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Category: Gynecology and obstetrics

Pre-eclampsia/Eclampsia

Posted on by priyeshbanerjeept

In this article, we will discuss Pre-eclampsia/Eclampsia. So, let’s get started.

Pre-eclampsia/Eclampsia

Pre-eclampsia is diagnosed clinically by the development of hypertension, proteinuria, edema which may be associated with convulsions (eclampsia) or hemolysis, hepatic dysfunction, i.e. elevated liver enzymes and thrombocytopenia (HELLP syndrome) even in the absence of significant hypertension. As the risk of eclampsia is real, BP control has to be much stricter in pregnant patients. Patient with mild eclampsia should be managed conservatively with limited physical activity. For women with severe eclampsia (BP>160/110 mmHg) should be treated with I.V. labetolol or hydralazine or nicardipine. Oral nifedipine and methyldopa can be used in patients with chronic hypertension in pregnancy (patients who are hypertensive become pregnant). Therefore, women with hypertension should be followed carefully because of increased risk to mother and fetus. The ACEs and ARBs should be avoided. The target blood pressure to be achieved is <140/90 mmHg by drug therapy.

Recommended drug (drugs of choice): Hydralazine, Labetolol, Nicardipine

Drugs to avoid: Nitroprusside, Trimethophan, Diuretics

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Causes and Complications of Labour Pain

Posted on by priyeshbanerjeept

In this article, we will discuss various Causes and Complications of Labour Pain. So, let’s get started.

Labour Pain is an emotional experience and involves both physiological and psychological mechanisms. It has two components, visceral pain which occurs during the early first stage and second stage of childbirth, and somatic pain which occurs during the late first stage and the second stage. The labour pain in the first stage is mediated by T10 to L1 spinal segments, whereas in the second stage is carried by T12 to L1, and S2 to S4 spinal segments. Various causes and complications of labour pain is given below:

Causes

  • Dilatation of cervix/distension of the lower uterine segments (greater sensory)
  • Ischemia of the myometrium and cervix
  • Pressure on the fundus and body of cervix
  • Inflammatory changes of uterine muscles
  • Reflex contraction cervix (fear, tension, pain cycle)

Complications

  • Failure to progress
  • Contracted pelvis
  • Fetal distress
  • Placental abruption
  • Maternal distress
  • Multiple births
  • Malpresentation
  • Perineal trauma
  • Breech presentation
  • Retained placenta
  • Prolapsed or presentation of the cord
  • Placenta accrete (life threatening)
  • Inco-ordinate uterine cavity
  • Knots of the umblical cord
  • Hemorrhage

Signs and Symptoms of Perimenopause

Posted on by priyeshbanerjeept

In this article we will discuss about the Sign and Symptoms of Perimenopause. So, let’s get started.

Sign and Symptoms of Perimenopause

Hot flashes

Irregular menses

Breast tenderness

Mood Swings

Dyspareunia

Vaginal dryness

Reduced libido or sexual drive

Urinary incontinence or urgency or both

Trouble sleeping

Night sweats

Weight gain

Bloating

Concerntration deficit, irritability, depression, anxiety, anger and fatigue

Dizziness

You may have few or majority symptoms (not necessary all) and if you are in the perimenopausal age (i.e mid to late 40s) then these symptoms may indicate perimenopause.

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