...500ml after delivery of the infant * Excessive bleeding that makes the patient symptomatic (lightheaded, syncope) and/or results in signs of hypovolemia (hypotension, tachycardia, oliguria) * PPH: occurs in 24 hour of delivery * the late PPH: occurs after 24 hour of delivery to 6 weeks * Obstetrical emergency that can follow vaginal or cesarean delivery * Incidence – 3% of births * 3rd most common cause of maternal death in US Causes of Postpartum Hemorrhage Four Ts | Cause | Approximate Incidence (%) | Tone | Atonic uterus | 70 | Trauma | Lacerations, Hematomas, Inversion, Rupture | 20 | Tissue | Retained tissue, Invasive placenta | 10 | Thrombin | Coagulopathies | 1 | Risk Factors * Prolonged 3rd stage of labor * Fibroids, placenta previa * Previous PPH * Overdistended uterus * Episiotomy * Use of magnesium sulfate, preeclampsia * Induction or augmentation of labor Management * Secondary steps * Will likely require regional or general anesthesia * Evaluate vagina and cervix for lacerations * Manually explore uterus * Treatment options * Repair lacerations with running locked #0 absorbable suture * Tamponade * Arterial embolization * Laparotomy * uterine vessel ligation * B-Lynch suture * Hysterectomy SURGICAL...
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...THE DEVELOPMENT OF A CHILD FROM CONCEPTION TO DELIVERY CONTENTS 1. The Meaning of psychology 2. The Meaning of development 3. Basic of development and growth of child 4. The development of the egg cells (OVA) 5. Gender (Male and female) 6. The Spermatozoon 7. The fertilization of the egg 8. The Fetus 9. Conception 10. Monthly development of pregnancy 11. The three stages of labour MEANING OF PSYCHOLOGY Human beings, so complex in their nature, that is lead to study of human development. The study of human nature and behaviour is called psychology. Concept of psychology is very elusive as a term because it has been given various definitions. Oladele J.O. Defined it as a scientific study of human behaviour and problems facing them at a given period of time. Generally speaking, psychology is scientific study of the behaviours of human beings right away from period of conception to birth and after birth to death in one’s life. Developmental psychology which studies changes in human behaviour with age. MEANING OF DEVELOPMENT Development Speaking, the process of development of any organism could be seen under the three main heading e.g. 1. Growth: which means a change in size or height and it could be physical or subjective in height or other human traits like honest, patience etc. 2. Learning: this refers to relatively permanent changes in behaviour due to the experience acquired. It occurs in every hung organism due to the inter...
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...P1 – Describe physical, intellectual, emotion and social development for each of the life stages of an individual. Everyone in their life is constantly going through life stages. Every person is put into a certain life stages there are seven which we are considered to be in these are: Foetal development Infancy 0-3 Childhood 4-9 Adolescence 10-18 Young Adulthood 19-40 Older adulthood 41-64 Old age (Elderly) 65+ Each stage a developments will happen, these will be physical, intellectual, emotional and social which will help in our lives as we all grow up. Foetal Development Foetal development is the stages that you go through when you are being developed through pregnancy, of from when you are fertilised all the way up to birth. You will go through many changes in these nine months. Physical Development – This is where the formation of a person will start, it starts off when the sperm fuses with the egg and from then development will happen right through the weeks. It will start off with the head, notochord and spinal cord developing. From then on more features will branch off and develop. At three weeks you have the embryo becoming c shaped and the umbilical cord starts to form. Then at five weeks your organs will start forming slowly these would include your gut, stomach, liver, start getting your heart bulge and intestinal loop. Then up to six weeks when your eyes are visible and mouth, this is where the ears and nose will start forming while your limps grow...
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...infection | Majority abort only once | Placenta: retained, cotyledons necrotic, red-yellow,; area between thickenedCalf: normal or autolytic with bronchopneumonia | placenta, foetus, or uterine dischargeDiagnosis: maternal serology, IFAT for Abs in placenta, bacteria isolation | Campylobacter fetus venerealisVibriosis | >10% | 5-8 months | Uncommon, convalescent cows resistant to infection | Placenta: mild placentitis, hemorrhagic cotyledons and an edematous intercotyledonary area.Foetus: fresh or autolysed; mild fibrinous pleuritis, peritonitis, bronchopneumonia. | Placenta, foetal abomasal contents, vaginal flushingDiagnosis: microscopic detection, isolation | C fetus fetusC jejuni | Sporadic | 4-9 months | Uncommon, convalescent cows resistant to infection | See above | See above | Leptospira interrogans, serovarsgrippotyphosa, pomona,hardjo, canicola,icterohaemorrhagiaeZoonosis | 5-40% | Last trimesterAbortion 2-5 weeks after infection | Immunity to the serotype causing abortion but sensitive to other types | Placenta: diffuse placentitis with avascular, light tan cotyledons and edematous, yellowish intercotyledonary areasFoetus: autolysed | Placenta, foetusDiagnosis: IFAT foe Abs or PCR testing forLeptospira | Arcanobacterium (Actinomyces) pyogenes | Sporadic | Any stage | Not known | Placenta: endometritis and diffuse placentitis, reddish brown to brown colour.Foetus: autolysed, fibrinous pericarditis, pleuritis, or peritonitis | Placenta,...
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...ABRUPTIO PLACENTA Placenta abruptio is separation of the placenta (the organ that nourishes the fetus) from the site of uterine implantation before delivery of the fetus. It affects about 9 out of 1,000 pregnancies. It usually occurs in the third trimester, but it can happen at any time after the 20th week of pregnancy. CAUSES: Unknown RISK FACTORS: a. Maternal hypertension b. Advance maternal age c. Grand multiparity d. Trauma to the uterus e. Hydramnios f. Short umbilical cord g. Cigarette smoking TYPES OF ABRUPTIO PLACENTA: 1. MARGINAL ( Overt ) Evident external bleeding, separation begins at the edges. 2. CENTRAL ( Covert ) Bleeding not evident, placenta separates at the center. SIGNS AND SYMPTOMS: 1. Painful dark red vaginal bleeding in covert type. 2. Painful bright red vaginal bleeding in overt. 3. Hard, rigid, firm, broad-like abdomen caused by accumulation of blood behind the placenta w/ fetal parts hard to palpate. 4. Abdominal tenderness due to distention of the uterus w/ blood. 5. Sharp pain over the fundus as placenta separates. 6. Signs of shock and fetal distress as the placenta separate. CLASSIFICATION ACCORDING TO PLACENTAL SEPARATION: 1. Grade 0 – no symptoms of placental separation, diagnosed after delivery when placenta is examined. 2. Grade 1 – some external bleeding, no fetal distress, slight placental separation, no shock 3. Grade 2 – external bleeding, moderate placental separation, uterine tenderness, some evidence...
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...INTRODUCTION Placenta previa is generally defined as the implantation of the placenta over or near the internal os of the cervix. There are four types of placenta previa; total, low-lying, partial, and marginal. The higher incidence of low-lying placenta and placenta previa is sonographically diagnosed in the second trimester and ranges from 6% to 46%. This rate, however, decreases to as low as 0.5 % at delivery (11). Despite advances in blood transfusion techniques and surgical procedures, abnormal placentation still remains a difficult challenge for obstetricians. Intrapartum maternal hemorrhage and the need for emergency cesarean section or hysterectomy related to abnormal placentation are main causes of maternal-fetal morbidity and mortality. The overall incidence of placenta previa at delivery is reported as 0.5 % in most studies (3, 5) and the risk factors for placenta previa include advanced maternal age (above 35 years), parity, smoking, and, most importantly, prior cesarean delivery. Placenta previa with prior cesarean delivery increases risk up to 1% - 4%. As the number of previous cesarean deliveries increases, the incidence of placenta previa and abnormal placentation shows a linear increase (3). Vaginal ultrasound is the most accurate method for localizing and diagnosing placenta previa, because it can provide a better resolution in the lower margin of the placenta (4, 6, 11). There is a little increase in congenital anomalies associated with placenta previa when...
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