pre eclampsia

episiotomy reapir

usually we use :
1. safil 2/0
-absorbable

2. cat gut 2/0
-non synthetic
-had allergic reaction
-can cause adhesion
Catgut is a type of cord^[1] that is prepared from the natural fibre found in the walls of animal intestines.^[2] Usually sheep or goat intestines are used, but it is occasionally made from the intestines of cattle,^[3] hogs, horses, mules, or donkeys.


3.vicryl
- same as safil
-is a polysorb
-Vicryl (polyglactin 910) is an absorbable, synthetic, braided suture
It is indicated for soft tissue approximation and ligation. The suture holds its tensile strength for approximately three to four weeks in tissue, and is completely absorbed by hydrolysis within 60 days. Vicryl and other polyglycolic acid sutures may also be treated for more rapid breakdown in rapidly healing tissues such as mucous membrane, or impregnated with triclosan to provide antimicrobial protection of the suture line.

case chorioamnionitis

g2p1 at preterm....
came with fever, leaking, fm good, no show, no abdominal pain
examination-
1. vital signs- 38.5 (high grade fever, )/PR= tachy
2. PA=ut term size, HPA= 5/5
3. SE= os closed, pooling,
3.VE= os closed

impression: PPROM with chorioamnionitis

mx:
1. take hvs during speculum
2. insert iv line green
2. TAS to see fetal condition
3. call MO- consult specialist
4. definitive tx- c-sec regardless of what th gestational age of the baby

mg sulfate in PE

date verification

can give syntometrine in PIH?

Drug interactions

Prostaglandins increase the effect of oxytocin and vice-versa. The contractions should be carefully monitored if oxytocin is given after a prostaglandin dose.

Syntometrine may enhance the blood pressure raising effect of vasoconstrictors (medicines given to constrict the blood vessels).

Some inhaled anaesthetics used for general anaesthesia, such as cyclopropane and halothane, may reduce the effect of oxytocin and ergometrine. There may also be an increased risk of a drop in blood pressure and abnormal heart beats if oxytocin is given with these general anaesthetics.

Oxytocin/ergometrine (trade name Syntometrine) is an obstetric combination drug. The components are synthetically produced oxytocin, a human hormone produced in the hypothalamus, and ergometrine, an alpha-adrenergic, dopaminergic and serotonin (5-HT₂) receptor agonist.

Both substances cause the uterus to contract. An injection of syntometrine is given in the third stage of labor, just after the birth of the child, to facilitate delivery of the placenta^[1] and to prevent postpartum hemorrhage^[1] by causing smooth muscle tissue in the blood vessel walls to narrow, thereby reducing blood flow.

Contraindications

Syntometrine should not be used in:

• Allergy to one or any of its ingredients.^[1]
• First stage of labor^[1]
• Second stage of labor before crowning of the baby's head^[1]
• Uterine atony during labor^[1]
• Severe kidney disorders^[1]
• Severe liver disorders^[1]
• Severe heart disorders^[1]
• Vascular diseases^[1]
• Severe hypertension^[1]
• Pre-eclampsia or eclampsia^[1]
• Sepsis^[1]

It should be used with caution in:

• Decreased kidney function^[1]
• Decreased liver function^[1]
• Mild heart disease^[1]
• Mild hypertension)^[1]
• Porphyria^[1]

Side effects

Possible side effects include:

• Nausea and vomiting^[1][2]
• Abdominal pain,^[1] feeling different than labor pains^[2]
• Headache^[1][2]
• Dizziness^[1][2]
• Skin rashes^[1], itching or hives^[2]
• Swelling of face, lips, tongue or other body parts^[2]
• Hypertension^[1]
• Arrhythmias (abnormal heart beats)^[1][2]
• Chest pain^[1][2]
• Fall in blood pressure (causing dizziness and lightheadedness)^[1]
• Difficulty in breathing^[1][2]
• Circulatory shock^[1]

post csec notes