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PREVENTION OF POST PARTUM HAEMORRHAGE BY DR SHASHWAT JANI
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Threatened abortion is associated with bleeding and/or uterine cramping while the cervix is closed. This stage of abortion may progress to spontaneous incomplete or complete abortion. While this event may be considered a part of the quality control process in human reproduction, it is important to know the possible etiologies and when therapy might prevent pregnancy loss. The World Health Organization estimated that 15% of all clinically recognizable pregnancies and in spontaneous abortion, 50-60% of which are due to chromosomal abnormalities. Apart from the fetal factors, several maternal and probably paternal factors contribute to the causes of spontaneous abortion. The maternal factors that may be responsible for abortion include both local and systemic conditions such as infections, maternal disease states, genital tract abnormalities, endocrine factors and other miscellaneous causes (antiphospholipid antibodies, maternal-fetal histocompatibility, excessive smoking and other environmental toxicants, etc.). This review focuses on the management of threatened abortion, but it should be emphasized that the management to maintain pregnancy is reasonable only in those cases, in which the fetus is not seriously affected. It would not be beneficial to provide treatment that would permit chromosomally and anatomically abnormal embryos to survive to term. Treatment is feasible first of all in cases with maternal factors. Surgical procedures may precede pregnancy (correction of septate uterus, removal of a submucous leiomyomata) or may be performed usually in the second trimester (cervical cerclage). Maternal general diseases (diabetes, hypothyroidism) and infections should be treated accordingly. The most common entity to be treated in this category is luteal phase deficiency. Progesterone is the most important hormone for the maintenance of an early human pregnancy. Besides progesterone administration, human chorionic gonadotropin (hCG) also is the logical endocrine treatment of choice. In the pregnant woman hCG stimulates and optimizes hormonal production in the corpus luteum and may also influence the fetoplacental unit. The contribution of environmental, physical and chemical agents to the incidence of spontaneous abortion is controversial. They may be abortifacient even if they are not teratogenic. Exposure to environmental toxicants should be avoided. Paternal leukocyte immunotherapy has been associated with successful outcome in patients with unexplained repeated spontaneous abortion. This therapeutic approach is considered experimental, as there may be some significant risks. Associating maternal antiphospholipid antibodies with reproductive failure is a rapidly developing field. Administration of corticosteroids with low doses of aspirin has resulted in fetal salvage in women in whom antiphospholipid antibodies are present.
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Threatened abortion is associated with bleeding and/or uterine cramping while the cervix is closed. This stage of abortion may progress to spontaneous incomplete or complete abortion. While this event may be considered a part of the quality control process in human reproduction, it is important to know the possible etiologies and when therapy might prevent pregnancy loss. The World Health Organization estimated that 15% of all clinically recognizable pregnancies and in spontaneous abortion, 50-60% of which are due to chromosomal abnormalities. Apart from the fetal factors, several maternal and probably paternal factors contribute to the causes of spontaneous abortion. The maternal factors that may be responsible for abortion include both local and systemic conditions such as infections, maternal disease states, genital tract abnormalities, endocrine factors and other miscellaneous causes (antiphospholipid antibodies, maternal-fetal histocompatibility, excessive smoking and other environmental toxicants, etc.). This review focuses on the management of threatened abortion, but it should be emphasized that the management to maintain pregnancy is reasonable only in those cases, in which the fetus is not seriously affected. It would not be beneficial to provide treatment that would permit chromosomally and anatomically abnormal embryos to survive to term. Treatment is feasible first of all in cases with maternal factors. Surgical procedures may precede pregnancy (correction of septate uterus, removal of a submucous leiomyomata) or may be performed usually in the second trimester (cervical cerclage). Maternal general diseases (diabetes, hypothyroidism) and infections should be treated accordingly. The most common entity to be treated in this category is luteal phase deficiency. Progesterone is the most important hormone for the maintenance of an early human pregnancy. Besides progesterone administration, human chorionic gonadotropin (hCG) also is the logical endocrine treatment of choice. In the pregnant woman hCG stimulates and optimizes hormonal production in the corpus luteum and may also influence the fetoplacental unit. The contribution of environmental, physical and chemical agents to the incidence of spontaneous abortion is controversial. They may be abortifacient even if they are not teratogenic. Exposure to environmental toxicants should be avoided. Paternal leukocyte immunotherapy has been associated with successful outcome in patients with unexplained repeated spontaneous abortion. This therapeutic approach is considered experimental, as there may be some significant risks. Associating maternal antiphospholipid antibodies with reproductive failure is a rapidly developing field. Administration of corticosteroids with low doses of aspirin has resulted in fetal salvage in women in whom antiphospholipid antibodies are present.
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EXAMINATION OF MALE IN INFERTILITY - WHAT NOT TO MISS BY DR SHASHWAT JANI
DR SHASHWAT JANI
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STANDARD TECHNIQUES OF BREAST FEEDING BY DR SHASHWAT JANI.pptx
STANDARD TECHNIQUES OF BREAST FEEDING BY DR SHASHWAT JANI.pptx
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EARLY PREGNANCY CHALLENGES IN ART BY DR SHASHWAT JANI
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THYROID DISEASES IN PREGNANCY BY DR SHASHWAT JANI
IMPACT OF DEEP ENDOMETRIOSIS ON PREGNANCY & DELIVERY BY DR SHASHWAT JANI
IMPACT OF DEEP ENDOMETRIOSIS ON PREGNANCY & DELIVERY BY DR SHASHWAT JANI
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DENGUE IN PREGNANCY BY DR SHASHWAT JANI
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DEBATE - SHORT CERVIX - OS TIGHTNING BY DR SHASHWAT JANI
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VASOMOTOR PROBLEMS IN MENOPAUSE BY DR SHASHWAT JANI
TRANSFER OF A CRITICALLY ILL MOTHER BY DR SHASHWAT JANI
TRANSFER OF A CRITICALLY ILL MOTHER BY DR SHASHWAT JANI
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PREVENTION OF PRETERM LABOUR - EVIDENCES FOR PROGESTERONE BY DR SHASHWAT JANI
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ECTOPIC PREGNANCY - FOGSI GUIDELINES BY DR SHASHWAT JANI
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OVARIAN REJUVENATION - ROLE OF PLATELET RICH PLASMA THERAPY BY DR SHASHWAT JANI
OBSTETRIC PRACTICES IN PRESENT SCENARIO BY DR SHASHWAT JANI
OBSTETRIC PRACTICES IN PRESENT SCENARIO BY DR SHASHWAT JANI
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NONHORMONAL DRUGS FOR MALE INFERTILITY BY DR SHASHWAT JANI
F.I.G.O. GUIDELINES & MEDICAL MANAGEMENT OF A.U.B. ( FOCUS ON PROGESTERONE ) ...
F.I.G.O. GUIDELINES & MEDICAL MANAGEMENT OF A.U.B. ( FOCUS ON PROGESTERONE ) ...
MEDICAL MANAGEMENT OF ABNORMAL UTERINE BLEEDING BY DR SHASHWAT JANI
MEDICAL MANAGEMENT OF ABNORMAL UTERINE BLEEDING BY DR SHASHWAT JANI
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MANAGEMENT OF PREECLAMPSIA BY DR SHASHWAT JANI
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MANAGEMENT OF GESTATIONAL DIABETES MELLITUS BY DR SHASHWAT JANI
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MANAGEMENT OF COMPLICATIONS OF HYSTEROSCOPY BY DR SHASHWAT JANI
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GENITAL TB - HOW TO DIAGNOSE & WHEN TO TREAT BY DR SHASHWAT JANI
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PREVENTION OF POST PARTUM HAEMORRHAGE BY DR SHASHWAT JANI
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Prevention of
Postpartum Hemorrhage Dr Shashwat Jani
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ACCIDENTS AND HAEMORRHAGE
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The incidence of
Induction of Labour is on the rise . Even otherwise, most women in labour have an IV line . Why not use the convenient Oxytocin to prevent PPH?
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PPH
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Non inflatable anti
shock garment
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