Obtetrics

• Pregnancy is officially diagnosed on the basis of symptoms reported by the woman and the signs seen by the OB.
• Three Classifications of the Signs of Pregnancy are Presumptive Signs (Subjective), Probable Signs (Objective), and Positive Signs (Documented).
• Presumptive Signs of Pregnancy include Breast changes, Nausea and Vomiting, Amenorrhea, Frequent in urination, Fatigue, Uterine Enlargement, Quickening, Linea Nigra, Melasma, and Striae Gravidarum.
• The frequency of contractions can be affected by various factors during labor.
• Use of abdominal muscles is a crucial aspect of contractions.
• The length of contractions can vary during labor.
• Decrement is when the intensity of contractions decreases.
• There are different phases of contractions: acme, increment, and decrement.
• Acme is when the contraction reaches its strongest peak.
• Increment is when the intensity of contractions increases.
• The duration of contraction increases from 20 to 30 secs during labor.
• The intensity of contractions can vary during labor.
• As labor progresses, intervals decrease from 10 minutes to 2-3 mins.
• Probable Signs of Pregnancy include Serum Laboratory Tests, Chadwick’s Sign, Goodell’s Sign, Hegar’s Sign, Sonographic evidence of gestational sac, Ballottement, Braxton Hicks Contraction, Fetal Outline felt by the examiner.
• Positive Signs of Pregnancy include Sonographic evidence of fetal outline, Fetal Heart is audible, Fetal movement felt by the examiner.
• Uterine Changes include Ballottement, Hegar’s Sign, Braxton Hicks Contraction, and Cervical Changes include Goodell’s Sign.
• Terminologies in Pregnancy include Uterine Changes, Cervical Changes, Vaginal Changes, and Breast Changes.
• Amino acid disorders can cause mental retardation and coma and death from metabolic crisis.
• Hemoglobinopathies can cause painful crisis, anemia, strokes, multi-organ failure, and death.
• Hemolytic anemia can also occur after eating fava beans or inhaling pollen from fava plants, a reaction called favism.
• Fatty acid oxidation disorders can cause development and physical delay, neurologic impairment, sudden death, seizure, enlargement of the heart and liver, and muscle weakness.
• Organic acid disorders can cause developmental delay, breathing problems, neurologic damage, seizures, coma, and early death.
• Endocrine disorders can cause severe mental retardation and death.
• Urea cycle defect can cause seizure, mental retardation, and death.
• Hemolytic anemia in people with glucose-6-phosphate dehydrogenase deficiency is often triggered by bacterial or viral infections or by certain drugs such as some antibiotics and medications used to treat malaria.
• The most common medical problem associated with glucose-6-phosphate dehydrogenase deficiency is hemolytic anemia, which occurs when red blood cells are destroyed faster than the body can replace them.
• Uterine Changes in Pregnancy include Ballottement, Hegar’s Sign, Braxton Hicks Contraction, and Cervical Changes include Goodell’s Sign.
• Vaginal Changes in Pregnancy include Chadwick’s Sign and Breast Changes include Montgomery Tubercles.
• Post-partum blues affect 50% of pregnant people, causing them to experience some feeling of sadness, sudden bursts of tears, depression, and irritability.
• The letting-go phase involves the woman redefining her new role, giving up the fantasizing image of her child, and accepting the new one.
• Disappointment is the feeling of disappointment to the baby, including expectations of how the baby looks like, always crying, bald, skinny, etc.
• The causes of post-partum blues include a decrease in hormones estrogen and progesterone, and a response to dependence and low self-esteem due to exhaustion, physical discomfort, and tension from the new role.
• The period of retrogression is characterized by the involution of the uterus and vagina.
• Management of post-partum blues includes anticipatory guidance and individualized support from health care personnel to let new parents know this is normal, assurance, allowing parents to verbalize their feelings, and keeping lines of communication open.
• Physical care a woman receives during the postpartum period can influence her health for the rest of her life.
• Emotional support a woman receives can influence the emotional health of her child and family, affecting the emotional health of future generations.
• The progressive phase includes the production of milk, restoration of the normal menstrual cycle, and the beginning of parental roles.
• Abandonment is the feeling of not being important after being the center of attention, as everybody’s attention is to the newborn.
• The taking-hold phase marks the beginning of the woman initiating action, stating “I am in charge”, and taking more interest in taking care of the baby.
• The taking-in phase involves new parents reviewing their pregnancy labor and birth experience.