Maternal

• Premature rupture of membranes (PROM)

  Rupture of the chorion and amnion, one hour or more before the onset of labor
• PROM


  • Associated with malpresentation, possible weak areas in the amnion and chorion, subclinical infection and possibly incompetent cervix
  • Leading cause of death is Infection
• Uterine inversion


  Uterus turns completely or partially inside out, it occurs immediately following delivery of the placenta or in the immediate post partum period
• Grades of uterine inversion

  • Incomplete inversion - The top of the uterus (fundus) has collapsed, but the uterus hasn't come through the cervix
  • Complete inversion - The uterus is inside-out and coming out through the cervix
  • Prolapsed inversion - The fundus of the uterus is coming out of the vagina
• Preterm labor


  The labor that begins after 20 weeks gestation and before 37 weeks gestation
• Dysfunctional labor


  Difficult, painful, prolonged labor due to mechanical factors
• Shoulder dystocia


  The anterior shoulder of the baby is unable to pass under maternal pubic arch
• Uterine rupture


  Tearing of the uterus, either complete or incomplete
• Placenta accreta


  Placental chorionic villi adhere to the superficial layer of the uterine myometrium
• Placenta increta


  Placental chorionic villi invade deeply into the uterine myometrium. The placenta extends into the muscles of the uterus.
• Placenta percreta


  Placental chorionic villi grow through the uterine myometrium and often adhere to abdominal structure like the bladder and intestine. The placenta extends through the entire wall of the uterus.
• Surgery is the most common and effective treatment for accreta. After birth of the baby, this usually involves either the surgical removal of the placenta, or a hysterectomy to remove the uterus along with the accreta.
• The ovaries are almost always left in place if a hysterectomy is performed.
• Methotrexate (MTX) has been suggested as a possible treatment for placenta percreta to avoid hysterectomy. For such patients, it is also important to diagnose the condition swiftly and not to miss any patients at high risk.