Haemorrhagic Stroke

Haemorrhage accounts for ~ 20% of strokes. It is divided into intracerebral haemorrhage (ICH) and subarachnoid haemorrhage (SAH). Haemorrhagic stroke is more severe than ischemic stroke since it creates mass effect faster than ischemic stroke (where edema peaks in 3 – 5 days). Aggressive blood pressure control…

Ischaemic Stroke

Ischaemic stroke is the most common cause of stroke (78%). For a patient who presents with stroke, thrombolysis +/- thrombectomy should be considered as soon as hemorrhagic stroke is ruled out. Presentation of ischemic stroke (in order of increasing severity) Cause Presentation Thrombotic…

Thromboprophylaxis in Pregnancy

Thromboprophylaxis can be started at 28 weeks if there are at least three risk factors. It can also be started as soon as the first trimester if there are 4 or more risk factors. Women with increased risk of VTE receive prophylaxis with low molecular weight heparin (LMWH)…

Cephalopelvic Disproportion (CPD)

Cephalopelvic disproportion occurs when the fetal head is too large to pass through the maternal pelvis, due to a mismatch between the fetal head and pelvic dimensions. It can lead to obstructed labour. Cephalopelvic disproportion occurs either at the pelvic inlet or at the mid-cavity. The…

Twin-Twin Transfusion Syndrome (TTTS)

Twin-twin transfusion syndrome (TTTS) is a serious complication that occurs in monochorionic diamniotic (MCDA) twins. It is caused by unequal blood flow due to abnormal vascular connections in the shared placenta. The donor twin experiences hypovolemia, growth restriction and oligohydramnios while the recipient twin experiences hypervolemia, polyhydramnios and the…

Peripartum Cardiomyopathy

Peripartum cardiomyopathy is a dilated cardiomyopathy which occurs in the last month of pregnancy and may last up to 5 months post-partum. It is characterised by left ventricular systolic dysfunction – LVEF < 45% – in the absence of any other possible…