This complication occurs in approximately 2 per 1000 abortions performed at less than 12 weeks’ gestation.  Several factors increase this complication.

1. Previous pregnancy: RR 2.2 for gravida greater than one
2. Gestational…

Hemorrhage from Surgical Abortions
During operative pregnancy termination (vacuum aspiration or D&E) general anaesthetics (especially halothane or similar agents) appear to increase blood loss compared with local   anaesthetics   using   intravenous…

Preinsertion of multiple osmotic dilators 6 to 24 hours prior to amnio-infusion may reduce the time from induction to completion,  reduce the risk of cervical laceration,  and almost   eliminate   posterior  …

There has been considerable controversy over which method of second trimester abortion is safest, least stressful to patient and provider, and most cost effective. However, evidence demonstrates that dilatation and…

As with all operative procedures, sound principles of surgical technique and the prevention of complications should include

•  accurate preoperative diagnosis and evaluation;
•  high level of operator skill;
• …

C. VACUUM ASPIRATION (≤ 13 Weeks)

Vacuum aspiration can be performed easily and safely with little discomfort in the first trimester under local anaesthetic and premedication with narcotics or sedation if necessary.

Advantages
1.…

B. MANUAL VACUUM ASPIRATION (≤ 10 Weeks)
Evacuation of early gestations, within one week of a missed period,  with a small-bore vacuum cannula can be performed in an office setting by a properly…

Determine the methods of early abortion for which a woman is eligible based on medical and other factors. Then after the options, with pros and cons, have been objectively and thoroughly explained,…

Summary of Recommendations
1. Manual vacuum aspiration can be performed safely and effectively in an office setting up to 10 weeks’ gestation. (B)

2. A cannula size in mm…

Preeclampsia

• Blood pressure of = 140 mm Hg systolic or = 90 mm Hg diastolic after 20 weeks of gestation.
• Proteinuria of = 0.3 g in 24 hours.

Severe Preeclampsia

• …

Postpartum mastitis occurs sporadically in nursing mothers shortly after they return home, or it may occur in epidemic form in the hospital. Staphylococcus aureus is usually the causative agent. Inflammation is generally unilateral, and women…

Preterm (premature) labor is labor that begins before the 37th week of pregnancy; it is responsible for 85% of neonatal illnesses and deaths. The onset of labor is a result of a…

Introduction

Breast feeding should be encouraged by education throughout pregnancy and the puerperium. Mothers should be told the benefits of breast feeding - it is emotionally satisfying, promotes mother-infant bonding, is economical, and gives significant…

The antibody anti-Rho(D) is responsible for most severe instances of hemolytic disease of the newborn (erythroblastosis fetalis). About 15% of whites and much lower proportions of blacks and…

Introduction

Elective major surgery should be avoided during pregnancy. Normal uncomplicated pregnancy does not alter operative risk except as it may interfere with the diagnosis of abdominal disorders and increase the technical…

Five to 10 percent of women have vaginal bleeding in late pregnancy. The clinician must distinguish between placental causes (placenta previa, placental abruption, vasa previa) and nonplacental causes (infection, disorders of the lower genital tract,…

Introduction

Essentials of Diagnosis

Hydatidiform Mole

• Amenorrhea.
• Irregular uterine bleeding.
• Serum hCG ß-subunit < 40,000 mU/mL.
• Passage of grape-like clusters of enlarged edematous villi…

Introduction

Essentials of Diagnosis

• Amenorrhea or irregular bleeding and spotting.
• Pelvic pain, usually adnexal.
• Adnexal mass by clinical examination or ultrasound.
• Failure of serum level of hCG to double…

Introduction

Recurrent abortion has been defined as the loss of three or more previable (< 500 g) pregnancies in succession. Recurrent abortion occurs in about 0.4-0.8% of all pregnancies. Abnormalities related to recurrent…

Introduction

Essentials of Diagnosis

• Intrauterine pregnancy at less than 20 weeks.
• Low or falling levels of hCG.
• Bleeding, midline cramping pain.
• Open cervical os.
• Complete or partial expulsion…

Introduction

Essentials of Diagnosis

• Morning or evening nausea and vomiting.
• Persistent vomiting severe enough to result in
• weight loss, dehydration,…

During an otherwise normal low-risk pregnancy, travel can be planned most safely between the 18th and 32nd weeks. Commercial flying in pressurized cabins does not pose a threat to the fetus. An…

Introduction

The first prenatal visit should occur as early as possible after the diagnosis of pregnancy and should include the following: history, physical examination, laboratory tests, advice to patients, and tests and…

Nutrition in pregnancy significantly affects maternal health and infant size and well-being. Pregnant women should have nutrition counseling early in prenatal care and access to supplementary food programs if necessary. Counseling should stress abstention…