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Rupture Of The Membranes
Rupture of membranes (ROM) or amniorrhexis is a term used during pregnancy to describe a rupture of the amniotic sac. Normally, it occurs spontaneously at full term either during or at the beginning of labor. Rupture of the membranes is known colloquially as "breaking the water" or as one's "water breaking." A premature rupture of membranes (PROM) is a rupture of the amnion that occurs prior to the onset of labor. This typically occurs before the pregnancy's 37 week gestation. In the United States, more than 120,000 pregnancies per year are affected by a premature rupture of membranes, which is the cause of about one third of preterm deliveries. Sometimes, a child is born with no rupture of the amniotic sac (no rupture of membranes). In such cases, the child may still be entirely within the sac once born; such a birth is known as an en-caul birth. Effects When the amniotic sac ruptures, production of prostaglandins increases and the cushioning between the fetus and uterus is dec ...
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Pregnancy
Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occurs by sexual intercourse, but can also occur through assisted reproductive technology procedures. A pregnancy may end in a live birth, a miscarriage, an induced abortion, or a stillbirth. Childbirth typically occurs around 40 weeks from the start of the last menstrual period (LMP), a span known as the gestational age. This is just over nine months. Counting by fertilization age, the length is about 38 weeks. Pregnancy is "the presence of an implanted human embryo or fetus in the uterus"; implantation occurs on average 8–9 days after fertilization. An '' embryo'' is the term for the developing offspring during the first seven weeks following implantation (i.e. ten weeks' gestational age), after which the term ''fetus'' is used until birth. Signs an ...
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Cervix
The cervix or cervix uteri (Latin, 'neck of the uterus') is the lower part of the uterus (womb) in the human female reproductive system. The cervix is usually 2 to 3 cm long (~1 inch) and roughly cylindrical in shape, which changes during pregnancy. The narrow, central cervical canal runs along its entire length, connecting the uterine cavity and the lumen of the vagina. The opening into the uterus is called the internal os, and the opening into the vagina is called the external os. The lower part of the cervix, known as the vaginal portion of the cervix (or ectocervix), bulges into the top of the vagina. The cervix has been documented anatomically since at least the time of Hippocrates, over 2,000 years ago. The cervical canal is a passage through which sperm must travel to fertilize an egg cell after sexual intercourse. Several methods of contraception, including cervical caps and cervical diaphragms, aim to block or prevent the passage of sperm through the cervical ...
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Amniotic Fluid Index
Amniotic fluid index (AFI) is a quantitative estimate of amniotic fluid and an indicator of fetal well-being. It is a separate measurement from the biophysical profile. AFI is the score (expressed in cm) given to the amount of amniotic fluid seen on ultrasonography of a pregnant uterus. To determine the AFI, doctors may use a four-quadrant technique, when the deepest, unobstructed, vertical length of each pocket of fluid is measured in each quadrant and then added up to the others, or the so-called "Single Deepest Pocket" technique. An AFI between 8–18 is considered normal. Median AFI level is approximately 14 from week 20 to week 35, when the amniotic fluid begins to reduce in preparation for birth. An AFI 24–25 is considered as polyhydramnios. Causes of low amniotic fluid There are many things that can cause low AFI, these include: * Leaking or rupture of membranes: Leaking or rupture of membranes may be caused by a gush of fluid or a slow constant trickle of fluid. This ...
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Fern Test
The fern test is a medical laboratory test used in obstetrics and gynecology. The name refers to the detection of a characteristic "fern like" pattern of vaginal secretions when a specimen is allowed to dry on a glass slide and is viewed under a low-power microscope. The fern test is most commonly used to provide evidence of the presence of amniotic fluid and is used in obstetrics to detect preterm premature rupture of membranes and/or the onset of labor. It also may provide indirect evidence of ovulation and fertility, although it does not predict the time of ovulation. Patrick Duff, MD (2016). Preterm premature (prelabor) rupture of membranes. In Vanessa A Barss, MD, FACOG (Ed.), ''uptodate'' Retrieved from http://www.uptodate.com/ Ferning was first described in the field of gynecology in 1945 by Georgios Papanikolaou, inventor of the pap smear, as a test for ovulation during a normal menstrual cycle. Papanicolaou GN. Mucus test. Anat Rec. 1945;91:293. When high levels of estroge ...
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Nitrazine
Nitrazine or phenaphthazine is a pH indicator dye often used in medicine. More sensitive than litmus, nitrazine indicates pH in the range of 4.5 to 7.5. Nitrazine is usually used as the disodium salt. Use *This test is done to ascertain the nature of fluid in the vagina during pregnancy especially when premature rupture of membranes (PROM) is suspect. This test involves putting a drop of fluid obtained from the vagina onto paper strips containing nitrazine dye. The strips change color depending on the pH of the fluid. The strips will turn blue if the pH is greater than 6.0. A blue strip means it's more likely the membranes have ruptured. This test, however, can produce false positives. If blood gets in the sample or if there is an infection present, the pH of the vaginal fluid may be higher than normal. Semen also has a higher pH, so recent vaginal intercourse can produce a false reading. * To perform a fecal pH test for diagnosing intestinal infections or other digestive probl ...
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Labor Induction
Labor induction is the process or treatment that stimulates childbirth and delivery. Inducing (starting) labor can be accomplished with pharmaceutical or non-pharmaceutical methods. In Western countries, it is estimated that one-quarter of pregnant women have their labor medically induced with drug treatment. Inductions are most often performed either with prostaglandin drug treatment alone, or with a combination of prostaglandin and intravenous oxytocin treatment. Medical uses Commonly accepted medical reasons for induction include: * Postterm pregnancy, i.e. if the pregnancy has gone past the end of the 42nd week. * Intrauterine fetal growth restriction (IUGR). * There are health risks to the woman in continuing the pregnancy (e.g. she has pre-eclampsia). * Premature rupture of the membranes (PROM); this is when the membranes have ruptured, but labor does not start within a specific amount of time. * Premature termination of the pregnancy (abortion). * Fetal death in utero and ...
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Obstetrician
Obstetrics is the field of study concentrated on pregnancy, childbirth and the postpartum period. As a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN), which is a surgical field. Main areas Prenatal care Prenatal care is important in screening for various complications of pregnancy. This includes routine office visits with physical exams and routine lab tests along with telehealth care for women with low-risk pregnancies: Image:Ultrasound_image_of_a_fetus.jpg, 3D ultrasound of fetus (about 14 weeks gestational age) Image:Sucking his thumb and waving.jpg, Fetus at 17 weeks Image:3dultrasound 20 weeks.jpg, Fetus at 20 weeks First trimester Routine tests in the first trimester of pregnancy generally include: * Complete blood count * Blood type ** Rh-negative antenatal patients should receive RhoGAM at 28 weeks to prevent Rh disease. * Indirect Coombs test (AGT) to assess risk of hemolytic dis ...
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Midwife
A midwife is a health professional who cares for mothers and newborns around childbirth, a specialization known as midwifery. The education and training for a midwife concentrates extensively on the care of women throughout their lifespan; concentrating on being experts in what is normal and identifying conditions that need further evaluation. In most countries, midwives are recognized as skilled healthcare providers. Midwives are trained to recognize variations from the normal progress of labor and understand how to deal with deviations from normal. They may intervene in high risk situations such as breech births, twin births, and births where the baby is in a posterior position, using non-invasive techniques. For complications related to pregnancy and birth that are beyond the midwife's scope of practice, including surgical and instrumental deliveries, they refer their patients to physicians or surgeons. In many parts of the world, these professions work in tandem to provide ...
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Artificial Rupture Of Membranes
Artificial rupture of membranes (AROM), also known as an amniotomy, is performed by a midwife or obstetrician and was once thought to be an effective means to induce or accelerate labor. The membranes can be ruptured using a specialized tool, such as an amnihook or amnicot, or they may be ruptured by the proceduralist's finger. The different techniques for artificial rupture of membranes have not been extensively compared in the literature. In one study comparing amnihook versus amnicot for artificial rupture of membranes, use of an amnicot was associated with fewer neonatal scalp lacerations. With the amnihook method, a sterile plastic hook is inserted into the vagina and used to puncture the membranes containing the amniotic fluid. With the membranes punctured, amniotic fluid is able to escape from the uterus and exit the vagina. The absence of a fluid buffer between the fetus and uterus stimulates uterine contractions, which are also promoted by the rush of prostaglandins from ...
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Tobacco Smoking
Tobacco smoking is the practice of burning tobacco and ingesting the resulting smoke. The smoke may be inhaled, as is done with cigarettes, or simply released from the mouth, as is generally done with pipes and cigars. The practice is believed to have begun as early as 5000–3000 BC in Mesoamerica and South America. Tobacco was introduced to Eurasia in the late 17th century by European colonists, where it followed common trade routes. The practice encountered criticism from its first import into the Western world onwards but embedded itself in certain strata of a number of societies before becoming widespread upon the introduction of automated cigarette-rolling apparatus. Smoking is the most common method of consuming tobacco, and tobacco is the most common substance smoked. The agricultural product is often mixed with additives and then combusted. The resulting smoke is then inhaled and the active substances absorbed through the alveoli in the lungs or the oral mucosa. Many ...
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Multifetal Pregnancy
Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occurs by sexual intercourse, but can also occur through assisted reproductive technology procedures. A pregnancy may end in a live birth, a miscarriage, an induced abortion, or a stillbirth. Childbirth typically occurs around 40 weeks from the start of the last menstrual period (LMP), a span known as the gestational age. This is just over nine months. Counting by fertilization age, the length is about 38 weeks. Pregnancy is "the presence of an implanted human embryo or fetus in the uterus"; implantation occurs on average 8–9 days after fertilization. An '' embryo'' is the term for the developing offspring during the first seven weeks following implantation (i.e. ten weeks' gestational age), after which the term ''fetus'' is used until birth. Signs an ...
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Polyhydramnios
Polyhydramnios is a medical condition describing an excess of amniotic fluid in the amniotic sac. It is seen in about 1% of pregnancies. It is typically diagnosed when the amniotic fluid index (AFI) is greater than 24 cm. There are two clinical varieties of polyhydramnios: chronic polyhydramnios where excess amniotic fluid accumulates gradually, and acute polyhydramnios where excess amniotic fluid collects rapidly. The opposite to polyhydramnios is oligohydramnios, not enough amniotic fluid. Presentation Associated conditions Fetuses with polyhydramnios are at risk for a number of other problems including cord prolapse, placental abruption, premature birth and perinatal death. At delivery the baby should be checked for congenital abnormalities. Causes In most cases, the exact cause cannot be identified. A single case may have one or more causes, including intrauterine infection (TORCH), rh-isoimmunisation, or chorioangioma of the placenta. In a multiple gestation pregna ...
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