Card 11

1. Changes in the organs in case of severe preeclampsia.

2. Classification of dysfunctional labor: hypotonic inertia.
3. Breech presentation: management during the 2nd stage in footling-breech
presentation.
4. Case: A 23 years old woman (2 abortion in anamnesis) with 38 weeks of gestation
has a vaginal bleeding (300ml) avter vaginal examination. A doctor palpates
placenta through the servix. – write the diagnosis. – what must you do in this
situation.
- Diagnosis : Pregnancy 38 weeks, central placente previa, bleeding.
- Do : cesarean section with infusion therapy.

Card 12
1. Definition & frequency of postpartum infection, risk factors of postpartum
infection.
2. Classification of dysfunctional labor, incoordinate contractions.
3. Causes of cephalic malpresentation : mechanism of labor in brow presentation.
4. Case : A 21 years old woman, primigravida, is in the 1st stage of labor. She has
severe headache, vomiting, & visual disturbances. Her BP is 180/110 mm Hg,
proteinuria is about 2 grams. Fetal head is over the pelvic inlet. Cervical dilatation
is 5 cm. – Does she as risk of PIH – what is her diagnosis – what will you do.
- Risk factor of PIH : primigravida.
- Diagnosis : preeclampsia.
- Do : CS

Card 13
1. Causes of spontaneous abortion & types.
2. Placenta previa, etiology, clinical pictures & management.
3. Causes of cephalic malpresentation : mechanism of labor in face presentation.
4. Case : 21 years old primigravida is in 1st period of labor. Her pelvis is
24-26-28-18cm. Fetal soft part is over pubis & fetal head is in fundus. FHB is
144b/min. The AC is 100cm & HUF is 35cm. Per vaginum: cervical dilatation is
4cm. There’re many small parts near cervix.
- Diagnosis : 1st period of labor, gynecoid pelvis, breech presentation.
- Do : normal labor by breech coz fetal weight is normal 3.5kg.
Card 14
1. The 1st prenatal visit & subsequent visits.
2. Placental abruption : etiology, clinical picture & management.
3. Classification of narrow pelvis : mechanism of labor in case of gynecoid pelvis
with reduce diameters.
4. Case : 28 years old second gravida (she has 6 years old baby) has 40 weeks of
pregnancy. Her AC is 104cm & HUF is 42cm. The firm big part of baby is
palpated in uterine fundus. The soft big part is over pubis. Per vaginum : Her
cervix is ripe.
- Diagnosis : pregnancy 40 weeks, breech presentation.
- Do : cesarean section coz fetal size is too big 4.4kg.

Card 15
1. Diagnosis of pregnancy.
2. Hemorrhage during 1st phase of 3rd stage : etiology, clinical pictures &
management.
3. Obstetrical forceps : medication types & complication. Technique of outlet
forceps delivery.
4. Case : 25 years old women in labor during 10hours. Her contraction are every 3
minutes & she has been pushing during 50 minutes ineffectively. Her uterus look
like pear. AC is 92cm & HUF is 38cm. Pelvis 25-28-30-20cm . The FHB is
150b/min . Per vaginum : cervix is fully open, fetal head is presented over pubis.
Fetal brow is presented & is adematous. DC is 13cm.
- Diagnosis : labor 1st stage, cephalo-pelvic disproportion with brow presentation.
- Do : cesarean section.