PRESENTATION:
-The part of the fetus which occupies the lower pole of the uterus (pelvic brim) is called the presentation of the fetus.
#Obs_Gyne
-The part of the fetus which occupies the lower pole of the uterus (pelvic brim) is called the presentation of the fetus.
#Obs_Gyne
PESENTING PART:
-The presenting part is defined as the part of the presentation which overlies the internal os and is felt by the examining finger through the cervical opening.
-Thus, in cephalic presentation, the presenting part may be vertex (most common), brow or face, dep ending upon the degree of flexion of the head.
#Obs_Gyne
-The presenting part is defined as the part of the presentation which overlies the internal os and is felt by the examining finger through the cervical opening.
-Thus, in cephalic presentation, the presenting part may be vertex (most common), brow or face, dep ending upon the degree of flexion of the head.
#Obs_Gyne
MOULDING:
- It is the alteration of the shape of the forecoming head while passing through the resistant birth passage during labor.
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- It is the alteration of the shape of the forecoming head while passing through the resistant birth passage during labor.
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Moulding disappears within few hours after birth.
Grading:
There are three gradings.
Grade-1—the bones touching but not overlapping,
Grade-2—overlapping but easily separated and
Grade-3—fixed overlapping.
#Obs_Gyne
Grading:
There are three gradings.
Grade-1—the bones touching but not overlapping,
Grade-2—overlapping but easily separated and
Grade-3—fixed overlapping.
#Obs_Gyne
-Brow: It is an area bounded on one side by the anterior fontanel and coronal sutures and on the other side by the root of the nose and supraorbital ridges of either side.
-Vertex: It is a quadrangular area bounded anteriorly by the bregma and coronal sutures behind by the lambda and lambdoid sutures and laterally by lines passing through the parietal eminences.
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#Obs_Gyne
-Sinciput is the area lying in front of the anterior fontanel and corresponds to the area of brow and the occiput is limited to the occipital bone.
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#Obs_Gyne
Remember:
-Recurrent miscarriage is defined as the sequence of two or more spontaneous abortions as documented by either sonography or on histopathology, before 20 weeks.
This is the updated definition.
#Obs_Gyne
-Recurrent miscarriage is defined as the sequence of two or more spontaneous abortions as documented by either sonography or on histopathology, before 20 weeks.
This is the updated definition.
#Obs_Gyne
Quick Notes
Remember: -Recurrent miscarriage is defined as the sequence of two or more spontaneous abortions as documented by either sonography or on histopathology, before 20 weeks. This is the updated definition. #Obs_Gyne
Earlier definition states prior three or more miscarriages before 24 weeks of gestation.
DEFINITION of Preterm labor (PTL):
-It is defined as one where the labor starts before the 37th completed week (<259 days), counting from the first day of the last menstrual period.
-The lower limit of gestation is not uniformly defined; whereas in developed countries it has been brought down to 20 weeks, in developing countries it is 28 weeks.
-Preterm birth is the significant cause of perinatal morbidity and mortality.
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-It is defined as one where the labor starts before the 37th completed week (<259 days), counting from the first day of the last menstrual period.
-The lower limit of gestation is not uniformly defined; whereas in developed countries it has been brought down to 20 weeks, in developing countries it is 28 weeks.
-Preterm birth is the significant cause of perinatal morbidity and mortality.
#Obs_Gyne
Quick Notes
DEFINITION of Preterm labor (PTL): -It is defined as one where the labor starts before the 37th completed week (<259 days), counting from the first day of the last menstrual period. -The lower limit of gestation is not uniformly defined; whereas in developed…
DIAGNOSIS:
(1) Regular uterine contractions with or without pain (at least one in every 10 minutes);
(2) Dilatation (> 2 cm) and effacement (80%) of the cervix;
(3) Length of the cervix (measured by TVS) < 2.5 cm and funneling of the internal os and
(4) Pelvic pressure, backache and/or vaginal discharge or bleeding.
(1) Regular uterine contractions with or without pain (at least one in every 10 minutes);
(2) Dilatation (> 2 cm) and effacement (80%) of the cervix;
(3) Length of the cervix (measured by TVS) < 2.5 cm and funneling of the internal os and
(4) Pelvic pressure, backache and/or vaginal discharge or bleeding.
Quick Notes
DIAGNOSIS: (1) Regular uterine contractions with or without pain (at least one in every 10 minutes); (2) Dilatation (> 2 cm) and effacement (80%) of the cervix; (3) Length of the cervix (measured by TVS) < 2.5 cm and funneling of the internal os and (4)…
Preterm labor is very unlikely when cervical length is >30 mm, irrespective of uterine contractions.
Quick Notes
DEFINITION of Preterm labor (PTL): -It is defined as one where the labor starts before the 37th completed week (<259 days), counting from the first day of the last menstrual period. -The lower limit of gestation is not uniformly defined; whereas in developed…
WHO definition of Preterm Labor (PTL)
-Regular contractions associated with cervical changes ( <37complete ->20 weeks of pregnancy )
-Birth weight < 2500 g
•Threatened PTL: presence of uterine contractions in absence of cervical changes.
•Early PTL: is PTL occurring < 34 weeks gestation.
lt is the more serious type of PTL.
•Late PTL: is PTL occurring > 34 but < 37 weeks.
It carries less foetal risks than early PTL.
#Obs_Gyne
-Regular contractions associated with cervical changes ( <37complete ->20 weeks of pregnancy )
-Birth weight < 2500 g
•Threatened PTL: presence of uterine contractions in absence of cervical changes.
•Early PTL: is PTL occurring < 34 weeks gestation.
lt is the more serious type of PTL.
•Late PTL: is PTL occurring > 34 but < 37 weeks.
It carries less foetal risks than early PTL.
#Obs_Gyne
Remember:
-Screening for GDM is done between 24 and 28 weeks of pregnancy.
-Fetal congenital malformations are high (2 to 6-fold increase) in diabetic woman (pregestational diabetes); most common is cardiovascular.
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-Screening for GDM is done between 24 and 28 weeks of pregnancy.
-Fetal congenital malformations are high (2 to 6-fold increase) in diabetic woman (pregestational diabetes); most common is cardiovascular.
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Remember:
-Fetal anomalies are however not increased in case of GDM, Why?
-This is due to the absence of metabolic disturbance during organogenesis, because GDM occurs later during second or third trimester.
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-Fetal anomalies are however not increased in case of GDM, Why?
-This is due to the absence of metabolic disturbance during organogenesis, because GDM occurs later during second or third trimester.
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-GDM is defined as carbohydrate intolerance of variable severity with onset or first rec ognition during the present pregnancy.
-The entity usually presents late in the second or during the third trimester.
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-The entity usually presents late in the second or during the third trimester.
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Remember:
-Pregnancy is a state of chronic low grade inflammation.
-This is associated with increased circulating levels of C-reactive protein (CRP) and interleukin-6 (IL-6).
-Both these factors enhance insulin resistance.
-The defect lies both in insulin secretion and action.
-The ultimate effect is the hyperglycemia.
-Nearly 50% of women with GDM will become overt diabetes (type-2) over a period of 5 to 20 years.
#Obs_Gyne
-Pregnancy is a state of chronic low grade inflammation.
-This is associated with increased circulating levels of C-reactive protein (CRP) and interleukin-6 (IL-6).
-Both these factors enhance insulin resistance.
-The defect lies both in insulin secretion and action.
-The ultimate effect is the hyperglycemia.
-Nearly 50% of women with GDM will become overt diabetes (type-2) over a period of 5 to 20 years.
#Obs_Gyne
Quick Notes
-GDM is defined as carbohydrate intolerance of variable severity with onset or first rec ognition during the present pregnancy. -The entity usually presents late in the second or during the third trimester. #Obs_Gyne
OVERT DIABETES in Pregnancy:
-A patient with symptoms of diabetes mellitus (polyuria, polydipsia, weight loss) and random plasma glucose level of 200 mg/dL or more is considered overt diabetic.
-The condition may be pre-existing or detected for the first time during present pregnancy.
-According to American Diabetic Association diagnosis is positive if:
(a) The fast ing plasma glucose exceeds 126 mg/dL,
(b) the 2 hours post glucose (75 g) value exceeds 200 mg/dL and
(c) HbA1C ≥ 6.5%.
#Obs_Gyne
-A patient with symptoms of diabetes mellitus (polyuria, polydipsia, weight loss) and random plasma glucose level of 200 mg/dL or more is considered overt diabetic.
-The condition may be pre-existing or detected for the first time during present pregnancy.
-According to American Diabetic Association diagnosis is positive if:
(a) The fast ing plasma glucose exceeds 126 mg/dL,
(b) the 2 hours post glucose (75 g) value exceeds 200 mg/dL and
(c) HbA1C ≥ 6.5%.
#Obs_Gyne
Remember:
-All obstetrics complications can occur in Multiple pregnancy EXCEPT Macrosomia and post-term pregnancy.
#Obs_Gyne
-All obstetrics complications can occur in Multiple pregnancy EXCEPT Macrosomia and post-term pregnancy.
#Obs_Gyne