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Uterine Atony
Uterine atony is the failure of the uterus to contract adequately following delivery. Contraction of the uterine muscles during labor compresses the blood vessels and slows flow, which helps prevent hemorrhage and facilitates coagulation. Therefore, a lack of uterine muscle contraction can lead to an acute hemorrhage, as the vasculature is not being sufficiently compressed. Text was copied from this source, which is available under Creative Commons Attribution 4.0 International License Uterine atony is the most common cause of postpartum hemorrhage, which is an emergency and potential cause of fatality. Across the globe, postpartum hemorrhage is among the top five causes of maternal death. Recognition of the warning signs of uterine atony in the setting of extensive postpartum bleeding should initiate interventions aimed at regaining stable uterine contraction. Risk factors There are many risk factors for uterine atony and several are due to the type of labor a mother experience ...
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Obstetrics
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 hem ...
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Chorioamnionitis
Chorioamnionitis, also known as amnionitis and intra-amniotic infection (IAI), is inflammation of the fetal membranes (amnion and chorion), usually due to bacterial infection. In 2015, a National Institute of Child Health and Human Development Workshop expert panel recommended use of the term "triple I" to address the heterogeneity of this disorder. The term triple I refers to intrauterine infection or inflammation or both and is defined by strict diagnostic criteria, but this terminology has not been commonly adopted although the criteria are used. Chorioamnionitis results from an infection caused by bacteria ascending from the vagina into the uterus and is associated with premature or prolonged labor. It triggers an inflammatory response to release various inflammatory signaling molecules, leading to increased prostaglandin and metalloproteinase release. These substances promote uterine contractions and cervical ripening, causations of premature birth. The risk of developing ch ...
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Spiral Artery
Spiral arteries are small arteries which temporarily supply blood to the endometrium of the uterus during the luteal phase of the menstrual cycle. In histology, identifying the presence of these arteries is one of the most useful techniques in identifying the phase of the cycle. The spiral arteries are converted for uteroplacental blood flow during pregnancy, involving: * Loss of smooth muscle and elastic lamina from the vessel wall. * 5-10 fold dilation at the mouth of the vessel. Failure of the physiological conversion of the spiral arteries can cause a number of complications, including intrauterine growth restriction and pre-eclampsia Pre-eclampsia is a multi-system disorder specific to pregnancy, characterized by the new onset of hypertension, high blood pressure and often a significant amount of proteinuria, protein in the urine or by the new onset of high blood pressure a .... References Arteries of the abdomen articles {{circulatory-stub ...
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Oxytocin
Oxytocin is a peptide hormone and neuropeptide normally produced in the hypothalamus and released by the posterior pituitary. Present in animals since early stages of evolution, in humans it plays roles in behavior that include Human bonding, social bonding, love, reproduction, childbirth, and the Postpartum period, period after childbirth. Oxytocin is released into the bloodstream as a hormone in response to Human sexual activity, sexual activity and during childbirth. It is also available in Oxytocin (medication), pharmaceutical form. In either form, oxytocin stimulates uterine contractions to speed up the process of childbirth. In its natural form, it also plays a role in maternal bonding and lactation, milk production. Production and secretion of oxytocin is controlled by a positive feedback mechanism, where its initial release stimulates production and release of further oxytocin. For example, when oxytocin is released during a contraction of the uterus at the start of c ...
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TNF Inhibitor
Tumor necrosis factor (TNF), formerly known as TNF-α, is a chemical messenger produced by the immune system that induces inflammation. TNF is produced primarily by activated macrophages, and induces inflammation by binding to its receptors on other cells. It is a member of the tumor necrosis factor superfamily, a family of transmembrane proteins that are cytokines, chemical messengers of the immune system. Excessive production of TNF plays a critical role in several inflammatory diseases, and TNF-blocking drugs are often employed to treat these diseases. TNF is produced primarily by macrophages but is also produced in several other cell types, such as T cells, B cells, dendritic cells, and mast cells. It is produced rapidly in response to pathogens, cytokines, and environmental stressors. TNF is initially produced as a type II transmembrane protein (tmTNF), which is then cleaved by TNF alpha converting enzyme (TACE) into a soluble form (sTNF) and secreted from the cell. Th ...
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Hemostasis
In biology, hemostasis or haemostasis is a process to prevent and stop bleeding, meaning to keep blood within a damaged blood vessel (the opposite of hemostasis is hemorrhage). It is the first stage of wound healing. Hemostasis involves three major steps: * vasoconstriction * temporary blockage of a hole in a damaged blood vessel by a platelet plug * blood coagulation (formation of fibrin clots) Coagulation, the changing of blood from a liquid to a gel which forms the fibrin clots, is essential to hemostasis. Intact blood vessels moderate blood's tendency to form clots. The endothelial cells of intact vessels prevent blood clotting with a heparin-like molecule and thrombomodulin, and prevent platelet aggregation with nitric oxide and prostacyclin. When endothelium of a blood vessel is damaged, the endothelial cells stop secretion of coagulation and aggregation inhibitors and instead secrete von Willebrand factor, which initiates the maintenance of hemostasis after in ...
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Myometrium
The myometrium is the middle layer of the uterine wall, consisting mainly of uterine smooth muscle cells (also called uterine myocytes) but also of supporting stromal and vascular tissue. Its main function is to induce uterine contractions. Structure The myometrium is located between the endometrium (the inner layer of the uterine wall) and the serosa or perimetrium (the outer uterine layer). The myometrium can be divided into three layers: * The inner one-third thickness is termed the ''junctional'' or ''sub-endometrial'' layer. In most mammals it is characterized by fibers oriented in a circular way. Humans, having a single uterus form the fusion of two Müllerian ducts, have the fibers forming two cones. Mice have an unfused uterus, so the arrangement is simply circular. * The middle layer occurs in both mice and humans. In mice it is a hard-to-spot mesh-like structure that probably helps coordinate the forces from the inner and outer layers. In humans there is also a mesh-li ...
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Disseminated Intravascular Coagulation
Disseminated intravascular coagulation (DIC) is a condition in which blood clots form throughout the body, blocking Microvessel, small blood vessels. Symptoms may include chest pain, shortness of breath, leg pain, problems speaking, or problems moving parts of the body. As clotting factors and platelets are used up, bleeding may occur. This may include hematuria, blood in the urine, GI bleed, blood in the stool, or bleeding into the skin. Complications may include organ failure. Relatively common causes include sepsis, surgery, major trauma, cancer, and complications of pregnancy. Less common causes include snake bites, frostbite, and burns. There are two main types: acute (rapid onset) and chronic (slow onset). Diagnosis is typically based on blood tests. Findings may include thrombocytopenia, low platelets, low fibrinogen, high International normalized ratio, INR, or high D-dimer. Treatment is mainly directed towards the underlying condition. Other measures may include givin ...
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Thrombocytopenia
In hematology, thrombocytopenia is a condition characterized by abnormally low levels of platelets (also known as thrombocytes) in the blood. Low levels of platelets in turn may lead to prolonged or excessive bleeding. It is the most common coagulation disorder among intensive care units, intensive care patients and is seen in a fifth of medical patients and a third of surgical patients. A normal human platelet count ranges from 150,000 to 450,000 platelets/microliter (μL) of blood. Values outside this range do not necessarily indicate disease. One common definition of thrombocytopenia requiring emergency treatment is a platelet count below 50,000/μL. Thrombocytopenia can be contrasted with the conditions associated with an abnormally ''high'' level of platelets in the blood – thrombocythemia (when the cause is unknown), and thrombocytosis (when the cause is known). Signs and symptoms Thrombocytopenia usually asymptomatic, has no symptoms and is picked up on a routine comp ...
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Eclampsia
Eclampsia is the onset of seizures (convulsions) in a pregnant woman with pre-eclampsia. Pre-eclampsia is a hypertensive disorder of pregnancy that presents with three main features: new onset of high blood pressure, large amounts of proteinuria, protein in the urine or other organ dysfunction, and edema. If left untreated, pre-eclampsia can result in long-term consequences for the pregnant woman, namely increased risk of cardiovascular diseases and associated complications. In more severe cases, it may be fatal for both the pregnant woman and the foetus. The diagnostic criterion for pre-eclampsia is high blood pressure, occurring after 20 weeks gestation or during the second half of pregnancy. Most often it occurs during the 3rd trimester of pregnancy and may occur before, during, or after childbirth, delivery. The seizures are of the tonic–clonic type and typically last about a minute. Following the seizure, there is either a postictal period, period of confusion or coma. Oth ...
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Pre-eclampsia
Pre-eclampsia is a multi-system disorder specific to pregnancy, characterized by the new onset of hypertension, high blood pressure and often a significant amount of proteinuria, protein in the urine or by the new onset of high blood pressure along with significant end-organ damage, with or without the proteinuria. When it arises, the condition begins after 20 Gestational age (obstetrics), weeks of pregnancy. In severe cases of the disease there may be hemolysis, red blood cell breakdown, a thrombocytopenia, low blood platelet count, impaired liver function, kidney dysfunction, edema, swelling, pulmonary edema, shortness of breath due to fluid in the lungs, or visual disturbances. Pre-eclampsia increases the risk of undesirable as well as lethal outcomes for both the mother and the fetus including preterm labor. If left untreated, it may result in seizures at which point it is known as eclampsia. Risk factors for pre-eclampsia include obesity, prior hypertension, older age, and ...
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Magnesium Sulfate (medical Use)
Magnesium sulfate as a medication is used to treat and prevent low blood magnesium and seizures in women with eclampsia. It is also used in the treatment of torsades de pointes, severe asthma exacerbations, constipation, and barium poisoning. It is given by intravenous, injection into a vein or intramuscular injection, muscle as well as by mouth. As epsom salts, it is also used for mineral baths. Common side effects include low blood pressure, skin flushing, and low blood calcium. Other side effects may include vomiting, muscle weakness, and decreased breathing. While there is evidence that use during pregnancy may harm the baby, the benefits in certain conditions are greater than the risks. Its use during breastfeeding is deemed to be safe. The way it works is not fully understood, but is believed to involve depressing the action of neurons. Magnesium sulfate came into medical use at least as early as 1618. It is on the WHO Model List of Essential Medicines, World Health O ...
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