ee SuCAT RATENDEA KADAY ay OBSTETRICS © oO Gamptogenesis. — - a) Decidua ~ 8 proce ; tise? ao © Amniohc Fluid © Fetal \ Croculation- ~~ 6] Pry. Charges £ Duping pregnancy © @ Breast Lvoeight Gate ~~ © Hormones cm Placenta : © Pregnancy, 1 3 mVictem _ © Fetus in wero : ® Antenatal care — ©Normed | labor” Mechanigr — @ fase pan ® lochia © loctatien _ ~__ & Hypesernesn Graviclaauny «» © Avoriton Ltyper - MTP @ Ectopic pregnancy © Hydatiditovmn pole _ ® Twing i _ © Polyhydramalos yd torantoe) Oligo dranynios _ © —8 PLH Preeclampsia _ Eclampsia _ ® APH CPacente Previa) CAtruptio plac — © Anemia in pregnancy @ Diebeles In pregnancy ii | | } @ Preteim labor ® “Tohaulezine feta! Death —@ Contracted Pelyio ® Breech presentation @® cord prolaps @ Prolonged lakoo obstructed = laboo —@ pp @ Relained Placensct @ Puerperal pyrerfa Crucs pool sepeie’) _ ® Newhoon Thfant © Breas} feeding ® Preteom Balby ® Jaundice & convuleion @® Asohyxia Neomboram @ Opthdalmia Neona}oruny _1@ Vasectomy & Fabectooyy @ Wysrerolny —_€pfsiotorny Cesarean Section ® High eis pregnancy @ usc to obs ® gubtnvolution _ & Cracked a Merle. Mashitts iE | Rockstar Pandyaor ‘fundamentals of Reproduction . iD. —® Gompetegenarit - The process cet i: Maturation oF 410 high| ‘spedialised “eelis, Spermatezo0n in male ard ovurn in-female before they - ‘unite __ to form zygote __ Gogenesic. - The procass Yovelued in development of a mature ovum fo called sagenesis , x : Floco cher?h _ Germ Cell see Fer A Mitasic cE Dogonia., WHT OF ae spree + a Primqoy oocyte Cas, xx) a= Arrested St meiotic Division Eb. — + 8 Maturation of Giaafian’ follicle ee See _ Secondary sou ist Palas bodke ___ ovulation © ig at | Bmale C3 X)| fechlined > pronullous Degeneration Com eon of ond — \ miofietic oil second pelee Sotthn 04 hrs, body (23,%) Bee__= Primitive germ cell take onigin from the pin female gordlas the get cells urdlergg | __ eapld mitotic division and diffeeentate Into Segonia . — eegenia at @0' weole Tmillion , 7 — Primary Socytes at bieth are emillion | The Primary socytes undergoes firy+ meiotic division giving isc +0 Secondo Secyte and ene polaw body . “Secondary Secyte . “The secondary eocyte completes the 2% melotc ‘division ant after fertlioation iby Sperm in the Fallapian tube. | — ) ovulation occurs after formation of Mature ovurs = 180 mictons in. Dia. | largest cell in body , COmains 9S, Chrorhasomes (23k) > =]Speematagenesis, = the: process! tavolged ti in | the development OF Spormatid) __ from the prinrezdial male germ Coll and their differention into Spermatozoa is called : |} Behore pubosty primeniia Gerrn coll, Jove lop “nt into. oe ! ac Germ cell’ + Milosto Primasy sperreateaya_ Cas XY)” =a, rete ier Secondary Spermettocyte \ ee —————— 7 frites 28), Kr? a. Yir > 12 PO Td a / Secondary meiotic pivi, in c ia “y — ii de x FBiKig iad eget \ = Sane, sequired i about @l days.SS SSS The: fand’ geeretory progesterone layoro— © superficid pc- pecidual coll Becidua is endometsiam of pregnant | ~Decidua) reaction — the inceased stractara) acuity | oF the endometrium that is brought about’ in response: to Fol) implantation is Enecon compach fayer —— consint of Compact mass DC , Gland ducts _ Maipillarias , — ©Ireamediato spongy‘ layow .~ Contains To dialeted uterine glands , BC ai iO Bleed’ vessels © thin basal lagoo - basal ‘po@Hon of : gland. _ = After interstitia| implantation of the blastecyst into compact layer oF decidua _ the diff? postions are . ) Pootio St = ® peddua basalis /serotina — the POtHoN OF docideia zim contactduq vera /pazietalig — Pest of : s+ decidua lining the > uterine 1 Aida) toboo? fms Cavity . ’ 3 %e ulation — ts precess vshereby a secondary cyte 19 reledsed from the ovaoy Fell? _____ mupture of q mature Gradfan follicle 2 “becomes available fer conception , e ) Feotiliantion — feotiliaation i the ‘precass OF Fusgion oF the: 9peEematercon eotth _ mature evan,| | | The Placenta oF ths, _shape “heme chovial @because. of direc fact “ek +he chéoien’ “wofty the ©) blood and decidude. oa @because of ome maternal Hsosuc is __Shed_ ot pactuattion, Bases =! deweloped. frem @ sources. __© Principal Component to Retad foetal which _ develop Ess the chevien Ceram peel ampere eonsiot! oF decidua _ i _f Basalio, } — Binterstial ioiplattaion | ts comp leted 0 ato dat.” © taabeculae develop stem witli on am Day — @ Antero Capillasy venous system -in the “mesenchymal core of each villus ts Jeomplered en 2st day. @lacunar space becomes confluent ce\ty Fenc another 2 filled ceoity matoane _[blood by Bt -alh seek. @chovion Frondosum and the decidactl Lbacalis foom disceete placenta . Tie beging with sth week 2 cemploted lath weet.Diameier —15-20cr) » Thickness - ~28cry Niet dat (= weight + Seog. - wa } esufaco - fetal £° ‘malernal Qa | a = ae | : presi pheral magin . I " Aieach ing = upper PA of body | oF | 7 -— LL uterus, SHucruke - Placenta consint wo lates Strucrute Placer OP Trjernally ~ les Chowionic ite P | OQeriemaly ~ Les Basal Plate 7 O Amniotic, membrane ~ single lager of cubical opithelian . © Chosionic Plato - consigk oF = Primifive mesenchymal Hissue Contaning branches of cambilical “vessel, = a Jayer of _cytetrephoblast _syneytt otropheblast . OB Basal Plate — — consip} of = Compact & spongy. layer of decidua poten _~ Nitabuch's layer cf fibsincid ~ Cytetoophoblast shell— syocyti chropheblast is __© Trienvillous “9paco - - bounded “inner sid: by | _ Choniontc plate _and ‘outer side by ga pbsenl Rote. “Sse Nill}, — arise From chosionic plato and 1p 8 extend to the: basal plate =| \° [Ans main Fant? aro i @ Transfer efunt® mechanirm i) Simple diffusion i) facilitated diffusfon it) Active tangle. i Ww) Endocytosis, : -N) -Exocytasin si) Leatage . j a _ Ui taspiatory Function “ a a "= Oxygen Supply to fetus ts emifg/min, + : Js Brood flow of 185+ 330 mL/min. 4 excretory function , Wacle. products: from feats ——__ ured, Uvic acid 2 creatinine -4@s ) - nite @ nutri ihve Function / Glucese lipid amine oid voater | jo Plecrrolyte_ Hormone. fer growth ” Ps © ) Enayenattic Function > Ai r _ = Diamine oxidase’ Le - Oxytocinase ~ | pro + Phospholipase i ®@Bavsiow Function’ = Res: ~Pinecytesis. ee Ore Tmmunologica) Function. il bopunat pot — Placenta prebably offers tmmun- Be | ___Oltgicatl_ protection -against agecton, Bi = Placental Hormones.eal | ol Amniotic: Fluid : 4029 @cireulation — ater In amniotic. fluid tp i __ Completely changed 2 replaced in fo hor “every. ebm. _© volume = related | to gestational age . Som| at 12 weeks, Goeom\ at woeks { iltitto at. Be-8F we . Ay term i+ measures about Sco-scom| ____ @ Physical Features.— faintly alkaline Ben | JO specific giavity , | — ®colour- easly pregnancry it ip colourtess . ni PAC “Shaw due te exfoliated Vanugo 7& epidermal coll; - —Meconium Stained (Green) - fetal dishes — c = = Golden cclour ~ &h Incamparibil b | _aGreenish yellows > Post maturity __| ~ Davk coloured, 9 Hamovohage | | = Deck brown OD TUD . ) Composition water 9F-99Y, | Solid 1-2 7,a - Gg: ra ae _Glucese- 2019), “creatinine | amg. ured gomgy “Total lipids” somg) __Torganic.~ sodium , ehlevide._, potassium __ Suspended particles = lanugo , epithelial —___ cells, -Nagind cells “functions = Main Fant? is 40 protect fekus, © During, Pregnancy = 4 - Acts_as shack absoober = Mainlainge temperature - Distends arnioHc sac -Nudoifive naluc-. L © Dueing ers = Dilahon of coovix on Uterine —_Contracton - Flushes biath canal prevents infechon , Teal ts Nps Ea Heal th status, Parteword yOQ “ambiltea! cord - Ferns: cenneckng 4 tink Ang 0 ve ba the Foetus. and Placenta. ware [ bevélopmient = “From connective stalk Pace os Covering epitheliany _ Peet sd - ‘tahaeton!s” Telly - Blood vesse| = Ni Felline duct - Allantois ~ Obliterated extraembny onic Coelony - Covering epithelium to Single er of* amniotic epithelicn = tohatton's Telig — consigh srlengtied cells ing gelatinous Fluid: Blood vemelg - +00 arteries +00 veins — vetelline duct if ome} yellow body cemnant oF yollk sac. Allantolo © blind subulae Gtractetro If _ShenaclersHe. — Gocny length Scry diameter —— Atlachmen| ~ venta} Sufaco of embryooe 751, oF blood in eight afiam sors 1 piectled ins he Feramen ovale INC — lett Nerbicle | © 26%, oF blood in sight atium x El: - - + ip § nf ca { Rig hE& ventoicle eo Ascending & ach of aoate, , kt © Daving Nentriculaa systole } tet ventticle ; Le Pump blood tn} | Ascending & a of aortq Lo A binotbaled a ee Heaot eat. << _ Brain| Hl ote ite aed ~ caasied © 10¥. cardiac ebtpe boy york ~ Ea - Bugsy Sf a ending ‘Aorta . PATE: oe 4o% output goes to placenta’ “through” a umbilical artovies, i ) a cardiac output in febus ts high som /kg /mnin, ’ 1BNatomiced , » Physioleg gical and | Matenical Beker ap Te Sb Ps tipi ~~ Wuterug. cut Non peg pregnant = sogms | 2S cry\ engi _seith S-iomnl cavity TAK ferry = 2900-10009 tot. 88cm al Factor [ Beslakt @appone asibl ® Changes in maede = 3 ok ' . “Hypeotrophy — and ib — Hyperplasia ~ ond” Stretching. ~ AL muscle Aber Increases in Leng Hy ‘and ready “under influence of — estragen & "paagestercne ,: Ab adit — Muscle fibre elongated beyond Bo woook, due i cto _ Gaset i distonsi lon _by! Swing fetus, __G outer longitudinal 4 Hood fee enr, ewer funda co mOy Inner reuters — scanty Esphigcler , over e7iAcop, © Arrangement of Muscle Fibro <8 Injermedicte +) thick & St¥ong WYr . chieseroas Fashion , Bicass. |-@vasculas Sanges — _ “Blood Plow Inereauos. ' ab 20 WEEKS. : : __# @ weight — MN due to 1 1 grcwth ulerlae Muscle | wit eee connecHve Hs9ue © Polation Shape = Nen pregnant pyriForn oe. Globular ‘at 12 week oe _ PYyP for or eid ovoid by 28 week © Spherical a+ BE weok: ____ © Postion = Normal antoverted position ty | Exaggerated Up to ¥ weeks, : @lateral ‘Sbliquity. - ao alesus enlergos tho cemix 19 deviated te Vent side , ‘Baiene peritoneum — Maintaing net voy | : Proporti ioncitely voilh groceing uleouy, “Biase — aro irregulas, Spasmodic fo painless volthout an effect aaa an dation oF Comwvix 2 erdemeiniar — decidua ie endometitum wih i159 oF Ppeegnan+ citerusoe [Beast| ) “Breast changes cro. beck evident ir in ce pramigravida. “S122 — Lncreage_si20 due +o marked — — __ Hypertrophy “and proliferat : | ducks) i - Hypettoshy of Connective Hésue _ Stroma. 4 Nipples - larger erectile and deeply 8 Pigmented -Areola - Become lar rgec, he peotropid called — Montgomery tuberties , = integular pigmented area appears | 1 _invatd timester called secondary arecla E sehe| secre toe = Colostrupsy squecied cout) att - , a. voeek - Micky ae eth week — thick and yellowith | penne (oF woman who bay newer lactated i a lap.. gign. of pene| _ 7 Breash'— Hypertropid: ___ Cutaneous changes. — Pigmentation, / Faco - extreme ‘pigmentation around “cheek forehead around eye, “Abdomen - ~ Uneq Nigra & SHae gravidarury a a LUnea Nigra browinth black pigmented area in midline - SHetehing “398 xXiphisternun "+o all Symphysis pabig, ’ ~. SM\rae are depressed Hiner masks ON Abdominal wath below aum\sica — Subjective sympter ' RN “ay NOUSEd -&€ Vomiting ae | e) Tec guency - of M Chuihion - 495 Tee at bub 2078) Quicening a4 4) Progressive enlagment . _ T@uickening decotes pewception of _achve _ | Feral Movements by women , — Progeessive eomgre oF “Tear er_ abdomen, — General | Examination ; = Chieasmet - Pigmentaien fore head _ 7 , cheele at 24th weet . | ~- Breast changes = Colastoun thick Yellocoish by | \eth woek, “Abdominal examination i _____Enapection ~ tinea Nigra, striae, fundal_ het ght cuserus an SOF4 € elcactic 3 Palpation oF feta) pawks. 4 Ache Fetal Movements, s. External Ballottemeat| “—Auseultation ee ie 20 FF > Fete! Hedit seund nail eeaneluslue sign as uterine : SOUS S6Lt blowing L Systolic. Murmuc, _- fumie of Fela} surface due to Ssh oF Bloods : Coat Naginal Examine on m7 | el - Bluigh Discoloraton | oF vulva , Nagin = Thternal BalleHement ‘Investigation. ~ _ | 4 Sonography py boa we Fetal “organ anatom | “Mageetic Fasopeince Tmaging (mez) ; : a Radio} legic -“©. is ene - (29-4 ~~ "subjechue. symptom Mga re eAmenowshea Fr “caainibhte | cost & Bs argrnent oF abdomen relat —— | _g. Lightening” rp ' “a. frequeneys oF “micturition - ate Ss. ke PsieNenNs, . de Cutaneous Changes. @ uterine shape. | y - & Funda height te Brayton Hicks s. Fetal movements e. Palpation of feted pacts, aM 1. Feta| Heast Sound. = ts Radiology , enColargment oF uterus rere by pregnancy / may have to differentiated frorp abdomino - Pelvic Senoltings. ! : 1 @ uterine’ Fibroid. © Cystic svarian tum. © tubercular peditonitis Zz ® Hematomerra | oe pe ® Distened uvindey bladder. ~ Pocudecyesio ~ ts physfologfeal disorder there woman hag false but fiom f : belief that she is pregnant il * Mlgheugh no pregnancy exist . __ -Fibeotd | Tumeur stow growing Amenosoheed absont Positive signs of preg. absenf. = Cystic cvanian Humes | Tumor Sloco rowing A _Amenovshoea absent . + : Feels cystic ot tense cyshe + |1 @. Felus in utevoye Mor pent see (bare — The Fetus |re Inside the uterus in a Closed sac filled wlth Viquor omn D Ary _= Periodic “exannination ip) essential to nofe | lie Ne, presentation» posikion: & attitude . ~ Que - sefers to the relatonship: of orig exis OF Fels te ‘long ext9 of! centralized uterus 6r matemal, Spide (99% longi itudina! ) “the. Jower ole oF uterus, ~ Presenting Poot. - past oF praterdehion vahich overlies the internal es, ~ GAth tude - elation oF aafrerent pacts oF Fetus to one another __ Qdenaminator - aebitrasy bony Fixed pointon ___ presenting poet . ) Position - Rel of denominator te the: rent quadrants of pelvismatena! Pelvi (a A 9. fotal seul! and > { mer REIT alteration of shape’ of the. Ried i: Com@ng head while passing through the | — vidésistan} broth: passage during laboar. @ False peluig’- formed by fliac poztons oF “¥onominate © bones and ida 19 limited _ Above by the iliac’ Crests, @ Two pelvic — thio past oF pelvic te chief) oF Concern te the absletricians as if forms | _____ the canal teugh which Hhe fetus hes fo _ pass. _ @ obstetical suHep - segment oF pelvis é pounded above b plaine -oF toast pe) vie __ dimensions and belore by anatomical Sutleda * . o[20 |. Apnatal care . ine mack! © = systematic supervision of a women during, pregnancy is caljed antenatal’ care. Sy Yt 2 te gegQigh 2 UIA ei 7 Antenatal care comprises 10 7 careful History Faking Lecamiination — Advice given to pregnant Woman , -_ fim O screen the high isk cases eh n=. O©ro prerent, deteck treat any complication - © To enpure continued ois _cesesoment _ ~ © te previde primary prevenhve Mectith cre + Oto educate _mether about physiology oF _ ____ptegnancey dod taboo. © te digeuss care of newbosn ____-@ fo motiveke about family planning. Chyechive = ‘ ’ “ @To ensure Normal pregnancy teith delivery oF healthy ede bab —-@® CrPleria’ of Nomad” pregnancy are __ ; _ delivery oF Single baby in geod cond” _ Seaet Fetal OE 26gAntenatal Advice 9 L Pariciple@est ic oviie» 4 jorinogng © To _consel the woman about importance. __ OF egular Checkup’ ° Se © To _impoove” health Status of women © To Counsel about Diet drags -£ hygiene. ®© ‘to improve psychology and semove __.. fear, mn Rcipin’ ‘ort Dre ont © Diet '- : ' - oo ‘= Diet duting pregnancy should adequate te provide @) Good maternal Heath - &) Optimum fetal-'grewth ®) Strength eg. labor ‘ ad) Successful lactation , - Rich tn protein 2 minerale ,witamin — viet shovld light , Nuteitious , _* digestable « — Dietary seomponehts are Protein , > Tron , calcium , zinc .Tedine« ait A MWitD Folic Acid , Nila Bo. — Pregnancy diet ideally be light | NutriHeus “ealsly digestablo «and ich, | — Supplementary fren therapy te needed | for all pregoant mothers frm 16 Weeks onuocide.@ 4mm 15th alge “Antenatal Liggione . Monet ai @eest ard sleop - “lebrs_ C&hr Might @he a) © Bowel =Sensipaon common _@ Ee ao) cei tus ° ® ‘Trave\) ~Seoks aveide . ® smoting and ailco Immunization ~ a “@Pubella -@& mumps @ varicella © yellow fever .©Pabies @Hepertitis A&B Nalues of Antenatal care . “© 10 coop Hectith of mother — @© To prevent obstetrical complication _ @ Detection of no Sigh PAS cases, TaTAI may be Exaggerated —= Quer cannot tere - foul \WYy Dieteny aduice© ) Hypertensign lg om ane ns ® cord prolapse ole : i a Beane bleeding | — © premature raptere _Theea eas. OAsenicum Aur © Palsatille Nigeicang — © nvx vomica ® Silicea , | : _Sedcated. Remedy — Arserfeum Album: Qnt - white oxide of Arsenic : P - Hahnemann fie (bBo = Asad + “Intro 7 Arsenic has grea} role tn antenated care oF wbmen tho Complain of painful distension - of Abdomen + a _Trdicationy = violent. burning pains. i AN troubles are masiced in “Hast trimesjer, 1: 18. Normal labow . Series of events that take place in the | gecital ergans_in an effovt to exple a ___the Niable products oF conception out of” womb Through the vagina into outer $ __ World called taboo . = __ TNermmed tabow Ceutecia) - laber ir called ermal i it FUlFFI9 FOllM coerid _ 1. spontaneous in onset and at fern. _& bith vertex presentation 8 Without undue preloagation —_..*& without any Complication. QA — Sages oF labow. Event of labor divided info 35 Stages . © Firsy Stage — Ccevical stage) —Shat from onset of Fac labor pain (Ends Loh Full dilaton of comix , — Average Duration hr in PAMIgranvidac Sho in mulipmae. (Svent Main events occur A Dilation & effacement of comix ! 4 Q. Full Tormedion of [ower ctetine + \ Segrnent -back r [DATE riltednercarinetion & & retracion + 8 Fetal axig praspures tt v e. Bag of _mernbianes . of © Secand SHage pe from Fall dilation ef cervix + ' — End with expulsion oF feHis: = 2 phases @ propulswe & © expulsiue Poo ae Fw DurdiHon Qhir Yo pa. Romi TH muy ~~ Phasep, - 2 phaser. te Propulsiwe = Full dilation aFuch | Head teuches” peluic Fico. 2 Uxpulsiue - bear down & push — unl, ety ir dolivered- ~ Othe stage orgs altler expulsion: af fefus = ends usith Sepen of placenta and _ membranes, Un plecental seperation | ~ Centra eechuttaoe)_ + Separation “of mombraner - Sse@pratton oF ple Blood vessels,a i of Normed labow. z — The: seater of movements that occur on = _ “head In Fhe process of adaptation dusinc [= _ “tbs jeurhey through the pelvis is cattle _M™echoniorm ef labor. Mechanism ~ - b tft ’ © Engagement + ue ‘Head Enters. the brim _ © Descent = Mead vis aimee to teach = Peluic fdeor, Bearing down Choe | ’ ®© Flexion - Flexied is: ‘assontra) fer descent , it aéduces Sheipe ¢ " Size OF” plane. _ © Tternal rotation - Petation eceut of ° peluic ’ Floor © croconing - maximum) diameler af | head strefches the vulved | ; eutlet — coftheul any Pecession F | oF head even atier the : “contraction -if© over called po A SF— extension - Delivery of head taves - plaice by extension threugh _ couple of force teow ~ Geeokitahon - sisivie passime mMovercn) oF head- — O&dernai estation ~ tatation of head _ Ninible externally due to lntemall rotation of shoulders, _ SE epulsion. ~@-F false pain Cralse labor , Spudieus labo?) = More found in primigtaui dae L __ TOppears PRG to onse¢ of true labow pair __ by 1 or 2weeks PANS are due to Sretching of cervix — Fatgo labow pain is, ® Dull in Natdre k. | @confined to tower abdemon | @ ually telioved by enema at Sedahue .so Lochia , a oe Lechia 1- Tt ig vaginal discharge for: fovtnight daring Pespesum. _7~ The digecharge. aignaies ror) _ievine body econix and ae _ 7 odor and Pett Feallar & offense Fishy tt smell _, Reaction 36 anlagiing e _—_ oT “= Colour + haral Lochia vubra a = jrebays Rod . —_ hechicr seresa = S-9 Dye yellowish Lechia elibar = lo-15 bys fae white —Amounti- e@som| Wh s- =6 DAYS, / _ _Poraton - Sees eae up to Bcwecks {mp .— lochia gives ino abouf rma pure: puerperatl Stel fo - indieatas Inf Amount scanty = iF or lochiomeion | —__buration - beyond @ weeles sugneet Jocal genital lessionene ~ 2: lactation ic fo Grit Nea ' poawhe secretion © “Frew the brea} “Teaiied colostram , * Colastrann. compose of ‘deep yellow awid Mkaline seation 4 bigh protein _ \iitamin 4 *SOdium and chbride . : : 7 Provides eae defense to new boon, — Has laxetue acton an belay ; Physioleg J oF lactation: if Q. Prepration of Breast Cmammagenesis) _ b. synthesis €secretion fiom bieas} ailucoli _Cactogenesio) . @ Ryoction’ oF mille Caalactokinasis) d. Maintenance of lactihon Caclactopeics) 7 A healthy mother produce abou+ | S00-s00m) mile a day, Therapo: © Mux vemica , | © Palsatila. @® secale cor _ © Borax,PAGE We i ma at panwaaee. T I Ttadicated _ medy “n MUX Vomica . atts Az = _ _ — ~~ “, COMMOM NaMe- = Polson-enuts 95 6 “Prover -— oHyperremos ii Cravidasurs | 3 | OR gom oe ae Q yemiting tn _piggnan ey: é =the Vomiting - is eelated to. ee oa Sate c° “depending ipa severity ‘Classified (os. ©: simple Nomiting * : Mies oP a) Hyperemesis gravidarum (severe Type) __ = Simple vomiting Common in early oegecngh LNomitus Ye smal!) and cleav. | ____. Feature disappear at to-tuth weet. _, Taking dry toast oo biscuit. ~ Hyperemesis - This a severe type of vomiting of Pregnancy which has got [deleterious effect om the health of mother, VA, Memited to ih Himesten. 2 more Common tn 1st pregnancy , 8, Younger age G low body Massy , s. History oF motion sickness 6. Famifict History 3 7 Hydatifoo nm mole g. _multiple pregnancy. 8. Common in unplanned Pregnancy » a: or - excess of -senadetapio - QqQ Peyehegenic_ _ 8. Diet - \ow cabbohydiate. & Alleigic Basie, — €. Tmmanolegical Basis. S. Decreased gastiic motility "foes ual “taming increase In Frequency , . oliguria . - “= epigastric “pain. | _ 7 Coashpation Signs io Dry coated tongue Sunken Eyes Tachycandia _ Hypotension | Rise in tempratare | to __ Tnvesigahon -_ uninalysio , Tetum Ts TSH Ta ,Caq, Dlagnaste —- Pregnancy confiomed . Managment - control vemiting , correct Murd prevent Complica Hors‘6. Hemersthage io Carty pregnangy - of a" _Abootion i- Cxpulsion of “embryo of fetus weighing scog or less from is mother when th is not capable _ OF independent sarvial - Abownon t see cae ' _ Spontaneous = acad - Coriscermriage ) (Deliberate) 4 4 tsclaled Pectitren} Cok ‘ Li = 4 \egcr) Wega’ S| cmrTe) Cunsate’ Ap TIT a : DoT sephe ed: j | | comme Threaten ne | 7 is | al Complete J Pissed Sepa ie - __Thev iFable : Trcomplet e @) sponta neous Abostion CMisseq riage) ~ Der Teromination oF pregnancy unr0F pa mosatyy _ < Le Nec mone Cndocmne 76 | Immunological tnfectione Anatomic Matomal illness | Enviromentalcauses ! - nevboe Po [er trimester = Genetic facter’ , endacrine PHF tA trimester - Anatomic abnewmoliies | © Threatened Miscorwiage + | disordes thyroid obnea matities +, LoFecten, _ Cewical Incompetence uterine Fibroid | i __BeFOK clinical entity where the process of _miccersiage’ hat srecited bub has pot Pregsessed. tod State ef Fram tahicls = GIF Bleeding _per_vagiram . Pain mild backache | Tov t= Blood , urine | ug, ' Pest ait Pain “elif weliok oO Inevitable Miscas age . __BeFM Clinical type of aboation where the changes howe progressed fo a Stete Freny wohere continuation of pregnancy i Nempassi ble.C/P = Trereased Vaginal | bleeding | eens penn iin. J bafeetoene “ranagment ! “accelerate. process _of expulsion — | f malntain SHTch” —— j ° © Complete Bacecs. Def when preducis of “concéption are: Sxpolied _2O masse fio acl complete miscazsiage “olF- Subsidence of abdominal pain _ Naginey! bleeding i Orit e _ eras te smaller “Ceruical os is closed _ Empty uterine Peavity ® Trcomplete Miscavviage berM!— when entire picducts of Conception are Not expelled Instead a. part oF The leh} Soside the uterine cavity d Heshy Mees per vaginand __Narying amount oF bleeding _| Gxpfietied mess found i ’ Mage accelerate process ef expulsten,; © missed, ae ) “pere 1 Brovonish vaginal | discharge Breas} changes, Comix feel Fors) _ Realtime us, © septic Abostion. ert Any abostion associated vith _ evidences oF ing? oF uterus Woman looks sick and AMKOUS | Sytner aimee Fa = Addomin dt penn _ Hae ide rnorer hoi © Thyury Management = _ Prostagiat adin , “oxytocin Clinical& Recurrent Miscasiage . _ Def: Define as a sequence ' of 8 OF more consecutive: Spontanesus absotion before | | weeks __ baller Bibles : Pia ip ree ae | oF Heimonlor abostien + - Genetic: factd. ~ Endocrine * | : : - Thfechon | | - Inherited thrombephilfg 7 oe (> Immune Factory, | OM AR mester ebostion t- Anatomical - : / o y 1 iF eongenitat : Defechue M¥lledan Fision Chronic Matoinal illness Tovestigatton, — Blood , uline cerita Sea r Hucband semen — | “Treat - Rant Reassurance To improve gearell health , _ Hormencd _ Supplement <Thess berate “erminaHten, Blgfeqnarcy elthor_ —__Niability, oF fetus PETS | “Qe. _ MTP - medical Termination oF - & Abovtion by a aegistered “medical _practitioner in the intrest of moathecs healthy and We ts protected] under ™TP Ae = Provisions” © continuation of _ pregnancy would Anvolve Serious dic of “tife. _ '@ substantial wist “oF child beng ‘boon th seriou? physical @ mented abnormality __ @Pregnancy caused as vesult oF faliure> oF a contraceptive . f oF Endicakions + — ©To save Whe of mother’ — eaidige disease nic gl glemeralonepiovie atignant hypeatensian . - Diabetes” MeLTHUS | qe indicaHonp - | unweinted prognance . |i SEwents, i outh ; = Substantial ¢ aricoF child being 2 | bow WI SerIOUS physical & mented _abnomeaitios oF handicaped L _ Methods oF Tearination ION of Plegnance| - - Own trimester. ee y medical, = “mifepristone t : Tifepristone & misoprostol. __Mehotroxate £ misoprostol Tamoxifen & Miseprostto| __ Surgical - Mensigual regulation > NaccuMm -agpivetion @and tamoster [ Prostaglanding ‘ ahsent = Pallow presoot = features of preeclampsia : ee aneeee - 9 of dferus mare — - fee| of uterus deughy -_ oo Feral ports absen fF ; _- fetal “Heart sound “Abs, __Naginal exam, — Toienall Ballottement - usilaterad er bileiferct! _ eplargrnent Finding of vessiclos in Discharge “Tovestigaton. __ = Blood count , ABO Bh grouping | ___=| Mepatic renal & thyeoid Fup) test. — Sonography Sooosttom App , = Plain x= ray _ —_etiand’ MET “i |increased ot os oF sepsis, - - Perforation of ater 9. - | : Preeclampsia } eee ee Coagulation failure. Stato Developmen} of isco Managmen i by Peotore blead | lose - |e - gucton evacutition " of «ters | _z Correction Anemia *€ THF ~ Blood tHansFussion , 7 ~Feata ree. ___ 5 Cornplo}e mole Fostial mole - Gembryo/reruy Absent Present. @trydtopic degenecition Promounced & Nidriaible @ oF witli | diflused Feoal , @Tropheblast. | DifFaso Focal , ~ hyperplasia | ; ot on \utein cysto . « Common é UNcommaen © Karyotype 46,xx 57) Triploid - 907, Paternal origi Dipbid ~1oy.| 17, Mulhple Pregnancy ; TWINS | eee _=uohen more tran one fetus _simulten- ~~ eously develops in the dtesus itis __ catied’ multiple pregnancey : DEMS simultaneously development. oF +00 _ “Fetus to uterus fo most common vacety OF multiple pregnancy “ vavieties, it _© vizygokic (pz) teins —_Mmast common c#e7) result from ferhlizatien .of +00 ena +: ~~ © Monoeygotic G2) toing - - (207%) eesult - “From fertilination of single evan, F — ® Diaygetic ting POY, 5— _ Cfratemal , binovulax fuwing ) — fertili2ed from +00 ova ~ Rupture from wo distnel Graafian follicles, — Bear only fraternal aesemblance . © Monorygotic twins ey. i _ftai ‘Crdonfieal , Uiovula®s ) ' ~ Twining eccur different peried alter fer |roation .- Two “embryo voi devolep sceieed by Sin \o: chorion . : I~ F-Single posers and: 2 aminoHc: Sac. eygestty 1 éno2ygotic Utieccnia TWO one a @® Communicating a) Abs, | preser} | Vessel é aout | @ tntervening sal Cearmimions) @ Camnions) membranes @ -choolons ) | P@ sex 4 May differ Tdenticat , © Genetic | differ Same. Feadre | | —@9ein 4 &gjection Accoptane. [ SR NG | ; ae peti neidence \— a ja Tocidonco: varIee - Laide) | Highest in Nigeoia Ain 20 ' Trdia about Tin sO pregnancy + _Skislogy / Monerygotc twins remains constant |__Bizygotic helnn ~~ © Race common ‘Megrees _ Hereditary. + ~ matemal sido @rdvancing. age oF mothor 80° 8SYS. _ @OTatrogenic + Prugs Used TEnduction or ovale Hom , fo Lo boMRE. © Super Fecundatien, / ee © Superfetation 5 Hla ill @O Fetus acaadicicus. ee — © Hydatid foorn mole. @ vanisbing toin _Biagnosin, $— O History — ovulation inducing drugs | Family Piston oF FLOIONING __ Gsymprome ~ tncreased Nausea & vomiting vr Shovinesm oF Breaty - swelling of legs - is - VaAVICASS veiling. = _Hemershoids. = area gps” Totecip! ik Ppreeclampsid .© Abdominal examination _Inseection 7 -baire| shape | “atareo? 4 i _Palpation me ‘height more, Palparioh oF tt a Wo many Feta parks, Ror s * Ee | ~ Fetal Heads : _ Auscuitation 3 two fede! Heart ro 7 Trvestigati on, &- S _ Senegra phy r Complication , % t ® Garena 7 rc } | - I ~ Pregnancy laboo Puerperian | Anemia. Early rupture ~ SubiAvelution — pre eclampsia oF Membrane , = TaFechon __ 7 Hydramnios ~ Cotd prolapse. = laction Pea ARHE — Prolonged. leo Ratiure ( ~ Preterm labox —~ Bleeding’. ~ PPH _ eee - Abostion bi TAHAUFEr2INOG Heath po __ Asphy xia. a Anter natal Managment &— _Adtfce « Hesplidieehion“pees Ta Faso aed TSupplement therapy [feted sqpuciane@ shit 2 oF“pers a A State where Aiquer ‘amt exceeds ; _2e00m|,_ 4 The excessive accumulation of tigour omoty causing - discomfoot to the patient S Clfelogy = : _| Result from — Deficient absorption 3 | iL excessive producHon of amnef ___ ® Fetal Anomalies - be _f Congenited Feta] malformations, -| i. Anencephaly : [ Wi apen spina “bifida ke : tv, Esophageal er duedence) atresta, Ni. Facial” clefks MI. Hydtops fetalis sil. Aneuploidy | ») Placenta = Chovieangioma ef placente, 2) multiple pregnancy . Matemcay + Diabetdo , ecidiac disccue 22. Renal disease .© chr eiranie. polyhydramnios. _~Most common, onser is insidious. | taking feo. weeks. Symptoms — 5 ee Pespiratory — pene __ Palpitation 3 edema on -te98 —_ / ‘Signs i= (A aT = _ Patient v4 ay ~dyspneic sta} stafe ' evidence of preeclampisia . Abdomienl Cxan'— Tasepection — Abdomen enlarged : Mein fg +ense - =i ee __ Palpatien — * Heigh+ of uterus D GAth oF abdomen . fetal pasts Not Felt ____ Aascultation = fetal hoax seund ee Mot heaodTquestigaHen $— ! ’ 79 Bh ' Sonegraphy : ae _ Blood - ABO £Ph _ Araniotic Cluid: Complicakien. '- Preeclampsia Aceidentct! hemorehage af Preterm jabo L Cany rupture ¢ : Cood poolapse § TManagmen} {— , . Mild = Bed Part for foro dawg Severe - HosptilizaHon Peq. : P @) Acute Polyhydramnian \ “= &tremely tare = fluid accuntulates within: feo days, Lov Before oe weeks oF preqnance — pregnancy. _Symptomy — Abdomincd pain Be tpt Ee » Neten6e | Nomiting .° —- — \9 - signs —1 Patent looks il| | edema on legs/¥qre read oN where quer rp _arynit is def€cient to ) amoun} te the extent af lass than 20m) at term Etiole tet cond? = (bn laot Chromasomal: anomalies, Sea Strarctacad AanoMed)ie> Renal agenesis Bupha oF crembrane _ ©Mmaferral cand) s— - ___ Hypesteosive Diseeder | - Dehydration — | Tdiopath Ic Diagnosis £— a ea uterine size much SMUNee _ Loss » feteu movements eat uterus Full of fetus “Abextion , Code] complessio __Prelonged labo “cteakment — water adminieteHon.| r 18. Hypertensive Disorders in Pregnancy ‘ | alk. J __ Hypertension i= 40 absoluke: aire in blood | pressure _ oF at least 1a@]90 sm Ho. Systolic 1 So mM) Hg a : Diastolic /\ 1s MM Hg” ! PL i Pregnancy induced hypesension ts defined as the hypeatension tak _ develop’ os a direct oF gravid Sate | TH includes, ( : _ © GesHationa) Hypertension. © Preeclampsia © eclampsia . aon © Preeclarnpsict t- } {9 a multiaysieny divowder \ Charcicterized by development oF hyper __ tension te the extent oF Io /9d mm Hg 8 More , Lolth proteinuria atier eo week. ~ Preeclarnptic Feature Mey appear eaalty acth lj weer in hydertidifoon male and I. a +e polyhyckamnias, ;predisposing factors 7 Younger *sr-elder | _- fami History - hype tt - ebes\: a = Torombophiliss. eR Blinical Types ; © Mild — Suictained vise oF blood pressur ; 10/90 mm Hg _ Without significant proteinuria.” @ severe -" Bleed praseure ov _ Protein excre Hon Ee ONgudict , Pulmonary edema . Clinical Feature. ® Mild symprome § or : = Swelling cver ankles — Hightness oF ring = Swelling on face O Alarming 3 Syne : —Headache _ __- Distarbed sleep’ : | Diminished urinary eutpat a : - Epigasttc pain .Rise tm blood “Aboormal weight Gain - press ure = “Pulmonary edema + Tnyestigation - Preteinusia Opthalmescopic “exam Bleod exam. Antendtel fetal moniting Complication &— ® tTmmedicate — 7 taemownage ~loligueia ganunia -|Pretetny \aboe HELLO Syndrome may eceur if untreated - Eclampsia i — _Sepais.aia Aophyxia = Prematarity “Treatment ( "AE pan / _ Mostly empicical and Symptematte _ Resp | High protein Diets Biuretics _, AntiIny periensiue ORIecHVED ~ “To stabiline hypertension , — TO prevent “complication oto “prevent eclampsia ~_Delivery of healthy baby | = Restoration of mer “hecttoe eclampsio_ ber? Preeclampsia when complicated with — Convalsion and coma 9 ‘called - eclampsia - = occur in parent corey Preeclampsia or chromic, Nephaits. Facidenco *- “waves widely Fon world In _Tndfa aanges in soo to 1 in 130 _™MOre commen in pAMigranidac : ¢ Cause of _convuisiont— a ia —: Anoyta Cerebral edemo Cerebra} dusehytnmia » ONndet oF FID ‘— Fits occur more commonly in a4 trimester. I \. Antepartum) — occur befere onset oF labor . 2 Tatra partun) - occur Rast time duning | labor . ls. Postpastum) = eccur SF me in | Puerperiuny o. THtercuirent — ater fey recouery