Wafa OBGYN
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📈 Аналитический обзор Telegram-канала Wafa OBGYN
Канал Wafa OBGYN (@wafaobgyn) языкового сегмента Английский является активным участником. Сейчас сообщество объединяет 31 445 подписчиков, занимая 567 место в категории Медицина.
📊 Показатели аудитории и динамика
С момента создания невідомо проект демонстрирует стремительный рост, собрав аудиторию из 31 445 подписчиков.
Согласно последним данным от 09 января, 2025, канал показывает стабильную активность. За последние 30 дней изменение числа участников составило 166, а за последние 24 часа — 0, при этом общий охват остаётся высоким.
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📝 Описание и контентная политика
Описание канала не предоставлено.
Благодаря высокой частоте обновлений (последние данные получены 10 января, 2025) канал поддерживает актуальность и высокий уровень охвата публикаций. Аналитика показывает, что аудитория активно взаимодействует с контентом, что делает его важной точкой влияния в категории Медицина.
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Подписчики
Нет данных24 часа
+497 дней
+16630 дней
Архив постов
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A 40-year-old sexually active patient presents for cervical cancer screening. Physical examination is unremarkable, menstruation is regular with a 28-day cycle and LMP was 5 days ago. Which of the following is the best advice about Pap smear?
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📌According to Berghella
Fetal Death
- Definition
o Fetal deaths ≥20 weeks of gestation or weight >350 g.
- Diagnosis
o Ultrasound examination should be performed for confirmation of fetal death
- Management
o Expectant management
Between 80% and 90% of women with fetal death will spontaneously go into labor within 2 weeks of fetal demise
Endomyometritis rate is higher in the spontaneous labor group (6% versus 1%) compared to induction
Coagulation abnormalities occur in about 3% to 4% of patients with uncomplicated fetal deaths over the next 4–8 weeks
o Induction
Induction of labor in women with fetal death is usually recommended, unless the patient is already in labor, given the problems mentioned with expectant management. Induction of labor is typically initiated soon after diagnosis of fetal death.
For gestations less than 28 weeks, misoprostol is the most efficient method of induction, regardless of Bishop score, although high dose oxytocin infusion is an acceptable alternative
o Dilatation and evacuation
Between 14 and 24 weeks of gestation, D&E is a safe method in this time frame, especially if done by experienced operators, under continuous ultrasound guidance
Patients should be counseled that efficacy of autopsy is very limited with D&E.
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Female at 26 weeks pregnancy came with abdominal pain, on examination uterus is 24 weeks and absent fetal cardiac activity. What is the most appropriate management?
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📌
Trichomoniasis
- Clinical presentation:
• Frothy, yellow-green discharge. Foul-smelling, vaginal itchiness, strawberry cervix
- Microscope:
• Flagellated protozoa
- Treatment:
• Metronidazole, Treat Sexual partner(s)
Note:
The symptoms of Chlamydia and Nisseria are similar, but based on the given senario, it is more consistent with Trichomonas infection
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Previous question.. Which of the following is the most likely diagnosis?
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A 21-year-old woman presented with an abnormal vaginal discharge, burning on micturition, and blood spotting for the past 2 months. On genital examination, there was an eroded and friable (strawberry appearance) cervix, with a yellow-green mucopurulent discharge >10 PMNs per oil immersion field. Which of the following is the most likely diagnosis?
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📌According to Williams gynecology and ACOG
Ectopic pregnancy
Epidemiology
- Ruptured ectopic pregnancy accounted for 2.7% of all pregnancy-related deaths and was the leading cause of hemorrhage-related mortality.
According to articles:
Ectopic pregnancy (EP) ruptures are the leading cause of maternal mortality within the first trimester of pregnancy with a rate of 9%–14%.
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Patient presented to the ER with severe abdominal pain and hypotensive, diagnosis of ruptured ectopic pregnancy was made. What is the morality rate?
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📌According to Williams Gynecology
- A small amount of peritoneal fluid is physiologically normal.
According to UTD
- A small amount of clear free fluid in the pelvis is a normal sonographic finding. There is no established threshold for the volume of fluid that is physiologic and the volume is difficult to measure sonographically. However, fluid that is anechoic and isolated to the pelvic cul-de-sac and adjacent recesses is likely physiologic
- The presence or absence of peritoneal free fluid is not a reliable indicator of whether an ectopic pregnancy has ruptured.
According to Williams Gynecology and ACOG
Ectopic pregnancy
Surgical management:
- Laparoscopy is the preferred surgical treatment for ectopic pregnancy unless a woman is hemodynamically unstable.
- Ruptured tubal pregnancies with hemoperitoneum-can safely be managed laparoscopically.
• Salpingectomy
o Standard procedure if the condition of the tube with the ectopic gestation is damaged (ruptured or otherwise disrupted), bleeding is uncontrolled, or the gestation appears too large to remove with salpingostomy.
• Salpingostomy
o Preservation of the tube for potential future fertility
o Preferred for patients who desire future childbearing and in whom the contralateral tube is absent or damaged.
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35 years old patient, had two miscarriages previously, Now her B-hCG is 12,000. 2.5 cm ectopic pregnancy and minimal fluid in the pouch of douglas?
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📌According to UpToDate
- Polyhydramnios presents with a uterine size that is large for gestational age (fundal height [cm] that exceeds the weeks of gestation by >3) or as an incidental finding on a prenatal ultrasound examination
- Polyhydramnios is more common in patients with GDM
Note:
- Both answers are correct, but with the given senario I will go with A
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Pregnant at 34 weeks, Diabetic on insulin, not compliant. Came with fundal height of 38 weeks what is cause?
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هذا السؤال جاني بالاختبار قبل شهر وحليته كذا وعطوني فل مارك وحطيته لكم عشان نفس السؤال اللي موجود بال SMLE بس تفرق الصيغة والخيارات، عشان تشوفون فرق الخيارات والاجابتين اللي لسا صامده هي ال HR و ال Visual estimation
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📌All references are not in support of any of the options. However, I will choose visual estimation as my preferred option because I answered it correctly in my promotion exam and received full marks.
According to berghella:
- Assessment of peripartum blood loss has classically been determined by a provider’s subjective visual estimation of blood loss (EBL). Visual EBL has consistently been shown to result in underestimation of large-volume blood loss (>1000 mL) by up to 30%–50% and overestimation of small-volume blood loss
- Gravimetric methods for quantifying blood loss, including weighing of pads and sponges, and the use of calibrated under-buttock drapes, as well as blood loss calculators, are recommended for the diagnosis of PPH.
According to Williams Obstetrics:
- A treacherous feature of pospartum hemorrhage is the failure of the pulse and blood pressure to undergo more than moderate alterations until large amounts of blood have been lost.
Hemoglobin and hematocrit:
- The Hb or HCT method has a delayed effect since intensive hemorrhage might cause the blood to concentrate in a short time, leading to a false impression that the value is within normal limits
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❗️(This question part of the promotion exam, not the SMLE but it covers the same concept as the previous question)
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Patient had PPH with EBL of 1500ml, what is the most accurate measure for severe hemorrhage?
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Previous question.. Anticipated management was taken because of risk of postpartum hemorrhage and hypovolemic shock. Which of the following is considered a best reliable indicator of above complications?
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A 38-year-old G9P8 woman presented at 38 weeks gestation in labor and diagnosis of prolonged 2nd stage of labor and finally delivered 4.3 Kg baby by vacuum extraction. Anticipated management was taken because of risk of postpartum hemorrhage and hypovolemic shock. Which of the following is considered a best reliable indicator of above complications?
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📌 According to Berghella
Clinical Features of Placeta previa
- Placenta previa typically presents as painless vaginal bleeding in the second or third trimester. The bleeding is believed to occur from disruption of placental blood vessels in association with the development and thinning out of the lower uterine segment. Between 70% and 80% of patients with placenta previa will have at least one bleeding episode.
