Medicine an Surgery notes

Apr 24th, 2015
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Antepartum HaemorrhageDr. Abdalla H. ElsadigMDDefinitionBleeding from the genital tract in pregnancy between20 to 24 weeks gestation and the onset of labour.It affects 4% of all pregnancies.It is associated with increased risks of fetal andmaternal morbidity and mortality.causes1.2.3.4.5.Placenta praevia.Placental abruption.Local causes:- cervical ectropion/cervical trauma.- local infection of the cervix/vagina.- cervical polyps/cervical cancer.Undetermined origin.Rare cause: torn from vasa paevia (fetal origin).Placenta praeviaDefinition:a placenta that partially or wholly situated in the lower uterinesegment. Its incidence is 0.4 to 0.8% of pregnancies. Lower uterine segment:it forms after 28 weeks gestation and it has 3 definitions Is that part of the uterus which measures about 5 cm from theinternal os (metric definition used in U/S). Is that part of the uterus which stretches and dilates in labour(physiological definition occurs in labour). Is that part of the uterus which lies below the level at whichthe visceral peritoneum is reflected on the dome of the bladderfrom being ultimately adherent to the upper uterine segment(anatomical definition used in caesarean section).Placenta praeviaGrades:Grade 1: the placental edge is in the lower uterine segmentbut does not reach the internal os (low implantation).Grade 2: the placental edge reaches the internal os but do

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