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Obstetrics & Gynaecology The Womens Clinic Saturday 31/7/04 Antenatal Talk City Hall
gush or slow leak). Regular tightenings or cramping. Dim or blurred vision or flashing bright lights or spots.
face and body Chills and fever Pain when passing urine Decreased fetal movement
Bleeding
Bleeding at any time during the pregnancy
should be immediately reported to your health care provider. In the second and third trimesters, it can be a sign of abnormal placental (after-birth) implantation to the uterine wall, or premature separation of the placenta. Bleeding can also occur after intercourse through pressure on or irritation of the vagina and/or cervix.
Abruptio Placentae
Placenta becomes detached from the uterine
wall prematurely leading to bleeding and a reduction of oxygen and nutrients to the fetus. The detachment may be complete or partial.Occurs in less than 3.5 % More common in women who smoke, have high blood pressure, and/or in women who have had previous children or a history of abruptio placentae.
Abruption
Symptoms and treatment of abruptio
placentae depend upon the degree of detachment. Symptoms may include bleeding, cramping, and abdominal tenderness. Diagnosis is usually confirmed by performing a complete physical examination and an ultrasound. Women are usually hospitalized for this condition and may have to deliver the baby prematurely.
Placenta Previa
Placenta previa is a condition in which the
placenta adheres itself to the uterus near or covering the cervix. Often, the placenta moves to the upper half of the uterus during pregnancy requiring no treatment. When the placenta does not move and remains in the lower half of the uterus, the condition is called placenta previa.
Placenta Previa
in one in every 200 deliveries and occurs more often in women who have scarring of the uterine wall from previous pregnancies, in women who have fibroids or other abnormalities in the uterus, or in women who have had previous uterine surgeries.
Placenta Previa
Symptoms may include vaginal bleeding
that is bright red and not associated with abdominal pain. Diagnosis is confirmed by performing a physical examination and an ultrasound. Depending upon the severity of the condition and the stage of pregnancy, modification of activities or bedrest may be ordered. The baby usually has to be delivered by cesarean section.
pressing on your bladder. Fluid leakage can also be the result of a spontaneous rupture of membranes. The membranes are a protective mechanism for the baby-they cushion him or her and allow room for fetal movement growth and provide a barrier against infection.
(watery, mucousy or bloody) Low, dull backache (intermittent or constant) Pressure like baby pushing down (comes and goes)
What to Do?
contractions in 1 hour Lie down drink some fluid and count the contractions Doesnt do away after 1 hour, or > 5 X / hour in the next hour
Pre-eclampsia
Cause is unknown More common in 1st pregnancy
5% of all pregnancy
Raise BP, Proteinurea, swelling
face and feet, epigastric pain, irritability, nausea ,visual disturbance, decreased urine output, raised blood pressure, proteinurea.
Treatment
Frequency
can lead pre-mature labour Treatment with antibiotics
Intensity decreases as
Previous section
Maternal medical condition
elective section vs vaginal delivery it showed perinatal mortality and serious morbidity of 1.6% vs 5%, and that 90% delivered by section in the planned group vs 56.7% in the vaginal gp Vaginal delivery is associated with with risk of urinary and feacal incontinence
incontinence 3 months after delivery 11% life time risk of surgery for incontinence and prolapse Feacal incontinence 19% 6 weeks Overall 1/3 of women will have evidence of anal sphincter defect on USS 6 weeks post-partum, and 65% of which will have symptoms of anal incontinence.and 75% if its a second vaginal birth
Fetal distress
Placental abruption Cephalo pelvic disproportion Premature labour ( <1.5 Kg) Failed instrumental delivery
The End