1 / 33

Nageles rule-  LMP-3m + 7d  derives EDC

Nageles rule-  LMP-3m + 7d  derives EDC. Multiple Gestation (1/99 deliveries ). 2/3 fraternal Autosomal recessive in daughters of mothers of twins 1/3 identical Random occurance High prematurity Increase incidence of congenital anomalies

luka
Download Presentation

Nageles rule-  LMP-3m + 7d  derives EDC

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Nageles rule-  LMP-3m + 7d  derives EDC

  2. Multiple Gestation (1/99 deliveries) • 2/3 fraternal • Autosomal recessive in daughters of mothers of twins • 1/3 identical • Random occurance • High prematurity • Increase incidence of congenital anomalies • Growth retardation, bacterial infection, hypoglycemia

  3. amnio-afp(fetal tissue breakdown increases this), bili (rH incompatability) creatnine -kidney mec staining, cytologic examination fhr - audible 16-20 wks quickening fetal heart beat nst st from placenta estriol level

  4. ultrasonography doppler

  5. cordocentesis

  6. Fundal height -cm height relates to weeks gestation

  7. Parturition Mediators • ROM • Cervical Dilation • Uterine Contraction • Placental Separation • Uterine Shrinking • Progesterone withdrawl • Estrogen induced uterine activity • Oxytocin & prostaglandin stimulation

  8. fetal scalp - 7.25+

  9. Dystocia – stage 1 & 2 > 20 hrs. • Uterine dysfunction (hyper or hypotonic) • Abnormal presentation • Breech 3.5% • Complete, footling, frank • Face, brow, shoulder, transverse • Excessive fetal size – cephalopelvic disproportion • Hydrocephalus • Abnormal size or shape of birth canal

  10. Delivery • Vertex –95% • Stations above & below ischial spines • Tocolysis- terbutaline sulfate, ritodrine, MgSO4 – not indomethicin

  11. Labor • Braxton Hicks • True – 3 contractions in 20 minutes • Cervix <4 cm & 50% effaced • 20 – 36 wks gestation • No fetal distress • No disorder contraindicating meds • Informed consent

  12. STAGES of LABOR

  13. Placenta • Placenta previa • Abruptio placentae • Maternal mortality 2 – 10% • Fetal mortality 50% • Apparent & concealed hemorrhage • Place mom in lateral lie

  14. Transient Tachypnea of the Newborn L/S ratio

  15. Lung Transition • Asphyxia stimulates gasping • Recoil of thorax draws in air • Bright loud cold pokey world initiates crying

  16. Circulatory Transition • Lung inflation • Decrease PVR – increase PaO2 • Ductus Venosis – flow stops –DV constricts • Cord Clamped – UA & UV flow stops • Ductus Arteriosis – constricts due to increased PaO2 • Foramen Ovale – closes due to pressure increase in left atrium • Umbilical Arteries constrict and close

More Related