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Maternal Rhesus Isoimmunization : Rh incompatibility

Maternal Rhesus Isoimmunization : Rh incompatibility

Alloimmunization (Isoimmunisation) is defined as the antibody response to foreign antigen derived from different individual of the same species. Rh alloimmunization refers to the development antibodies to Rh D antigen. Antibodies may be produced to Rh antigens C,c,D,E, or e but only D is strongly immunogenic.
PATHOPHYSIOLOGY

1st Rh+ve pregnancy: Rh negative mother bearing Rh positive fetus
Feto-maternal bleed: Abortion, Amniocentesis, Antepartum hemorrhage, …

Uterine leiomyoma or Fibroid

Uterine leiomyoma or Fibroid

Definition: Most common benign neoplasm of female genital tract composed of smooth muscle and connective tissue that is hormonally responsive (Growth ↑ in pregnancy and ↓ after menopause).
Gross pathology:

Discrete, round, firm, irregularly lobulated and often multiple.
Enlarged uterus
Smooth and white cut surface with whorled appearance
False capsule: pinkish color
Center of tumor is least vascular and likely to degenerate

Risk factors:

Nulliparity
Obesity
Hyperestrogenic state
Black race

Types:

Types
Features

Intramural
Within uterine …

Acute Pelvic Inflammatory Disease (PID)

Acute Pelvic Inflammatory Disease (PID)

Definition: It is the polymicrobial infection and inflammation of the upper genital tract typically involving the fallopian tubes, ovaries and surrounding structures (endometritis, salpingitis, pelvic peritonitis, tubo-ovarian abscess).
Causative organisms:
Primary organisms: Ascending spread of micro-organisms from cervico-vaginal canal

Neisseria gonorrhoeae (1/3rd cases)
Chlamydia trachomats (1/3rd cases)
Mycoplasma hominis (1/10th cases)

Secondary organisms:

Endogenous aerobes: Non-hemolytic streptococcus, E.coli, Group B streptococcus, Staphylococcus
Endogenous anaerobes: Bacteroides, Peptostreptococcus, Peptococcus

Risk Factors:

Young, …

A Short Review of Spontaneous Abortion or Miscarriage

A Short Review of Spontaneous Abortion or Miscarriage

Abortion is defined as the termination of pregnancy, either spontaneously or intentionally:
1. Prior to age of viability (28 weeks) OR
2. < 500 gm birth weight
Common Causes of Spontaneous Abortion (Miscarriage):
A) 1st trimester (GEI)

Genetic factors: Autosomal trisomy, Polyploidy, Monosomy X, Mosaic, Double trisomy
Endocrine disorders: Luteal phase defect (LPD), Thyroid abnormalities, DM
Immunological: Autoimmune (ANAs, Anti-DNA antibodies, Anti-phospholipid antibodies), Alloimmune, Antifetal antibodies (Rh isoimmunization)
Infection …

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