1. 1. .. 2545 .. 2546
2. 2. .. 2512 4 1 3 1 2 3 2 3 4, 5 6 3 2 7 8 Puerperium 4 9 .. 2544 e-learning 3 1. 2. 3. e-learning 1 2
3. 3. II 1 - 4 4 ..2508 12 .. 2545
4. 4. III 1 1 1 1.1 ............................................................................................ 4 1.2 ................................................................ ..................... 6 1.3 ................................................................. 6 1.4 .....................................................................................................12 1.5 ..............................................................................17 1.6 ......................................................................................56 1.7 .................................................. .................. 57 1. 8 ..........................61 1.9 ............................................................. ................. 77 1.10 ......................................................................................86 2 89 2.1 ...........................90 2.2 ....................... 94 2.3 .................... 97 2.4 .............................................................................. .................. 102 2.5 ..........................................................................................103 3 106 3.1 ............................................................................. ....................108 3.2 ......................................................................................................109 3. 3 Amniotomy ..................................................................................................................110 3. 4 ...................................................................................................115 3.5 ..............................................................................................119
5. 5. IV 2 4 125 4.1 ..................................... 1 28 4.2 ........................... 141 4.3 ..................... 1 48 4.4 .. .................. 1 50 4.5 .. ..................... 172 4.6 ........................................................................ 173 5 187 5.1 ........... 189 5.2 ............................................................. 230 5.3 .......................................................................263 6 277 6.1 ........................................................................ 279 6.2 .................................................................... . 302 6.3 .................................................................. 309 6.4 .......................................................................................................328 6.5 .......................................................... 333 3 7 365 7.1 ................................................................................................................. 366 7.2 ................................................................................ ................... 369 7.3 ....................................................................................................................... 374 7.4 .........................................................................................374 7.5 ..... ................... 387
6. 6. V 8 Puerperium 389 8.1 ................................................................................. .................. 391 8.2 ...........................................................................391 8.3 ................................................................................................................406 8.4 puerperium .........................................................413 8.5 ............................................................................................414 8.6 .....................................................................................................................416 8.7 6 .....................................................................................417 4 9 421 9.1 ....423 9.2 .......................................................................................443 9.3 ..................................................................456 9.4 ...................................................................458 9.5 ........................................................................................533 9.6 ........................................................535 537
7. 7. VI 1 1 Waller 16 2 Hoffman 16 3 Fetal Ovoid 18 4 19 5 20 6 biparietal bitemporal 21 7 22 8 23 biparietal 9 25 10 26 11 Compound Presentation () 27 12 Synclitism Asynclitism 28 13 denominator 31 8 14 32 15 LMA 33 16 RST 33 17 RscA 34 18 LScP 34 19 L eft Dorso Superior 35 20 Right Dorso Inferior 35 21 36 Williams 22 Garland Quikley 37 23 37 Pschyrembel Beck & Rosenthal
8. 8. VII 24 Bartholomews Rule of Fourths Greenhill 37 25 McDonald 38 26 38 27 41 28 43 29 Leopold Handgrip 1 44 30 45 31 P awliks Grip 3 Leopold 46 32 Leopold 4 48 33 Leopold 4 cephalic prominences 48 34 cephalic prominences Leopold 49 3 4 35 50 36 51 37 ballottement 52 38 52 39 53 40 53 41 54 42 Diagonal conjugate 63 43 conjugate diameter 64 44 Ischial Spine 64 45 ischial spine 65 46 Sacrosciatic Notch Sacrospinous Ligament 65 47 sacrum 66 48 66 49 67
9. 9. VIII 50 69 51 Martin Pelvimeter 70 52 Martin Pelvimeter interspinous 70 53 Rhomboid of Michaelis 71 54 External Conjugate 71 55 Subpubic Arch 73 56 ischial tuberosity 73 57 74 58 74 4 59 Friedman Curve 1 29 60 1 31 61 131 62 Bandl's Ring 131 63 Retraction Ring Constriction Ring 1 31 64 1 32 65 1 32 66 1 33 67 1 35 68 Ball Valve Action 1 35 69 1 36 70 Fetal Axis Pressure 1 36 71 Esbach's Albuminometer 1 42 72 Friedman Curve 1 49
10. 10. IX 73 1 52 74 1 54 75 Dorsal Position 1 55 76 Sim's Position 155 77 157 78 C.D. = Cervical Dila tation 157 C.E. = Cervical Effacement B.F. = Bag of Fore Water 79 station 160 80 sacrospinous ligament 161 ischial spines 81 caput succedaneum 162 molding 82 167 83 Trendelenburgs Position 177 84 Knee Chest Position 177 5 85 190 2-3 86 191 sacrum 87 191 88 station 196 89 parietal eminences 197 90 Bitrochanteric Bisiliac 197 91 198 Presentation
11. 11. X 92 Molding 199 93 - Synclitism 201 94 - Anterior Asynclitism 202 - Naegele's Obliquity - Anterior Parietal Bone Presentation 95 - Posterior Asynclitism 202 - Litzmann's Obliquity - Posterior Parietal Bone Presentation 96 SYNCLITISM ASYNCLITISM 2 04 OCCIPITO TRANSVERSE 97 206 (Attitude) 98 2 07 99 SOB 2 08 OM 100 2 09 101 Pelvic Floor 2 09 102 2 10 (Internal Rotation) 103 2 12 104 2 12 105 2 13 106 2 15 pelvic axis 107 2 15 108 Restitution 2 17 Internal Rotation 109 External Rotation 2 19 110 External Rotation 2 19 LOA 221
12. 12. XI LOT LOL 223 OA 224 LOP 226 111 Lithotomy Position 233 112 Lateral Position 233 113 234 114 ( open method) 235 115 236 116 237 117 237 118 237 119 Bozeman Sponge Holding Forceps 238 120 240 121 240 122 Pudendal 241 123 Cyprane Inhaler Trilene 241 124 243 125 Right Medio-Lateral 244 126 245 127 safe perineum 247 Ritgens Maneuver 128 safe perineum 247 Modified Ritgens Maneuver 129 248 130 Restitution External 248 rotation 131 250 132 251 133 252 134 Modified Malmstrom Vacuum Extractors Handle Pump 256
13. 13. XII 135 256 136 257 137 Traction Bar Traction Bar 258 138 258 139 cup 259 140 Artificial Caput Succedaneum Chignon 260 141 Caput Succedaneum 264 142 Cephalhematoma 264 143 Incarcerated Cervix 266 144 Munro Kerr's Maneuver 270 145 Muller Hillis Maneuver 270 146 Walcher's Position 272 147 Subpubic Arch 273 148 274 149 275 150 275 6 151 280 152 embryonic pole blastocyst 281 153 blastocyst 282 154 Syncytiotrophoblasts 283 155 (lacuna) Syncytiotrophoblasts 283 156 Primary villi 283 157 Secondary villi 284 158 Tertiary villi Placental Barrier 284 159 Chorionic vesicle 285
14. 14. XIII 160 Chorion Laeve Chorion Frondosum 286 161 287 162 Amniotic Cavity, Yolk Sac Body Stalk 289 163 Trophoblastic Shell 289 164 Embryo 290 Allantois Body Stalk 165 Embryo dorsal 290 166 Amnion Body Stalk 290 167 292 Decidua Vera Capsularis 168 293 169 295 170 297 171 Placenta Succenturiata 298 172 Placenta Spurium 299 173 Placenta Circumvallata 300-301 174 304-305 175 306 176 Schultze 307 177 Duncan 308 178 310 179 311 180 Cord Sign 312 8-10 . 181 Uterine Sign 313 182 314 183 Modified Crede Maneuver 315 184 Crede maneuver 316
15. 15. XIV 185 316 186 317 187 Brandt-Andrews 318 188 319 189 322 190 True Knot False Knots 323 191 324 192 Chorion 325 193 327 194 Allis Tissue Forceps, Rigby Gelpi Perineal Retractor 329 195 330 196 Rectum 331 197 sphincter ani muscle 331 198 Crown Stitch 332 199 340 200 341 201 341 202 344 203 345 204 355 205 359 206 Aorta 359 207 Ritzman Instrument Aorta 360 208 Dickinsons Method 360 209 Bimanual Compression 360
16. 16. XV 210 361 7 211 372 8 Puerperium 212 394 213 395 214 Homan's Sign 402 215 408 216 408 217 409 218 409 219 Nipple Shield 411 9 220 (LST) 425 221 426 SACRUM 6 222 428 223 ballottement 430 224 431 225 432 226 433 2 227 434 228 RSA-Engagement of Breech 435 229 RSA-Internal Rotation of Breech 436
17. 17. XVI 230 RSA- Birth of Breech 437 231 RSA - Restitution of Breech 438 - Engagement of Shoulder 232 RSA - External Rotation of Breech Internal Rotation of Shoulder 438 233 RSA - Restitution of Shoulder 440 - Engagement and Descent of Head 234 RSA - External Rotation of Shoulder 440 - Internal Rotation of Head 235 RSA - Birth of Head 442 236 443 237 443 238 451 LST left iliac fossa 239 451 240 transverse diameter 452 241 452 242 460 243 462 244 463 245 463
18. 18. XVII 246 464 247 465 248 465 249 465 250 467 251 frank breech 468 (popliteal fossa) 252 469 253 470 254 cat's paw motion 472 255 4725 256 473 257 Muller 473 258 474 Muller 259 474 260 475 261 476 262 479 263 479
19. 19. XVIII 264 479 265 479 266 480 267 480 268 481 269 481 270 482 271 482 272 483 273 483 274 484 Mauriceau-Smellie-Veit 275 484 276 Mauriceau - Smellie-Veit 485 277 Prague 486 278 487 279 487 280 488 281 489 3
20. 20. XIX 282 9 489 283 490 284 shank 490 Edmund B. Piper 285 Edmund B. Piper 491 286 - 491 287 pivot - 492 288 - 492 289 493 290 frank breech 495 291 495 292 496 293 497 Saxtorph-Pajot-Osiander 294 498 295 breech hook 499 296 complete breech 500 297 Pinard Maneuver 501 298 502 299 503 300 503
21. 21. XX 301 302 frank breech 504 303 504 304 505 bitrochanteric 305 505 306 nuchal arm 506 307 extended arm 508 308 extended arm 509 Munro Kerr 309 extended arm Macaffe 510 310 nuchal arm 512 Sellheim 311 513 Lovset 312 Lovset 514-515 313 521 314 522 Reverse Mauriceau-Smellie-Veit 315 Reverse Prague 522 316 Reverse Prague 522 317 523 318 527 319 527 groin extraction
22. 22. XXI 320 528 bisacrominal 321 528 Burns 322 Burns 528 323 529 324 530 325 crochet blunt hook 530 326 530
23. 23. 1
24. 24. 2 1 1 1 1.1 ... 4 1.1.1 .... 4 1.1.2 .. 5 1.2 ................................................................. 6 1.3 ................................. 7 1.3.1 .. 9 1.3.2 Naegele's Rule 10 1.3.3 11 1.3.4 ossification center 11 1.3. 5 . 11 1.4 .. 12 1.4.1 13 1.4.2 . 13 1.4.3 14 1.4.4 .. 16 1.4.5 .. 17 1.5 ............................................................... 17 1.5.1 ... 17 1.5.2 ........................................................................... 17 . . 28 . 28 ... 20 .. 24 . 24 ( Lie).. 24 (Attitude) 25 (Presenting part)... 26 . 29 Denominator...... 30
25. 25. 3 (Position). 31 1.5.3 ...................................... 35 35 McDonald........................................... 37 .. 37 .. 39 1.5.4 42 . ... 42 . .... 43 Leopold Handgrip..... 43 .... 45 cephalic prominences. 47 ... 47 ... 51 .. 51 overriding 52 . ............................................... 53 .... 53 Uterine Souffle, Umbilical Souffle Fetal Shocking Sound 55 1.6 56 1.7 ..................................................... 57 1.7.1 . 58 1.7.2 ... 59 1.7.3 ... 60 1.7.4 ( Retinoscopy) ... 61 1.8 .. 61 1. 8.1 .. 61 1. 8.2 ... 69 1. 8.3 . 72 1. 8.4 ... 75 1. 8.5 . 76 1.9 ... 77 1.9.1 .. 78 1.9.2 .. 86 1.10 .. 86 ... 88
26. 26. 4 1 1.1 1.1.1 1. 2. 3. 4. (stillbirth) (neonatal death) (perinatal death) 5. 1 4
27. 27. 5 (malmanagement) 1.1.2 o 7 (28 ) 4 o 7 (28 )