DOCTOR8.page

DOCTOR 8.

1.HYPEREMESIS.
2.TWIN PREGNANCY.
3.HYDRAMNIOS& OLIGO.
4.PRE-ECLAMPSIA.
5.ECLAMPSIA.
6.RHESUS-INCOMPATIBILITY.
7.PLACENTAL INSUFICIENCY.
8.MALPOSITION &MALPRESENTATION

1. HYPEREMESIS: See

2. TWIN PREGNANCY:
Twin is the term used when more than one baby in the uterus.
Twins are found 1/80 pregnancy.
   Twins may be monovlar(FROM ONE EGG) = MONOZYGOTIC OR binovular (FROM TWO EGGS) = DIZYGOTIC.
WHY some women have TWINS? May be due to:
1. Age. monovular common in young women between 20-30 years of age.
2. Heredity. Binovular common in genetic heredity and 35-45 years of age.
3. Race and people. More common in Negroid than caucasian and is least in Mongol.
Diagnosis. Is very easy 1. By Uterus and abdomen biger than date.
                                     2. By palpation more parts and more movment.
                                     3. By hearing more than one baby heart beat.
                                     4. By Ultrasound you can see clearly two babys.
ATTENTION: (Any question or any worry contact me. Click here.
                       Twins usually are not without problems but, take it easy and do not to worry because any obstetricien can deal with them very well.
1. Anaemia. Is common. See                          . Click here.
2. Premature labour due to bulk of pregnancy.
3. Pre-eclampsia and Eclampsia. Click here.
4. Placenta praevia. Due to large placenta. Click here.
5. Hydramnios. See below.

3. HYDRAMNIOS:
Definition.
Normalment your baby surrounded by membrane and inside this membrane there is liquide called amniotic fluid and is normally a volume of (700-1500ml)
If it is excessive it is called HYDRAMNIOS.
Sign of Hydramnios.
1. The uterus is bigger than expected.
2. Identification of baby, parts and heart beats are difficult.
Sources of Amniotic fluid is UNCERTAIN. But may be a transudate through the membranes from the mother or a secretion from the amniotic Epithelial cells. This fluid turnover every 3 houres. Baby swallowing and urinary excretion make contributions to this turnover.
The development of Hydramnios is usually gradual and in the last trimester.
Differential diagnosis. Twin, and full bladder and overian cyst. The Ultrasound will put the diagnosis easily and quickly without any complication.

4. PRE-ECLAMPSIA:
This is a disease which commonly appears in the last trimester and characterised by the following signs:
1. HIGH BLOOD PRESSURE.
2. PROTEINURA (PROTEINE = Albumine IN THE URINE).
3. PITTING OEDEMA.
In general diagnosis is consider to be possible when any two of the above are present, but generally considerable emphasis is placed on the presence of hypertension. By definition hypertention can be said to exist when the blood pressure reaches a level of 140 systolic/90 diastolic on two occasions more than 6 hours apart.
TWO TYPES OF PRE-ECLAMPSIA:
1. MILD. With slight hypertesion 150/95. A trace proteine or absent in the urine.
Oedema slight or absent. At this stage pre-eclampsia is asymatric and all the signs disappear rapidly after delivery.
2. SEVERE. As the signs of the disease increase in severity symptoms tend to appear. In some cases the disease is of sudden onset and severe from the beginning.
SYMPTOMS: FRONTAL HEADACHE, HIGH BLOOD PRESSURE ABOVE 160/100, PROTEINURIA, OEDEMA SEVERE PITTING, EPIGASTRIC PAIN AND VOMITTING AND BABY SMALL.
Management and Treatment. Contact me. Click here.

5. ECLAMSIA:
This is commonly the terminal phase of a very severe pre-eclampsia (Shows signs like epilepsie). The fits are preceded by a sharp rise in blood pressure, increase in proteinuria and rapid extension of oedema. Symptoms increase in intensity and sudden BLINDNESS may supervene. This is a critical case the patient must be immediately transferred to the hospital if she was not in the hospital, because usually severe pre-eclampsia and eclampsia are in the hospital and the three stages are recognised:
1. Premontory stage: the patient rolls her eyes and there are TWICHING of the hands and the face.
2. Tonic stage. Spasm of muscles spreads until the patient is rigid. Cynossisis intense due to fixation of the chest and diaphragm.
3. Clonic stage. The muscles now contract rapidly and spasmodically. The breathing is stertorous and bubbly. This is followed by a period of coma.