cpd + uterine rupture

Upload: temmy

Post on 01-Mar-2018

226 views

Category:

Documents


0 download

TRANSCRIPT

  • 7/26/2019 CPD + Uterine rupture

    1/50

    !"#$%& ()*&%+%&, -./.

  • 7/26/2019 CPD + Uterine rupture

    2/50

    References

    Cunningham, F. Gary, et al. Williams

    Obstetrics, 24th Edition. McGraw HillEducation, 2014.

    Lynch, Christoper B. A Textbook ofPostpartum Hemorrhage. Jaypee Brothers

    Pub, 2006

  • 7/26/2019 CPD + Uterine rupture

    3/50

    Objective

    0) 1&"*#23%&" 34* 5#$&6$57*2 $& 34* "$%8&)2$2

    %&" 9%&%8*9*&3 ): %;&)#9%7$

  • 7/26/2019 CPD + Uterine rupture

    4/50

  • 7/26/2019 CPD + Uterine rupture

    5/50

  • 7/26/2019 CPD + Uterine rupture

    6/50

  • 7/26/2019 CPD + Uterine rupture

    7/50

    !7*#3 !6

  • 7/26/2019 CPD + Uterine rupture

    8/50

  • 7/26/2019 CPD + Uterine rupture

    9/50

  • 7/26/2019 CPD + Uterine rupture

    10/50

  • 7/26/2019 CPD + Uterine rupture

    11/50

  • 7/26/2019 CPD + Uterine rupture

    12/50

    109

    8

    7

    6

    5

    4

    3

    2

    1

    0

    XXX

    X XXXX X

    1 2 3 4 5 6 7 8 9 10 11 12 13 14

    - 3

    -

    2

    -

    1

    0

    + 1

    + 2

    + 3

  • 7/26/2019 CPD + Uterine rupture

    13/50

    /?23)6$%

    Abnormalities of:

    1. Expulsive forces

    2. Maternal bony pelvis

    3.

    Soft tissues of the reproductive tract

    4. Fetal presentation, position or development of

    the fetus

  • 7/26/2019 CPD + Uterine rupture

    14/50

    @ AB2

    A)+*#

    A%22%8*

    A%22*&8*#

  • 7/26/2019 CPD + Uterine rupture

    15/50

    /?23)6$%

    Abnormalities of:

    1. Expulsive forces

    2. Maternal bony pelvis

    3.

    Soft tissues of the reproductive tract

    4. Fetal presentation, position or development of

    the fetus

  • 7/26/2019 CPD + Uterine rupture

    16/50

    A%22%8*

    C&7*3

    -$"57%&*

    D137*3

  • 7/26/2019 CPD + Uterine rupture

    17/50

    A%22%8*

  • 7/26/2019 CPD + Uterine rupture

    18/50

    A%22%8*

  • 7/26/2019 CPD + Uterine rupture

    19/50

    C&3*#&%7 EF%9$&%

  • 7/26/2019 CPD + Uterine rupture

    20/50

    C&7*3

    !A G => 69

    0#%&2H*#2* G =I 69

    J7$&$6%7 A*7H$9*3#?K "$%8)&%7 6)&L18%3* G ==.M69

  • 7/26/2019 CPD + Uterine rupture

    21/50

    C&7*3

  • 7/26/2019 CPD + Uterine rupture

    22/50

    C&7*3

  • 7/26/2019 CPD + Uterine rupture

    23/50

    C&7*3

    E%#7? #1531#* ): 34* 9*9;#%&*

    -%75#*2*&3%

  • 7/26/2019 CPD + Uterine rupture

    24/50

    C&7*3

  • 7/26/2019 CPD + Uterine rupture

    25/50

    -$"57%&*

    C&3*#25$&)12 G N 69

    C&3*#25$&)12 O A)23*#$)# P%8$3%7 < 13.5 cm

  • 7/26/2019 CPD + Uterine rupture

    26/50

    -$"57%&*

  • 7/26/2019 CPD + Uterine rupture

    27/50

    D137*3

    C&3*#$264$%7 31;*#)12 G N 69

    04)9B2 Q17*KR+4*& 34* 3#%&2H*#2* "$%9*3*# 5712 5)23*#$)# 2%8$3%7

    "$%9*3*#2 ): )137*3 S =M 69 ;? TUQ%? A*7H$9*3#?, ;)&?

    5*7H$6 $2 6)&2$"*#*" %"*V1%3*W

  • 7/26/2019 CPD + Uterine rupture

    28/50

    J7$&$6%7 A*7H$9*3#?

    Parametersassessed

    Adequate Contracted

    Sacral Promontory Not reached Easily reached

    Curvature ofsacrum Concave Straight or flat

    Sacrosciatic notch Admits 2 fingers < 2 fingers

    Ischial spine Blunt Prominent

    Bispinousdiameter

    Not reached by 2fingers

    Reached by 2fingers

  • 7/26/2019 CPD + Uterine rupture

    29/50

    J7$&$6%7 A*7H$9*3#?

    Parametersassessed

    Adequate Contracted

    Pelvic sidewalls Parallel ordivergent

    Convergent

    Pubic arch Obtuse angle Acute angle

    Ischial tuberosities > Closed fist < Closed fist

  • 7/26/2019 CPD + Uterine rupture

    30/50

    P)X 0$221* /?23)6$%

    Y7%""*# "$23*&

  • 7/26/2019 CPD + Uterine rupture

    31/50

    /$%8&)2

  • 7/26/2019 CPD + Uterine rupture

    32/50

    /$%8&)2

  • 7/26/2019 CPD + Uterine rupture

    33/50

    /$%8&)2

  • 7/26/2019 CPD + Uterine rupture

    34/50

    P4)17"*# /?23)6$%

    E9*#8*&6? 2$31%

  • 7/26/2019 CPD + Uterine rupture

    35/50

    P4)17"*# /?23)6$%

    -6Q);*#3B2 9%&*1H*#

  • 7/26/2019 CPD + Uterine rupture

    36/50

    P4)17"*# /?23)6$%

    -6Q);*#3B2 9%&*1H*#

  • 7/26/2019 CPD + Uterine rupture

    37/50

    P4)17"*# /?23)6$%

    ]))"B2 9%&*1H*#

  • 7/26/2019 CPD + Uterine rupture

    38/50

    P4)17"*# /?23)6$%

    Q1;$&B2 9%&*1H*#

  • 7/26/2019 CPD + Uterine rupture

    39/50

    P4)17"*# /?23)6$%

    /*7$H*#? ): 34* 5)23*#$)# 24)17"*#

  • 7/26/2019 CPD + Uterine rupture

    40/50

    A%22*&8*#

    P4)17"*# /?23)6$%

    ^%H%&*77$B2 9%&*1H*#

    J7*$")3)9?!"*%" :*312

    P?954?2$)3)9?

  • 7/26/2019 CPD + Uterine rupture

    41/50

    -%3*#&%7 E_*63 ): /?23)6$%

    `3*#$&* #1531#*

    a$2317% :)#9%

  • 7/26/2019 CPD + Uterine rupture

    42/50

    a*3%7 E_*63 ): /?23)6$%

    J%513 2166*"%&*19

    -)7"$&8

    d*#H* $&L1#?

    a#%631#*

    J*54%7)4*9%3)9%

  • 7/26/2019 CPD + Uterine rupture

    43/50

    a*3%7 E_*63 ): /?23)6$%

  • 7/26/2019 CPD + Uterine rupture

    44/50

    `3*#$&* Q1531#*

    A#$9%#? H2 P*6)&"%#?

    J)957*3* H2 C&6)957*3*

  • 7/26/2019 CPD + Uterine rupture

    45/50

  • 7/26/2019 CPD + Uterine rupture

    46/50

    `3*#$&* Q1531#*

  • 7/26/2019 CPD + Uterine rupture

    47/50

    `3*#$&* Q1531#*

  • 7/26/2019 CPD + Uterine rupture

    48/50

    `3*#$&* Q1531#*

    P$8& %&" P?953)92

    d)&U#*%221#$&8 :*3%7 4*%#3 5%e*#&!7%3*

    "*6*7*#%

  • 7/26/2019 CPD + Uterine rupture

    49/50

    `3*#$&* Q1531#*

    -%&%8*9*&3K

    f?23*#*63)9? H2 13*#$&* #*5%$#

  • 7/26/2019 CPD + Uterine rupture

    50/50