondary to DVT occur after-
Superficial vein thrombosis
Puerperal septic vein thrombosis
Puerperal ovarian vein thrombosis
• Most of them occur between 15-20 weeks of gestation.
• Superficial vein thrombosis
0.15% can occur during the antepartum period and incidence increases 8 fold into
postpartum period.
• Puerperal ovarian vein thrombosis
0.025%
• Septic pelvic vein thrombosis
0.1%
Continued-
11. Thromboembolic Disorders in Post-natal Mothers
Thrombosis of the leg veins and pelvic veins is one of the most common and important
complications in puerperium period especially in Western countries.
Venous Thromboembolism
Venous Thromboembolism is a condition in which a blood clot forms most often in
deep veins of the leg, groin or arm (known as DVT-Deep Vein Thrombosis). Risk
for postpartum venous thromboembolism is highest during the first 3 weeks after
delivery.
Pregnancy & Puerperium one well established risk factors for venous
thromboembolism (VTE), a disease that includes pulmonary embolism (PE) &
Deep Vein Thrombosis (DVT)
11
16. I. Deep Vein Thrombosis
Deep Vein Thrombosis or DVT is a blood clot that forms in a deep vein inside the body.
DVT usually occurs in a deep leg vein that runs through the muscle of the calf and the
thigh. Blood clots from when blood thickness and clumps together.
16
17. Deep Vein Thrombosis
Symptoms:
Pain in calf muscle. Edematous legs
17
Clinical diagnosis is unreliable. It remains asymptomatic.
18. Deep Vein Thrombosis
Rise in skin temperature
A positive Homan’s Sign
On examination asymmetric leg
edema ( Difference in
circumference between the affected
and the normal leg more than 2 cm)
18
19. Deep Vein Thrombosis
Investigations:
Venous USG- It is done by placing the transduces over the femoral vein and
then gradually it is moved to the great saphenous vein, the popliteal vein
& to its branches with the deep veins of the calf.
Doppler USG- The most accurate ultrasound criteria for diagnosis of
venous thrombosis.
Venography- By injecting non-ionic water soluble radio-opaque dye to note
the filling defect in the venous lumen is a reliable method if case is fully
interpreted. Venogram is restricted in pregnancy due to the risk of radiation
and contrast allergy.
Magnetic Resonance Imaging- It is helpful to detect thrombosis in pelvic,
iliac, femoral vein. The sensitivity and specificity of MRI in the diagnosis of
DVT are 100% and the accuracy is 96%.
19
21. II. Pelvic Thrombophlebitis
Postpartum Thrombophlebitis originates in the thrombosed veins at the placental site by
organism such as streptococci or bacteroides (fragilis), when it is localized in the pelvis,
it is called pelvic thrombophlebitis.
Extra-pelvic Spread:
i. Through the right ovarian vein into
Inferior vena cava and then to the lung.
ii. Through the right ovarian vein to the left
renal vein and then to left kidney.
21
22. Pelvic Thrombophlebitis
Clinical Features:
There is no specific clinical features of pelvic thrombophlebitis, but it should be
suspected in cases where the pyrexia continues for more than a week inspite of antibiotic
therapy.
It usually develops on the 2nd week of puerperium.
Mild pyrexia is common prior to the dramatic local manifestation.
Fever, chills and rigor.
Headache, Tachycardia,features of toxemia.
The affected leg is swallowen, painful, white & cold.
Polymorphonuclear Leukocytosis.
22
24. III. Pulmonary Embolism
Pulmonary Embolism is a blockage in one of the pulmonary arteries in the lungs. In most
cases, Pulmonary Embolism is caused by blood clots that travel to the lungs from deep
veins in the legs or rarely, from veins in other parts of the body (deep vein thrombosis).
It is the leading cause of maternal death in many developing countries.
24
28. Management
Active Treatment:
• Resuscitation-
Cardiac Massage
Oxygen Therapy
IV heparin bolus dose of 5000 IU and morphine 15 mg are given.
LMWH (enoxaparin 1 mg/kg,S/C×BD) maybe used.
Anticoagulant continued for 6 weeks to 6 months.
IV fluid support is continued and blood pressure is monitored if
needed Dopamine or Adrenaline.
28
31. Management
Placement of inferior caval filter or ligation of inferior vena cava and ovarian
veins.
31
32. Management
A low risk woman who has – no family history of VTE and is heterozygous for
factor-V mutation.
Management-
Need no thromboprophylaxis.
Early mobilization is needed.
Hydration to be maintained properly.
A woman with high risk-
Management-
Low molecular weight heparin (LMWH) prophylaxis needs
throughout pregnancy and postpartum 6 weeks
Immediate Risk woman with 3 or more risk factors-
Management- Management at puerperium period not only means
manage after delivery. VTE is such a condition which needs early
diagnosis and treat it throughout pregnancy to prevent massive
complications during puerperium. 32
33. Gross Management
The patient is put to bedrest with the foot end raised above the heart level.
Analgesics must be used to relieve pain or affected area.
Administration of the anticoagulant therapy should be continued till all evidences
of the disease have disappeared which generally take 3-6 months. The
anticoagulant therapy is safe for breastfeeding.
As soon as the pain subsides, gentle movement is allowed on bed by the end of 1st
week.
High quality elastic stockings are fitted on the affected leg before mobilization.
Inferior Vena Cava filters are used for patient with recurrent pulmonary
embolism or where anticoagulant therapy is contraindicated
Venous thrombolectomy is needed for massive illio-femoral vein thrombosis.
33
34. Nursing Management
In postnatal period good observation of the mother must be done.
When pain is present then analgesics must be given.
Making the client wear prescribed compression stocking to help circulation in the
leg.
Elevation of affected extremity.
Drink plenty of water.
Leg exercise must be shown to the mother.
LMWH is given to reduce risk of a pulmonary embolism and reduce risk of
developing another clot in the leg.
Antibiotic must be administered as per doctor’s order.
34
35. Prevention
Prevention of trauma,sepsis,anemia in pregnancy and labour.
Dehydration during delivery should be avoided.
Use of elastic compression stocking and intermittent pneumatic compression
devices during surgery.
Leg exercise, early ambulation are encouraged following operative delivery.
A high risk woman is one who has previous venous thromboembolism or anti-
thrombin deficiency she needs low-molecular weight heparin throughout
pregnancy and post-partum 6 weeks.
Regardless of their venous thrombo-embolism immobilization of the patient should
be avoided throughout pregnancy.
Mothers should be encouraged for early mobilization during postnatal period.
35
40. Health Teaching
Mother should be advised to bed rest with the foot end raised above the heart level.
Elastic stocking must be fitted on the affected legs
When pain present then as per doctor’s order analgesics can be taken.
When pain is relieved then gentle movement is allowed on bed by the end of 1st
week.
Must wear loose fitting cloths.
Psychological support should be given.
Leg exercise should be performed and early ambulation is encouraged.
Don’t drink alcohol and take light meals.
40