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Not every woman undergoes a traditional vaginal delivery with the birth of her child. Under conditions of fetal or maternal distress, or in the case of breech presentation (when a baby is turned feet first at the time of delivery), or if the woman’s first baby was born by cesarean delivery, a procedure called a cesarean section may be required. During a cesarean, a doctor will make either a lateral incision in the skin just above the pubic hair line, or a vertical incision below the navel. As the incision is made, blood vessels are cauterized to slow bleeding. After cutting through the skin, fat, and muscle of the abdomen, the membrane that covers the internal organs is opened, exposing the bladder and uterus. At this time the physician will generally insert his or her hands into the pelvis in order to determine the position of the baby and the placenta. Next, an incision is made into the uterus and any remaining fluids are suctioned from the uterus. The doctor then enlarges the incision with his or her fingers. The baby’s head is then grasped and gently pulled with the rest of its body from the mother’s uterus. Finally, the abdominal layers are sewn together in the reverse order that they were cut. The mother is allowed to recover for approximately three to five days in the hospital. She will also be quite sore and restricted from activity for the following several weeks. There are several potential complications associated with this procedure that should be discussed with a doctor prior to surgery.
Acute aortic dissection can be treated surgically or medically. In surgical treatment, the area of the aorta with the intimal tear is usually resected and replaced with a Dacron graft. Emergency surgical correction is the preferred treatment for Stanford type A (DeBakey type I and II) ascending aortic dissection. It is also preferred for complicated Stanford type B (DeBakey type III) aortic dissections with clinical or radiologic evidence of the following conditions: Propagation (increasing aortic diameter) Increasing size of hematoma Compromise of major branches of the aorta Impending rupture Persistent pain despite adequate pain management Bleeding into the pleural cavity Development of saccular aneurysm
What is Wallenberg syndrome? Wallenberg syndrome is a rare condition in which an infarction, or stroke, occurs in the lateral medulla. The lateral medulla is a part of the brain stem. Oxygenated blood doesn’t get to this part of the brain when the arteries that lead to it are blocked. A stroke can occur due to this blockage. This condition is also sometimes called lateral medullary infarction. The cause of the syndrome isn’t always clear, however.
Bronchiectasis is an abnormal dilation of the proximal and medium-sized bronchi (>2 mm in diameter) caused by weakening or destruction of the muscular and elastic components of the bronchial walls. Affected areas may show a variety of changes, including transmural inflammation, edema, scarring, and ulceration, among other findings. Distal lung parenchyma may also be damaged secondary to persistent microbial infection and frequent postobstructive pneumonia. Bronchiectasis can be congenital but is most often acquired.[9] Congenital bronchiectasis usually affects infants and children. These cases result from developmental arrest of the bronchial tree. Acquired forms occur in adults and older children and require an infectious insult, impairment of drainage, airway obstruction, and/or a defect in host defense. The tissue is also damaged in part by the host response of neutrophilic proteases, inflammatory cytokines, nitric oxide, and oxygen radicals. This results in damage to the muscular and elastic components of the bronchial wall. Additionally, peribronchial alveolar tissue may be damaged, resulting in diffuse peribronchial fibrosis.[12] The result is abnormal bronchial dilatation with bronchial wall destruction and transmural inflammation. The most important functional finding of altered airway anatomy is severely impaired clearance of secretions from the bronchial tree. Impaired clearance of secretions causes colonization and infection with pathogenic organisms, contributing to the purulent expectoration commonly observed in patients with bronchiectasis. The result is further bronchial damage and a vicious cycle of bronchial damage, bronchial dilation, impaired clearance of secretions, recurrent infection, and more bronchial damage
An atrial septal defect (ASD) is a hole in the wall between the two upper chambers of your heart (atria). The condition is present from birth (congenital). Small atrial septal defects may close on their own during infancy or early childhood. Large and long-standing atrial septal defects can damage your heart and lungs. Small defects may never cause a problem and may be found incidentally. An adult who has had an undetected atrial septal defect for decades may have a shortened life span from heart failure or high blood pressure that affects the arteries in the lungs (pulmonary hypertension). Surgery may be necessary to repair atrial septal defects to prevent complications.
Postmenopausal bleeding (PMB) is defined for practical purposes as vaginal bleeding occurring after twelve months of amenorrhoea, in a woman of the age where the menopause can be expected.[1] Hence it does not apply to a young woman, who has had amenorrhoea from anorexia nervosa, or a pregnancy followed by lactation. However, it can apply to younger women following premature ovarian failure or premature menopause. Unscheduled bleeding in women of menopausal age taking hormone replacement therapy (HRT) should be managed in the same way from a practical perspective.[2] 'Unscheduled bleeding' is defined as non-cyclical bleeding still continuing six months after commencing HRT or after six months of amenorrhoea.
A Pap smear (Papanicolau smear; also known as the Pap test) is a screening test for cervical cancer. The test itself involves collection of a sample of cells from a woman's cervix (the end of the uterus that extends into the vagina) during a routine pelvic exam
Pulmonary embolism symptoms can vary greatly, depending on how much of your lung is involved, the size of the clots, and whether you have underlying lung or heart disease. Common signs and symptoms include: Shortness of breath. This symptom typically appears suddenly and always gets worse with exertion. Chest pain. You may feel like you're having a heart attack. The pain may become worse when you breathe deeply (pleurisy), cough, eat, bend or stoop. The pain will get worse with exertion but won't go away when you rest. Cough. The cough may produce bloody or blood-streaked sputum. Other signs and symptoms that can occur with pulmonary embolism include: Leg pain or swelling, or both, usually in the calf Clammy or discolored skin (cyanosis) Fever Excessive sweating Rapid or irregular heartbeat Lightheadedness or dizziness
Nosebleeds common. Most often they are a nuisance and not a true medical problem. But they can be both. Nosebleed care Sit upright and lean forward. By remaining upright, you reduce blood pressure in the veins of your nose. This discourages further bleeding. Sitting forward will help you avoid swallowing blood, which can irritate your stomach. Pinch your nose. Use your thumb and index finger to pinch your nostrils shut. Breathe through your mouth. Continue to pinch for five to 10 minutes. Pinching sends pressure to the bleeding point on the nasal septum and often stops the flow of blood. To prevent re-bleeding, don't pick or blow your nose and don't bend down for several hours after the bleeding episode. During this time remember to keep your head higher than the level of your heart. If re-bleeding occurs, blow out forcefully to clear your nose of blood clots and spray both sides of your nose with a decongestant nasal spray containing oxymetazoline (Afrin, Mucinex Moisture Smart, others). Pinch your nose again as described above and call your doctor. When to seek emergency care The bleeding lasts for more than 20 minutes The nosebleed follows an accident, a fall or an injury to your head, including a punch in the face that may have broken your nose
Hypertensive emergencies encompass a spectrum of clinical presentations in which uncontrolled blood pressures lead to progressive or impending end-organ dysfunction. In these conditions, the BP should be lowered aggressively over minutes to hours. Neurologic end-organ damage due to uncontrolled BP may include hypertensive encephalopathy, cerebral vascular accident/cerebral infarction, subarachnoid hemorrhage, and/or intracranial hemorrhage.[1] Cardiovascular end-organ damage may include myocardial ischemia/infarction, acute left ventricular dysfunction, acute pulmonary edema, and/or aortic dissection. Other organ systems may also be affected by uncontrolled hypertension, which may lead to acute renal failure/insufficiency, retinopathy, eclampsia, or microangiopathic hemolytic anemia.[1] With the advent of antihypertensives, the incidence of hypertensive emergencies has declined from 7% to approximately 1% of patients with hypertension.[2] In addition, the 1-year survival rate associated with this condition has increased from only 20% (prior to 1950) to a survival rate of more than 90% with appropriate medical treatment
A sleep disorder, or somnipathy, is a medical disorder of the sleep patterns of a person or animal. Some sleep disorders are serious enough to interfere with normal physical, mental, social and emotional functioning. Polysomnography and actigraphy are tests commonly ordered for some sleep disorders.
Atrial fibrillation (also called AFib or AF) is a quivering or irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure and other heart-related complications. Some people refer to AF as a quivering heart. An estimated 2.7 million Americans are living with AF.
Atrial flutter is a type of abnormal heart rate, or arrhythmia. It occurs when the upper chambers of your heart beat too fast. When the chambers in the top of your heart (atria) beat faster than the bottom ones (ventricles), it complicates your heart rhythm