Gynecology & Obstetrics department (case 1 ) Practice clinical pharmacy BY : DR. Safia A. Alrezami
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Gynecology &
Obstetrics department (case 1)
Practice clinical pharmacy
BY : DR. Safia A. Alrezami
Definationis delivary of the baby through operation via abdominalwall
Causes
Related to mother contractedpelvis ,maternal diseases(heart disease eclampsia or
preclampsia , Pelvic tumor
Releated to fetusMalpresentation & malpostion, Multiple pregnancy(twin)
Large baby Planenta previa placenta abrouptionUmblical cord problem
Incidence twin is one in 80 of pregnancies .Types of twins- uniovlar(identical) twin 30% They result from division of a single fertilized ovum-binovular (dizygotic) twin 70%: They result from fertilization of two separate ovum
During labourDelivery must be in hospitalIf labour strat before 38week the mother is given 2g ampicillin IV every 6 hour until delivery to prevent group B streptococcal infection in the newborn.the docter after examintation
give decision about the route of delivery( narmol or need to operation (L.C.S.C )
During pregnancy
-Diet the mother is given more nutrient kilocalories, protein, iron ,Ca, folic acid and vitamins.- frequency moniter by Dr. to give the suitable adivce
Management
Personl historyfile no ,255Patient Name: X
Age: 18 years work as housewife Admission date 3-3-2013 discharge date 8-3-2013
The main compliance The patient 9 month of pregnancy complaining of sever lower abdominal pain associated with vaginal bleeding.
Medical & past historyThe patient has no history of HTN or DM or taken any drugs. Also there is no past history of hospitalization . Both parents have no any chronic diseases
Primary diagnosis -patient in labour. (delivery)
Differential diagnosis_Time of delivery (normal or operation).placenta previa _Abruption placenta.
The physical examination She is look well &awake and can walk BP 130 \95 mmhg Pulse 64 beat per minuteRespiratory rate 20Vaginal examination cervix open 2 fingers and the placenta is first descent the
InvestigationHb =11.88 R.B.S =65mg\dl Blood group ( O+ )
(HIV , HCV , HBsAg ….. Negative )Protective tests
Serum cretinine 0,7 mg \dl.
the operation was done and she birth twin(two bobies), two boys they are in good health then transfer to department to necessary care
NOW what about the Treatment ?
Taken or not therapeutic use
Dose1The drug The trade drug
Yes 2day
Supplement1 3Dextrose 5%
infusion Dextrose
Yes 2day
Supplement1 2
Normal saline
500cc infusion
Normal
Saline
In patient drugs
Taken or not therapeutic use
DoseThe drug The trade drug
Yes 3day
AntibioticAnaerobic)
1 3Metronidazol
500mg infusionFlagyl
Yes 3day
Antibiotic(cephalosporin)
1 2Ceftriaxone
1g vialCefex
In patient drugs
Taken or not therapeutic use
DoseThe drug The trade drug
SOSAnalgesic1 3Tramadol 100mg\ml amp
Tramal
first day
Post op.
PREVENT FIBRINOLYSIS
12
TramexicAcid250mg\2ml
Tramexi c acid
Yes
2Day
StimulateUtrinecontraction
1 1Oxytocin 10 I.U.
Ampule
Oxytocin
In patient drugs
Preoidtherapeutic use
DoseThe drug The trade drug
5 daysAntibiotic1 3MOXACILLINE LAVERUONIC
1g tab )ACIDOne weekAntibiotic1 3
Metronidazole500mg tab
SOSNSAIDs-----Diclofene Sodium)
75mg\3ml ampule IM
Out patient drugs
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