Third Complications of labor

All women who deliver are at risk of complications in third stage of labor.These complications include
Post partum Hemorrahege
Retention of placenta (Retained placenta)
Inversion of uterus
Plumonary embolism
Obsteric shock
Injurier of birth canal
   
Retained placenta
Management
1) Fundal pressure
2) Controll word traction
3)Manual remove of placenta under Genearl Anesthesia
1) Fundal pressure
After seperation of placenta
Pressure=Dounword and backward pressure on funda part and pull out the umblical word
2) Controll card traction
 placenta separate
Pressure on symphysis punia upword and backward
Pull out with umblical word
3) Manual remove of placenta under general anesthesia
Placent not seperat
Female=General Anesthesia (Thiopentel sodiyam 4 to 5 mg/kg)
Wear the gloves and insert hand in cone shape manner
And reach hoti placenta margin
Slicing movement of finger
Placenta seperate
Pull out the umblical word
Methargin0.2mg or Ergometrin 0.5mg 
And than pull out the hand

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Anatomy and physiology of Vagina to prevent infection

चित्र
In adult female ,vagina is lined by stratified squamous epithelium.In newborn female,it is lined by transitional epithelium.squamous epithelium is resistant to gonococcal infection.Thus , gonococal vaginitis cannot occur in adult female. Vagina has local inhabitant bacteria called Doderlein's bacillus Which breaks down the glycogen present in vaginal epithelium into lactic acid resulting in acidic pH(4-5.5, average 4.5) of vagina.The acidic pH of vagina acts as a barrier for external organism and protect from infection. Physiological vaginal discharge..... Clear, white and flocculent odourless discharge. Smear contains epithelial cells, lactobacillus pH ranges from 3.8 to 4.2 pH increase with increased oestrogen States:in pregnancy,OCP,mid-cycle,PCOS or premenarchal If pH increase in primenopausal woman, investigation for other effects of excess oestrogen. This area is subject to both primary and secondary infection.Ascending infection can occur from the vagina and c
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Antepartum Heamorrhage APH

चित्र
Antepartum haemorrhage APH APH is usually define as bleeding form the birth canal after the 24 to 28 weeks of  pregnancy.It can occur at any time until the second stage of lobour is complete; bleeding following the birth of the baby is postpartum haemorrhage=Miscarriage Or  Any ammount of bleeding from genital tract after 28 weeks to before of bleeding 28wk ..... Delivery time....6wk APH_________IPH_________PPH ETIOLOGY  --- Idiopathic/unknown 2types    1) Placenta previa (pp) 2) Abrupto previa (AP) Placenta previa=in lower uterin segement Implantation posterior wall of bady of uterus near the fundus Abrupto precisa=premature separation of placenta Most common risk of APH Dropping down theory= Drop down in lower uterine segments Implantation Due to less endometrial reactions Increase that cilliary active of fallopian tube A)Types of placenta previa 1)Types 1 (PP)  low lying place
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