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 […]
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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
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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
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Contraindications for cerclage → Cervical dilatation ≥ 4 cm → Ruptured membranes → Presence of gross anomaly of fetus → Vaginal bleeding Present → Pelvic infection +nt. → Placenta Previa- relative contraindication
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Cardiac Muscle-Unique features 1. Gap junctions → SINGLE NUCLEUS CENTRALLY placed – Seen in Intercalated disc region. → Protein subunit – CONNEXONS – 6 subunits of “Connexin” functions: → Gap junctions causes “SYNCHRONIZED CONTRACTION” / “SYNCYTIAL CONTRACTION”. → Entire cardiac muscle unit contracts as single unit – FUCNTIONAL SYNCYTIUM. 2. Elasticity → Cardiac muscle ELASTICITY
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Blood brain barrier BBB Locations: → Formed by TIGHT JUNCTIONS & FOOT PROCESSES OF ASTROCYTES. → ABSENT BBB = CIRCUMVENTRICULAR ORGANS (mnemonic – SOAP) → S= Subfornical organ; O – Organum Vasculosum of Lamina Terminalis; A – Area Postrema; P – Posterior Pituitary BBB Permeability: PERMEABLE Substance: • Glucose (GLUT-1), • Water (Aquaporin-4), • Gases
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Heading-Auditory pathway Mnemonic – E C O L I M A E – EIGHTH Cranial Nerve C- COCHLEAR Nerve O – Superior OLIVARY Nucleus L – Lateral LEMNISCUS I – INFERIOR Colliculi M – MEDIAL Geniculate Body A-Auditory Cortex (Brodmann Area – 41)
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Antiphospholipid antibody syndrome • APLA syndrome can lead to thrombosis in vessels. Depending upon which vessels get thrombosed we will get the manifestation like if cerebral vessel get thrombosed manifestation of stroke can be seen. It can even lead to thrombosis in placental blood vessels. Based on this size of placenta will decrease and there
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Antihypertensives for chronic hypertension in pregnancy For PIH/PE-1st choice- Labetalol Chronic HT in Pregnancy-Labetalol or α-Methyl Dopa HT Crisis-I/V Labetalol, I/V Hydralazine Safe Antihypertensive: Labetalol Alpha-methyldopa (safest) Nitroglycerine Calcium channel blockers – nifedipine Hydralazine Sodium nitroprusside (last resort) Beta Blockers Contraindicated during pregnancy: ACE inhibitors – like enalapril, captopril Angiotensin receptor blockers-Losartan Diuretics Atenolol Diazoxide
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