Initial factors considered to diagnose intrauterine growth restriction 1. Identify mothers at risk: – → PIH → Chronic Renal Disease → BMI↓ & Less wt. gain → Infections 2. Sure about gestational age
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Confirmed causes of recurrent abortion • Recurrent abortion: RPL- (recurrent pregnancy loss): – It is defined as a sequence of three or more consecutive spontaneous abortions before 20 weeks. American society for reproductive medicine (2013) defines RPL as 2 or more failed pregnancies confirmed by USG or histologically. • Uterine causes account for 10-50 %.
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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 is a part of inner ear with 2 membranes & 3 parts Entire structure is explained diagrammatically.
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
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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.
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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
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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
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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
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Cervical incompetence → M/C cause of 2nd trimester loss → Painless, sudden dilatation of internal OS → Sudden rupture of membrane & expulsion of fetus. Etiology: Congenital Acquired- → Forcible Dilatation of cervix → Cervix Surgery
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