1. Gynecological disorders in pregnancy

3. CA CERVIX WITH PREGNANCY
DIAGNOSIS
Asymptomatic cases
Symptomatic cases
EFFECTS OF PREGNANCY ON CA CERVIX
Malignant process remain unaffected
Rapid spread following vaginal delivery or induced abortion

4. CA CERVIX WITH PREGNANCY
EFFECTS OF CA ON PREGNANCY
Abortion
Premature labour
Secondary cervical dystocia
Missed labour
Injury to cervix and lower segment
PPH
Lochiometra and pyometra
Uterine sepsis

5. CA CERVIX WITH PREGNANCY
TREATMENT
Surgery or radiotherapy
First trimester
Radical surgery with fetus in situ
Radiotherapy – external pelvic radiation
Second trimester
Uterus is to be evacuated
Prophylactic antibiotic
Radical surgery after days
External pelvic radiation followed by intracavity radiation
In operable stage – Palliative radiotherapy
Labour – Vaginal delivery not allowed

6. FIBROID WITH PREGNANCY
EFFECTS ON PREGNANCY
May be none
Pressure symptoms
Abortion
Malpresentation
Non engagement of presenting part
Pre term labour and prematurity

7. FIBROID WITH PREGNANCY
EFFECTS ON LABOUR
May be unaffected
Uterine inertia
Dystocia
PPH

8. FIBROID WITH PREGNANCY
EFFECTS ON PUERPERIUM
Subinvolution
Sepsis
Secondary PPH
Lochiometra
Pyometra

9. FIBROID WITH PREGNANCY
EFFECTS OF PREGNANCY ON FIBROID
Increase in size
Changes in position
Changes inn shape – becomes flattened
Red degeneration
Torsion of pedunculated subserous fibroid
Infection

10. FIBROID WITH PREGNANCY
DIAGNOSIS
USG

11. FIBROID WITH PREGNANCY
TREATMENT
DURING PREGNANCY
Uncomplicated
Usual ANC
Impaction in early months
Manual correction
Acute pain following red degeneration

12. FIBROID WITH PREGNANCY
TREATMENT
LSCS
Cervical or broad ligament fibroid
Associated complicating factors
DURING LABOUR
Fibroid situated above the presenting part
Fibroid situated below the presenting part
Alert PPH and retained placenta

13. FIBROID WITH PREGNANCY
RED DEGENERATION
Probably vascular origin
CLINICAL FEATURES
Acute onset of pain
Malaise
Dry furred tongue
Rapid pulse
Constipation
Tenderness
Rigidity over the tumour
Leucocytocis

14. FIBROID WITH PREGNANCY
RED DEGENERATION
TREATMENT
Patient put to bed
Ampicillin 500 mg
Analgesics and sedatives
Laprotomy