Obstetrics

Abnormalities can sometimes complicate pregnancy, increasing the risk for the mother, the fetus, or both.

Similarly, while most labors and deliveries progress without incident, some are complicated and require special attention.

Pregnancy

Pregnancy is a time of profound changes. This video demonstrates through video and time-lapse photography some of those changes.

Spontaneous Abortion

Any bleeding during the first trimester of pregnancy is abnormal. The cause may be trivial or serious, but it is always abnormal.

Recurrent Pregnancy Loss

With increasing numbers of consecutive miscarriages, the likelihood of another miscarriage does go up, and the causes of these miscarriages change.

Pre-eclampsia and Eclampsia

Elevated blood pressure during pregnancy is a significant problem affecting as many as 10% of pregnancies. In some cases, the hypertension is pre-existing, while in others, it develops over the course of pregnancy. Occasionally, it does both.

Second and Third Trimester Bleeding

Bleeding during the second and third trimester has special clinical significance, encompassing problems that are quite serious and those that are normal or expected. It’s important to be able to distinguish between them.

Medical Problems in Pregnancy: Anemia

During pregnancy, the total blood volume normally increases 40%, reaching a maximum of about 5 liters. This 40% increase is accompanied by a smaller increase (about 33%) in the red cell mass. Because the red cell mass doesn’t quite keep up with the total blood volume, there is a naturally-occurring decrease in both the hemoglobin and the hematocrit.

Medical Problems in Pregnancy: Renal Disease

During pregnancy, there are a number of normal physiologic changes that occur in the kidney.

Medical Problems in Pregnancy: Diabetes

Pregnancy affects glucose metabolism. The placenta produces hPL (Human Placental Lactogen) in large quantities that decreases glucose uptake an promotes lipolysis, leading to increases in circulating free fatty acids. The placenta also produces large amounts of estrogen, progesterone and insulinase, all of which have the effect of increasing the insulin requirements of the mother.

Medical Problems in Pregnancy: Pulmonary Disease

There are some clinically important changes in respiratory anatomy and physiology during pregnancy.

Medical Problems in Pregnancy: Thyroid Disease

A number of predictable changes occur in the thyroid gland during pregnancy that has consequences for those evaluating and managing pregnant patients.

Postpartum Care

Lochia is the name for vaginal discharge following delivery. For several days, vaginal bleeding will persist, similar to a heavy menstrual period (lochia rubra). Then, it will thin and become more pale in color (lochia serosa).

A Training Simulation in Introductory Obstetrics & Gynecology