Pregnancy and Birth

Learning Objectives At the end of this presentation you should: 1-Enumerate the problems a woman affected with celiac disease may encounter during her life 2-Be aware of the methods of diagnosis of celiac disease 3-Describe effective control for the disease to minimize symptoms and long term sequelae of the disease

Puberty Dr. Ashraf Fouda Damietta General Hospital Puberty It is a physiological phase lasting 2 to 5 years, during which the genital organs mature. Manifestations of puberty in the female include:

DEFINE Any deviation in normal frequency, duration or amount of menstration in women of reproductive age. NORMAL MENSES Frequency: 21-35 d Duration: 3-7 d Volume: 30-80 ml

PCOS: An Epidemic • An epidemic in developing countries (ED & PCOS!!!). • About 20% of reproductive age women demostrate the ultrasound picture of polycystic ovaries. • About 5-10% have clinical or biochemical signs of Anovulation and androgen excess. (These date were collected prior to Rotterdam diagnostic consensus).

• The name of this group of diseases was changed from "venereal diseases" to "sexually transmitted diseases" or "STDs" • Now many persons call them "sexually transmitted infections" or "STIs."

Serial BSU's • -hCG Levels Double Every 48 Hrs • < 66% Rise / 48 Hrs Consistent With Ectopic • Single Determination Not Helpful • Best If Done Within Same Laboratory • Never Rules Out Ectopic

Anti-Mullerian Hormone (AMH) in Female Reproduction (Part 1)Essay Submitted by: Mohamed D. MansySpecialist of Obstetrics and GynecologyMinistry of Health & Population (MOHP) Port Said2009

D17 ET - After ET, 14th day β hCG If pregnancy is present, E2 ve P dose administered until placental autonomy. Muasher;1991

1. Introduction • Pelvic inflammatory disease (PID) is a common cause of morbidity and accounts for 1 in 60 GP consultations by women under the age of 45

With increasing rates of women at high risk for stroke due to obesity, congenital heart disease, and autoimmune disorders, there is a growing concern about stroke during pregnancy. In fact, the World Health Organization (WHO) has chosen stroke during pregnancy and the postpartum period as an area of special interest; WHO is considering labeling stroke as a life-threatening obstetric complication and as a condition that may make unintended pregnancy an unacceptable health risk.

Uterine Fibroids can effect quality of life, can at times cause dangerous problems such as severe hemorrhage, but most often cause no problems at all. The first question to ask is should fibroids be treated rather than how.

Researchers have found that obese women are twice as likely to experience failed induction of labor compared to women of normal weight. The rate of failed induction increased with increasing obesity. Further, obesity was also associated with increased neonatal morbidity-infants born to obese women were more likely to have an Apgar score of less than 7 at 5 minutes, require assisted ventilation, require use of antibiotics, and experience neonatal transfer.

The increasing epidemic of obesity affects all areas of obstetrics. Obesity is associated with medical, surgical, and obstetrical complications and higher rates of induction dysfunctional labor patterns. Since one-third of all reproductive-aged women are obese and almost 10% are extremely obese, this represents a significant problem for obstetricians. Thus, researchers from the division of maternal fetal medicine in the department of obstetrics and gynecology at University of Cincinnati College of Medicine in Ohio conducted a study to better understand the association between failed induction and obesity as well as to determine if the link is correlated with increasing class of obesity.

Definitions Primary amenorrheaFailure of menarche to occur when expected in relation to the onset of pubertal development. • No menarche by age 16 years with signs of pubertal development. • No onset of pubertal development by age 14 years. Secondary amenorrhea • Absence of menstruation for 3 or more months in a perviously mentruating women of reproductive age.

ORMELOXIFNE - A new Treatment Modality in DUB Dr. Surendra Nath Panda, M.S. Professor of Obstetrics and Gynaecology M.K.C.G. Medical CollegeBerhampur, Orissa, INDIA

PROCLACTIN • Is a polypeptide hormone containing 198 amino acids and having a molecular weight of 22,000 daltons. • It curculates in different molecular sizes- a (small) form (mol wt 22,000), and a (big) form (mol wt 50,000), and an even larger (big-big) form (mol wt > 100,000). • The small form is biologically active, and about 80% of the hormone secreted is in this

CLINICAL PICTURE •Vaginal Bleeding I. Speculum Examination:The vagina is full with clots, portio exophytic or shows. Carcinoma crater surface bleeding stronger after touching.II. Palpation:Often large tumor that fills the small pelvis.

2. Direct microscopy: >10 WBC in vaginal fluid (in the absence of T.V.): sensitive indicator of cervical inflammation caused by C.T. or N.G., with a high negative predictive value.

It has been suggested that hormonal risk factors act predominantly on estrogen receptor and progesterone receptor (ER/PR)-positive breast cancers. However, the data have been inconsistent, especially in younger women.

In a study published today in Europe's leading reproductive medicine journal Human Reproduction1, researchers from New York's Cornell University report the first IVF pregnancy to result from the use of tamoxifen as an ovarian stimulant.