Author: Renu Maurya

Complications of Intrauterine growth restriction


Complications of Intrauterine growth restriction


1. Oligohydramnios

• Less space for fetus leading to cord compression

• Umbilical artery & vein gets compressed

• Fetal distress & fetus will pass meconium

• Fetal swallows meconium with amniotic fluid

2. Meconium Aspiration Syndrome

3. Low birth weight

4. Fetal distress/ hypoxia

5. Still birth

→In Neonates

1. Loose Skin

2. ↓ Tone

3. ↑ HMD/RDS

4. ↑ IVH

5. Neonatal Death

→Fetal Surveillance in IUGR is done by NST (Non-Stress Test) Biweekly

Complete abortion


Complete abortion


→Patient C/o initial bleeding and pain and product of conception comes, then bleeding

→ P/A or P/V- Size of uterus is less than period of gestation.

→ Internal OS -Closed

→ Diagnosis- USG-empty uterus

Cochlea


Cochlea


Cochlea is a part of inner ear with 2 membranes & 3 parts

Entire structure is explained diagrammatically.

Classification of receptors-Based on location


Classification of receptors-Based on location


Receptors on cells are classified based on their location into:

Extracellular / Cell membrane Receptors:

• G-protein coupled receptor (GPCR)

• Tyrosine Kinase Receptor

• Janus Kinase Receptor (JAK-STAT)

Intracellular Receptors:

• Cytoplasmic Receptors

• Nuclear receptors

Classification of receptors-Based on adaptation


Classification of receptors-Based on adaptation


The receptors of cells are divided into the following based on adaptation:

1. Rapidly Adapting Receptors (RAR’s)

o Adapts quickly to stimulus

o Ex: Corpuscles – Meissner’s & Pacinian Corpuscles

2. Slowly Adapting Receptors (SAR’s)

o Adapts slowly to stimulus

o Ex: Merkel’s Cells, Ruffini’s endings, Free nerve endings.

Classification of hormones-Based on chemical structure


Classification of hormones-Based on chemical structure


The hormones are classified into the following based on chemical structure

1. Amino Acid Derivative

• SINGLE amino acid

• TYROSINE = (T3, T4) & Catecholamines (Epinephrine, Norepinephrine, Dopamine)

• TRYPTOPHAN -5-HT (Serotonin) & Melatonin

• ARGININE (Nitric Oxide)

2. Protein / Peptide

 MULTIPLE amino acid

 Acts on “EXTRACELLULAR RECEPTORS

 INSULIN (51 amino acids), PARATHORMONE (84 amino acids)

3. Cholesterol derivatives

• Crosses cell Membrane

• Acts on “INTRACELLULAR RECEPTORS”

• STEROID HORMONES (Aldosterone, Cortisol, Estrogen, Progesterone, Testosterone)

4. Vitamins

 VITAMIN A & D

 Acts on “INTRACELLULAR RECEPTORS

Chronic hypertension in pregnancy v/s pregnancy induced hypertension


Chronic hypertension in pregnancy v/s pregnancy induced hypertension


Chronic Hypertension in Pregnancy Pregnancy Induced Hypertension
  • Means a hypertensive female has conceived
  • Normotensive patient conceived & due to placental pathology @20 weeks, her BP ↑
  • Past H/O hypertension present
  • No past H/O hypertension
  • ↑ in B/P will be seen before 20 weeks
  • ↑ in BP is seen after 20 weeks of pregnancy
  • BP- does not come back to normal within 12 weeks of delivery.
  • BP-normal within 12 weeks of delivery.

 

 

Chronic Hypertension with superimposed pre-eclampsia


Chronic Hypertension with superimposed pre-eclampsia


In a pregnant Chronic HT Female if at 20 weeks: –

BP suddenly becomes incontrollable/New onset proteinuria/Signs of end organ damage are +nt
v

Cervical Incompetence-Management


Cervical Incompetence-Management


Cervical incompetence managed by using cerclage procedures. The 3 types of cerclage that are used are:

1. McDonald’s Cerclage (M/C)

2. Shirodkar Cerclage

3. Abdominal Cerclage -Benson & Durfee Cerclage

Cervical Incompetence-Diagnosis


Cervical Incompetence-Diagnosis


Diagnosis in non-pregnant female:

1. History: –

→ RPL

→ Only 2nd trimester loss

→Painless dilatation of cervix

→ As the no. of pregnancy loss ↑ POG at which loss occurs↓

2. Hegar dilator no. 8 can pass through Internal Os without Pt. resistance.

3. On hystero cervicography- Funnel Shape

• In hysterocervicography with the help of foleys catheter radiopaque dye is injected.

• In normal pt. as os is closed dye will not come out but in cervical incompetence dye will

ome out and result in funnel shape.

• All these are not a very good method to be performed in non-pregnant females.

Diagnosis in pregnant female:

  1. TVS (cervical length should be ideally 3.5)

→ Length of cervix <2.5 cm

→ Dilation of cervix ≥2cm

→ Shape of cervix-U shaped (Normally T shape)

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