Wafa OBGYN

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📣 هذا الملف نسخة ٢٠٢٦ الله ينفع به، ولا تنسوني من دعواتكم🙏🏻 ونشوفكم بكره على خير بالكورس🤩❤️

طبعاً ما أنسى أول قناة استقطبتني وكانت معي من بداياتي، ولا زلت معي إلى اليوم، شكراً من القلب 👇🏻 https://t.me/fairdaily

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جالسه اسوي اللمسات الاخيره على الملف ان شاء الله، واجمع الاسئلة المتشابهة جنب بعض عشان المعلومة تدخل المخ اسرع، فلو سمحتو ادعولي معكم وانتو تذاكرونه اني انجح بإختبار البورد 😔😔

📌According to Williams Obstetrics External Cephalic Version: ECV is attempted before labor in a woman who has reached 37 weeks' gestation. Before this time, breech pre­sentation still has a high likelihood of correcting spontaneously. And, if ECV is performed too early, time may allow a rever­ sion back to breech

📌According to Berghella  and Williams Obstetrics ·       Most laboratories consider 16 as the critical antibody titer for Rh(D) and non-Rh(D) alloimmunized pregnancies, except for Kell-immunized pregnancies in which case 4 is considered the critical titer. ·       If alloimmunization is detected and the titer is below the critical value, the titer is generally repeated every 4 weeks for the duration of the pregnancy (American Col­lege of Obstetricians and Gynecologists, 2016). ·       In any pregnancy in which an antibody titer has reached a critical value, there is no beneit to repeating it. The pregnancy is at risk even if the titer drops, and further evaluation is still required. ·       The middle cerebral artery peak systolic velocity (MCA- PSV) performs well as a screening tool for severe fetal anemia of any etiology and it is associated with a reduction in the number of invasive tests. Screening with MCA- PSV can be started as early as 15 weeks. If the MCA-PSV is ≥1.5 multiples of the median (MoM), fetal blood sampling (FBS) is indicated. Blood transfusions should be ini- tiated for fetal hemoglobin <5th percentile, 2SD below the mean for gestational age or HTC <30%.

📌According to UpToDate Turner syndrome (TS) Growth hormone therapy: offer growth hormone therapy to most patients with TS and short stature to maximize adult height and improve body composition. We initiate the therapy as soon as the height of a patient with TS falls below the 5th percentile for age on the growth chart for girls in the general population Estradiol therapy : In most patients 11 to 12 years of age with absent, delayed, or stalled puberty and elevated gonadotropins, we initiate low-dose estradiol treatment. This approach allows puberty to begin at an age-appropriate time without compromising adult height. Growth hormone and estradiol may be given together until epiphysial fusion occurs, after which we stop growth hormone.

📌According to Williams Obstetrics Angiotensin-Converting Enzyme Inhibitors and Angiotensin-Receptor Blocking Drugs -       These medications may result in ACE-inhibitoretopathy. Nor­mal renal development depends on the fetal renin-angiotensin system. ACE-inhibitor medication may cause fetal hypotension and renal hypoperfusion, with subsequent ischemia and anuria. given the many therapeutic options for treating hypertension during pregnancy, it is recommended that ACE inhibitors and angiotensin receptor-blocking drugs be avoided in pregnancy.

📌According to Berghella Systemic lupus erythematosus (SLE) -       Hydroxychloroquine therapy is desirable in all pregnant SLE patients, for maternal and fetal benefit. If stable with no recent flares on hydroxychloroquine, it is recommended to continue it in pregnancy and postpartum. If not previously taking, consider initiating hydroxychloroquine therapy, unless contraindicated.

📌-       Second-trimester “fetal anatomy” ultrasound: An ultrasound to screen for structural anomalies is ideally performed between 18 and 22 weeks. (Berghella) -       When anatomic ultrasound examination is planned, the optimal timing is at 18 to 20 weeks of gestation (UpToDate)

📌According to UpToDate Antepartum hemorrhage causes and management: Placental abruption: -       Unstable mother with live fetus: Cesarean birth is the best option when vaginal birth is not imminent and rapid control of bleeding is required because of Maternal hemodynamic instability or deteriorating vital signs Placenta previa: -       Cesarean birth is indicated for: ● Active labor. ● A category III fetal heart rate tracing unresponsive to resuscitative measures. ● Severe and persistent vaginal bleeding such that maternal hemodynamic stability cannot be achieved or maintained. ● Significant vaginal bleeding after 34+0 weeks of gestation