FOGSI FOCUS we present chapters on Placenta Previa & Placental . FOGSI has focused on this subject of Antepartum hemorrhage. This is. FOGSI Focus – Medical Disorders in Pregnancy – Written by webmaster 18 FOGSI Focus – Women Health Wellness Empowerment – Written by. I am happy to know that the FOGSI Focus on 'Comprehensive Abortion Care .. ns/unsafe_abortion_estimates_04/estimate musicmarkup.info • woman not be able to.
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In view of this, the present FOGSI Focus is aimed at solving Practical Problems in Infertile Couples. Experts from the fields are choosen from far & near. FOGSI FOCUS ON OVULATION INDUCTION & IUI. Chapter 1. Physiology of Ovulation. Chapter 2. Stress in Infertility - Is evolution stronger than psychology?. It is a great pleasure to present to you FOGSI-FOCUS on Ultrasonography in. Obstetrics & Gynaecology. USG is an integral part of Ob. Gyn. Practice. USG for Ob.
Firmness in the uterus or abdomen References- www. Abruption is more likely to be related to conditions occurring during pregnancy and placenta praevia is more likely to be related to conditions existing prior to pregnancy. Placenta praevia is defined as a placenta that lies wholly or partly within the lower uterine segment. It occurs in. The condition is mostly diagnosed on ultrasound examination.
In placental abruption some of the bleeding escapes through the cervix causing external haemorrhage and sometimes bleeding is concealed when blood does not escape externally.
The precise cause of abruption is unknown, but risk factors for placental abruption include: pre-eclampsia, fetal growth restriction, non-vertex presentations, polyhydramnios, advanced maternal age, multiparty, low body mass index BMI , pregnancy following assisted reproductive techniques, intrauterine infection, premature rupture of membranes, abdominal trauma both accidental and resulting from domestic violence , smoking, drug misuse cocaine and amphetamines during pregnancy and maternal thrombophilia.
Bleeding in first trimester also increases the risk of abruption later in the pregnancy. Placental abruption is mostly diagnosed on ultrasound examination. Though Sonography is not sensitive for the detection of placental abruption but it is highly specific.
Placenta accrete- When the placenta or part of the Placenta invades and is inseparable from the uterine wall, it is called placenta accrete. It can cause bleeding during the third trimester and severe blood loss during delivery. Many of these conditions are evident on the initial speculum examination. Initially clinical assessment of women presenting with APH is done by medical person to establish urgency of intervention required to manage maternal or fetal compromise. If there is no maternal compromise a full history should be taken.
It includes history taking to assess coexisting symptoms such as pain, an assessment of the extent of vaginal bleeding, the cardiovascular condition of the mother, and an assessment of fetal wellbeing. In placenta previa, uterus is felt to be relaxed on palpation and non-tender.
Generally presenting part is high up and floating. In placental abruption, the triad of sudden onset of abdominal pain, bleeding per vagina, tense and tender uterus constitutes the main diagnostic criteria. Speculum examination- A speculum examination can be useful to identify cervical dilatation or can visualise a lower genital tract cause for the APH. If placenta praevia is a possible diagnosis for example, a previous scan shows a low placenta, or there is a high presenting part on abdominal examination, or the bleeding is painless , digital vaginal examination should not be performed until an ultrasound has excluded placenta praevia.
If APH is associated with pain or uterine activity digital vaginal examination can provide information on cervical dilatation.
Transvaginal ultrasound is more accurate than transabdominal in diagnosing placenta previa. The sensitivity of ultrasound for the detection of retroplacental clot abruption is poor. In spite of the fact that this method will be misused in the community, the health care providers have expressed their deep concerns as regards selection criteria, the type of drugs, the dose, its complications and post abortion care.
I am very happy to know that the FOGSI Focus is going to be released in the AICOG where various aspects of medical abortion has been dealt with in greater detail so as to reach at a consensus out of many many controversial aspects. I congratulate the committee for this brilliant scientific endeavor. Maternal health has become an extremely sensitive health issue for India and the high maternal mortality a glaring revelation of failure at various social, governmental, economical levels.
Yes; we agree that the issue of women dying in India is multifactorial in origin but we as FOGSI have regularly endeavored towards trying to help the situation. The efforts have been small but the urge has always been there. The various national surveys have revealed that contraception, safe abortions, later age of marriage are important interventions which can help change the maternal health related scenario dramatically.
The very poor contraceptive usage of the Indian woman has to be changed. We need to empower women with the knowledge of spacing and each one of us as members must strive to empower them thus. The FOGSI focus on safe abortions, am very glad to mention is a detailed update on the subject of medical abortions.
The advent of Misoprostol in Obstetric practice; has drastically changed the situation favorably and no wonder it is identified as the molecule of the millennium. Likewise the RU mifepristone has indeed increased the safety of abortions. However a lot of scientific information as far as the pharmacokinetics are concerned are essential for a practitioner.
I am sure that the focus will help guide all regarding this in a scientific manner. Save the Mother and Newborn Initiative is targeted at reducing the maternal mortality of India and you all as members of FOGSI should actively participate in these projects with great enthusiasm.
We have to make a mark and help our mothers. We need to take the step and I am sure with all of us working towards this goal we shall definitely be able to deliver. I am grateful to all the members who contributed in the drafting of the same and the members of the Managing Committee for their active inputs and participation.
Wish you all a pleasant reading.
Professor Obst. Every year approximately million women become pregnant and as many as 80 million of these pregnancies are unplanned. Unintended pregnancies continue to be a major problem that affects not only the individual, but the larger society as well. These occur due to failure of contraceptive method or because the contraceptive method is difficult for the women to use consistently and correctly. The advent of Medical Abortion has made a great impact on the life of women all over the world.
Medical Abortion has a great potential of being the modern, reliable, safe and non-invasive method of termination of pregnancy which can serve large number of women particularly in developing countries like India. The aim of family welfare is to improve maternal and child health by reducing the number of children, spacing of the children and to offer the safest method of abortion in cases of unwanted pregnancies which can drastically reduce the maternal mortality and morbidity.
I congratulate Dr. I am sure that this issue of FOGSI FOCUS will make an interesting reading as well as throw lights on the new development in medical abortion and will serve as useful resource to all concerned whose Mission is to reduce Maternal Mortality and Morbidity.
Treasurer's Message Dr. Hrishikesh Pai Treasurer - FOGSI Medical Abortion has a great potential of being the modern, reliable, safe and non-invasive method of termination of pregnancy which can serve large number of women particularly in developing countries like India. It is a fantastic job done by Dr. No woman can call herself free until she can choose consciously whether she will or will not be a mother.
Most deaths still occur in sub-Saharan Africa 38 and south-central Asia 24 This tragic and unnecessary toll follows from an unchanged rate of unsafe abortions: 14 per women of childbearing age, currently at 20 million annually. Thus, somewhere in the world a woman dies every 8 minutes because of an unsafe abortion.
Unsafe abortions and related complications occur almost exclusively in the developing world, the report states. A poor woman in a rural area is more prone to turn to traditional practitioners and unsafe abortion methods, and is thus three times more likely to experience complications of unsafe abortion and half as likely to receive medical treatment compared with a well-off woman in an urban area. Worldwide, 8 million women have complications from abortion, but only 5 million receive the necessary care.
That access to safe abortion is still highly restricted for women in the developing world.
Medical Abortion has come a long way since it was first introduced to the world. The worth of the technology has withstood political, medical, legal, media and activist opposition and only emerged the stronger for it.
The focus on abortion should be urgent, immediate, and multidimensional. In the few minutes it has taken to read this text, a woman will have died from an unsafe abortion—the time to act is now. FOGSI is committed to saving women's lives and the cause of providing safe abortion. Several activities have been undertaken and bought to successful conclusion.
We hope that this Focus on Medical Abortion will help in disseminating knowledge about this powerful technology and enable improved access through this to the end users. The concept of the focus was initiated to offer to the health care providers a diverse and wide ranging view on a given topic.
I would also like to place on record appreciation for Population Services International for making this issue of the focus possible through a generous sponsorship.