Gyaecology summarized notes, Summaries of Gynecology

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the periad Folbywing —— reproductive organ — pregnant state - adays) g@ Physiological changes- @) 20terus = Ondergoes IN vo luton @ -weight 1o0og wmmeciictely after delivery — 60g by 6 weeks 39 @ - fonda! height returns to pelvis 4 2weeks — <= @ —involuten completed by 6 weeks - Dn B 22 lochic — @ -lochia rubra Crecl> ~1—s Cero — ® —Lochia serosa (pink =browind Se ee p ~lLochic alhe Cwhitish / ellow) — 10-2) dows — ~~ mex: firm by 1 eek psrcervix 4 vacunag = cervix hece! R— vagmea reduces In size qrachall one | yes — D Wwrelks: ee . _ ; _ {Li dD @ 42 Dhdomen = Abdoemenal we : S? -| valNcle. es rm 4 : — - : -[ c. — ) — J tov vi } i calorie cet check Funda! height —Pijaple clear4 Arg - Assess Lechia =! "anagement =I ron. 4-calcium ——___— cupplemeantatian_—____—— hygiene engorgement .- Eably ambulation — ee )_ - Pemneal by y —— oo Moy owioy Page no +t. ¥ bu] Youva mmuniaat? — Pnb A For RA negative weiae, = PObelc : coniraceystion=lactational amenorrhea method __ “ _ —Progesteron = onhy pil)s - -~JUCD after 6 weeks > Condoms Cam lic 1 [ ; ications Daring ReEUr PERM — QuUEPRera] Sepsis Rast par tom hemorrhage = Thrombophlebitis — Breas? complications -Orinary retentiin ~ Postpartom depressjon / Psy chasic. Lactation T+ tc Phy lological Process of milk secreation from the mammary alancds iNitioted after delivery ZmMaintyi- Nee) by brea tPeeding . * Stages of Lactation %- 1 Mammeogenesic — brea st de ve lopment cloring pregancy ue to - Eetrogen — > ductal growth Progesterone => lakulo = alveolar growth DBlactogenasrs= Milk cecrection begins after Fall in progesterone Following delivery = Prolactin is the main hormone Por milk formatter _-Tnittates within 2~2 days Post artom “2)Galactokinesis~ Mlk ejection reflex: Oxy toxin Cauces contraction of myoepithe lig) cells. = Triggered by sUCking OF infant ery 4) Gralacto poiesic= Mantenance of milk joraducton -DRepends on regular suckling - prolactin reflex T =Removal of mills from breast .Ccle mand ~ Supiaty MECCAGN isp Campa sition OF Breac t milk + Colas trum-— Fits} -2-3 day Thick, yellow High in. protein Tea A, lactoPerr’n, Wy Be‘ —_———————j Youva Placental abrophan - 320bsteric complicagtions- jn “Placenta previa /obrcjation Lahour = ue to impored anclome trio!) Ardystunctiona) Jakour Bo aperchve interference vascUlar regene kathon . 2) Postpartum Hemorrhage ~ ~ceusayEean sechorn . Jterine muscle fetigue tanemia - Vagina) deli very assis ted) t nutritional deficits ->Uderine - atonyy . yy) retained pla enta— exhausted uterus -2T nacdence. 22HY per tensive olf’sorcders= “repeated phusdlogical stress. 49Past partum comp )catian &- tnutritjional clepletion ma -exacerbolon of anem's Pornisk of —Gestetong) hypertension = Poor lactation -moaternal esxhausten ~Pre - eblampsia . —High risk of post partum S20terine rupture Cib previous Cepressorn lens = TPT < 12 monthr S>Long-term maternal Healt, issues = Feta! Complications 8 Avlow birth weight - coe ty = Pelvie organ prolapse moaterna) pac) nutrition, uterd -Uterine sulin yo \ohon placente) insu FFiciency. -CMronm)c backache 8 Preterm birth - strongly associoted 8 short bir th ~ Higher umulahve risk of Ohsteric marlorcity Spacing cyITntrauterine Growth restriction CT UGR) -Notritiong) depletion > Poor Fetal Growth, o2. spermiciclas = BrFerble periad-Ccalender / ddu - €asy to Ose jubricatny Rhytam merthec) > cis -low e frective ness clone Od -—nodrugs ;Noclevices , agqiNa) jrritatian acceptable ta rehglous gGrouss lay Tntravuterine Devices CTUDS) Jis~High Failore rate) irre gular menstrual cycles=> olifficalt | Types -12Non= mec) icorted = [apes +o use- log - 22Cogper -bearing Tubs = Cr Coituc Trtercuptus:= CcU-T 2807, CURZ75 Adv- na cost, no hormones 2z7Hormona) TUDs ~ LNG =~T US Ais - Veryhigh Failure rate Cmireng,s 2 mg ladonargestre! ) Cypre ~ eyacubtory sperm) vweHiahly efFective ong acting, reversible 22 Barrier Methods 8— Na efFeck no lactation A?2Male condoms- = Copper TU! can be Useckas Ady - protects against SIRs/HIV eng= contraception Easily quctlable , chea,2. dis A- Heavier bleecling 4 —No systemic side effec’ | dysmenorrhea Ccu-~ TOp) dais= Cor tar [sli srisk of eepulsion -Pelvic inflammatory fs =Teduce sencation -user depenglentt d =pqgin coring insertion ee S LF ne young —~Reversa!l dy fic WI} Dlactationg) Amenorrhea Method C Lary) &- €xclosve breast feeling <6 Manths adv -Natoral free effechve Tf Criterig Followed) Cgey ) is - effective only for 15+ & months Netermal Conmplication-< -requjver exec lusive breast | 4- Anemia —meost camnmmon la eeciing complicator Doeto- Depletec! iron steres Si Newer methods & Tnaclequate recovery Hime ~vasging) ring?o Novaring > bet? pregnancies -Tronsaderma) patch le Leads to 37 Fatigue ~Mlale / female hor mana!) covtraception onder research ~Tncreasec) cistc oF Pe ~ Poor wsoond healing 2-Naternal Net itional deficiency -leNeCiciency of -~ Tron calcium L Folic actd - Protein eRe sulks in = Weakness pone pain - Tec Fracture risk - ls-Utevine Aton-Overstretched terus clue +o repecded joregnanc eleacds to* -Poor uterine contraction after desivery F Heed righ of PPH id y a ) Qe — Postpartum Hemmbrrhage cep! Prolonged Labor Fos “Canman J clargercus camplicohen Inffe dive oterine caomructuns Ars - . "Cousses - Wi erme alony | Leads fo MaterNa! eahswstorn Lome, “ Anennics Prolonged labor ound Fetal cis tress ° th ‘ ‘Can Jaad Jo shock ~maternal Has death if octreaded Fetal Compicahuns 2B . 7 | 4- Lew birth weight _ S- Genital prolapse | * Due ta - matter nal anemia C hope rWeakening of elvic Hloor musce| = Poor nutritioa— Pros ie Conmmen_iA_Mu) Hi paraus women |2- Intrauterine Grauth Retarclabon Nan r tlypes-_Oterine prolapse __|-Tnadequate p lecental nutrition dTner, ~Cystocele -Rettocele |3%-Perinatal Mortality ——_—— ~2Inc ce + Higher Incidence of) = Lastromental clelivery 6-Tacreasec! Operciive clelivery | + Tacreased risk due ta =—— Preterm birth -Tafectioo Birth asphyxia ee Psyche logica) Comyplicathans __=Caesarean section «Doe ta! Majoresentahons ~DMaternal stress — Anxiety — -~Weak uterine Com racHons ~Postnactum depressian Poor mother - child banding Obs teria complications .4.-Malpresentation- Breech Prevention = Adequate bicth Transverse le spacing Cminimun 2-s4ears Dor to lax oterine muscles -Proper antenbtal cave _2:Preterm Labor Ie Tron , calcium 4 Falic acicl sujal) eTacréatec) risk clue to: ~Family planning counseling vf TF a J ~ Poor moderne! hecalit -Pelyic floor trenthening ex. vOterine overdistension commery- Repetitive Pregnancy - 3- Placental Abnormalities fees risk of nremia, PRY, prolapse “-Placenig pre vig preterm |ahar 4 low) birth weight: =Placenta accereta Adequate spacing ¢ Mutrit® recce eamplications “Inecrened rick & repected) pregnancies ane) surgerier Emphasis on Maternal heath & +~— Ss an ~~ e 3. Surgical CRare) a ee L SPS LLaparco pic ovenrign “Normal ovary \\ / Z palGen yshe | dr ig, € LOD (JO) every \ Pragaasis { PCOS =Sympioms wnprove 6 weight lass Fertility canbe achvived é Complications Shor -Term- Trferthlity treatment -Menstrual inregulariti S One line exam answer — Long +erm-T+pe2 DM COS f< the most commsn ~Enclometria) hyperp last -Encometrial coercinome -Carchovascular AL Couse of qnovulatary roferhiyy $n Women Management 4: Lifestyle Mocli fication — Weight reduction -Diet contro) ~Reqular exercise 2-mectical Management °For menstroc! irreguiarity "combined eral contrcice ptive “pill Ceocp) “efor hirsutsm ¢ Acne + ~cocpP == Pb-androgencé combrace shia? —e Per fofertility =-Qvlation induction Letrozgle/ clom iphene) =e For msolin rerictance - Metformin » (9 es rite ate - * a ee ee Definition- Vberine prolapse js 15. Congenital Weakness cle Fined as the downward. _-congenibal weakness of pelvic cisplacement_of the uterus | supeacts — From iks normalanatomica! "4 - pesition into the vaginal cang) 1e Supports Of Uterus clOe +o Weakness of pelvic ‘Failure OF these supports Floor supports. ' beads te prolap aleficiercg sal estfogeo Uterine prolaps€ is often Associated with: — ; d 1 \ | 1 T a] t l } T 1 cystocele -Prokes e.aF bladded - , — vom Date Pelvic Floor exercises intta_vaaging —___+ Ckege}| exercises) _____ \nto vagina Enterocele=her niaton of sma)! intestine. -Elangahon of cervix: Surgical) Management °C )inica) Recrtorey pChoeice depends an Age F Leeprocductive wishes common symptoms jncluce: ' “Feeling of 12: Vagina) hysteectsmy ‘e ~Pelvie heavinasx- H . pelvic Floor repair ~Lows be brache Pe Sacrospinous Fixa har, —DifFico ly In walking 14. Le fort's aperaten Cc for elder - Orinary ¢ 4 pnptones. Laly women motse was —Freguency Lact ye) —Tn comtinence. ~ Cons Haakon | t [ 1, eComplications “Vaginal discharg e_or VUleerat | ~Decobtus vieer —Vrinary retention © Examination Findings -Recvrrent vrinary infechn: jaAswsevere Hy drone phrd.cis Oy pelvic excamnanhon CASTES -~Dexscant of cervix 4 uterus “Associated cystocele or brectocele =congested_or Vicerc ted cervix. in severe cares ¢ Management ConservaHve management* YVsed in mile! cares _or elekr ly _ Pahenks x —-4 GO Breas tft eCCING ae A process by Which a mother! for> TgA Feels her infant & breas- stmilk| = Lacte Ferric 4 From the breach uhich!= by 202gm tS the iclen | 4 Natura) oud r N€whloyn ¢_ jnfonts - |} macro erage. > a Typesof breast milk- t : acuanbages of breastteedis waka} > 1 CoJas trom — rs secregteal curing First 3-5 eer I oewten bs agginst=Diarrhea > Oars, Thick yellowish Fluid. ~ Respiratery iné” rich in protein: ImMonaglahins -Otihis medra TagA> vitamin A gle. = Allergies | act-as the First immunization a : '-Enhances TA4 nevradevelopras Lransitional milk = !_ Recluces risk of-obes thy , Eram st chy to 2 weeks —~cliaketes intermediate camposifagn. : ~srps ceudden jnFfant death syndion i) Mature milk = I For the mother= After 2weeks Provide complete nutriten for |. Drones Uterine ivolot? ipnfont Leto 6 months - I-Recluces’ Post pak tum hemorrks 7 INeatu ral methad of comracephon ma) —@ Composition of breast milk~ CLATIS -@ - water - Sy. ~Reduces risk of -breast cancer @ - Carbohydrates > lactose ~GOvarnjian Comcer.- = mother-chilel AO — Proteins= Whey 2 Casein Cenergy + brain dlevelopmart ~Enkhanges- | han cling - ZT @ -Foks— essential Fotty Gack 2 DHP CRrain + retina! Jeverarsil Initiation of Areest Feecling 2 vitamins 4jninera Ik -acdlegucte t-Shaclc) be started within eoccept vil. Dp. B cm 2 ! 4 hour of birth. | — an Pagano YOUVA ome enon Compliccati ys. During Pre gndecy——= Pregnana ce lertedl_ complications | featuce --SeVvere _somiting —— eccur clue to physiological bor Dal hemackynamic < hangar; in| selec draly te ieabaliace the merernal bady — Cause - urinary stasis due to— _ Hatred oretert — ph catans - pylo nephritis L-Anemia in pregnancy | y Cause -Plasma vai” P mere than RBC mass a oe com Tacreased jron requirement Type =P sislogica) Anemid Tron _cleficiency anemia M hecds -Fatique, recluced O2 supely | -ause-Tncreased bl to fetus, risk of preterm labour. _|wenous compression by wher ir oe oo | Ls 5 + \Edlema_4 _vericcose veins oocl volume tcommon-sites = lego volwva 2» Pregnancy induced! Nypertens ion H Types mestahena) hyeertension \aastre - esophagea! Reflux 4 -Pre-eclapsig loonstipahon Teause- smooth muscle cotiorcit’ ~Eclampsicu Patho phys logy ~Tne reased vascokt by prag esterane - | mecinanical pressure of uterus - resistance, enclathelial ajpstun”: c)inical Fectures - BP 2 190/9omMmHs | Edema, protenuric.: | Preterm labour ' ayske Rac tor — infectHon, Pnemicg, 5-Gmesctationa) diahetes_ me litus. Hypertension | Cause —Tnsulin resistance chet Plecental hormone Cestrogen | Placenta) complications Types = Placenta previa progey te rone S EF fects ~ macrosomia, poly hyolro! Placenta aerushdn -amnios, Birth injory iE FRects -Ante partum hemorhage Feta) distress: 4 Hy pevamnesic Graviclum. cause- High hCG leve} Alterecl meka bolism | | | | di — ae Te ~ ~ - Polyhydramnios. 4 Oligohyclromnias- - IRIs factors ~ obesity _~ Poop Polyhydlramin jos = seen ba Aabeles} _=Faniily histocy of DID i Fetal anomalies t= Adwarncec! materng) Age ig ehyclromnies— Placenta |Asvffi - ciency , TUG IClinical Features Ralyoria ~Polyo isfa . Fatigue 7 “uscolaske letal Problems excessive weight gain - Back pain ~Pelic girclle pair Diagnosis- Oral glucos € tolerance - Pestuoral changer Test, Fasting bleac glucose | — ED «x | lahetes Mellitus in PregnaralMaeral compli cg Hons ‘Prealmpsia -poly hyclraam) ios ef inition-Dighetes mellitus in preg |-Diahetic ketoacidasis Ine ks cconditoan characterizec! y_hyper.ghcemia resulting from Fetal Corn plications | Neonatal) Hype glyce ng efectve JASUNN secretion, insoln | Antenata } t ction Or both cluricgy pregnancy * Macresacnic « angen ta! anamolitRespirciterychis res Ipasok Diabetes -in pregnancy TOG HU Ricth | synclrome Pee gestational Diaheter Type 4 pI ! Management — Diek contro } ype 2 0M |Reguiar blood glacese msn Horr Ores emt before pregnancy l[Tasolin therapy, acercise Gestationa! Drm weight carmtro) diabetes cliagnasccl for the S!time OMING pregnancy Usually, develops in +cimexter 2M Any atd >, . “athophy siology, -Tinsolin fesistance | =Tacdlequate insulin responce =TBlood glucose Jevole q + 1 ' | 1 T | ' 1 ! a ! H ! ! ] ' + ! ' i) 1, i i Ceacarcan Sect t * *Defination - Cex Se, Placental is a. surgical procedure in| Pbrunt uterine rupture ec Jamnpyi which the baby is cleliverad'Feetures - Urgent procedure thraughan_incis ion in the —i=Higher risk compared te | to ' abdominal wallg vterus hes elective Cesarian section vagina) delivery is not i= Lani bed prerarat” time. . i _pPossible or safe _ Post -OP core after as Ty pes _ of cesarean sectan id Dmmedsette pastor? care | 1. Elective cegaregn secton mon Hor vito) signs | 2.Emergent, cesaregn SECHON. inobserve Heeding = pain manager jomaittain Jv Flos d-Elechve cesarean sechoan Ie. Wound! care —— Ai plan ed cesqrean clelivery dei! = = Mob yec Hon -Early Mevlzc” ded before theonsetof Joka! oithin 24 hours: indicetions - Placen me: feeding ~ENncou —Prevjous cesarean secHon tearly breast Feecling ~ePD - Breed presen taton 4 Promotes boncling —Mottiple pregnancy - meterva) |S: Pein management requeat = contracted! pelvis | Areloedes- Advantages —Planed goon} rolled 16: Ph iiotherapy role — lower maternal ¢feral risk "| Breathing eacerc ise Timing=-Osvdlly of 38739 weeler |_ kegel) exercises : 1s of gestahoy Pelvic Floor escercices Postora) carrecHon CGaceclua) abclamina) Strenghhe =Ning na |_| 2-Emerngjemy cesarean sechon cesarean section performed _cluring labour or clue to \ sudden comphcahons threatening Comp)ications- of oS -Trkection . Mother or fe tus. - Hemarrhage-~ LRelayecl recovery, Common indications - Feta! alin! i -Failure to Progress in \hbour 1 a thucted labour ! -f ey. Gecalogical surg SPS ec at the Operahans pPerformedsn the | psec) boc hysterectaa4~——— suck as uterus ovaries,“Fallo-| om qpian thes, cerurs ¢ vaging - € ofer! a ids ° enone og ler 4. Hysterectomy IChertiliby cons er uiig SOrgey)y i Surgical removal of the ute fus | Types~ 14. Oo1pho rectomsy me e Toto) hysterectomy ~ Oteros + —- Removal of one 6.c_both——— i ; : cervie removed eSobtotwC Csopracervicel hystem = Unilectoral oojsharectomy _ =ctomy= Uterus removed ce ruix iBileskerct! coojwhorec tomy — + La icorhons ovarian ton preserved - -Raclical bygterectomy ~ uterus cyst, mna lig mancy Ooper Legina. #sveround z Ss. sal pingscto09y Removal of Fallopian tube eervi => ina tissVes - a) Pon hytenectomy = OFCros” # - AGQhes +evernes remo el Tniclicatans = - - Ectopic pragnaacy | Appreachat =" Abdaminal hysterecta =Tokul ?nfecthos -\ agunal hystereclamy |= Tonnar 1 i ~ Lapro scopic hysterectomy -—--|--4 J le Salpingo = oophorectamy Tadicationc- Fiblraicl uterus” Removal « of fallanian tube + = Ote rine pralapnse lovary together. ) - Abnormal Uterine heeding \ ) -Endometriosts '2. Tubal sigaton =~ Gr pnecological malignancy Permanent Female teri jizqt” 4 proce dure \ ) i f ut