Anticoagulation during pregnancy:
• In mechanical valve prosthesis:
- First trimester: warfarin if daily dose is 5 mg or less, or unfractionated heparin (IV) or LMWH (anti-factor 10 adjusted).
- Second and early third trimesters: warfarin (whatever the dose achieving target INR)
- From week 37 till term: UFH (IV).
• In AF or in venous thromboembolism:
- First trimester: warfarin (if daily dose is 5 mg or less), UFH (IV or SC), or LMWH (weight-based).
- Second and early third trimesters: warfarin (whatever the dose achieving target INR), UFH (SC), or LMWH (weight-adjusted).
- From week 37 till term: UFH (IV).
#Obs_Gyne
• In mechanical valve prosthesis:
- First trimester: warfarin if daily dose is 5 mg or less, or unfractionated heparin (IV) or LMWH (anti-factor 10 adjusted).
- Second and early third trimesters: warfarin (whatever the dose achieving target INR)
- From week 37 till term: UFH (IV).
• In AF or in venous thromboembolism:
- First trimester: warfarin (if daily dose is 5 mg or less), UFH (IV or SC), or LMWH (weight-based).
- Second and early third trimesters: warfarin (whatever the dose achieving target INR), UFH (SC), or LMWH (weight-adjusted).
- From week 37 till term: UFH (IV).
#Obs_Gyne
Quick Notes
Anticoagulation during pregnancy: • In mechanical valve prosthesis: - First trimester: warfarin if daily dose is 5 mg or less, or unfractionated heparin (IV) or LMWH (anti-factor 10 adjusted). - Second and early third trimesters: warfarin (whatever the…
This is according the American college of chest physicians "ACCP"!!
BIOPHYSICAL:
Principle—Biophysical profile is a screening test for uteroplacental insufficiency.
-The fetal biophysical activities are initiated, modulated and regulated through fetal nervous system.
-The fetal CNS is very much sensitive to diminished oxygenation. Hypoxia → metabolic acidosis → CNS depression → changes in fetal biophysical activity.
#Obs_Gyne
Principle—Biophysical profile is a screening test for uteroplacental insufficiency.
-The fetal biophysical activities are initiated, modulated and regulated through fetal nervous system.
-The fetal CNS is very much sensitive to diminished oxygenation. Hypoxia → metabolic acidosis → CNS depression → changes in fetal biophysical activity.
#Obs_Gyne
Nuchal translucency:
NT is the fluid-filled space (detected by USG) between the fetal skin and the underlying soft tissue at the region of the fetal neck. NT ≥ 3 mm is abnormal.
#Obs_Gyne
NT is the fluid-filled space (detected by USG) between the fetal skin and the underlying soft tissue at the region of the fetal neck. NT ≥ 3 mm is abnormal.
#Obs_Gyne
Remember:
-Oral contraceptives’ link to an ↑ in breast cancer is not proven.
-Oral contraceptives’ link to an ↑ in breast cancer is not proven.
Quick Notes
BIOPHYSICAL: Principle—Biophysical profile is a screening test for uteroplacental insufficiency. -The fetal biophysical activities are initiated, modulated and regulated through fetal nervous system. -The fetal CNS is very much sensitive to diminished…
The following biophysical tests are used:
-Fetal movement count
-Ultrasonography
-Cardiotocography
-Nonstress test (NST)
-Fetal biophysical profile (BPP)
-Doppler ultrasound
-Vibroacoustic stimulation test
-Contraction stress test (CST)
-Amniotic fluid volume.
#Obs_Gyne
-Fetal movement count
-Ultrasonography
-Cardiotocography
-Nonstress test (NST)
-Fetal biophysical profile (BPP)
-Doppler ultrasound
-Vibroacoustic stimulation test
-Contraction stress test (CST)
-Amniotic fluid volume.
#Obs_Gyne
Types of Hysterectomy:
Abdominal and Vaginal
1-Abdominal
-Total hysterectomy (body& cervix are removed).
-Subtotal hysterectomy (body is removed and cervix is preserved) as in PPH and severe adhesions around the cervix
- Extended hysterectomy(TAH + removal for upper vagina + medial part cardinal ligament. It is for treatment of microinvasive cervical CA (IA2)
-Pan hvsterectomv (TAH + BSO).
-Radical hysterectomy (Wertheim' s operation), it's removal of
TAH and BSO
The whole parametrium (broad ligament)
Pelvic ligaments & LN .
-Extended radical hysterectomy (removal of periurethral tissue & up to 3/4+ ofthe vagina.
-Ultra radical hysterectomy (exentration → anterior, posterior or total).
In obstetrics:
-Supra-vaginal hysterectomy
-Caesarean hysterectomy
-Hysterectomy en toto:
Cervix infection
Cervical cancer is first trimester.
2-Vaginal hysterectomy:
-In Uterine prolapse or inversion
-Any patient with uterine size less than 12 week pregnancy as DUB, small fibroids, adenomyosis.
#Obs_Gyne
Abdominal and Vaginal
1-Abdominal
-Total hysterectomy (body& cervix are removed).
-Subtotal hysterectomy (body is removed and cervix is preserved) as in PPH and severe adhesions around the cervix
- Extended hysterectomy(TAH + removal for upper vagina + medial part cardinal ligament. It is for treatment of microinvasive cervical CA (IA2)
-Pan hvsterectomv (TAH + BSO).
-Radical hysterectomy (Wertheim' s operation), it's removal of
TAH and BSO
The whole parametrium (broad ligament)
Pelvic ligaments & LN .
-Extended radical hysterectomy (removal of periurethral tissue & up to 3/4+ ofthe vagina.
-Ultra radical hysterectomy (exentration → anterior, posterior or total).
In obstetrics:
-Supra-vaginal hysterectomy
-Caesarean hysterectomy
-Hysterectomy en toto:
Cervix infection
Cervical cancer is first trimester.
2-Vaginal hysterectomy:
-In Uterine prolapse or inversion
-Any patient with uterine size less than 12 week pregnancy as DUB, small fibroids, adenomyosis.
#Obs_Gyne
Weight gain during pregnancy:
Normal during whole pregnancy is 11-15 kg.
During first month: No weight gain
During second month: Decrease about half to one kg due to nausea, vomiting and loss of appetite.
During third month: Weight is like that of pre-pregnancy weight.
Remaining 6 months, weight gain is by rate of 2kg/month or 1/2 kg per week.
Excessive weight gain occurs as in Hydrominos, multiple pregnancy, diabetic mother.
Sudden weight gain occurs is Preeclampsia.
#Obs_Gyne
Normal during whole pregnancy is 11-15 kg.
During first month: No weight gain
During second month: Decrease about half to one kg due to nausea, vomiting and loss of appetite.
During third month: Weight is like that of pre-pregnancy weight.
Remaining 6 months, weight gain is by rate of 2kg/month or 1/2 kg per week.
Excessive weight gain occurs as in Hydrominos, multiple pregnancy, diabetic mother.
Sudden weight gain occurs is Preeclampsia.
#Obs_Gyne