Book of Medical Disorders in Pregnancy - Tintash

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9. Papageorgiou, E.A.; Karagrigoriou, K.; Tsaliki, E.; Velissariou, V.; Carter, N.P.; Patsalis, P.C. (2011). "Fetalspecific DNA methylation ratio permits noninvasive prenatal diagnosis of trisomy 21". Nature Medicine. 10. A New Non-invasive Test for Down Syndrome:Trisomy 21 Diagnosis using Fetal-Specific DNA Methylation". SciGuru.com. Retrieved 8 March 2011. 205
Chapter No: 16 X-Ray Pelvimetry - X-Ray Pelvimetry is a valuable aid in predicting the course of labour by providing assessment of tube pelvic capacity. This can be possible if the procedure is performed by an experienced person who is fully aware of the danger of radiation to the fetus and, the films are interpreted jointly by the obstetrician and the radiologist. Fig16.1: Shows X-ray of pelvis AP views. There is considerable danger of exposing the fetus and the maternal gonads to the hazards of radiation therefore this examination should be done with great reservation and only when absolute indications are present. Certain clinical circumstances can point to the probability of pelvic contraction or potential dystocia. It is only in such cases that the X-Ray pelvimetry should be done. The type of pelvis and measurements of its diameters, the size of the fetal head, its presentation and position can all be determined with this method. This information is very vital for the obstetrician in making decision for a safe vaginal delivery. With this information at hand the physician is forewarned and therefore forearmed to deal with problems arising due to faults in pelvic capacity. He can avoid unnecessary use IMMAGING IN PREGNANCY 206 of oxytocin to correct faults of forces and thus stop trial of labour at proper time. There is no place for routine pelvimetry in modern obstetrical practice. The student must appreciate that; for a full radiological pelvimetry four films are taken i.e. one lateral film in standing position, the supero-inferior view of the brim (Thom's view), the anteroposterior view and the subpubic arch or outlet view. Generally Thom's superoinferior view is not taken in routine pelvimetry, this helps to reduce the amount of radiation. Since the information provided by good radiographs of the pelvis can be of great help in the conduct of a trial of labour or of a trial of forceps, pelvimetry has a definite place in cases where genuine indication is present. It provides opportunity for measurement of various pelvic diameters which can not be determined by other means. Measurement of transverse dia-meter of the inlet and the antero-post-erior Nd interspinous diameters of the mid pelvis and the outlet is very im-portant since it is at these points where the arrest in progress of labour usually occurs and their precise me-asurement can be very helpful in guiding the phy-sician, who is contemplating difficult forceps operation. In any given case the progress of labour can be predicted on the basis of the size and shape of the bony pelvis, the size of the fetal head; the force of the uterine contraction and the presentation and
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MEDICAL DISORDERS IN PREGNANCY M. S
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PREFACE Almost all medical disorder
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Dedication This manuscript is dedic
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Uri. Elkayam MD Professor of Cardio
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Chapter No: 1 Anaemia in pregnancy:
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performance. Tiredness, listlessnes
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pregnancy and labour. The monthly b
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Fig 1.3: Shows developmental stages
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Prophylactic this includes routine
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granulocytes and thrombocyte is als
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or because the hemoglobin A is repl
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iron. Decrease in the number of gra
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Labor/delivery: Expedite for normal
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Risk factors: The risk of GDM incre
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to a large extent on the measure of
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vomiting, or through intercurrent i
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largely related to the problems of
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femoral epiphyses can help in asses
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in a randomized design the efficacy
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of the previous day’s dose of ins
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women with vascular disease are awa
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Chapter No 3 THYROID DISEASE IN PRE
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such as phenobarbitone 30 mg given
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REFERENCES: 1. Hawe, P. and Francis
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Incidence - Its incidence varies ac
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cerning the disturbance in the Reni
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Renal function: In normal pregnant
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severe pre eclampsia and eclampsia
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Epipastic pain: It is also a late s
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arely occurs. However, if pregnancy
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differentiating between chronic hyp
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fetuses. Recent studies indicate th
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to procrastinate all available meth
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cases are said to occur up to 1 wee
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has been carried out. There can be
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intensive care room for the next 48
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Severe pre eclampsia at or remote f
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Chapter No: 5 HEART DISEASE IN PREG
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pregnancy. The increase in volume i
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Fourth Heart sound - This is rarely
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Class III - With cardiac disease pr
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differentiate from hemodynamically
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dominant). Jervell + Lange Nielson
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striking of which is stippling seen
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increase venous pressure and burden
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determine whether she will be safe
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supplemental 02. Fetal surveillance
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11. Percutaneous transluminal angio
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ureter at the pelvic brim may play
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Fig6.3: Shows location of kidney in
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A clear cut history of streptococca
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(a) Polycystic renal disease - Fort
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with patients in this category. In
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2. Beard, R.W.and Roberts, A.P. (19
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increases slightly. Arterial blood
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scan, 0.004 Gy; pulmonary angiograp
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CD4 + cell count (200/ml) should re
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embark upon a pregnancy. Severe air
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Chapter No: 8 LIVER DISEASE IN PREG
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owel, but conjugated bilirubin is n
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Hepatic causes - Viral hepatitis bo
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Immunoprophylaxis at birth followed
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highest reported rate of vertical t
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curs in 60 to 70 percent of subsequ
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Chronic liver disease: An increased
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22. Riely CA. Hepatic disease in pr
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ilirubin is transported across the
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when the titre is greater than 1: 3
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Induction of labour: When screening
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Blood brain barrier and bilirubin e
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place if the infant develops jaundi
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REFERENCES 1. UpToDate a. “Pathog
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of embolus formation is far less in
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Unfortunately this faculty is not a
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hours. The maximal effect takes 36
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may complain of constricting type o
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When the embolus is small and non f
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3. Sukal S, Geronemus R. "Deep Veno
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damage specific cells in the tissue
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is capable of breaking off and deve
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Chapter No: 12 PARASITIC INFECTIONS
Page 164 and 165: sporozoite stage. The main characte
Page 166 and 167: insect repellents and insecticide s
Page 168 and 169: is 2 tablets i.e. (400 mgs) thrice
Page 170 and 171: Cardiac failure resulting from seve
Page 172 and 173: dysmenorrhea, dysuria, and even obs
Page 174 and 175: Chapter No: 13 VIRAL DISEASES IN PR
Page 176 and 177: after exposure favors but does not
Page 178 and 179: Fig13.4: shows CMV infection rash o
Page 180 and 181: three quarters of HYH strains isola
Page 182 and 183: where 'T' stands for toxoplasmosis
Page 184 and 185: Chapter No: 14 Introduction: The dr
Page 186 and 187: hexacyanoferrate (II) 2H2O (Prussia
Page 188 and 189: Restricted indications: Anti lepros
Page 190 and 191: potential Teratogen and inhibits ma
Page 192 and 193: placental abruption, and intrauteri
Page 194 and 195: Inhalation of volatile organic comp
Page 196 and 197: Chapter No: 15 Pregnancy is a norma
Page 198 and 199: time periods during the pregnancy f
Page 200 and 201: y the maternal kidney in urine or b
Page 202 and 203: continues after the end of the uter
Page 204 and 205: Amniography - In this technique rad
Page 206 and 207: at the cranial end of the neural tu
Page 208 and 209: least maceration: placenta, lung, a
Page 210 and 211: fetal hydrops with monosomy X, or T
Page 212 and 213: cause progressive renal failure as
Page 216 and 217: position of the head. The student s
Page 218 and 219: centimeter ruler is placed alongsid
Page 220 and 221: echoes in B mode. The operator appl
Page 222 and 223: also affects depth resolution and t
Page 224 and 225: From twelve week onwards the bipari
Page 226 and 227: tract. Normal kidneys can easily be
Page 228 and 229: 3.19, 1.29 and 1.30, respectively [
Page 230 and 231: iodinated contrast during pregnancy
Page 232 and 233: Only tiny amounts of iodinated or g
Page 234 and 235: intraperitoneal hemorrhage, or inju
Page 236 and 237: REFERENCE: 1. Stewart A, Webb J, Gi
Page 238 and 239: cardiac defects 181, 200 cardiac di
Page 240 and 241: gestational age 26, 31, 40, 165, 19
Page 242 and 243: monitoring, invasive 83-6 monosomy
Page 244 and 245: sensitization 124-5 sepsis 22, 95-6
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