Minor

• Backache

  • due to laxity of spinal ligaments

  • weight of pregnancy

• Symphysis pubis dysfunctino

  • excrutiatingly painful condition - 3rd trimester

    • ‘loose’

    • only imporve after delivery

• Constipation

• Hyperemesis gravidarum

  • N&V

  • most pronounced in 1st trimester

  • worse in molar/multiple gestation

  • hcg

• Heartburn

  • common

• Varicose veins and haemorrhoids

• Carpal tunnel syndrome

Fibroids

• may enlarge in prgnancy

• large fibroid @ cervix or in lower uterine segment may prevent descent of presenting part and obstruct vaginal deliver

• Red degeneration

  • one of commonest complications of fibroids in pregnancy

  • fibroid ay become ischaemic

    • acute pain

    • tenderness over fibroid

    • vomiting

  • may ppt uterine contractions

Abdominal pains

• common

• Extrauterine

• Uterine

Antepartum haemorrhoage

• vaginal bleeding from 24w

• placental

  • placental abruption

    • premature separation of the placenta

    • dangerous for mother

  • placenta previa

    • placenta covering/encroaching on the cervical os

    • maternal not fetal circulation

    • compromise mother compared to baby

    • risk factors

      • multiple gestation

      • previous CS

      • Uterine structural anomaly

      • assisted conception

  • vasa previa

• local

  • cervicitis

  • cervical erosion

  • cervical carcinoma

  • vaginal trauma

  • vaginal infection

Breach

• 40% @ 26/40

• 20% @ 30/40

• 3% at term

• become problem if not cephalic @ 37/40

• External cephalic version

  • @ 36/40

  • contraindications

    • placenta previa

    • oligohydromanios (or poly)

    • histoyr of antepartum haemorrhage

    • scar on uterus

    • multiple gestation

    • pre-eclampsia/htn

    • plan to deliver CS anyway

  • risks

    • placental abruption

    • premature rupture membranse

    • cord accidnet

    • transplacental haemorrhage

    • feal bradycardia

Rgesus isoimmunisation

• anti-d within 72hrs of exposure