Episode 2

OBSTETRICS REVISION PROGRAMME SEMESTER II Episode 2

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A 22 years old lady, G2P1L1 at GA of 30 weeks ,comes to obstetric department presenting with a 4 hours history of per vaginal leakage with the fluid soaking all the underpants and flowing down her thighs to her knees. On examination she is febrile with body temperature of 40 degrees Celsius with all other vital signs being within normal range. Per abdominal examination reveals tender abdomen.On Per vaginal examination, a yellowish green fluid which is foul smelling is evident escaping through her cervix. Discuss the management of this patient.

A 34 years old lady G4P3L2 at GA of 36 weeks is brought to EMD presenting with an acute severe abdominal pain radiating to the tip of her right shoulder associated with moderate PV bleeding and loss of fetal movements. On examination, she is restless, with BP of 87/50mmHg. On abdominal examination, she has muscle guarding and easily palpable fetal parts. Discuss management of this patient.

XY, G2 P1L1 with one previous scar, at term is taken to Labour ward for delivery. After four hours of monitoring Labour progress, thick meconium is observed on PV examination. Discuss the management of this patient.

A 30 years old lady G4P3L3 at GA of 22 weeks presents with a 2 days history of headache associated with general body swelling, visual disturbances and epigastric pain. On examination, she is weak with massive bilateral lower limb edema which neither tender nor pitting. Her BP is 154/110mmHg. Discuss the management of this patient.

A 22 years old lady, prime gravida at GA of 12 weeks, presents with two episodes of loss of consciousness associated with body stiffness and shaking movements of almost all body parts. She presents with froth per mouth and urinary incontinence during such attacks. On admission, her blood pressure is 140/90mmHg. Discuss the management of this patient.

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