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OBSTETRICAL EMERGENCIES

ANTEPARTUM HEMORRHAGE:

Any bleeding from or into the vagina after 28 weeks of pregnancy (viable period).

A) Placenta Previa: Placenta where partially or completely situated in lower uterine segment. It may cause bleeding during pregnancy.

B) Abruptio Placenta: Bleeding in pregnancy due to early separation of normally situated placenta in upper uterine segment due to few disorders during pregnancy like hypertensive, pre-eclampsia, renal hypertension. Other causes like trauma, vascular accident, nutritional and social factors, etc.

EMERGENCY CERCLAGE:

It is the treatment of choice for cervical incompetence( painless cervical dilatation with ballooning of amniotic sac into vagina) – where a stitch is placed on cervix to make it competent.

PREMATURE RUPTURE OF MEMBRANES (PROM):

Rupture of membranes spontaneously before onset of labor pains (uterine contractions). If it occure before 37 weeks it is termed preterm premature rupture of membranes. This occurs due to low socio-economic status, cervical incompetence, genital tract infections, urinary tract infections, polyhydramnios, fetal abnormalities, multiple pregnancies, Iatrogenic invasive procedures like amniocentesis, fetal blood sampling.

PRETERM:

Onset of labor before 37 weeks of gestation counting from the first of last menstrual period and after attainment of period of viability. The causes are numerous like low social-economic factors, genital tract infections, systemic infections, maternal systemic diseases like hypertension, diabetes, asthma, renal disease. Pregnancy complications like multiple pregnancies, placenta previa.etcfetal factors like congenital malformations, intrauterine death and idiopathic.

MULTIPLE PREGNANCIES:

Development of 2 or more than 2 fetuses simultaneously in a pregnant uterus is a multiple pregnancy. Other types are triplets (3 fetuses), quadruplets (4 fetuses) and soon..

Cephalo pelvic disproportion (CPD):

Disproportion between the female pelvic bone and fetus head which leads to difficulty in passage of the fetus head through the uterus which causes arrest of the fetus head, there will be no progress of labor and there will be no descent of the fetus.

Malpresentation:

Usually the presenting part during labor is the head of the fetus. Sometimes the presentation varies like the buttocks as presenting part, the fetus may be transversely placed or oblique lie. This is called as malpresentation.

Eclampsia:

When the mother has seizure during pregnancy is called eclampsia. This is considered to be high risk. The cause may be due to increased Blood Pressures and so on. Immediate admission and close monitoring has to be done along with the treatment.

Severe PIH:

PIH is pregnancy induced hypertension. BP more than or equal to 140/90 mmhg during pregnancy needs immediate medical attention as it is a high risk for the mother and the fetus. Regular antenatal visits are a must.

Gestational Diabetes:

The increase in blood sugar levels at 28 week of pregnancy is known as Gestational Diabetes. In few it may be controlled with diet alone and few may be requiring medication inorder to control the blood sugar levels. Again GDM is also a medical condition in pregnancy which has to be closely monitored as it is a high risk.

Previous LSCS:

When a mother had a cesarean delivery in her previous pregnancies then she is labeled as previous cesarean.

RH Incompatibilities:

Mother whose blood group is negative and the husbands blood group is positive, then the fetus blood group may be either negative or positive. Rhesus disease can be prevented by giving an injection called Anti D. This helps to avoid a process known as sensitization, which is when a Rh negative blood exposes to Rh positive blood and develop an immune response to it.

Bad obstetric histories:

A woman who has had the previous history of 3 or more abortions in the past is considered to have a Bad obstetric history.

Bad obstetric histories:

A woman who has had the previous history of 3 or more abortions in the past is considered to have a Bad obstetric history.

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