see FIRST EDITION Obstetrics Dr Mayur Sayta Sayta Medical Coachinng Institute Sf 1,2 Samarth Tower, Waghodiya Road Vadodara -390025 Gujarat ,India. M- 9104448555 971494135022000 29986800 Qet Anatomy S sere Ropeoduchy €_o-gun: T T sxrernal drromnad acces gemitealict Sea SHopeo chucHVe S. -\ ° G) Evvomel sentria C Nunet) visible e@ecterne genre oxgems KNOUTNL_ as NUNCA. Ae Mons pubis . > Pou 94 arssue m Laon OF pubrs. hs having supcurenegs Fer pad. py Hons > covered y in shape. Base- upurarels 2 Taio) ‘ olinected, 1@ Labia Meyorc. ~> These we ¢ be, fords Kin) orm subcuyemend ‘ : Nuno sissue CONEN! Ne tn Al infrent —> They meet exichothel oF ™ NE - well ds back, + ouside - SKIL mayonce gnside 7 MUCUS 1 Reb + contain’ sebareous gland Vv maiinena ' FOOL _. guyside- sweat glands. Posten a. oo Pyed ap with teak. @3, Labie Minore > thee ae twe Ret. = They Lies fads > skin but devoid. inside Leebra NY Ore6 ° lo oO °o © € A ¢ oo epuse lw —» Labia mrnowel Preruse : ee ere CuO Arxerosdy In Ahe emalurn mdlina unite. frente saginal OOF fossa beck o4 po Newnes gn SHOT oat 4 ny Mute founchette. Pp evvxoHt —_ v known as Fa Known as Prenuiumy Fo puepuse herre- — posreriowdy unise ~~ en cing eee : ng - Pourchert€ and Veun caer = 7 “ weak g)ands. No Hav. and No swe nds. seb dcegus grand curd enacHre = a= dls honing muscie bets: 4, ewrors euyow advice @MCACHIE aissue @ a A ~~ \Ss Qo. — stuard Anyeion pur % Nive, behween_ Puepuse ound. puenalurr. guns. Body — mode up of Two ont cotuets conuen, Body ond glans: 5. Vesnbwe spare inside Leebia minor, a A txia — rdusiesy goundsy Anrewosly — cw tons Vesti Wrethag posterionly - fowichett+e —— syaging sides 7 Quebre minoNa. = Openings - UWrethuel ofening, Vagina openingothe openings Cre) © Baritholin giand's ofenirg New Naginar endhs ofening on end +8 Labivrn minora” bemoeen, he secuetes edkaline mu c in (Lan cation | () skenes ¢ = Ofen on the ments: & Nesribuiet_ Bub - = oithin__ lesb. Seal cecal sword 19 muscle retard 42 oa ard _ Lunges Poort 0) egthor side > elongareal massed ‘) ” 4 which heips ethned. giord oad unepoud excderrmest WEIN ecHe rssue stvuareal uginal ti Fer" b- punbocaver™yVagina. => fiypormsculen 4ube C sheuth) Lire Seu ceurne Jrvemally- Uterus 2999000000 — Exyenr - poet eanally - Niuwa. _s dinection > Fem below CVuNE) upwocid ard poeKevaid. + 45° degreo ange ootth horizontal —> Lumen Noormally diame 250m disteundenbye C erasHc) me wans| = = Anse - Posteo -awo Laredal wens — [Qumen| ‘s ciosea bY op prosermaHen 4 Anon and Posteri on wes oe lumen - ‘)? shaged, L =) Anyetosy Wall-e ? = ales = posierion Wel - Fem, ~ fosnics ~ foxmed ch superion Parr % in Rela Hon wir centr formes Veugina COANIX ¥ wets: > @® fornies. ~ Ane oo a =~ posten'oH ~ clesp, t -2 lawl : fosqourcsReluri ond e 6 e 6 Anieody - oO c c r : C ( Base o uppecpart — Wino Bladder 1 Lower po - Uietvia, + posrerioaly ~ rou Sous ty CReCrO Ureuing Pouch) STV - Recenegunel fess cick — Pervinenrl Body, ame) ~ revoudlly — Ogroad Dg se dieghwrpr) S ‘Govnatin 9% ind , Butboceyemoug @ Be n 9\a eee Layers QO rmucosclh Senn Hed FA @® Submucusel - Loose aneoray +issue. @ muscular = cyrteular, Longrsuclined @® Pirvous. - rough Dewy er Neginel pH- aeidic C4405) wie puberty +0 menopause - popertermis baciit- Lavifegert) SECTLH ONS) - Reyon (5 LacHic er) aeh'o. Pee (2) Irene gbrao, & aca @ middie sete 0 ® roma pudendal A.inxs e@ OS e Nena ouinseye - e goer jhe Neins © goxemal _fuderalul vein, © Lb hw Cc Doak age = tprerg S Inxeyned c Middle sho c Cupto h Aled ed c Qower put —7 mapa “prguined ¢ Group yb Nene | super — f\usonamrc - spreader Sop . Pelvic piend somauH'c puck tid Ni Oue-B ' (Uxesus) — wm onow onus anger, givuared > go pene can tyy, bebweo__ Uninc Bludder ama RecuU™m. Postion — Amerienteal amd. Anretiered, ted and CenNixe suighh 1 dexyxonota Levono+ Q cox oe 5 om 6 ied ~ osem -— ar om ay? ca eh Pike Devel ¥ fundus — SOT Yriaeness —» Op |, esemo Body — deuided C5 om, owen tation eal Pees cundus Chem) — (o.sen — Paw of uterus a= spe Y. 3 cove the Ofening | T?™ ‘and “ - 4wo * prorerreel fellopialt fan _™ abe dquo SUP 4 pian megld No coulny tesent conrmuse af UFOS. _ ene- dstenud sitwaled berweer Gody are: —_——— @ Ysa) - os CeaNTX. > emosy constvcsek Pot o4 urequs amt _ peek uppe. Arrcuper'coel, qmiomead 0s (eFrrre Lowe{ pistologiot oud gnierud. os, @® Fewtx] - cyplindvt shee _[zBom\ - _ ysrole — Expert pee. SOT 08: Lowe. extern — [cont] - teiange ls in shape Gase- upside ten downweind. (downside) Bs orm fm Body peoten. ; O.s om m dsthmus iS county Cisne in, CeANdE sem iL eundus. —_——-_ CF er cONiay in uteny19999000000 Rdlunions ~ fnexoxtY — UrerdXescell Pouch 9 Pedtoreum = Bludde. Recroutrerine Pouch Posrewordy — Cfouch a doug Lus) tatoudly fallopian awbe @ Broad Ligern ork Uterine Ane. ® ~reansverse connie Diguermard, Utena usar, mace wp thee Courier - +O inside) sewus codk. sMuant — Qesryerd ©. Perteepium = tick smooth muscled @) myornesdum— Y @ Longinudines! aa @® Fred aide) © cielo “boron " @ lendomevuium] - dieatty pred om ome cirejeal Colournnet : epithelium - simpre ue du, Newel ynesory — glomds, Ness _ Canvevied = +0 decidua in JAegmeny, CeNix = cy the Qevel a4 goepernel os squame wlunmer. qunaion. secaup'eny erdomanien Te acral SeANIX scan ty CLess? aia (. ecient f ne, uCOSO, wd toy IPM to facten)ea —> two Utewine estah sic Porrery side. ar A Cbhaunch 4 qnyermel guess } Axntevay On Conmmen 3vKk Nerow) — uterine Nein = \ frieqred qlrene Metre, ql yer TIVT990000000 Common nut eres cen Lypmpheuic Doerr © pevicicvosic par Qenerd Core Your Oconmusy > suporrreral. trgunat goop ®. souermerl pice goer Ln Rene +} Porsprpet Hc, ope ae posin IMF. ——— dua ne mst pers. “ Tato Te To told a Insensikve Fo pur, douch, Hee. uz cenix "Ss —_—__i e Que fallopran tube (U+etine tube) ‘ veov. a.iy jo7 | ‘ drbramural stem) © me Beeps 7 ¢ B ; Simba, == jis ad Jom +ube frem Uretus te oNwuy, ees > Parrs: arn gonominal — athe ie (ase (a-tem) LI anon fom “ ” mads up > 3 hovers | T 4 Osenosee @mvsculer (utes -Lorigrauet SRAOS Ch CmrdNO) tenes. ct ee - ‘aeuyeuy) © OURHTOSE Cine s ha © Galore | Gmesosalphiny smooth mizeeto nail 9999099000008 @ mnucoselL Crnner mosr ee © erircbium = civicred colourmer epithelium @. Secomyposry §To\WUMNar CEILS ~ mone at — Isthm @- Pea ceus: ‘d Pow ‘ fumuion —_—— © Teonsyorut wr arel Sperm @ Fenn rahe) . (3) Zygore « CowniNed. and “ten sport to ureune cavity’) Brod PPPY pase prey — Navan Aniery ane uteine A, Nensys - ONawen plexugd % Vein L hum'c ~DNcuN - nun along ovewan, Vesseld ard Hersek puraconn'c geoup 4 LN. ovuvien Newnes. Nene Suppy Utewne arel2729290000000 > gis a + ofmension ~ Longe - Bom wid - 27 Hworness * 3 7%: gross Fenawies Nessdallenie. Bonde. - © - @ oe Anirosupewoy Border @® posrere rjewion Border pree"| — WUneter surfaces pe - foveal Yiac vessers Medic Lateral Fetlopron aacbe ~ dawan éMonbsuiated fo sset. pod Cletanel pelu'e woes!) oNewan fossd nelawens IE I J 1 sugeror| kererdby. posreniondy obbuic0) - uneler goriemns| vessel = fresh en, essed red lby Cows)00000 Jremal_ svonne COmteNe idl, Meohurig quate - geminal gute hue - COnnecHye CN ep w'ssu @_ doer, en Cou — Tunic cbuypnig | ~ Blood Vessers A Newes- on — purmocial fouvcer Santen} = Vessels and ~ moarusins Fonicied . a Renved emreurg growing reo haem, - ign FOWcle oY Nien “en fovwrcre) Wak _ htwemr's fasgenh Uden = compu) Luter ak mesooNerionn_ border - cosepus. A\bveeng Brood Sup - avatar Artonl poarch. 4 cubdorni nek Promter MenewJ ~ onal reer. U oNawan, Nein ee gh s ae, Remar vein —73YC Lyrephens'¢ gacdiruge + Perrererdortre § Joour P Nowe suppry Seale TI0 S€aamerih,1 @ a ° Qeé Placenta. Cgr0s2 Sh werwne) ie -e > Tissue Howugh which bey 1s atthehad_ gait Mother UFO) (Comey be ote Port) 900 ee Placentee S -rmercle fom. chosor) O Gxer baby) ond. — deniduas Ca} mro}her), StAUcr wr & ¢ ———— Coy craeler di'se 1 'Ke SAU CHU > Length = js- 20 77 / — Ahicness - 3 OL cur conzee and — Hickness Aaeouss jowands edge weight - 500 fren Body weight 2 Placenta weight E 4 ery) ( soogm) wet I ; Conver) monemed. Ue -~ smooth C How) 15” 4 - shiny Plarenyer is ampnical coud 15 ached, nore av tenn fi] 9 vom SOBs is fetal ongin -~ Red colour — conver . Ammon "Ss easily Peereel ¥ i fae — chostio Ow, than te eee ood ° CS ~ Gg s cucuthmons of) Umbinrcal cane, Cuobed) cuie io e 16 eC CG eC C c C C ¢ ( ( ab jewphol = Parr 4 Pla renpe. chonronre Plate and Byul plare fushven. chundus) : mosh ck «Uppec pout => on Utesus a\so ial ad ro Anretooy. a WH UtenUs om posto wor seperation - ppter athe biath 4 boy yiKIS sepened. . foe desichu Sporg,osum_eg- $ LE Barensa__Amerior) os THansfer the Nupaterus ond waste © gsiod US bUH eee Caco ane oo Amarens We descoibed below - c &) endocofne _Funcvor| - . 3 Placenta puodures Horm ones (stewid : PepHde ) : + these hormones ere Ne CLSSCUY : fox the comninnor) af Paeymonay (2) Bare funcker, x placer does not allow passoge a gUb HAnces. a 50, b is prorecttad through herd ul substonte- Unnore @(3) pespinaxesy FUNC Ee pAom mnother to fetus: —» O01 ON SP O7UF ° : shvough sre digpsion pO fexuj to the merhee aeons Por didpudior - 3 cg aproug simple op verry med gee 4) Exc creek oon funcH orl, > waste Produes Uren, wie etetol, cHeuirne — ear farethe towdrold = mo}er rough — platentd,sors rel oo 5299000 G Nutaton fount on a a cee 2 = WnhesaS fersilircured - dore = Tounstee Cone. IN amore > Lipid - dinechy Bouby ase JV OSE Ht PUNS POA 7 ABANS yous Canon Hou Aitfusior]. a puoretn C(GLut41) prune decaess IS MU wse waycenise. cur Ferster Meme, oped PMOL mothe —_— so fexus ahouah Placenta es 1OwI, aauns ported , Torigycerides, chol - RAmingarids - Requiee oF ene perme cc ite sod : Jrospho-g b : ‘ onbeutan gradient acevle Keunspost aes energy ftom ATP. and chonvdt by a yes’ COL fuernsporwe ahyroid ) Ce0S5 \CHert Horme Ned - Cynsubin, Stmwidss piarenta. © Enz ewe funch’ _ Oxrsocmeafe - preux down dyrocn, — Dlemrne oxcideage - IneverNayey Pxeseure Agent CAryp'cterny7)8 Ore @ phos phollipafe Ao - bstewelown — phos phoiipid-s. enw alld ‘cul. Furor Hca supsiess gmmuanty 7) © o> weeds, TG oO (prodmad for Moyher. Placendet) o c ¢ damon oe cel mediited — fromuntyy ——> shifts sowarels pmribody —macioned “derrevinihf CHumox eth) > nowt Hier certs C Ppmphoete) hep #0" peasiseecel — A therwhomort so hetps in acreptance of beuby ee Povey ent termine CUHRK, blocks anybody - whch — 100K manera ; cal Pyeteee enue ey mapa Aveoeats oo Shcsunillal X99900000e0 _ prese L m Amnto We a) ame }4 SUounds Ferus. producwen - mixed. matemel as weil cs feral omigin, ciarlunton. - des seplaad el Z% hows: Monemnenh cotedlun'en. —_ Amo ae e), ————> | Am voric ers ‘i Wand Bid exchenge. fete ducer. Yorume dipenr ar Ujeurr 99% \2 wxs 7 0 Ben ag wre —> Ff a g00 -s00mb, Ay uot (40) 7 wre 7rr Physical feusured _, pH alkaline speuic spray — \@ ~ %so mm osral I opmolerning C hypororic nasure) at teHm 7 cooly fregna ney — COLON [e@s8$ Clean. Ronen’ Bogner ~ Cole ees Parespeew, a Moormal corewts fered . Fecontumn _stuined] Cateen) — Ges, -[gaden fowrl> = FM inceomporHt bri Cary Arowbrasresy's tered’ + test ma Uasry oTey|- croor'dented. hasmesvshege, _ fax ee + HRB Composin'en = - 98 gay. water ongame susyended- Poorer Pann'cied Soc'um_ ee ° - Lo chiont2- oie creid, + epithelial cers: CHeanina, + Nerina cysens et, Liptas = CAS PVM ome MmUmne + Reapiricory, tate ¥ reve Hesmomes (nsdn, yrolecH¥]) eeale yn dQcuK29999000 Functions y \ Ouarng J | preanan Duh Lebo Wy, so, ferus is poorected ingory fiom a Merrcuin temper tune <1 foieo_mealemerth 5 wer fater_ qaow rh. pupryive Fancher. footer WwW eyectroryr 4 woyer) crnveal Ferpons ance _> @ fare wellbeing, pid) Nuwre, > forms hudeosheet'c cohtch —herps Ww canna diclure or. L, during enonwusHon. qnalenbs chee cone open coor poor SHOT —> YorechS urmbiit'ce- cond compress!O7_ Fishes he piath cunal pricidal ween = bad qredents ingore IN NUNY GnchuHor 9%) Lebar @ chore nseHon — ® arr C Prmiove fd — ineler) Jory hydaermios ~ mone Hurd Non drernt OF — Less tivid, @ feprinr- Indunior. oy Labour mMemaare.,© Q-3 Fereel_cinewluion. Tr q CORY genared piood. (Piacente 40 Fens) Porterl ; Ne J v Lie) ive an J el Hamer, é t R ovale Venparcle. ay " \ Lee Apium Purmoneary +7uUnK ! Lefh Nenbrcle y | er rags] Ly puc+us |S HenvOSUS _ Bo he eee very] Commen give Araewey dari cual, “od. Tijernen — davece_ Aniou'ey Placonte) “ene ye hecd amsowessere allel 2979900000008 chang in Petal covcuferion abiee | bixcth. Clos ne ° umbsn'ced Avpeu'ey a convent eal nro Umbria ciosuz © umbiicd Nery), — commented into Ligamentum mucus Venous clos une 4 — comiened In te Ligermenturn Nese closure + pucaus Asteviosty — convenseah in 40 Ligermen rn cite 0 SUM close d Fontermmer] ovedo. = cometeal trgo fesse oneal.| 2979900000 e@ . o 5 Q- to Diagnosis 4 Pregnancy in, Piast e +uImes+e Shmyrons- ——— +O Pmenorchedj — stofage d mnensp Hon) 2 ay Poprena] ~ cyclic srw Urnown- of breeding wey Occ. UPFO 12 WKS ( “4 (2) Most - ~ mMausenl emd Nomipng, C4 HCG) roth wis 7 me aocwend.cal beyond (3) Frequency oj mnicrunation. > Foorerded _ burky urerus AO compression OTL Bladdex. CH) Beieasy ats semper a> mM pain gaen dat » Bred dli's cornpork ts commen, Furness 4 bored sensaHens OCCU, oO (D Fevique easing becomes fear > Womensiqns —— 77799000000 ee a NPE ~ eect. , lu, a amon borne |8 subeicle. - Prominent Csebaceow) giund) — seconde cchreala dev elopmert. > Yetlow'sh discharge anual 127k, © fea ctbelarnent _s Uterus xemarns penrte organ, ~ ean nor be felt’ crneund jet wr - suprapubic bvig# ts Seon. cha pewre wk TJacaueuents sign. > aweund gth brursh dr’s Colo eH, Cive) nragined mncwsd vagina — sob . = pusaHon Incrende ~ alyschaye: ostandes'S agri U Lapened, Forte cove) puysaH' Or) inoyende. COHN > Cacs) ——= Croodeuls signa cei becomay Soft — dicen secoeH'o?), = closed,sateen alll .99900000 Uterine sign size “andl shape cherrge 7 sHh Cc wK — ) oe yents _*8s. Janitor K catered bau, r + vet ok - fewus ie) we gys Ke ces S' owe. potaon’s 32 C PLs) 4 Larered “gepiantan on — one hoy % wren) soy - Qnothn- fam SB, 1 os demon Sion Oh: L eacuimny TELM ON, Protech ne — Bima a gne hund — Heer) Vagnnd, Hingert's praccel in Aieviort. Pomnbe Abdoamen, onothey hand = essed p omal cuppaea roaiea) 4o vaginal hemd, Uterus {Ss fey peewee these +0 hemd-s- — fF oscuns because lung pocag nemney Dower par | we berorne sot — ty shoud be gente.‘ae YVVIVI9N 0000 © fParmesis sign. ete HOY. —» Bimanud\ > Utena conte ctons Fae + dusting Eos Canty as i — dither v0 elveit ammound Framunoroay cel. Tests: [Exinsere] — [cal wane + Re CHees) Any seunl. cpus) , feet — -8 wos) \oth wks- creer) uning 4 Hon WALntor) Zo stow BD Fndirecr Agarvinanier Test. Annisequm MRO : [Laan ane] | a tsibie Ratu HNCH ON N on femme10 a ces @Pirect Aqgiurinanen Test - 2 muse — eet cage ttt / 6 lo ° ‘ ha HCG ams ss Are Pet | * : cre + Anrbody period, S CF . c Nonyp »eynem} c ¢ c , freq nem UAMne + Lerten ody ° wa i Het Prob Het Ann pect F 4 _ No nisi bye Ra giuvinedtt visible Aasynnext on @@ Brssa — ELSA Uno son bem CENeprt Qerteod pom ect) — Pnibody Pirxc2o Ss & Ee Fact Cuarine, serum) = Urine, sesum Aele Pmubody = Aniibocly cooned wrth fied, Enegone add, ~ Baopeaa - See > hows. 2-4 / os : ica 4 \-g mau)™ sduuys before wn'ssecl period [eather _ peo peoduoren), @, Pro grmunoass] ee pated tages) wih, front olf > = Ny sensitive method @ ~ \ maudral a-3 howd,D2 29727°770000008e Rack’s dmmuno assay > frnnboaly combed wrth Readout tb stanco a > 4 om qu) mb 7 Z-4+ hoy = ash doy “| oycie. 4 4 Hety Amivscly Te ggecl wih 4 fas. — 30 Nt ed > gomau | mt. - Hime - gh dony raise posimene Test : Chonvoceret'n oma) > molar Jesqrnny =a NEGA NG SAO evs) — Cupra somo yap hy) See (crdon — Trumnsv agi nal Soro gouerphy ts waa) — ferus tmpiantcien site fois 1 fey floes C york sete, Ormmvonc cevity, Cordie comity — 6th wx, diss) ~ Tew Weer sounds (10 wx) (esr afte. wmssed Pewiod,Q.-1 Mechanism of Nownal Lebow, 1d 1 ® oe 2 og} Sees of — rmwverronpy ter tue plase c * c on the hed in the proces) OF el oduptaxen. dung tris Jowined _thngt ‘ The Penis: com bindy wrown as c Meohorn frm “4 Labor, : The steps we dey aided. below. CE, F, 1 ec. D A, E, DJ Engeyement . tng LicrmMeretS - a 7 nl _, Subocen {140 — Anaero po sxe O71 3 COMM My bocegrn atic (3.597) _ Teemsveye diamtier Bipwritel piomerer. cy.5o™) injo the penic 5 once the Heard Feed te 7° gece known AS ort. om wt > uung Erigugemvernt As Hf oO CUS Aner Asprclisidm gosie-ion tomy Portis agyncherisen Ameo, Pastel oun Moskeson ce yresentoH1onr frees picsenteH orn, pennies - Biyurtrel cltumerer Creynsveye dt'ermeter) \S mob foreller with felvic daler.| o G ie c c c C ¢ c syndi iro — Taunsslense Aimee plane, pelvic alu plane qoneblel, — thun ir ts Known oS smd Hom, => asynclindes {s beni tiered In tRe wechin'frm 4 engagement _y Mepured ond perss tam asy dittm — indioutes a cepeale « geric dis eaporHtOn Ce) Eyere'on) — 5 dueio urovine ceorrectald On. beuby hero iS = ~ fore 4 conreunan 9) aed push tre bey woe pis rots ed cervix, ~ Fpoutoles He desist ent perome a SO) thet hen dewstanal ROYLH'OT gk peuby gnvermedly 6 drier Rotel wp iad ston Br : we un a rere o} ihe FOLAES, Anaesor) “S yr" cea corms} ny from she LY occipite teunsetse postion, > oceiqur Deey quot Neen fubic Ym prysts:~ »b ore goed sowenes — posieiar —_ ~ YAS 96 HoAetterL, om AP Rohetror ~ dyed this tuisHry force oceuy ON NECK, ~ neck _nodetted and tuxsirg become Less, cxuownrng " qyts further oles Cem o bobby” Aare ( sean ese evurnesex) NVgth. TD 9900000000 aa Biportred eqynesnehes curved Ute, qoiehoue OMY seegssion Sf ead exer) cafe the. Crom aH O71) is ower = Know) ds caoooning, perivery of hesal by Eurensiome . on = Now dueto doit Udseune coonraedH 1 pearl desert - pead dleliyany Ocewr’® by Exrens' O71, ~ hi _, 30) Hast ocaipub P and He © nn your amy our fom niumnd = duck “ou youby is sourwte 5 al ope rg, 4 an yr Cs cha wrsvble Resiaungn. > anwor'shry pussNe aman ememy- ° *| Neck. oy the HeadarnecHhon thun + Jr occws in Reverse aho mien cel ROTHH'O7L, ee ie Veit C45) Euemal Roker) — movement o Roreh'on pearal exreornally due 40 ayernad RodeHon o shourdet . des in ReVeHSE ainecHon ther pnaenned Rote OT in con“ or a4 ResHquHoyr. D000 9008e — je ys cdinech OTL. ° C Yet) ayer. puemel RopeHrarl. occtpuk comed pos! on ¢ Bryeperen oO ced pur Now imigh fate (4 Lot, qmorrenrs bef Rig thigh) pebryery_ 34 chourder and +ounk by Layeuk Be2uor. eoyermet RotraHon chouider com in AP dim erHorL _ pdvey done Hy Ounce Provo eG) ue baby esi ceomef Out,TVIO9900000 # fosivnens OF bocby in] Ute) — vives Rt = Longitudinal 3 Jaesentunen > cephalic . @resenting fart] Newstext. (Lie srelions’p bekven uaering es cond Fea oper, avhuee tHe al eam ened Mudin feaus cohich putas gresenta@n — Park O) SPE pins Gwe weno > enk) Oy > Nic C Buyuek )JV99909000 Poesentirel york > the fur of Guemal 08 cephol'c foresenH'ory feejentir9) pou ——_ 1a ere [pew | [Face\ Neve] bor pico Point Or fruenting Parr which. comes 19 srelunrensmonshie with Aha Navous , Qudaanm + mMetexneL Downy oelyen, Rs) ap Knoun As fxelenting fot 4 pels - usejun for descieli ry pos! Hery cee) _ poe © Cephanc _ presenbestt OY part | Rone, — : fsAuwon At dengrminyrl. @ Podedic. Presenter” [eared cond fs hao aS dengminkh, enk—-> whore bypon'xed- Arumerer ts enon, Engagement fass inside _pedic__botirn, Cprorg) as Exgagemerd.tel aT 29000 SII99ND000 Dia mero +0 be Stern em bersal $f 9 (rem vie \ se —_ oO ocd pi+0 borer ee 7 chictrneten. Marries - | Biputtel a. om ciate 9.5 om ~ Supra Sub. yourpel diameyer B.5aN ———* 4+ ye-P Teunneve het a diarneter- diame Obsebi'e obsrerrine bispiino 3| Longer coer VE | chrovmeren., te Ton utter jos orn jaa = Opnans orhens -Taue Conjupuke Right obnque Becgeeta Lepy obrique. ) ConjugateSaito) tania) - 199000000 ie e Labor, c VSD sye Laboou. © flask _. onse+ 4 AicereorL - jt wtth Fur Pos + ae Nonmal timing - paige ee Gros! enh? ss gene @ seconal s: ; fury clialercrten. 4 —> je stass corth connie orn erds wrth eacpulst@7L fexus em por . =f hua _ 2his nee parmigoeet _ go mind re? mul peee® ferus Pore (2 thind Ss a Ww eaepulstore -» it gots, oa worth eepunsh ore oy plarenie inh. pe cri ornerrye timing — | s_meinut es _ 5 minted a te > “d “aAcHNe remagarnart @ Fourth srrge ers tre Ss o Ob senvctHon, fo bleed} 4 hour ater eoepursiore of plaerndct: og riret. pleroling, — Nites of morhor, Besby romped Usewrn £ wedactaHtor).' ° i © naH'ens Cute) 7 6 a) co * Labos © sewiey of everus thet take rire e tq the | den me ee . repel the Cherus and pracemet) out © urns dem agin fro ; quar coord. ae periveny + Je vs the exepursfon. 27% goroucio) Sf wicbie ferus ode 7M ures Cwomb) — be vaginal Aelia OAL — cescuieu) Sou Lauko» asd, delivery cun be uotyrour ue Labor. poun. ao Gy paintul Uterine MAeANen S @Q> Ruequency >} Se gmersty cine] aH, PP w @> Pssocvareas Manwcus Plyg? aa oO A vrssousive dialerearion om “a ae @+ vesurk of Peesersirg m . (Ge bag of omtaer, sedatives 071 enemet, M+ Nok Melrevecl by| e 6 e o o Cc C C c c c ¢ ® Fase Labour Pain A © Dun in Vertue oclegmorl. rad =O Lower oth. C2) Comp od assocreued poth herclenhg C3) ray be uyenUs iu usually prelievedl by omalgesiey sed. uHNed: eroma, a wee cs) No Othe feral ee poun qoresent.“gue ye Management 9) Thine ita) = oj Labor stone with the “4 Leben 7 ard ends orth erepuis'©7_ 3 wsien feyus ; | Pracentd. ® ' pyenrs MA thie oetge” @ pwacenee seperenverL ( noes oh ectducs G 4 utenus censeu\ sepenrnHer] _ t | e ea c Third srage 7 c { c Margret seper eH. Mone’ RrrequenHy | @ sepeunion of Merk co Geruserh 9] NC Een ~ due 40 yyerine comme (yy mechenstrn + oe ne > past en ses emg berg comorneal, « Lin Ligat peypen oeguhle syet 0 40) pjezelin > thwmbos's @ crinteably yon 4 Helined, a Gatenmistent cis ceomfou memperrss because 9 Uteunt commen, Nagas THadhigCP FTINVD9DONN0BB00 fer abdomen - Udenus— globnar, Fam, ~ fundus righ - sug’ sri - Supacepubic — bunge. Pen Neginum a aa Teaap ee PCR ent} — two en exhods paveinable mage Man gemernr E ecron* cles o peeby @ dexen ee clamp), ¢ devide cmel wee Ligare “he comd, @ netnonging %" oy _ ran 4 peinte " Fount and wd fone 4 ™ “¢ ie \ * CO len a ae ees ; « quand Phx fundus are “ee + Wain fot _ spontnesuy SeperuHen. Prucenter Seperton. i 1st fein feuys Reraye pee Semm L Assis dep isior AP Ful er le mugs war Reet t ee| ® 2é e e oO - C , ( F = nut oer) = S[lo Unie | s\ Methuupin 0.2 mg 19m, [49 esermine - | ¢ Placenta g Membrenes, a guciprion _# __ Assisted) eeepuranen = gsistec| Sep uion oe (_Cconrm cord cpocicl G71, > Let homnol Cfingerd) placa benwert_ upper segment cmd Lower segmerr of Utequs on tho ower cabcuarninee! poke 4 Pewee eto oe hineceal upward chrd pevkwercl cdow ral Umm pt ivcus) > Right hanna 7 Uariscet ond rs punedk pelekw uns) Yaw downoad wapeos SUS placntet corned ct | SS wee stomnaled ours de a cone] 7 avoid = St tauHor % umpnvou cord "4 ’ (2) Funded bessune 5 fundus is heid perwor — Firgers ond thumb fom Abdyminal S'Ae, —> push CRub) downward S coher, Urexus peal hwid Cotene cegnrseupion, ave cbeninte) OCIS. Potente use for Aemotat Placenga pauly mel od enasedd bey,) Fram nen on > Plante membeqnes gnd. ps © _ cosid. Cay fnspenron a Placonie and Umbivrceel © cosid. afer washerd it, co D> Matern fe ts covered cuvth clectdluar - 4 COmedond AL counsed « qoujerk— “indore missing — Any elepesston eo fyLedlens > umpitot cwid 9 2 Umpiical conta ord ont ums el Ne poem NUH OT) = chon or], Shagay S& Whar is puanpedum. Fonowd chid boa °4 the ettod —~ i+ [period cdebiveut) during vobich hoody +tssue Cespeciedlly pervic Onquns: nealert back approximate} ic pees mate bo, gruteientll op ph Jojo oY > ecceprion = byes 45°98. > Nosimeay dwiaHon ~ ee he trpo Dat aS ten, esos © irrensehiotee j @® ead — Upre. 4 dey @ yemole- “rte & ws, his iso Conndete a9 4th pstimnistey9999900000000 Q-i3 LOCHIA Pager =— => da is the Nagined! dl'sch ange fon +ho por CE) dogs ducing —Bucstpentren— a ats change or qina te4 Paem Utes bot, COANIVAE 4 Nogind, Normal properties odount — offense FIs smell). Reacher — pAryaliine - camieied inxo Aerdic ReacHOrl - 5 Lochice Loch'a Looe seose cobb. - Real cowpured - ydlowish _ wohixish, dlisch oe _} be a lone - 4-4 dou pinkor pole = WwBe som cin prowmsh _ mutyy - ans ~ : ~ deride Petey mermbaanes ° a . deidua , meceniy™ dogs: qounvloce a Less RBC ced — WBC. amirro oogonia, 3 wand excudae, + dt mo Comair) bacteud , » Nok farkazen'c 5 unl the signs . “ appears, ree]frst S66 dos ee ene Arno um} gsoml. Heres ten III9IV9 M90 EO90e8e) Nawonion in dAwunen —+ Nosmnably - je cur be fon 3% wxs eso. — Scunty Cles) - prem ature lebiyery 9% bee by = Mone - wns preanancy = Pory al Hom mio us. fs fon mone dou fn women) who - je Je up prem bed. fasr mg Late. cunicel, as tance - gine fryer evo? cubout cebnermad- puenperuel ste : tunel ped S RegureL eximered . odowi > mcl\od out sndiente frmount 7 seunt scm Puerper; al. sepsis CO|oUH{ ~ Reo for Longer Cgnfect'on) Hime pureEH’on ~ mong Therm 3B wks° ogi Hyperemesis Gooniderur 02 Mn yy ots seve ype Nomiving of 7 P2ce9pn erney hr slew epfeos ( ‘ % hath ) moter SO thet she is) Unable (ko do het doy to doy _cuciniles: Exi010g9¥ ; mosry ced i Peis yma tata common 11 hal paregmeey Younnge te. commen 1) Low body mass. moyon sickness 774 miavedna, mere cheney Pamir, _Hysroo"4 positive. wyderiforra TONE; teats Pregnant), Theomre, colaich erepleit) he fosthn gonty's @ fosraanar) - © Hohe Level wi el @ gr @ pupyess C07 el- rroltild Atebe © Prychogerv’e - spjess, Uncarnge @ vier Ayreon e Diyus — ceerbokyetoctge. 21 2800NE- Pr , 86 Apion, oS proteins @ Anegye - G Devaessed geste anon Y aa Nomi? “4 TS ccecbal get vu shou Us Ketecicidlosy s 2Parroiesy Coe aed are NlecroH'c Charged , fare} chengyed © vidney = faray chung. tuted Neorosis. © cet ss) Chere, dormuge icneny : heer ~ cubeneto cercral haxe03e hese, Baan - Hanene thoge = Wernicexe!s or cophedio peury In dfteiensy cA vite By Aap crenc/, weaebone Change > [Y_ camo] a far mexeeborg™ orl / yopern poed ) ~ ie nn ee ereetone “4 eroeesi dos? v E all nm elector te wm bene , Biothorn cu — pypegryem MY Po (are ener e pypo wiretrninosis p concent ToHON inMede, cit cullenerty — wer derpets, cyriolerony NOM Linco fortune ea — Norm Hing) sovoughh jre dey, - doy qo dy cuepiNn Hed ctisnirbeol, ShouryeH'on, — no dehydaatian = N°reer cmd stanNaton, 6 e Late - dehdeaion a © Sresoms — ft Preqenoy «] Nomminia Cc ab Uatnn Peequerey © ON apenas ch 7 epigesrnv'c pan i 4 CeonsHp HO, signs ~ Perrys | deky doctor — PHA coureed +0! _ Roleren eet o ~ catercone C Pmitp smell - Towky corel _ hyfetensievL . ~ gaund' ce C Lene fougurs) Ne on jregrer) rs poresert. epost Tone garner a on. \lo\ume = Less 0d - umn excurminaHon = Clute ere gerent prresenh @ eteramoryre conc. - Nevis) cr eH matron — genpelomee Senum 71$h) 1 Tyo Novimet . ¢ Tes = mu be expected wre a cilreucy Frown code. ® Opshalme scopic grees nu On = Rer'teal hooray) © EG. MA be adnosrmeel - fryyerclunna, 2 © USG- tocornfinm +o feoe frtarnedl TyesHoN 7 Pe genders - UTL > tortsted Canaan Tumour 4 diabetes. Hosts eb’s eon 7 fruvds = Ie Sih OHP HOSE opprmurmutely 3 Lied o> Ringer Lactate 04 conysHoids eon, also be ured, neues + eleossente CN IS muuingosineal, o Ryle TUbe Is Useal toy Fesalind pos 4 @ prone rhu zine @® Porochronpar 2'n€ és Qumine + Viterni7 B pre voxyrure heel pone esufe and Navy much eppechve U@. ondansat Xone — Navy mush open. ©: Merochoparmrd e= Cun alav be Useal - VOY much, potent onus, storwids - Hy deo omrison?, > 100 ra) Ww prednisolone > orally cam ve used. a coun be Ven. qutmmoned Super fenentoul Nubniworl + Nuitermin 61 BEY Cr Bia Psychovosical supportwen mMmarn*seu'naa — chow 18 = AR, BP, Use ourpet, Tempe dairy sr ecrded. > Featuney Teprovem enh — Nomning + Feeling of Hunger -— Peer. Look HP, etecrrors+ed, Y77990000000 Nosmnadisanon 4 BP unentHt on err! a — Then stop peromoul 1 ( oneal ; ¥ If parens clocd Ot deprye- a Qusy opHen. as |, Temminanen 9 Prego}— cL CL > Q- @)- 1544 Spontaneous) bot”) ond Cmi'scanat ges. & => PAbowen is the 7 oe embryo Less then = S00 Faern coen'eVhy qreapaballo 4 gndependomt swivived trem -Motheite. —> Age 22 weeks fos Soo From wel ght: Aboxno) —— __ ae iWleges SF coms AME, OM", Comms ae : MT (2S) fimo] J poe J bie | Ace) e Gnevi Freon eel ephie EHo\ON => JeneHc 7 teisomy , monosomy, pouprondy, ordocet (3, 4n) > cofines> LPO (Cprogerrerone. depictions} qryeord omomalres. Dldbery ™ — <> Ametkornicadl eet erence > en etO care in 0H HON, e malfoueneh' epics @. congex'nal on tdetus pepra@ parasites + Toxo plagmna gordi @ Bacreia> chiermydiat spioochaes 10 e @ usenine Rbeotd, ie : lo @ Fneouderine aahestor. 5 a C feeri¢ : ; 0 vies - Rubelicl, curomegadon ios We med c ch Fommnrorogtanth mS 2 And phospaiiptd anybody syncbiome. > T hetpen celts CLoRN UY OTL = NK Ces clcHNcLH O71, Nother medical Gllmus- > eynoHc Hent cdisecise. _ Rlemarure Auptwre % momsacnes- — Porenpul Keetors sjorm abnovrnedt _ thetembophinict protein © Doss- poo thor birL more Hyper cocey bint, 0 clgense smerny - enainenmentel > © Alchoho} dnimary ® commaceps! eS* ® OMUYS Chore! - © eminerinonzel suach'aHer1, 2 Jdopatu'e Cumexpreeinael) 40-60 +e /e 3399900000 Qzi6 Thiettened _Miscommiage pe a gr ys the cbinical cond’ Of wha abo Proress aj ris eee has Steuttedl paog2i essed do a siete put has mot prom. coh'ch. 2 CNY \'s Jenposs' be. symp, +6ms ie = @ Bleed pes Nagin - 9 _ ap poughe real _ mor be baisks - spor erred} Ste PS. @ pai > des peu es% guy Lowe cabdomen Pea7L. a fo\owed by b) eaol4, Pole Estminanon so Q speculum exer inuH ON > breocing exrernal OS: oO. rat al enceornineakion 7 COTA os ©1089 —y Wrenring gize ~ NON ~ cenix soft. re Ust aNarab)e- - onordedl Frvestigenions Rourine — © Blood, - Hb, Hern cutogsi't, Ao Blood Jeu Rh ge upton @). wane - Gerenuinoi ogc Test. = No} ™much help Ful. as sh CSO Herre ager Perel cleneth, postHVe |oN hy NE) e @ ©UMBdS © @ ° ae wer formed gesraten scic.{ move © @) feral condacre movement. Chernes c @ eee Comm nanos] © h c @ re aa ee nto c Cond cee CLANITAY CUb stor cherneed of C CORHNVOH OM. — @ serum yoogerreroye = > 25ng| mb. Ly \ilebie yaegnency, @® sem hea, Treukmenk i toot . Resk on should fe ea bed Ga nesr: de unyy whe resol srops. — fe on ard heey coor K, Jer S> @ prazeperm. Csmg) Tob (2) Dwg 9 EON in ca . ) paogesrerene — GMPIONe OUR, C¥psig es AAYARALI prowiice seis on aC ae chowid be ovoides| gto + Wk > = Repent Uscr copter > Pg curses coon Mua beyord Ly wKs —y more cheaned 4 Predenm Labor ; growth eta eon ; qrarenta Paeniely feral error S123900 99990900 a= it Missed M's covvt ge -> whin ane for is dearel and Heedned| pede tre Unenis for Nawal’ Pewtook- ay sme. ynoun as missed abonwior] paths logical Chemgea ; \ | wo WKS <\ewKs paeedls _y fers become Flesh Oe moacerued ry > srneny ™MUSS mum cae _ placental thn Pane Lbs prmioe Aurel - ” e) —_ epbsor1pH1 71. a _ aso KNOWN tS piood mooie On 7 anole. cain chinical features: cont => fernwy Y thie iq cust 71. me preeding 5 qaur. sy pwants ais change ~ pxsaynerret S ory amd sign d's copPe U4 ~y cessaHon of urine growth no feta hecwur sound fxm ~ 4 CON (2e a Semunociosial teat- Negative. - Ustr-» emyay sc, Feet Cwidine moron ctb stent, NO feted mements.6 C ic lo C Cc c c C Manegmnent => Expectant Ci Meds cul amanegern enk 7 s wey coull W [ ) UteAUsS < [2 WKS i AteHNUs 7 (2 OKs sapecrant 7 spanranrous\y| en out. nde) ' 0. mrsopoost0 | - 200 eaticerh Gas po sseuon Pornise “J C misofeosto!) 9) \eepinas s00 : Vagineny, ok hts mew tn poste on fon% pope = => Repeuted afer 24 bAS @. oonyrocw" - TE need ed. ~ \on go vats TL => Moshy exepuistor OCs soo m0 NS wyhin 43 MS: = go_deops [rv , . W. sungicat agp meds ot J yaign and evacuhen wmtthod FANS > aAtasenon ond wacuien. surgrcel methods chanres uaeine welll ®) pidicyeuron emol Mm sutare eveleu cut Oo. : dam Seethed3 lo ees fry cboste7L ssocieted tthe © eynteed evidence @ tnteet of ovens co oma ws coment Samed SepHc cLbastH O71. ° . qnedence > Moy clter imeged gndued : aboxHon, € Etology berctet BOIS Anécobic Newbie srscoptococet-: cow) crasinidiur oveloh jrebsielly 7 FRET pseu alornorr) sgpuptoccd sjephyloce 4 moshy mixed (nfecHo7L . CRSA) sy Oper anvisepHic ard asepsis ae no} +cukorL , _, Fram oe eV MUHOTL, _, genisel ongunns dere. Parola Com termm aon 44 ms Te eratomnedasihss emdomersiurn ) ~ Lo\yoweel by endomorneni ts » FF ~ speads +0 Pemurnersaiurer 7 Navies) fertonom + * . + fewttoni's sepric shock, PeNica 3590500008 tal KKK | crcnvel _Peurwned = woman Qooxs sick ak anedous: qempewtwe 7 33°C cits & AVION Taek) conrdl'al. ppdorninet , ohsF peur. olay Ne (RR sel min) fenpoui eo Mental Sterus: cnn apt anrho eA ond Vom alton fend! Reread oma le tendleaness \leueboe fedaafc_exemmineron “donk Naginal turer ~ offensve > pur (Meas ~ Fendey. qeading guade 1 gues a Qenerulrsiea! guade finfecrion US prfeeon Locals eol +0 apo{ead ve yesrdoniHs roramebm) — im Pts faalloslen wa shock, wy, uterus