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19:32, 26 July 2023 Nikolas talk contribs created page B19. Multifetal gestation, twin delivery (Created page with "Multiple pregnancy (or multifoetal gestation) refers to pregnancy where there’s more than one foetus. Twin pregnancies account for 1 – 2% of all pregnancies, but triplets and quadruplets are very rare. Multiple pregnancy is a risk factor for virtually all obstetric complications. As such, they require close monitoring and follow-up. The incidence of multiple pregnancy has been rising slightly since the 1970s due to increased use of IVF and increasing maternal age....") Tag: Visual edit
19:32, 26 July 2023 Nikolas talk contribs created page B18. Diabetes and pregnancy (screening and management) (Created page with "Gestational diabetes mellitus (GDM) refers to the development of new-onset diabetes in pregnancy. It usually develops in the second or third trimester. Pregestational diabetes refers to pregnancies in women who already had diabetes mellitus prior to the pregnancy, most frequently type 2. Diabetes mellitus in the pregnancy, whether pregestational or gestational, increases the risk for complications in both the mother and the foetus. Both are relatively common conditions...") Tag: Visual edit
19:31, 26 July 2023 Nikolas talk contribs created page B17. Pregnancy induced hypertension and preeclampsia (Created page with "Hypertensive disorders of pregnancy are disorders characterised by hypertension in pregnancy, more specifically the second half of pregnancy. The most important are preeclampsia and eclampsia, which may cause severe morbidity and mortality for both the mother and foetus, and so screening, prevention, and treatment of these disorders is important. These disorders can progress to become serious and life-threatening over hours or days. In most cases they resolve within hour...") Tag: Visual edit
19:28, 26 July 2023 Nikolas talk contribs created page B16. The mechanism and the prevention of Rh-isoimmunisation, erythroblastosis fetalis (Created page with "Haemolytic disease of the newborn (previously called erythroblastosis foetalis) is a condition where haemolysis occurs due to incompatibility between the mother’s and foetus’ RBC antigens. In most cases, we talk about rhesus (Rh) incompatibility. ABO incompatibility can also occur but causes only mild disease. Kell incompatibility may also occur. Haemolysis may cause neonatal anaemia or jaundice. In the most severe case (and only in case of Rh incompatibility, not A...") Tag: Visual edit
19:25, 26 July 2023 Nikolas talk contribs created page B15. Intrauterine growth restriction (IUGR) (Created page with "Intrauterine growth restriction (IUGR) or foetal growth restriction (FGR) is a pathological state where the foetus does not achieve its intrauterine growth potential. In other words, the foetus does not grow as much as they would if all factors were optimal. In most cases, IUGR causes a foetus which is small for gestational age (SGA)''. Small for gestational age is defined as an estimated foetal weight which is less than the 10th percentile for that gestational age and g...") Tag: Visual edit
19:23, 26 July 2023 Nikolas talk contribs created page B14. Diagnosis and pathomechanism of hydramnios and oligohydramnios (Created page with "''By “hydramnios” the topic name refers to polyhydramnios.'' == Amniotic fluid == The amniotic fluid is a clear, yellowish fluid which is present in the amnionic sac after day 12. It has multiple functions, i.e., to cushion the foetus, to facilitate the exchange of nutrients and water between the mother and foetus, to maintain temperature, to assist development of lung, <abbr>GI</abbr> system, musculoskeletal system, etc. It’s formed from maternal plasma and foeta...") Tag: Visual edit
19:21, 26 July 2023 Nikolas talk contribs created page B13. Legal regulation of pregnancy interruption, methods and complications (Created page with "== Legal stuff == Pregnancy may be terminated at the woman’s will, although the exact terms for who this is possible for and when this can occur varies wildly from country to country. In Hungary, a pregnancy can be terminated up to the 12th week for any reason. However, the woman must go to a “Family Planning” committee to get permission for the abortion. She must bring a letter from an obstetrician which confirms the pregnancy. She must attend the committee twice...") Tag: Visual edit
19:20, 26 July 2023 Nikolas talk contribs created page B12. Resuscitation of the neonate, the Apgar-score (Created page with "== Apgar score == The Apgar score is a scoring system used to quantify the neonate’s condition at birth. More specifically, it provides information on the toleration of labour and adaptation to life outside the uterus. It’s named after obstetrician Virginia Apgar, who managed to come up with a scoring system which is not only named after herself but is also an acronym for the scored parameters. Each parameter gives a score of 0, 1, or 2. The scores are added to give...") Tag: Visual edit
19:15, 26 July 2023 Nikolas talk contribs created page B11. Obstetrical analgesia and anaesthesia (Created page with "Labour pain has both visceral and somatic components. Visceral pain occurs in both the first and second stages of labour and is due to dilation and ischaemia. Segments T10 – L1 are involved. Somatic pain occurs in the late first stage and second stage and is due to stretching of the vagina, pelvic floor, and ligaments. Segments S2 – S4 are involved. As such, neuraxial analgesia must block T10 to L1 for the first stage of labour, but if the aim is to give analgesia f...") Tag: Visual edit
19:14, 26 July 2023 Nikolas talk contribs created page B10. Disturbances of the feto-maternal gas transport during labor (Created page with "Perinatal asphyxia refers to the condition in which foetal gas exchange is abnormal antepartum, intrapartum, or postpartum, which leads to the neonate’s brain and other organs being deprived of oxygen. It’s characterised by progressive hypoxaemia, hypercarbia, and lactic acidosis. Unless reversed, perinatal asphyxia will cause irreversible CNS damage and other organ damage, or even death. The main complication of perinatal asphyxia is ''hypoxic-ischaemic encephalopa...") Tag: Visual edit
19:12, 26 July 2023 Nikolas talk contribs created page B9. Fetal monitoring during labor (CTG, fetal blood gas analysis) (Created page with "== CTG during labour == ''CTG was already described in topic B5, and this topic assumes you know the basics from there.'' === Introduction === CTG is often used during labour for intrapartum monitoring to monitor for interrupted foetal oxygenation. Intrapartum CTG has a low specificity but high sensitivity, and so is more suited as a screening tool for interrupted foetal oxygenation. During normal labour, uterine contractions cause transient interruptions of the foetal...") Tag: Visual edit
19:11, 26 July 2023 Nikolas talk contribs created page File:Intrapartum CTG classification.jpg
19:11, 26 July 2023 Nikolas talk contribs uploaded File:Intrapartum CTG classification.jpg
19:10, 26 July 2023 Nikolas talk contribs created page B8. Prenatal diagnostics II. (non-invasive methods) (Created page with "Non-invasive prenatal diagnostics are the first-line investigations for screening for foetal genetic disorders. Multiple non-invasive methods exist: * Ultrasound * Cell-free DNA * Combined tests * Biophysical profile In general, it’s recommended that all women should be offered prenatal diagnostics should they wish. However, the conditions for which the diagnostics are paid for by the state differ from country to country. In general, women with a higher risk for foet...") Tag: Visual edit
19:09, 26 July 2023 Nikolas talk contribs created page B7. Prenatal diagnostics I. (invasive methods) (Created page with "Prenatal diagnostics are techniques which can be used to detect genetic disorders or birth defects in the foetus. There are three purposes of these: * To prepare necessary medical or surgical treatments soon after birth, or even intrapartum * To give the parents the chance to abort a foetus with the diagnosed condition * To give the parents the chance to prepare for a baby with a certain condition We distinguish invasive and non-invasive methods. The invasive methods a...") Tag: Visual edit
19:07, 26 July 2023 Nikolas talk contribs created page B6. Infectious diseases during pregnancy (hepatitis, HIV, toxoplasmosis, syphilis, Group B Streptococcus) (Created page with "''There was never a lecture on this and so much of this topic is based on Norwegian sources and UpToDate.'' == Group B streptococcus == Group B streptococci (GBS), technically ''streptococcus agalactiae'', is a bacteria found in normal flora (<abbr>GI</abbr> tract, vagina) but is the most common cause of neonatal infection. 10 – 35% of pregnant women are colonised with GBS, and colonised women can transmit the bacterium to offspring. GBS bacteriuria is a sign of signi...") Tag: Visual edit
19:05, 26 July 2023 Nikolas talk contribs created page B5. Non-stress test and stress test (+ CTG basics) (Created page with "The non-stress test (NST) and contraction stress test (CST) are two tests which use cardiotocography (CTG) to measure how the foetal heart rate (FHR) changes in response to foetal movements and oxytocin-induced uterine contractions, respectively. The cardiotocograph is a diagnostic tool which records both the foetal heart rate and the uterine contractions with the help of two electrodes placed on the mother’s abdomen. It gives information of the foetal wellbeing. One...") Tag: Visual edit
19:04, 26 July 2023 Nikolas talk contribs created page File:CTG without FHR variability.jpg
19:04, 26 July 2023 Nikolas talk contribs uploaded File:CTG without FHR variability.jpg
19:03, 26 July 2023 Nikolas talk contribs created page File:Variations in CTG.png
19:03, 26 July 2023 Nikolas talk contribs uploaded File:Variations in CTG.png
19:02, 26 July 2023 Nikolas talk contribs created page File:Normal CTG.png
19:02, 26 July 2023 Nikolas talk contribs uploaded File:Normal CTG.png
19:01, 26 July 2023 Nikolas talk contribs created page B4. Fetal lie. Assessing fetal lie (Created page with "Foetal lie refers to how the foetus lies in the uterine cavity, specifically how the foetus’ long axis is compared to the mother’s long axis. Foetal lie may be: * Longitudinal – foetus’ long axis is parallel with the mother’s ** Can be either cephalic (physiological) or breech presentation * Transversal – foetus’ long axis is perpendicular to the mother’s * Oblique – foetus’ long axis is oblique compared to the mother’s Transverse lie and breech p...") Tag: Visual edit
19:00, 26 July 2023 Nikolas talk contribs created page B3. Placenta accreta, increta and percreta (Created page with "The placenta accreta spectrum (PAS) disorders, also called abnormally invasive placenta (AIP) or placentation abnormalities, are a group of disorders where the placenta invades deeper into the uterine wall than normal. The three disorders are: * Placenta accreta – (80%) – the placenta extends to the myometrium and attaches to it * Placenta increta – (15%) – the placenta invades through the entire thickness of the myometrium * Placenta percreta – (5%) – the p...") Tag: Visual edit
18:59, 26 July 2023 Nikolas talk contribs created page B2. Conception, implantation (Created page with "Fertilisation (conception) is the process during which a sperm cell fuses with the oocyte. This occurs within 1 day of ovulation, usually in the ampullary region of the fallopian tube. Before sperm cells can fuse with the oocyte, they must undergo two processes, capacitation and the acrosome reaction. After these reactions, the sperm cell has fused with the oocyte, forming a zygote, a diploid cell with 46 chromosomes. At this point, the oocyte completes meiosis II. The...") Tag: Visual edit
18:59, 26 July 2023 Nikolas talk contribs created page B1. Diagnosing pregnancy (Created page with "== Signs suspicious for pregnancy (presumptive signs) == These signs are not proof of pregnancy but may make a woman suspicious that she is pregnant. * Nausea, morning vomiting * Affection to unusual things (like food, ice, etc, or reverse feeling for things she liked earlier) * Breast enlargement and tenderness == Probable (“warning”) signs of pregnancy == These signs are also not proof of pregnancy but are more specific to it than the presumptive signs. * Change...") Tag: Visual edit
18:57, 26 July 2023 Nikolas talk contribs created page A15. Puerperal fever and sepsis (Created page with "Puerperal fever (postpartum fever or childbed fever) refers to fever which occurs within the first 10 days postpartum. In most cases, fever is due to endometritis, but it can also be due to other causes. It’s most commonly seen after C-section but may occur following vaginal birth as well. Most cases are mild and resolve quickly with antibiotics. Fever in the first day is especially common and often resolves spontaneously. However, some cases are severe and may cause...") Tag: Visual edit
18:56, 26 July 2023 Nikolas talk contribs created page A14. DIC, HELLP, amniotic fluid embolism (Created page with "== Amniotic fluid embolism == Amniotic fluid embolism (AFE) refers to the entry of amniotic fluid (which contains foetal cells or hair) into the maternal circulation, which then embolise. It causes a systemic inflammatory response syndrome (SIRS)-like syndrome and is an obstetrical emergency which is often lethal. It occurs during labour or within 30 minutes postpartum. Thankfully, it is rare (1 – 10 per 100 000 deliveries). === Etiology === Risk factors for AFE are n...") Tag: Visual edit
18:55, 26 July 2023 Nikolas talk contribs created page A13. Uterine rupture (Created page with "Rupture of the uterus is a life-threatening complication for both the mother and the foetus. It mostly occurs during labour, and mostly in people who’ve had a previous C-section (vaginal birth after C-section, VBAC). However, it can also occur antepartum and in women without previous surgery. It’s an obstetric emergency which requires emergency surgery. In a uterine rupture the uterus opens into the abdominal cavity. In case of uterine dehiscence, a related conditio...") Tag: Visual edit
18:54, 26 July 2023 Nikolas talk contribs created page A12. Uterine atony (Created page with "In normal conditions, the uterus contracts after delivery. A high uterine muscle tone is essential for compressing vessels postpartum, preventing haemorrhage. Uterine atony refers to when the uterine muscle tone is absent. It’s the most common cause of postpartum haemorrhage. If uncontrolled, it can lead to haemorrhagic shock. == Etiology == * Overdistension (macrosomia, polyhydramnios, multiple pregnancy) * Exhausted myometrium (long labour, excessive use of uterot...") Tag: Visual edit
18:53, 26 July 2023 Nikolas talk contribs created page A11. Maternal obstetrical injuries (Created page with "Multiple injuries may befall the mother during labour. The most common maternal obstetrical injuries include perineal ruptures, labial and vaginal lacerations, cervical injury, genital haematoma, nerve injuries, and uterine rupture (covered in topic A13). == Perineal rupture == === Definition === During vaginal birth, the perineum may rupture, which constitutes the most common form of maternal obstetric injury. Most nulliparous women sustain a perineal injury during va...") Tag: Visual edit
18:52, 26 July 2023 Nikolas talk contribs created page A10. Placenta praevia (Created page with "Placenta praevia refers to the situation when the placenta partially or completely covers the internal os of the cervix. This makes vaginal birth impossible and increases the risk for preterm delivery and severe postpartum haemorrhage. Also related are the marginal and low-lying placentas. Placenta praevia is associated with the placenta accreta spectrum disorders (accreta, increta, percreta). == Etiology == The cause of placenta praevia is unknown. Some risk factors i...") Tag: Visual edit
18:51, 26 July 2023 Nikolas talk contribs created page A9. Placental abruption. Pathomechanism, diagnosis, differential-diagnosis (Created page with "Placental abruption refers to when the placenta separates from the uterus prematurely, sometime before the second stage of labour, but typically sometime in the second half of pregnancy. This leads to a retroplacental bleeding which may range from small and asymptomatic to severe and life-threatening. It is one of the life-threatening causes of vaginal bleeding in this half of the pregnancy, and so recognising it early is important. Abruption may be partial or complete....") Tag: Visual edit
18:50, 26 July 2023 Nikolas talk contribs created page A8. Signs and differential diagnosis of pending uterine rupture and placental abruption (Created page with "''You should read topics A9 and A13 before this.'' == Vaginal bleeding in the second half of pregnancy == === Definition === There are many possible causes of vaginal bleeding in the second half of the pregnancy. Some are life-threatening and some aren’t. In either case, it’s important to identify the cause of bleeding and treat it if possible. As the topic name suggests, we’ll focus on signs and differential diagnosis of pending uterine rupture and placental ab...") Tag: Visual edit
18:49, 26 July 2023 Nikolas talk contribs created page A7. Prolapse of umbilical cord and fetal limb (Created page with "== Umbilical cord prolapse == === Definition and epidemiology === Umbilical cord prolapse refers to when the umbilical cord prolapses before or alongside the foetus during labour, causing both to be present simultaneously in the pelvis. This is problematic because the cord will be compressed during delivery, which deprives the foetus of oxygen and nutrients, causing asphyxia. Luckily, it’s rare. === Etiology === Umbilical cord prolapse is often seen in presentation a...") Tag: Visual edit
18:49, 26 July 2023 Nikolas talk contribs created page A6. Premature rupture of membranes (Created page with "Prelabour rupture of membrane (PROM) refers to rupture of the membranes before labour begins, but after 37 weeks of gestation. If it occurs before 37 weeks of gestation, it’s called preterm prelabour rupture of membranes (PPROM). As the membranes protect against infection, early membrane rupture predisposes to intrauterine infection. They main issue with PROM is whether to wait for spontaneous labour to begin or to induce labour. Almost all patients with PROM will go...") Tag: Visual edit
18:47, 26 July 2023 Nikolas talk contribs created page A5. Operative vaginal delivery. forceps and vacuum-extraction (Created page with "Operative delivery (or assisted vaginal delivery) refers to using special tools to assist vaginal birth, either forceps or vacuum extraction. It’s only performed during the second stage of labour. These tools allow the operator to apply both pulling forces and, in case of forceps extraction, rotation forces as well. Like C-section, operative delivery carries some risk to the mother and foetus and so is only used when the risk of not performing it outweighs the risk of...") Tag: Visual edit
18:47, 26 July 2023 Nikolas talk contribs created page A4. Forms of cesarean delivery, indications (Created page with "Caesarean section (from Latin, ''caesura'' = to cut) is a surgical procedure where the foetus is delivered by open surgery, through an incision in the abdominal wall and uterus. Often called simply C-section, this procedure has no absolute contraindications and can therefore in theory be performed on anyone. This makes C-section the ideal “plan B” in case vaginal labour is too risky, not progressing properly, or frankly impossible. However, C-section is generally onl...") Tag: Visual edit
18:46, 26 July 2023 Nikolas talk contribs created page A3. Classification of abortions, etiology, therapy options (Created page with "An abortion is the termination of a pregnancy before a life birth is possible (< 24th week of gestation). We distinguish spontaneous (uninduced) and induced abortions. Some use the term “abortion” to refer to induced abortions only, while leaving the term “miscarriage” for spontaneous abortion. Transvaginal ultrasound is essential in evaluating these conditions, as the foetus is too small to be visualised with transabdominal ultrasound. == Spontaneous abortion...") Tag: Visual edit
18:45, 26 July 2023 Nikolas talk contribs created page A2. Lactation, mastitis (Created page with "== Lactation == === Introduction === Lactation is the process of secreting milk from the breast to feed the infant. The synthesis of breast milk is induced by prolactin and ejecting of milk is induced by oxytocin. Ideally, the infant should be exclusively breastfed in the first 6 months, followed by partial breastfeeding and partial vegetables and fruits from month 6 onwards. Breast milk contains enough energy and nutrients for the infant for the first 6 months, but af...") Tag: Visual edit
18:44, 26 July 2023 Nikolas talk contribs created page A1. Stages of labour (Created page with "Labour (childbirth) is the last phase of pregnancy, which ends with the foetus, placenta, and foetal membranes being expulsed through the vaginal canal or by Caesarean section. In most cases they begin spontaneously, but in some cases, labour must be induced (topic B23). Although it’s sometimes called childbirth, labour doesn’t end when the foetus is out of the birth canal; there are two more stages after this. ''Normal labour'' (partus normalis) refers to childbirt...") Tag: Visual edit
18:43, 26 July 2023 Nikolas talk contribs created page A0. Good-to-know gynaecology stuff which isn’t covered in other topics (Created page with "''This topic includes some stuff which I think is important to know, but which don’t fit under any specific topic. I will add to this topic as I go about writing the other topics.'' == Obstetric notation == During obstetric history taking, it’s important to ask the number of pregnancies and deliveries thus far, as well as the mode of delivery. Not all pregnancies end in a delivery, and so the two numbers are often different and summarised in a short-hand notation. T...") Tag: Visual edit
18:41, 26 July 2023 Nikolas talk contribs created page Category:Obstetrics and gynaecology 1 (Created page with "Category:5th year") Tag: Visual edit
18:40, 26 July 2023 Nikolas talk contribs created page Category:5th year (Created page with "Category:Pages by POTE course") Tag: Visual edit
14:30, 25 July 2023 Nikolas talk contribs created page Future perspectives of pharmacology (no longer a topic) (Created page with "According to prof. Erika Pintér this is not part of the curriculum for pharma 3 exam this semester (2019 fall semester). She was surprised that it is on the topic list, and she said that it shouldn’t be on it. If you are interested, here are some of the things she talked about in the lecture: ==== Advanced therapy medicinal products ==== * Gene therapy ** SiRNA *** Patisiran – silences amyloid gene, treatment of a rare type of amyloidosis ** MiRNA * Cell therapy...") Tag: Visual edit
14:29, 25 July 2023 Nikolas talk contribs created page 86. Drug intoxications. Mechanisms, symptoms, treatment (Created page with "''According to the lecturer the most important drugs to know here are sedative hypnotics, opioids, digitalis, sympathomimetics, anticholinergics, iron and paracetamol.'' == Types of intoxications according to mechanism of death == * Intoxication with decreased level of consciousness ** Sedative hypnotics ** Tricyclic antidepressants ** Antipsychotics ** Opioids * Intoxication with excitatory drugs ** Sympathomimetics ** Ketamine and PCP ** Anticholinergics ** Theophyll...") Tag: Visual edit
14:25, 25 July 2023 Nikolas talk contribs created page 85. The treatment of the intoxicated patient: decontamination, facilitation of toxicant elimination, antidote administration, supportive treatment (Created page with "''According to the lecturer the most important parts of this topic are the fascilitation of elimination and the antidotes''. The most important mechanisms intoxications can cause morbidity and death are: * Respiratory failure * Circulatory failure * Systemic hypoxia * Seizures * Other organ damage ** Liver ** Lung === Poisoning-related respiratory failure === This is usually due to overdose by CNS depressant drugs, like opioids, sedative hypnotics, ethanol, tricyclic...") Tag: Visual edit
14:19, 25 July 2023 Nikolas talk contribs created page 84. Drug interactions (Created page with "We can categorize drug interactions based on the magnitude of the combined effect. When two drugs interact, the result can be: * Additive – the combined effect is higher that either of the individual effects but not higher than the sum of the two individual effects * Potentiated/synergic – the combined effect is higher than the sum of the two individual effects * Antagonized – the combined effect is smaller than that of one of the individual effects We can also c...") Tag: Visual edit
14:14, 25 July 2023 Nikolas talk contribs created page 83. Harmful effects of drugs (Created page with "Drugs rarely have their intended therapeutic effect without causing some harmful effects too, most often mild effects but sometimes severe. What are the “side effects” of a drug? Can what qualifies as side effects of a drug change? The truth is that we decide which effects a drug has are its “main” effects and which are its “side” effects. When minoxidil was used as an antihypertensive the increased hair growth was called a side effect. Nowadays minoxidil is...") Tag: Visual edit