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🌟قناة علمية للقروب D , الدفعة الثالثة

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#Short_Note.. 🌸

#Etiology_of_post partum hemorrhage.. (4T)🌿

ⓐ-Tone: ➥Utrine atony 95%..🍂

ⓑ-Tissue: ➥Retained Tissue / Clot.. 🍃

ⓒ-Trauma: ➥ Laceration, Rupture, inversion.. 🍂

ⓓ-Thrombin: ➥Cougulopathy..🍃
🛑 most common in obstetrics 😍😍😍😍😍😍😍😍😍

🔰 The most common cause of APH is placental abruption
🔰 The most common cause of PROM is infection ( chorioamnionitis ) and the most common infection is group B streptococcus

🔰 The most common cause of oligohydramnios is PROM
🔰 The most common cause of primary PPH is atone
🔰 The most common cause of secondary PPH is tissue retained
🔰Vasa previa is the only cause of APH of fetal origin
🔰 The commonest type of anemia during pregnancy is iron deficiency anemia ( and is the commonest problem during pregnancy )

🔰 The commonest organism that cause pyelonephritis is E.coli
🔰 Graves disease is the most common cause of hyperthyroidism in pregnancy
🔰 The commonest cause of occipitoposterior is special type of pelvis( Android or anthropoid pelvis)
🔰 The commonest fetal cause of breech presentation is prematurity
🔰 The commonest cause of shoulder presentation is multiparity
🔰 The commonest causes of cord prolapse are malpresentations and contracted pelvis.
🔰 The commonest cause of perineal lacerations is obstetric trauma
🔰 The commonest cause of DIC and hypofibrinogenamia is severe placental abruption ( concealed type)
🔰 The commonest cause of acute mastitis and breast abscess is S.aureus
🔰 The most common organism that cause septic abortion is anaerobic streptococcus
🔰 The commonest cause of IUFD , postmaturity, IUGR is idiopathic












#obs
#Short_Note.. 🌸

#Cord_prolapse..
Cord is presented before the presenting part after rupture of membranes.

#First aid in cord prolapse:
Pulsatile cord should be returned as low temperature causes vasoconstriction and fetal asphyxia..
Patient put in the tendlemberge position (Pelvis elevation).

#Mode of delivery:
#For alife baby..
If full dilated cervix..
immediate vaginal delivery..
If cervix is partially dilated..
CS.

#For dead baby wait for spontaneous delivery..🍃
#Short_Note.. 🌸

#TTTS (twin-to-twin transfusion syndrome)
Occurs when there is anastomosis between twins circulations (monozygotic monochorionic twins)..
when there is A-V shunts; Donor dead due to anemia.
Recipient dead due to CHF common..
#Short_Note.. 🌸
#Ectopic_pregnancy..🌿

In Ectopic pregnancy there is pain then followed by bleeding while in Abortion bleeding comes first..

#normally  at 1500 IU/L value of beta-hCG there is a gestational sac seen only by transvaginal ultrasound, and at 3000 IU/L value of beta-hCG there is a gestational sac seen by transabdominal ultrasound..


#Types of ectopic pregnancy:🍂 acute , subacute , chronic.

#Acute cases present with signs and symptoms of acute abdomen and patient may be shocked due to pain and/or bleeding..🍃


#Risk_factors for ectopic pregnancy include:
🍂
* previous ectopic pregnancy..
* preceding tubal or pelvic inflammation..
* previous tubal surgery.
* intrauterine contraceptive device..
* congenital abnormalities of the tube..

#sites of ectopic pregnancy:
Tubal (90%), ovarian, cervical, rudimentary horn of uterus, abdominal...🍂


#Diagnosis of ectopic pregnancy:🍂

1- careful history and physical examination. .
2-Pregnancy test.
3-Ultrasound  (exclude intrauterine pregnancy, and may demonstrates the pregnancy outwith the uterus)..
4-Laparascopy..
5-Culdocentesis (there is a picture below)..


#Management of ectopic pregnancy can be medical or surgical..🍂

#criteria for medical therapy:🍃
1-Gestational sac less than 3cm..
2- No cardiac activity.
3- Beta-hCG less than 1500 IU/L.
4- Vitally stable patient.

#Drugs_Used:🍃
methotrexate + folonic acid.

#Surgical_options_include:🍃

Laparatomy..
Salpingestomy..
Salpingetomy..
Salpingectomy..
Salpingo-oophorectomy..
Milking..
Oophorectomy..
Hysterectomy..🍃
👍1
#Short_Note..
#Shock_in_Obstetrics..🌸
#Definition:🍃
a state of circulatory failure
( hypotension, tissue hypoperfusion )..

#Etiology: 🍂
#Hemorrhage shock.. bleeding in early pregnancy.. APH.. PPH..🍃

#Hypovolomic a dehydration: (hyperemesis gnvidarum)..🍂

#Neurogenic pain in early preg.... pain in late preg....🌱

#Septic: a septic abortion, chorioamnionitis, puerperal sepsis..🍃

#Pulmonary embolisrn + amniotic fluid or thrombus..🍂

#Splanchnic a sudden drop of infrauterine pressure (polyhdramnios, twins)..🍃
#Short_Note..

#Classification_of_abnormal placental attachment:🌸

#Placenta accreta 75-78%:🍂
lnvades superficially into the myometrium..

#Placenta increta 17%: 🍃
lnvades deeply into the
myometrium..

#Placenta percreta 5-7%:
Invades through the myometrium and penetrates the outer serosallayer of the uterus.. lt may invade adjacent structures, including bladder and bowel..🍁