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PREGNANCY
PRESENTER
DR.IKOBHO E.H
SENIOR REGISTRAR
DEPT.OF OBSTETRICS AND
GYNAECOLOGY
U.P.T.H
INTRODUCTION
HISTORY
PHYSICAL EXAMINATION
INVESTIGATION
ANTEPARTUM MANAGEMENT
MANAGEMENT IN LABOUR
MANAGEMENT OF SOME COMPLICATIONS
CONCLUSION
HISTORY.
Family history
Excessive fetal movement
Exaggerated pregnancy symptoms.
-Nausea
-Hyperemesis gravidarum
-Back ache
-Abdominal distention
-Difficulty in breathing
-Constipation
-Hemorrhoids
-Varicose veins
Early onset of complications
Use of ovulation induction drugs
History of assisted reproduction
CLINICAL EXAMINATION
pallor
Gross pedal oedema
Excessive maternal weight gain
Uterus may be larger than expected for date (> 4cm )
-Wrong dates
-Uterine fibroid
-Polyhydramnios
-Ovarian cyst
-Molar pregnancy
-Urinary retention
-fetal macrosomia
Polyhydramnios (10 times commoner)
Ballottement of more than two fetal poles
Multiple fetal parts
Simultaneous recording of different fetal heart rates
Palpation of one or more fetuses at the fundus after delivery
Abnormal lie and presentation
INVESTIGATIONS
Early booking
-early diagnosis
-optimal management
Dietary advise
-The requirements for calories, protein, minerals, vitamines
-essential fatty acids are further increased
- they require 300 kcal/day
-Hematinics should be given
Antenatal visits
-More frequent antenatal visits
-Detect complications early and admit when nessesary.
Serial ultrasound scan
-done 3-4 weekly till 28 weeks, then weekly till term to monitor:
-Fetal growth and detect growth discordance
-Intra uterine growth restriction
-Twin-twin transfusion syndrome
-Polyhydramnios
Decision on mode of delivery
-Lie and presentation of the leading twin
-Contra-indication to vaginal delivery
MANAGEMENT DURING
LABOUR
THANK YOU