Remember:
-Fetal heart sound (FHS) is the most conclusive clinical sign of pregnancy.
-With an ordinary stethoscope, it can be detected between 18–20 weeks.
-The sounds resemble the tick of a watch under a pillow.
-Its location varies with the position of the fetus.
-The rate varies from 110–160 beats per minute.
#Obs_Gyne
-Fetal heart sound (FHS) is the most conclusive clinical sign of pregnancy.
-With an ordinary stethoscope, it can be detected between 18–20 weeks.
-The sounds resemble the tick of a watch under a pillow.
-Its location varies with the position of the fetus.
-The rate varies from 110–160 beats per minute.
#Obs_Gyne
Remember:
-Active fetal movements can be felt at intervals by placing the hand over the uterus as early as 20th week.
#Obs_Gyne
-Active fetal movements can be felt at intervals by placing the hand over the uterus as early as 20th week.
#Obs_Gyne
Palpation of fetal parts can be felt distinctly by 20th week.
-The findings are of value not only to diagnose pregnancy but also to identify the presentation and position of the fetus in later weeks.
#Obs_Gyne
-The findings are of value not only to diagnose pregnancy but also to identify the presentation and position of the fetus in later weeks.
#Obs_Gyne
Remember:
-FHS may not be audible in cases of maternal obesity, polyhydramnios, occipitoposterior position and certainly IUD.
#Obs_Gyne
-FHS may not be audible in cases of maternal obesity, polyhydramnios, occipitoposterior position and certainly IUD.
#Obs_Gyne
Sonography in Pregnancy:
-Routine sonography at 18–20 weeks permits a detailed survey of fetal anatomy, placental localization and the integrity of the cervical canal.
-Gestational age is determined by measuring the biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL).
-It is most accurate when done between 12 and 20 weeks (variation ± 8 days).
#Obs_Gyne
-Routine sonography at 18–20 weeks permits a detailed survey of fetal anatomy, placental localization and the integrity of the cervical canal.
-Gestational age is determined by measuring the biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL).
-It is most accurate when done between 12 and 20 weeks (variation ± 8 days).
#Obs_Gyne
Antenatal care visits:
-Generally check up is done:
•at interval of 4 weeks up to 28 weeks;
•at interval of 2 weeks up to 36 weeks
•and thereafter weekly till delivery.
- Ideally this should be more flexible depending on the need and the convenience of patient.
-In the developing countries, as per WHO recommendation, the visit may be curtailed to at least 4; first in second trimester around 16 weeks, second between 24–28 weeks, the third visit at 32 weeks and the fourth visit at 36 weeks.
-WHO recommends a minimum of eight antenatal care visits for a healthy pregnancy.
#Obs_Gyne
-Generally check up is done:
•at interval of 4 weeks up to 28 weeks;
•at interval of 2 weeks up to 36 weeks
•and thereafter weekly till delivery.
- Ideally this should be more flexible depending on the need and the convenience of patient.
-In the developing countries, as per WHO recommendation, the visit may be curtailed to at least 4; first in second trimester around 16 weeks, second between 24–28 weeks, the third visit at 32 weeks and the fourth visit at 36 weeks.
-WHO recommends a minimum of eight antenatal care visits for a healthy pregnancy.
#Obs_Gyne
Causes of edema in pregnancy:
(1) Physiological
(2) Pre-eclampsia
(3) Anemia and hypoproteinemia
(4) Cardiac failure
(5) Nephrotic syndrome.
#Obs_Gyne
(1) Physiological
(2) Pre-eclampsia
(3) Anemia and hypoproteinemia
(4) Cardiac failure
(5) Nephrotic syndrome.
#Obs_Gyne
•Physiological edema during pregnancy:
-The cause of physiological edema is due to increased venous pressure of the inferior extremities by the gravid uterus pressing on the common iliac veins.
-The features of the physiological edema are:
(1) Slight degree (ankle edema), usually confined to one leg, more on the right
(2) Unassociated with any other features of pre-eclampsia or proteinuria
(3) Disappears on rest alone
(4) Other pathologies of cardiac, renal and hematological are absent.
#Obs_Gyne
-The cause of physiological edema is due to increased venous pressure of the inferior extremities by the gravid uterus pressing on the common iliac veins.
-The features of the physiological edema are:
(1) Slight degree (ankle edema), usually confined to one leg, more on the right
(2) Unassociated with any other features of pre-eclampsia or proteinuria
(3) Disappears on rest alone
(4) Other pathologies of cardiac, renal and hematological are absent.
#Obs_Gyne
Remember:
-Auscultation of FHR at the earliest by 18–20 weeks using ordinary stethoscope and that using Doppler principle at 10th week.
#Obs_Gyne
-Auscultation of FHR at the earliest by 18–20 weeks using ordinary stethoscope and that using Doppler principle at 10th week.
#Obs_Gyne
Hegar’s sign:
-It is present in two-thirds of cases"Pregnant women".
-It can be demonstrated between 6–10 weeks, a little earlier in multiparae.
-This sign is based on the fact that:
(1) upper part of the body of the uterus is enlarged by the growing fetus
(2) lower part of the body is empty and extremely soft and
(3) the cervix is comparatively firm. Because of variation in consistency, on bimanual examination (two fingers in the anterior fornix and the abdominal fingers behind the uterus), the abdominal and vaginal fingers seem to appose below the body of the uterus.
-Examination must be gentle to avoid the risk of abortion.
#Obs_Gyne
-It is present in two-thirds of cases"Pregnant women".
-It can be demonstrated between 6–10 weeks, a little earlier in multiparae.
-This sign is based on the fact that:
(1) upper part of the body of the uterus is enlarged by the growing fetus
(2) lower part of the body is empty and extremely soft and
(3) the cervix is comparatively firm. Because of variation in consistency, on bimanual examination (two fingers in the anterior fornix and the abdominal fingers behind the uterus), the abdominal and vaginal fingers seem to appose below the body of the uterus.
-Examination must be gentle to avoid the risk of abortion.
#Obs_Gyne
NORMAL LABOR (EUTOCIA):
Labor is called normal if it fulfils the
following criteria:
1. Spontaneous in onset and at term
2. With vertex presentation
3. Without undue prolongation
4. Natural termination with minimal aids
5. Without having any complications affecting the health of the mother and/or the baby.
#Obs_Gyne
Labor is called normal if it fulfils the
following criteria:
1. Spontaneous in onset and at term
2. With vertex presentation
3. Without undue prolongation
4. Natural termination with minimal aids
5. Without having any complications affecting the health of the mother and/or the baby.
#Obs_Gyne
Forwarded from Draft of some imp. notes
ABNORMAL LABOR (DYSTOCIA):
-Any deviation from the definition of normal labor is called abnormal labor.
#Obs_Gyne
-Any deviation from the definition of normal labor is called abnormal labor.
#Obs_Gyne
Women are informed about the warning signs of pregnancy, when they should report the hospital.
#Obs_Gyne
#Obs_Gyne
Forwarded from Quick Notes
Forwarded from Quick Notes
Anovulation is an anovulatory cycle or a menstrual cycle during which the ovaries do not release an oocyte. Therefore, ovulation does not take place.
#Obs_Gyne
#Obs_Gyne
Forwarded from Quick Notes
Polycystic ovary syndrome(PCOS) is a set of symptoms due to elevated androgens (male hormones) in women.
#Gynecology
#Gynecology
Forwarded from Quick Notes
Life saving treatment in PPH
Once PPH has been identified , involve the following :
1- Identify possible PPH
2- call for help
3- ABC
4- give O2 for pt .
5- insert 2 Large bore IV access
6- CBC/cross-match and type
7- insert Foley catheter
8- massage of uterus
9- diagnosis of 4 “ Ts “ & spescific treatment accordingly.
#Obstetrics
Once PPH has been identified , involve the following :
1- Identify possible PPH
2- call for help
3- ABC
4- give O2 for pt .
5- insert 2 Large bore IV access
6- CBC/cross-match and type
7- insert Foley catheter
8- massage of uterus
9- diagnosis of 4 “ Ts “ & spescific treatment accordingly.
#Obstetrics
Forwarded from Quick Notes
▫️The most common cause of bleeding in females before puberty is a foreign body.
▫️The most common cause of bleeding in females during adolescence is pregnancy complications.
▫️The most common cause of bleeding in females after menopause is atrophic vaginitis.
#Obs_Gyne
Emergency treatment of hyperkalemia:
◼️Attach ECG monitor and obtain IV access.
◼️Priority is to PROTECT MYOCARDIUM and this should be the first to be done, give 10 mL of 10% calcium gluconate over 5 minutes (some authorities advocate 2 minutes), the protective effect is short lasting and this may need to be repeated 15 minutes later.
◼️Drive Potassium inside cells by administrating insulin, give 10 units in 50 mL of 50% glucose IV over 10 minutes and then monitor potassium and Glucose levels.
◼️If severe acidosis is present (pH less than 6.9) give sodium bicarbonate 1.26%.
◼️Additional line of treatment is salbutamol 0.5 mg in 100 mL of glucose IV over 15 minute, this is rarely done in current times.
◼️Deplete potassium over the next 24 hours by using polystyrene sulphonate resins, give 15 g orally three times a day followed by a laxative, or give 30 g rectally followed by enema 3-6 hours later.
◼️If above treatment lines fails, hemodialysis or peritoneal dialysis is indicated.
#Medicine
◼️Attach ECG monitor and obtain IV access.
◼️Priority is to PROTECT MYOCARDIUM and this should be the first to be done, give 10 mL of 10% calcium gluconate over 5 minutes (some authorities advocate 2 minutes), the protective effect is short lasting and this may need to be repeated 15 minutes later.
◼️Drive Potassium inside cells by administrating insulin, give 10 units in 50 mL of 50% glucose IV over 10 minutes and then monitor potassium and Glucose levels.
◼️If severe acidosis is present (pH less than 6.9) give sodium bicarbonate 1.26%.
◼️Additional line of treatment is salbutamol 0.5 mg in 100 mL of glucose IV over 15 minute, this is rarely done in current times.
◼️Deplete potassium over the next 24 hours by using polystyrene sulphonate resins, give 15 g orally three times a day followed by a laxative, or give 30 g rectally followed by enema 3-6 hours later.
◼️If above treatment lines fails, hemodialysis or peritoneal dialysis is indicated.
#Medicine