Perineal laceration and Episiotomy Obstetric lacerations are injuries to the perineum during vaginal delivery. Lacerationa sre common, and usually occur spontaneously. They are classified according to their extent. Grading of perineal lacerations Tear Extent First degree Perineal mucosa only Second…
Preterm labor and Preterm Birth Preterm labor is defined as the onset of contractions and cervical changes between 24-37 weeks of pregnancy or weight less than 2500g in an unknown duration of pregnancy. Definition of terms Term Definition Preterm <…
Overview The management of preterm prelabour rupture of membranes and prelabour rupture of membranes depends on weighing the risk of fetal neonatal complications, whether the patient is in labor or not, evidence of sepsis, and the prospect of fetal survivial…
Placenta accreta spectrum Placenta accreta is a condition whereby the placenta attatches too deeply into the uterine wall. It is characterized by obliteration of Nitabuch’s fibrinoid layer, which acts as a barrier to trophoblastic invasion beyond the decidua. The principles…
Vasa previa Vasa previa is a very rare condition where the fetal placental vessels cross the internal cervical os. It can be easily diagnosed via ultrasound with a color doppler.
Uterine rupture Uterine rupture is complete separation of the wall of the uterus i.e separation of the myometrium and perimetrium. When the perimetrium remains intact, it is called uterine dehiscence or incomplete rupture. Uterine rupture is more commonly associated with…
Abruptio placentae Abruptio placentae is premature separation of the placenta from the uterus. Abruption is difficult to pick up through ultrasound, but it is still done to rule out placenta and vasa previa. The preferable mode of delivery in case…
Placenta previa Placenta previa is a common condition in which the placenta lies in the lower segment of the uterus. The placenta may avulse from the uterine wall as the lower segment begins to stretch at 28 weeks, classically resulting…
Overview Gestational trophoblastic disease is the presence of abnormal tissue derived from fetal cells. These are also known as molar pregnancies or hydatidiform moles. hCG mimics TSH, LH and FSH Classification of Gestational Trophoblastic Disease Classification Example Benign (75%) Complete…
Ectopic Pregnancy An ectopic pregnancy occurs when the embryo implants somewhere other than the endometrial cavity (95% in the fallopian tubes of which 70% occur in the tubal ampulla). A clinical triad of abdominal pain, vaginal bleeding and a pelvic…