Obstetrics

Hypertensive disorders of pregnancy are the second most common cause of maternal death, accounting for 15% of all maternal deaths. Effects of pregnancy on the maternal cardiovascular system: • Blood volume increases 800 ml by 12 weeks (1.5 l in twins). • Blood pressure (BP) decreases in early pregnancy (due primarily to a decrease in… Continue reading Hypertensive Disorders

Abdominal Pain with Pregnancy (A) Pregnancy Related Pain: (I) First trimester: 1. Abortion: Inevitable, incomplete or septic abortions. 2. Vesicular mole: when expulsion starts. 3. Ectopic pregnancy: pain precedes bleeding. (II) Second trimester: 1.Mid-trimester abortion: although abortion due to cervical incompetence is relatively painless it may be preceded by mild lower abdominal pain. 2. Angular… Continue reading Abdominal Pain

Bacterial Infections Group B streptococcus • Incidence. In developed countries, neonatal group B streptococcus (GBS) sepsis complicates 1.8/1,000 live births. • Maternal signs/symptoms. Of all pregnant women, 20% are asymptomatically colonized in the vaginal or perianal region. • Fetal/neonatal effects. Two clinically distinct neonatal GBS infections have been identified: 1 Early-onset, neonatal GBS infection (80%)… Continue reading Infectious Diseases

Normal Blood Standards (A) Red blood corpuscles (RBCs): 1- Number: In females : 4.5-5 millions/mm3. 2- Haemoglobin (Hb%): In females : 12-14 gm/100 cc (dl) blood. During pregnancy: 10-12 gm/dl i.e. physiological anaemia due to the increase in plasma volume more than RBCs volume. 3- Haematocrit value: It is the volume of packed RBCs in… Continue reading Anemia in Pregnancy

Gingivitis Increased vascularity and hypertrophy of the interdental papillae. It is improved usually after pregnancy termination. Sequelae: 1. Increased tendency for bleeding. 2. Retention of food debris predisposes to sepsis and dental caris. Treatment: 1. Proper dental hygiene. 2. Cryosurgery for severe cases. Ptyalism (Sialorrhoea) Increased salivation may occur early in pregnancy and subsides later… Continue reading Minor Complaints

Principles of Ultrasonography • Ultrasound uses sound waves delivered at high frequency (3.5–5 MHz for transabdominal and 5–7.5 MHz for transvaginal transducers). The higher the frequency the better the resolution, but the less the tissue penetration. • Interpretation of images requires operator experience. Indications Routine use of obstetric ultrasound can improve the detection of fetal… Continue reading Ultrasonography

Objectives of Perinatal Care • To promote the health and wellbeing of the pregnant woman, fetus, infant, and family up to 1 year after birth. • The major components of perinatal care include: (1) early and continuing risk assessment, including preconception assessment; (2) continued health promotion; and (3) both medical and psychosocial assessment and intervention.… Continue reading Recommended Medical Tests

Physiologic adaptations in the mother occur in response to demands created by pregnancy. These include: 1 support of the fetus (volume, nutritional and oxygen support, clearance of fetal waste) 2 protection of the fetus (from starvation, drugs, toxins) 3 preparation of the uterus for labor 4 protection of the mother from potential cardiovascular injury at… Continue reading Maternal Adaptations

The placenta is a rich source of hormones, including human chorionic gonadotropin, human chorionic somatolactotropin, steroid hormones, oxytocin, growth hormone, corticotropin-releasing hormone, proopiomelanocortin, prolactin, and gonadotropin-releasing hormone. A few are discussed here. Human Chorionic Gonadotropin • Human chorionic gonadotropin (hCG) is a heterodimeric protein hormone that shares a common α-subunit with luteinizing hormone (LH), follicle-stimulating… Continue reading Endocrinology of Pregnancy

Assessment of Foetal Maturity and Wellbeing (A) Antenatal : 1. Clinical assessment. 2. Ultrasonography. 3. Daily foetal movement count. 4. Antenatal cardiotocography. 5. Biophysical profile. 6. Amniotic fluid study. 7. Hormonal studies. 8. Vaginal smear. 9. Amnioscopy. 10. . Foetoscopy. 11. . Chorionic villus biopsy. 12. . Radiological methods. (B) Intranatal: 1. Monitoring of the… Continue reading Foetal Maturity and Well-Being Assessment