For difficult vaginal delivery,forceps delivery,vacuum application are done to assist the vaginal delivery.Many types of forceps are there divided in 3 categories.
Please find the power point on Management of Preterm labor. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
For difficult vaginal delivery,forceps delivery,vacuum application are done to assist the vaginal delivery.Many types of forceps are there divided in 3 categories.
Please find the power point on Management of Preterm labor. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Abnormalities of placenta and cord obgjagan _jaggi
Has a velamentous insertion of the cord (the umbilical cord inserts abnormally into the fetal membranes, instead of the center of the placenta) Has placenta previa (a low-lying placenta that covers part or all of the cervix) or certain other placental abnormalities.
Oligohydramnios by dr alka mukherjee dr apurva mukherjee nagpur m.s.alka mukherjee
• Oligohydramnios refers to amniotic fluid volume that is less than expected for gestational age. It is typically diagnosed by ultrasound examination and may be described qualitatively (eg, reduced amniotic fluid volume) or quantitatively (eg, amniotic fluid index ≤5 cm, single deepest pocket <2 cm).
• Oligohydramnios may be idiopathic or have a maternal, fetal, or placental cause The fetal prognosis depends on several factors, including the underlying cause, the severity (reduced versus no amniotic fluid), and the gestational age at which oligohydramnios occurs. Because an adequate volume of amniotic fluid is critical to normal fetal movement and lung development and for cushioning the fetus and umbilical cord from uterine compression, pregnancies complicated by oligohydramnios from any cause are at risk for fetal deformation, pulmonary hypoplasia, and umbilical cord compression.
• Oligohydramnios is associated with an increased risk for fetal or neonatal death, which may be related to the underlying cause of the reduced amniotic fluid volume or due to sequelae of the reduced amniotic fluid volume.
• This topic will discuss issues related to oligohydramnios. Methods of amniotic fluid volume assessment are reviewed separately.
• Oligohydramnios occurs when the amniotic fluid is < 5th centile for gestational age.
• The most common causes are premature rupture of membranes (often missed by the mother) and placental insufficiency, however structural abnormalities such as renal agenesis should be considered.
• Prognosis is linked to gestation at diagnosis and likely development of pulmonary hypoplasia and premature delivery.
• Treatment is by optimising gestation of delivery
Abnormalities of placenta and cord obgjagan _jaggi
Has a velamentous insertion of the cord (the umbilical cord inserts abnormally into the fetal membranes, instead of the center of the placenta) Has placenta previa (a low-lying placenta that covers part or all of the cervix) or certain other placental abnormalities.
Oligohydramnios by dr alka mukherjee dr apurva mukherjee nagpur m.s.alka mukherjee
• Oligohydramnios refers to amniotic fluid volume that is less than expected for gestational age. It is typically diagnosed by ultrasound examination and may be described qualitatively (eg, reduced amniotic fluid volume) or quantitatively (eg, amniotic fluid index ≤5 cm, single deepest pocket <2 cm).
• Oligohydramnios may be idiopathic or have a maternal, fetal, or placental cause The fetal prognosis depends on several factors, including the underlying cause, the severity (reduced versus no amniotic fluid), and the gestational age at which oligohydramnios occurs. Because an adequate volume of amniotic fluid is critical to normal fetal movement and lung development and for cushioning the fetus and umbilical cord from uterine compression, pregnancies complicated by oligohydramnios from any cause are at risk for fetal deformation, pulmonary hypoplasia, and umbilical cord compression.
• Oligohydramnios is associated with an increased risk for fetal or neonatal death, which may be related to the underlying cause of the reduced amniotic fluid volume or due to sequelae of the reduced amniotic fluid volume.
• This topic will discuss issues related to oligohydramnios. Methods of amniotic fluid volume assessment are reviewed separately.
• Oligohydramnios occurs when the amniotic fluid is < 5th centile for gestational age.
• The most common causes are premature rupture of membranes (often missed by the mother) and placental insufficiency, however structural abnormalities such as renal agenesis should be considered.
• Prognosis is linked to gestation at diagnosis and likely development of pulmonary hypoplasia and premature delivery.
• Treatment is by optimising gestation of delivery
16-Aug-2021-"Gestational trophoblastic disease (GTD) is a spectrum of abnormal growth and proliferation of the trophoblasts of the placenta that continue even beyond the end of pregnancy of the placenta".
Gestational trophoblastic disease is a spectrum of interrelated disease processes originating from the placenta.
GTD is a spectrum of tumours with a wide range of biologic behaviour and potential for metastases
They are characterised by an abnormally high amount of HcG levels in the blood
3. Incidence: 1:2000 pregnancies in United States and Europe 1:200 in Asia 10 times more in women over 45 years old. The increasing use of ultrasound in early pregnancy has probably led to the earlier diagnosis of molar pregnancy
4. 1 -Maternal age : Young mothers (under age 20 years) have a slightly higher prevalence of GTD, although not nearly so great as those mothers over age 35 years. 2- Women who have had a previous molar gestation 3- The risk increases with the number of spontaneous abortions . 4- Women with blood type A may be more likely to develop choriocarcinoma (but not hydatidiform mole); RISK FACTORS:
5.
6. Differentiation Between Complete And Partial Mole Rare 5-10% Malignant Changes Paternal and maternal 69 XXY or 69 XYY Paternal 46 XX (96%) or 46 XY (4%) Karyotype Focal Diffuse Trophoblastic hyperplasia Focal Diffuse Swelling of the villi Present Absent Embryonic or foetal tissue Partial Mole Complete Mole Feature
7. Three components make up the trophoblast: cytotrophoblast, syncytiotrophoblast intermediate trophoblast The cytotrophoblast is a stem cell with high mitotic activity but without hormonal synthesis. The syncytiotrophoblast, which constitutes the villous trophoblast, has low mitotic activity. The syncytiotrophoblast is responsible for the synthesis of the (beta-hCG) and can be identified with immunohistochemical stains. The intermediate trophoblast has features of the other two components and is responsible for endometrial invasion and implantation
8.
9.
10.
11.
12.
13.
14.
15.
16.
17. Complete Hydatidiform Mole Theca lutein cysts multiloculated, often bilateral resolve after treatment of the intrauterine process Occasionally seen in twin gestations, fetal hydrops, pharmacologic stimulation (especially with human maternal gonadotropin) U/S evaluation .
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28. Therapy: dilatation and suction curettage ( at which time the diagnosis is confirmed ). 15% of women with complete hydatidiform mole will develop recurrent disease in the form of invasive mole or choriocarcinoma . all patients are followed up with successive serum beta - hCG measurements to allow early detection of persistent gestational trophoblastic neoplasia SO IF serial testing shows progressive decrease in the serum beta - hCG level The clinical diagnosis of complete hydatidiform mole is reached. Avoid pregnancy
29. At the Eleventh World Congress on Gestational Trophoblastic Disease 2001, over 70 cases of persistent low level hCG elevation were reported from four Trophoblast Centres. The majority view of an expert panel was to refrain from immediate chemotherapy and/or surgery but to monitor such patients carefully and repeatedly (even over many years) looking for evidence of tumour or for a definite rise in hCG values. Hancock BW, Everard JE, Drew D. Quiescent gestational trophoblastic disease (FTD): how common is it and what is its outcome? XIth World Congress on Gestational Trophoblastic Diseases, Santa Fe, 2001, abstract. Kohorn EI. Persistent low level hCG: a clinical enigma. XIth World Congress on Gestational Trophoblastic Disease, Santa Fe, 2001, abstract. Newlands ES, Seckl MJ, Foskett M, Short D, Fuller S and Mitchell H. Problems of interpretation of persistent low levels of hCG in patients suspected of having gestational trophoblastic disease (GTD). XIth World Congress on Gestational Trophoblastic Diseases, Santa Fe, 2001, abstract. Clinical management of persistent low level hCG elevation
