Cervicitis vs Vaginitis

Cervicitis :

• PV bleed

Vaginitis

• Vaginal discharge

Cervical Incompetence

Suspect cervical incompetence if:

(e.g)

Baby delivered earlier, and earlier..

1st - 32 weeks

2nd - 28 weeks

3rd - 24 weeks..

Fluid in Pouch of Douglas

Fluid in Pouch of Douglas = Ectopic Pregnancy

**also remember, B_HCG slight lower.

Sampling & Studies in OnG.

Chromosome studies

• take blood from both parent.

Tissue Karyotype

• Malaysia send sample to Singapore, Australia.
• In KL, only blood sample is sent for karyotyping
• result late, months..

Chorionic Villus Sampling.

• Not in Malaysia.
• Usually send to Singapore

Amniocentesis

• government : no
• private lab: yes

Chordocentesis

• Available in Malaysia
• sample taken after > 26 weeks

100 000 unit B- HCG

"If the B-HCG is 100 000, chances are the lesion could be malignant (choriocarcinoma). Start on chemotherapy, after 12 weeks shoudl resolve/negative. If not, poor prognosis."

- Prof Hamizah, Problem in Early Pregancy

.

Gestational Sac & TVS

" Gestational sac can only be seen by Tranvaginal Ultrasound Scan if the serum B-HCG is > 1500 unit.."

- Prof Hamizah

Syphilis & Organogenesis

" Syphilis does not cross the placenta until 14 weeks.

After 14 weeks POG, because of less syncitiotrophoblast, Treponema are able to cross..."

- Prof Hamizah , lecture Problems in Early Pregnancy

How to say it - O&G

How to gauge days of cycle:

" Bulan ni datang darah kotor berapa hari bulan? Selalu tarikh sama ke? Awal, atau lewat? Berapa hari awal/lewat?

e.g. = if her period falls every month on 10th. Asked if next month falls on 10th also. If earlier (e.g.) 8th.. next month 6th.. then we know her period is most likely 28-day cycle.

Keputihan (?)

"ada tak keluar lendir (dari faraj), ber'tali' mcm telur putih"..

Intercourse = "bersama"

Hirsutism:

"Ada tak tumbuh bulu di tempat yang tak sepatutnya.. misalnya tumbuh misai, belakang leher e.t.c."

Symptomps of Menopause:

• "cepat nak marah"
• kulit, faraj rasa kering
• cepat rasa nk kencing

Hot flushes:

"Makcik, ada tak rasa badan/dada rasa panas, pastu naik ke kepala/muka, peluh-peluh.. tiba-tiba je datang."

P Mitrale vs P Pulmonale

P Mitrale:

• Bifid 'P' wave = looks like "M" (Mitrale)
• Left atrial hypertrophy > remember L is nearer to M

P Pulmonale

• Peaked (large) P wave = remember giant 'P' (Pulmonale)
• Right atrial hypertrophy > remember R is nearer to P