By Isabel Stabile, Tim Chard, Gedis Grudzinskas
This article offers a brief connection with all vital evidence within the scientific sciences for applicants aiming at a postgraduate qualification in obstetrics and gynaecology, together with these applicants learning for the MRCOG half II exam. the data is gifted in a concise demeanour and covers all crucial features of the topic. it is going to even be of worth to clinicians as a short guide.
This quantity will function a important significant other to the hugely winning simple Sciences for Obstetrics and Gynaecology via Chard and Lilford, now in its 4th version.
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Asymptomatic but proteinuric women and asymptomatic, non-proteinuric women with elevated urate excretion; the remainder can be managed as outpatients. Once hospitalised, severe pre-eclamptic women should have weekly renal and liver function tests as well as platelet count, coagulation status and protein excretion. Elevated urate levels and falling platelet counts reflect worsening of the clinical condition. Fetal size and liquor volume are assessed ultrasonically; cardiotocography Clinical Obstetrics and Gynaecology 58 is repeated at intervals determined by clinical status; absent or reversed flow in the umbilical arteries during diastole as determined by Doppler ultrasonography is associated with higher perinatal morbidity and mortality.
9) which is non-invasive, allows accurate pregnancy dating and early diagnosis of multiple pregnancy. However, accuracy is very dependent on the quality of the operator and the equipment. 10. 5 per 1000 pregnancies). It is commoner in hydatidiform mole (25% of cases) and multiple pregnancy, and an association with high levels of heG has been suggested. In 90% of cases the corpus luteum is in the right ovary. It may be the first sign of thyrotoxicosis in pregnancy. Starvation and fluid and electrolyte disturbances may occur.
Reduced trophoblast volume in the spiral arteries leads to imbalance of the prostacyclin - thromboxane system, which causes local platelet aggregation, vasospasm of the spiral arteries and removal of pregnancy protection against circulating pressor agents such as angiotensin II. The retained muscle coats are sensitive to angiotensin II and peripheral resistance does not fall. Acute atherosis (fibrin and platelet deposition) in terminal segments of the uterine spiral arteries is characteristic. The subsequent rise in blood pressure fur- Hypertensive Disorders of Pregnancy 57 ther reduces placental perfusion leading to fetal growth retardation, hypoxia and intrauterine death.