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Childbirth (also called labour, birth, partus or parturition) is the culmination of a human pregnancy or gestation period with birth of one or more newborn infants from a woman’s uterus. The process of normal human childbirth is categorized in three stages of labour: the shortening and dilation of the cervix, descent and birth of the infant, and birth of the placenta. In some cases, childbirth is achieved through caesarean section, the removal of the neonate through a surgical incision in the abdomen, rather than through vaginal birth
At one time, women who had delivered by cesarean section in the past would usually have another cesarean section for any future pregnancies. The rationale was that if allowed to labor, many of these women with a scar in their uterus would rupture the uterus along the weakness of the old scar. Over time, a number of observations have become apparent: Most women with a previous cesarean section can labor and deliver vaginally without rupturing their uterus. Some women who try this will, in fact, rupture their uterus. When the uterus ruptures, the rupture may have consequences ranging from near trivial to disastrous. It can be very difficult to diagnose a uterine rupture prior to observing fetal effects (eg, bradycardia). Once fetal effects are demonstrated, even a very fast reaction and nearly immediate delivery may not lead to a good outcome. The more cesarean sections the patient has, the greater the risk of subsequent rupture during labor. The greatest risk occurs following a “classical” cesarean section (in which the uterine incision extends up into the fundus.) The least risk of rupture is among women who had a low cervical transverse incision. Low vertical incisions probably increase the risk of rupture some, but usually not as much as a classical incision. Many studies have found the use of oxytocin to be associated with an increased risk of rupture, either because of the oxytocin itself, or perhaps because of the clinical circumstances under which it would be contemplated. Pain medication, including epidural anesthetic, has not resulted greater adverse outcome because of the theoretical risk of decreasing the attendant’s ability to detect rupture early. The greatest risk of rupture occurs during labor, but some of the ruptures occur prior to the onset of labor. This is particularly true of the classical incisions. Overall successful vaginal delivery rates following previous cesarean section are in the neighborhood of 70 This means that about 30of women undergoing a vaginal trial of labor will end up requiring a cesarean section. Those who undergo cesarean section (failed VBAC) after a lengthy labor will frequently have a longer recovery and greater risk of infection than had they undergone a scheduled cesarean section without labor. Women whose first cesarean was for failure to progress in labor are only somewhat less likely to be succesful in their quest for a VBAC than those with presumably non-recurring reasons for cesarean section. For these reasons, women with a prior cesarean section are counseled about their options for delivery with a subsequent pregnancy: Repeat Cesarean Section, or Vaginal Trial of Labor. They are usually advised of the approximate 70successful VBAC rate (modified for individual risk factors). They are counseled about the risk of uterine rupture (approximately 1in most series), and that while the majority of those ruptures do not lead to bad outcome, some of them do, including fetal brain damage and death, and maternal loss of future childbearing. They are advised of the usual surgical risks of infection, bleeding, anesthesia complications and surgical injury to adjacent structures. After counseling, many obstetricians leave the decision for a repeat cesarean or VBAC to the patient. Both approaches have risks and benefits, but they are different risks and different benefits. Fortunately, most repeat cesarean sections and most vaginal trials of labor go well, without any serious complications. For those choosing a trial of labor, close monitoring of mother and baby, with early detection of labor abnormalities and preparation for
Scar revision includes techniques that improve the appearance of an unsightly scar, regardless of its size, type or age. This is typically not covered by insurance carriers and is treated as a cosmetic procedure. Though scars can never be completely removed, the appearance of scarring can be greatly diminished. Who Should Get Scar Revision? The best candidates for scar revision are in good health and have realistic expectations. Scar revision may be used to treat: Hyperpigmented scars Large or plainly visible scars Keloid scarring Raised scars Deep depression scars After scar revision, the appearance of your scar should be greatly reduced. Scar revision can improve the size, shape and color of your scar. Multiple procedures may be needed to achieve optimal results. There are several different techniques that can be used during your scar revision. During a consultation, we can discuss the best techniques and determine if you are a suitable candidate. What to Expect During Your Scar Revision Your scar revision may involve one or more of the following techniques: Topical treatments (gels, creams, external compression) can treat mild scarring or changes in pigmentation. Injectable treatments like dermal fillers are best for filling in scar depressions. These treatment options can provide long-lasting improvements, however, they are not always permanent. Surface treatments like chemical peels, dermabrasion, laser therapy and skin bleaching can improve skin tone and texture. More than one treatment may be needed to achieve optimal results. Surgical scar revision is only used in more severe cases. Reconstructive techniques like Z-plasty, tissue expansion, or skin grafting replace a prominent scar with a less noticeable scar. After Your Surgery Scar revision recovery varies depending on the procedure you have elected. Topical and injectable treatments rarely require downtime. Surface treatments and surgical removal can require several days of recovery. You may experience some temporary bruising, swelling, or discomfort. Over-the-counter or prescription medication can be used to manage pain. Topical and injectable treatments are likely to require sustained application to maintain results. The final results of surface treatments and surgical removal may not be visible for several weeks to months. It is important to protect the treatment area from direct sun exposure for several weeks. Additional details about your specific recovery will be discussed during your consultation.
CORRECTION: After review of this video, it is clear that this video is of a baby who is near full term (40 weeks) based on the size. Late trimester "abortions" are defined only to viability of a baby (24 weeks) A 24 week baby is much smaller than this baby shown and by definition this is not a late "abortion" procedure. The proper labeling of this video should be management of a deceased breech baby with "head entrapment" as this was almost certainly a naturally occuring delivery and an OB nightmare (Reviewed by Dr. Frederick Bright)
During the examination, the doctor gently puts a lubricated, gloved finger of one hand into the rectum. He or she may use the other hand to press on the lower belly or pelvic area. A digital rectal exam is done for men as part of a complete physical examination to check the prostate gland .
Vital signs help us assess patients in the nursing profession, and there are six common vital signs that we assess as nurses:
1. Heart Rate (Pulse)
2. Respiration Rate
3. Temperature
4. Blood Pressure
5. Pain Rating
6. Oxygen Saturation
This video will demonstrate how to check vital signs (live) on a patient, along with normal rates for each assessment. I also give you a few tips for taking vital signs as a nurse, CNA, or other healthcare profession.
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Dr Raewyn Teirney - fertility specialist and Gynaecologist in Sydney shows a video recording of a laparoscopy for a woman with infertility and pelvic pain.
Eye tests are important for the detection of many common eye infections and diseases. Eyes are also an important indicator to detect chronic systemic diseases like Hypertension and Diabetes. Must after maxillofacial trauma to rule out any near and late complications emerging for the eyes. 2. There are two perspectives for examining the eyes : 1. Ophthalmic Perspective – because eyes are prone to many infections, diseases and conditions. 2. Maxillofacial Perspective – because the eyes and the orbit forms an integral component of facial and mid-facial fractures and trauma.