Calculation of pregnancy’ term

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Calculation of pregnancy’ term

By the first day of LNMP: February 14^th 2020

By the 1^st fetal kick: July 4^th 2020 (2^nd trimester) (21 week)

By the 1^st US: march 14^th 2020 (week 5) gestation sac visible

march 28^th 2020 (week 7) (heart beat detectable by ultrasound)

Estimated date of delivery: November 21^th 2020

Auscultation of the fetus heart sound :

Heart rate: 140 bpm

Heart sound: rhythmic

The most audible sound: right side of the mother’s abdomen

Clinical Diagnosis:

The main diagnosis:

The fetus is a term baby having rhythmic normal heart sound with the heart rate of 140 bpm.

Pregnancy is in the 2^nd stage of labor since there is rupture of bag of water and there is occurrence of expulsive pain

According to the pelvimetry of the mother we can see that the internal pelvis is small for the fetus head to pass through.

The fetus head is pressed on to the internal pelvis which is the 1^st plane of the pelvis.

Since the forewater is broken and the maternal pelvis is small for the fetal head to pass through cesarian section must be performed or else it might cause an injury to the fetal head

Complications:

The complication of C-section is infection of the wound causing redness, swelling of the endometrium (endometritis) which is diagnosed with the help of performing a physical exam in which the internal reproductive organs are evaluate and looked for tenderness in the uterus and possible discharge from the cervix.

Post-partum hemorrhage is to be seen due to excessive loss of blood after giving birth because of uterine atony.

Accompanying disease: None

Management

1. Listening to the heart sound every 2-3 min

2. Observing the rules of sepsis and antisepsis

3. Preservation of fetus

4. Monitoring of blood pressure of the mother

5. Epidural catheter: it delivers pain medication just outside the sac of fluid around the spinal cord. The medication diffuses into the spinal space to reach the relevant nerve receptors.

6. Uterotonic agents for treatment of post partum hemorrhage like oxytocin, misoprostol.

7. ampicillin, gentamicin, metronidazole, doxycycline are given for endometritis.

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