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Pre-eclampsia/Eclampsia

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

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

Terms in Obstetrics (Part-2)

In this article, we will discuss some of the Terms used in Obstetrics Part-2. So, let’s get started.

Terms

Gestation: Duration of the pregnancy, usually 280 days or 40 weeks, marked from the first day of the last menstrual period.

Trimesters: Division of weeks of pregnancy first, 1-13 weeks; second, 14-17 weeks; third, 28-40 weeks.

EDC/EDD: “Expected date of confinement” (EDC) is an old-fashioned term indicating the date of a woman was expected to deliver and be confined. A more mordern term, estimated date of delivery (EDD), is now commonly used.

Parturient: A woman in labour

Pre-term labour: Labour that starts after the 20th but before the 37th week.

Term labour: Labour initiated after the 37th week of pregnancy but before the 42nd week.

Terms in Obstetrics (Part-1)

In this article, we will discuss some of the Terms used in Obstetrics (Part-1). So, let’s get started.

Terms

Nullipara: A woman who has not been pregnant or has never completed a pregnancy beyond 20 weeks of gestation.

Primipara: A woman who has had one delivery beyond 20 weeks of gestation.

Multipara: A woman who has had delivered two or more pregnancies beyond 20 weeks of gestation.

Nulligravida: A woman who never has been pregnant.

Primigravida: A woman who has been pregnant once.

Multigravida: A woman who has had more than one pregnancy.

Postpartum: The period after childbirth.

Puerperal: The period from the end of labour until the uterus return to pre-pregnancy size, generally from 3-6 weeks postpartum.

Signs and Symptoms of Perimenopause

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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