After recovery, early ambulation is a must.
Always try to get mobile...and if cant get out of bed and abot, then atleast do physiotherapy and exercises in bed.
Early amblation or physiotherapy or exercise in bed is amust.
Even in surgery and not just in obsgyn. only if theres fracture then must fixate until it heals. but if no fracture, then move and ambulate.
Ambulate = moving around. not just in one place.
Heart disease in pregnancy:
In fetas distress leadsbto preterm delivery... Its like the fetud wants to escape because conditions inside are bad and outside is hettef
Eisenmengers syndrkme is when a left to right shunt becahse right to oeft because of pulmonary hypertension. Serious disease.
Nopes is the.menmonic for adverse cardiac outcomes in rhd not congenital and eisenmnegers syndrome!!!!!!!!!
Ither5soeecifics heart disease management is for the cardiologist to decide. So for ohsgyn just say cardiology opinion
All of those things are the triggers for heart failure.
Induction of labour is not a contraindication for heart disease. Thats a mistake in the slide.
Aortic stenosis leads to fixed cardiac outout. Canr increase well.
Amtsl is still dome. Oxytocin is given IM.
Oxytocin can be given for augmentation but use a conc infusion eith minimal. Fluids so wont precipate heart failure
Warfarin is the better anticoagulant even though cant be regulated well and cauuse pregnancy effect.
So pregnant women with very high risk of thrombosis is given warfarin continuously. Guidelines say thay.
Warfarin counter actor is vitamin K.. But. Heparin has a direct antidote which is protamine sulfate. So heparin is preferred fo4 pph prevention as can give anti dote.
Some guifelines say haparin. For enti4e pregnancy
But these guidellines especially for mechanical valves
Bioproetshteic valves dont need much anticoagulation
These are all guidellines so when answering say guidelines and that different guidelones have different things. For example when t9 restart coagulation after labour. 6hr after vaginal and 24 hr after ceasarian. But some guidelines say 12 hours after cesarean.
Why warfarin stopped beforre delivert and switch? To prevent inttacranial haemorrhage during delivery. And heparin can be titrated and controlled easily. And iv infusion. To stop pph before.
During labour prefer ufh because can be controllekd well and can stopped and be titrated... And its infusion so. Easy titration and. Be adjusted... Vs lmw which is subcutaneous and longer action so. Ahard to regulate even though no need of checking PT inr.
Deepal - cardiac patient in labour
Case
