udk,f0efaqmif tapmydkif;umv arG;vrf;a=umif;rSaoG;qif;jcif;

oifcef;pm&nf&G,fcsuf

- uk,
d f0eftapmydkif;umvrSm arG;vrf;a=umif;rSaoG;qif;jcif;udk &SmazGuko&eftwGuf
taumif;qHk;ukoenf;rsm;udk jyefvnfavhvm&ef?
- om;tdrfjyifyoaE<wnfjcif;udk ppfaq;od&ESd dkifrnfeh nf;vrf;udk jyefvnfavhvm&ef?

t"dy`g,fowfrSwfcsuf
ud,
k f0efoufwrf; yxr 22 ywftwGif; arG;vrf;a=umif;(rdef;rudk,)f rSaoG;qif;vmjcif;?

udk,f0eftapmykdif;umv aoG;qif;jcif;udq
k Hk;jzwfjcif;
- ud,k f0efysuf&eftajctaejzpfay:jcif; (threaten abortion)
- aocsmaygufudk,f0efysufusjcif; (inevitable abortion)
- rjynfhrpHkom;avSsmjcif; (incomplete abortion)
- tjynft h pHkom;avSsmjcif; (complete abortion)
- om;tdrfjyifyrSmae&mrrSefoaE<wnfjcif; (ectopic pregnancy)
- pyspfo;D oaE<wnfjcif; (molar pregnancy)

jywwfonfhvQ%mrsm;ESifh
a&m*gqkdif&moD;oef@vQ%mrsm;
o aoG;tenf;i,fqif;jcif;
o om;tdrfryGifhjcif;
o om;tdrftjrifhESifh udk,f0ef
ouffwrf; udkufnD aejcif;
wcgw&H&SdEdkifonfh vQ%mrsm; jzpfEdkifonfhtajctae
o Adkuaf tmufyidk f;atmifhjcif;/xdk;jcif; ysufvkysufqJ uav;
o yHkrSefxufom;tdrfydkaysmhaejcif; ysufusjcif;
(Threatened
abortion)

o aoG;tenf;i,fqif;jcif; o Adkuaf tmifhydkif;tenf;i,fatmifh

o om;tdrfacgif;ryGifhjcif;
o om;tdrftjrifhrSm cef@rSef;xm;
onfxufedrfhaejcif;
o yHkrSefxufom;tdrfydkaysmhaejcif;
o om;tdrftvGefqif;aejcif;
o om;tdrfyGifhaejcif;
o om;tdrftjrifhESifhukd,f0efouf
wrf; udkufnDaejcif;
jcif;/ xk;d jcif;
uav; tpHkvifysufusjcif;
o tom;p/ uav;xGufuszl;onfh
&mZ0if&Sdjcif; (Complete abortion)
o Akduaf tmufyidk f;atmifhjcif;/ udu
k fjcif; rvGJraoGysuf&rnfhuav;
o Adkuuf dk ESdyfvdkufv#if rsm; ysufusjcif;
om;tdrfae&memjcif; (Inevitable abortion)
o tom;p/uav;xGufuszl;jcif;r&Sd
1
o aoG;tvGefqif;aejcif; o Adkuaf tmufyidk f;atmifhjcif;/udkujf cif; w0ufwysuf
o om;tdrfyGifhaejcif; uav;ysufusjcif;
o om;tdrftjrifhrSm cef@rSef; o tom;pwcsdK@xGufxGufuszl;jcif; (Incompletes
xm;onfxufedrfhjcif; abortion)

o aoG;tenf;i,fqif;jcif; o owdvpfjcif;
o Adkuaf tmihfjcif;/ o om;tdrfteD;w0kdufae&m ESdyfv#if
o om;tdrfryGifhjcif; emjcif;
om;tdrfjyify oaE<wnfjcif;
o om;tdrftjrifhyHkrSefjzpf&ifjzpf o &moDxed fjcif;
Ectopic Pregnancy
(odk@)yHkrSefxuftenf;i,fydkjrifh o rdef;rudk,ftwGif;rSaeI
o yHkrSefxufom;tdrfydkaysmh om;tdrfacgif;udkvSKyfprf;v#if
aejcif; tvGefemjcif;

o aoG;tvGefqif;aejcif; o ysdK@jcif;/tefjcif;
o om;tdrfyGifhaejcif; o tvdt k avsmuf udk,f0efysufjcif;
o om;tdrftjrifhrSm o Adkuaf tmufyidk f; atmifhjcif;/udkufjcif;
cef@rSef;xm;onfxuf o om;OtdrftvHk;t=udwfrsm;
ydkjrifhaejcif; tvG,fwuluJEG dkif pyspfo;D oaE<wnfjcif;
o yHkrSefxufom;tdrfydkaysmh o ud, k f0efaqmifaoG;wkd;vQ%m (molar pregnancy)
aejcif; apmawG@&jcif;
o pyspfo;D uJho@dk tom;pwcsdK@ o uav;&Sdonfv h Q%mrsm;r&Sdjcif;
xGufuszl;jcif;

udk,f0eft&ifhtrmumvESifh arG;zGm;qJuav;rxGufrSD arG;vrf;a=umif;rSaoG;qif;jcif;

oifcef;pm&nf&G,fcsufrsm;
- ud, k f0ef t&ifhtrmumveSifh arG;zGm;qJ uav;rxGufrSD arG;vrf;a=umif;rSaoG;xGufjcif; udk
&SmazGppfaq;uko&eftwGuf taumif;qHk;ukoenf;rsm;udk jyefvnfavhvm&ef?
- tcsif;a&S ha&mufjcif;udk ppfaq;od&eSd kdifrnfeh nf;vrf;udjk yefvnfavhvm&ef?/

t"dy`g,fowfrSwfcsuf
- ud, k f0efoufwrf; 22 ywfaemufydkif;
- arG;zGm;qJ uav;rxGufrSDtcsdeftwGif;
2
 - arG;vrf;a=umif;(rdef;rudk,f)rS aoG;qif;vmjcif;?

udk,f0ef t&ifhtrmumv arG;vrf;a=umif;rS aoG;xGufjcif;udk &SmazGppfaq;jciff;

- tcsif;uGmjcif; ( Abruption Placenta )
- tcsif;a&S ha&mufjcif; ( Placenta Previa)
- om;tdrfuJGjcif; (Uterus Rupture)

jywwfonfhvQ%mrsm;ESifh
a&m*gqkdif&moD;oef@ vQ%mrsm;
- ud,k f0efoufwrf;22ywf
aemufydkif;aoG;qif;jcif;
- om;tdrftwGif; tom;p
usefaeonf?
- wcsufwcsuf(od@k ) wpfcsdefvk;H
Adkuaf tmifhjcif;
- udk,f0efoufwrf;
22ywfaemufydkif; aoG;qif;jcif;
- aoG;qif;jcif; AdkufwGif; (odk@ )
rdef;rudk,frS aoG;qif;jcif;
- Adkutf &rf;atmifhjcif;
(om;tdrfu+GJ yD;aemuf Addkfufatmifh
oufom Ekdifonf)
wcgw&H&SdEdkifonfh vQ%mrsm; jzpfEdkifonfhtajctae
- aoG;vef@jcif;
- om;tdrfae&mwif;jcif;
- ESdyfv#ifatmifhjcif;
tcsif;uGgjcif;
- uav;v_yf&Sm;r_enf;vmjcif;/ r&Sdjcif;
Abruption Placenta
- uav;yifyef;EGrf;e,fvmjcif; (odk@)
uav;ESvHk;ckefoH r=um;&jcif;
- aoG;vef@jcif;
- vdifqufqHjcif;a=umifhaoG;qif;jcif;
- om;tdrfaysmhaejcif;
- qD;pyfwGifuav;tpdwftydkif;rsm;
tcsif;a&S ha&mufjcif;
r&Sdjcif;
- om;tdrfatmufyidk f;wGif bmrS ( Placenta Previa)
prf;rrdjcif;
- uav;tajctaerSm omref
uJoh @dk jzpfjcif;
- aoG;vef@jcif;
- om;tdrfae&mwif;jcif;
- Akdut f wGif;t&nf&Sdonfh vQ%m
- om;tdrfyHko¾rrSefjcif;
- ESdyfv#ifAdkufwif;jcif;
om;tdrfuJGjcif;
- uav;tpdwftydkif;rsm;udk
(Uterus Rupture)
tvG,fwulprf;rdjcif;
- uav;ESvHk;ckefoH r=um;&jcif;
- uav;rv_yfjcif;
- rdcif. aoG;ckefESKef;jrefjcif;

3
 uav;arG;zGm;+yD;arG;vrf;a=umif;rSaoG;qif;jcif;
oifcef;pm&nf&G,fcsufrsm;
o uav;rD;zGm;jyD;cdsef arG;vrf;a=umif;rSaoG;xGufjcif;udk &SmazGppfaq;uko&ef?
o uav;rD;zGm;jyD;csdefarG;vrf;a=umif;aoG;xGufjcif;udk umuG,f&ef?

t"dy`g,fowfrSwfcsuf
o uav;arG;zGm;jyD;aemufarG;vrf;a=umif;rS aoG;500pDpDxufykdIarG;vrf;a=umif;/ rddef;rudk,frS
aoG;qif;vmjcif;?

o aoG;qif;onfhyrm%udktuJjzwf&efcufcJygonf? aoG;onfa&rGm&nf/ qD;wk@d jzifha&mae

wwfaoma=umifhjzpfygonf?

Differential Diagnosis of Postpartum Hemorrhage

(rD;zGm;jyD; aoG;qif;jciff;.ta=umif;rsm;rSm)

o Atonic uterus (om;tdrfnpftm;enf;jcif;)

o Retained placenta (tcsif; tpteusefjcif;)
o Tears of cervix,vagina or perineum (rdef;rudk,f/ om;tdrfxdyf/ =uGufom;pkwf+yJjcif;)
o Retained placental fragments (tcsif;uyfjcif;)
o
o Rupture uterus (om;tdrfujGJ cif;)
o Inverted uterus (om;tdrfajymif;jyefveS fjcif;)
o uav;arG;zGg;+yD;aemuf 24 em&DtwGif; rdef;rudk,frS aoG;tvGefqif;jcif;
( arG;zGg;+yD;aemuf csufcsif; aoG;qif;jcif;)
o uav;arG;zGg;+yD;aemuf 24 em&D aemufydkif; rS 6 ywf t=umrdef;rudk,rf S aoG;tvGefqif;jcif;?

4
 jywwfonfhvQ%mrsm;ESifh
wcgw&H&SdEdkifonfh vQ%mrsm; jzpfEdkifonfhtajctae
a&m*gqkdif&moD;oef@vQ%mrsm;

o arG;zGg;+yD;aemufcsufcsif;aoG;qif;jcif; o aoG;vef@jcif; Atonic uterus

om;tdrfnpftm;enf;jcif;
o om;tdrfaysmhae+yD; usHK@qef@jcif;r&Sd
o rdcifbufrsufESmjyifu tcsif;rSm o arG;zGg;+yD;aemuf csufcsif;
tpdwftydkif; wcsdK@aysmufaejcif; (odk@) aoG;qif;jcif; Retained placenta
tcsif;tpte usefjcif;
aoG;a=um awGESifh pkwf+yJae aom o om;tdrfusHK@qef@r_&Sdjcif;
tajrS;rsm;awG@&jcif;
o tcsif;vHk;0usjcif; Tears of cervix,
o arG;zGg;+yD;aemufcsufcsif;aoG;qif;jcif; vagina or perineum
o om;tdrfusHK@qef@r_&Sdjcif;
(rdef;rudk,f/ om;tdrfxdyf/
=uGufom;pkwf+yJjcif;)
o uav;arG;zGg;+yD;aemuf rdepf 30 twGif; o arG;zGg;+yD;aemufcsufcsif; Retained placental
tcsif;rusjcif; aoG;qif; jcif; Iragments tcsif;uyfjcif;
o om;tdrfusHK@qef@r_&Sdjcif;
o arG;zGg;+yD;aemufcsufcsif;aoG;qif;jcif; o aoG;ve@fjcif;
o 0rf;Akdut f wGif;aoG;qif;jcif;(odk@) o Adkut
f xdrcHEdkifatmif Rupture uterus
rdef;rudk,frSaoG;qif;jcif; emjcif; (om;tdrfujGJ cif;)
o Akdutf &rf;emjcif;(om;tdrfu+GJ yD;rS o rdcifaoG;ckefESKef;
avsmhEdkifonf? t&rf;jrefjcif;
o om;tdrftwGif;tjyif
o Akduuf dkprf;oyfonfhtcg
vSefjcif;? t*FgZmwfrSm Inverted uterus
om;tdrfxdyfydkif;udk prf;vk@d r&ay
odomxif&Sm;jcif; om;tdrfajymif;jyefveS f
o tenf;i,f(odk@)
o arG;zGg;+yD;aemuf jcif;
jyif;xefaomemusifr_&Sdjcif;
csufcsif;aoG;qif;jcif;