Multiple Pregnancy

• This lecture note is prepared to relieve the shortage of reference materials in the country
• Finally, my special thanks and gratitude goes to Ato Aklilu Mulugetta for his devoted support and facilitating the preparation of this lecture note
• The obstetric nurse does a three or four month course of obstetrics part as part of an integrated training
• Important abbreviations and glossaries have been included in order to facilitate the teaching learning process
• Importance of Obstetrics and Gynecology nursing
• The nurses work among the community and they bear the great responsibility of having to deal with mothers in remote areas and far away from hospitals
• Magnitude of Maternal Health problem in Ethiopia
• Each chapter contains learning objectives, descriptions, and exercises in the form of discussion, case studies
• Historical development of obstetrics
• The nurse is part of the health team expected to be able to deal with midwifery
• I would also like to thank my faculty secretaries for their cooperation in writing this lecture note
• This lecture note offers nurses comprehensive knowledge necessary for the modern health care of women with up-to-date clinically relevant information in women’s health care
• The learning objectives are clearly stated to indicate the required outcomes
• I also extend my thanks to my colleagues from Alemaya University, Faculty of Health Sciences for their invaluable comments during the revision of the lecture note
• My deepest appreciation and heartfelt gratitude goes to The Carter Center, EPHTI, Addis Abeba for the financial support, initiation of the lecture note preparation, and provision of necessary materials
• The nurses must do their best to educate mothers in prevention of complications
• It is organized in a logical manner so that students can learn from the basics to the complex
• Last but not least, I thank my university authorities; Academic Vice President, Faculty dean, and Department for their permission to work on this lecture note besides my other responsibilities
• Multiple pregnancy

  1. Monozygotic (Uniovular)

  2. Dizygotic (Binovular) Twins
• Conception

  1. Development of the Fertilized Ovum

  2. Functions of Placenta

  3. The Fetal Circulation

  4. Anatomical Variations of the Placenta and the Cord

  5. Physiological Changes Of Pregnancy
• Mechanism and Stages of Labour

  1. Management of 1st Stage of Labour

  2. The Second Stage of Labour

  3. The Third Stage of Labour
• Disease Associated With Pregnancy

  1. Infection

  2. Pulmonary tuberculosis

  3. Cardiac Disease

  4. Diabetes Mellitus
• Postpartum Hemorrhage

  1. Atonic Postpartum Hemorrhage

  2. Traumatic Post Partum Hemorrhage

  3. Hypofibrinogenemia
• Antepartum Haemorrhage

  1. Placenta praevia

  2. Placental Abruption
• Breast Infections

  1. Acute Puerperal Mastitis

  2. Breast Abscess
• Version

  1. Internal Version

  2. External Cephalic Version
• Physiology of Puerperium

  1. Management of the Puerperium

  2. Postnatal care (Daily care)
• Antenatal Care

  1. History Taking

  2. Examination of the Pregnant Woman At First Visit

  3. Laboratory test
• Malpresentation and Malposition

  1. Breech Presentation

  2. Brow Presentation

  3. Shoulder Presentation

  4. Face Presentation

  5. Unstable lie

  6. Compound or Complex Presentation

  7. Occipito-Posterior Position
• Physiology of the Female Reproductive Organs

  1. Puberty – the age of sexual maturation

  2. The menstrual cycle

  3. Phases of menstrual cycle
• Table of Contents

  • CHAPTER ONE: INTRODUCTION
  • CHAPTER TWO: ANATOMY OF FEMALE PELVIS AND THE FETAL SKULL
  • CHAPTER THREE: NORMAL PREGNANCY
  • CHAPTER FOUR: NORMAL LABOUR
  • CHAPTER FIVE: THE NORMAL PUERPERIUM
  • CHAPTER SIX: ABNORMAL PREGNANCY
  • CHAPTER SEVEN: ABNORMAL LABOUR
  • CHAPTER EIGHT: ABNORMAL PUERPERIUM
  • CHAPTER NINE: INDUCTION OF LABOUR
  • CHAPTER TEN: OBSTETRIC OPERATIONS
• Pregnancy Induced Hypertension

  1. Preeclampsia

  2. Eclampsia
• Destructive Operations /Embryotomy/


  Chapter 10.3
• Forceps Delivery


  Chapter 10.1
• Vacuum Extraction / Ventouse delivery/

  Chapter 10.5
• Uterine Abnormalities

  Chapter 11.1
• Caesarean Section


  Chapter 10.2
• Trauma of the female genital tract fistulae

  Chapter 12.5
• Pelvic Inflammatory Disease

  Chapter 12.1
• Prolaps Of The Uterus

  Chapter 12.6