AAUN Obs and Gynae

04/04/2026

How to start Aloka Alpha 7 Ultrasound Scan Machine

03/04/2026

Intrahepatic Cholestasis of Pregnancy
Definition
Pregnancy-specific liver disorder
Characterized by:
Pruritus (especially palms & soles)
Raised serum bile acids
Usually occurs in 3rd trimester
⚠️ Risk Factors
Previous ICP
Multiple pregnancy
Family history
IVF pregnancy
Hepatitis C / liver disease
Advanced maternal age
🧪 Diagnosis
Unexplained itching + elevated bile acids
Key tests:
Serum bile acids (most important)
LFTs (ALT/AST ↑)
Diagnosis confirmed when:
Bile acids ≥19 µmol/L
📊 Severity Classification (RCOG)
Mild: 19–39 µmol/L
Moderate: 40–99 µmol/L
Severe: ≥100 µmol/L
⚡ Maternal Features
Intense itching (worse at night)
No rash (except excoriations)
± Jaundice (rare)
Sleep disturbance
⚠️ Fetal Risks
Stillbirth (risk ↑ with bile acids ≥100)
Preterm birth
Meconium-stained liquor
Fetal distress
💊 Management
🔹 Symptomatic Treatment
Ursodeoxycholic acid (UDCA)
Improves itching
May reduce bile acids (limited fetal benefit evidence)
Antihistamines → for sleep (not very effective for itch)
🔹 Monitoring
Weekly bile acids + LFTs
No strong evidence for CTG/USS predicting stillbirth
Growth scans if clinically indicated
🔹 Vitamin K
Consider if:
Prolonged PT
Severe disease
⏰ Timing of Delivery (KEY EXAM POINT)
Bile acids 19–39 → Consider delivery by 40 weeks
Bile acids 40–99 → Planned delivery at 38–39 weeks
Bile acids ≥100 → Delivery at 35–36 weeks
👶 Postnatal Care
Symptoms resolve after delivery
Repeat LFTs & bile acids at 6 weeks postpartum
Counsel:
High recurrence risk (45–90%)
Avoid estrogen-containing contraception if severe ICP
🚫 Important Points
ICP is NOT an indication for cesarean section
Stillbirth risk is unpredictable
Early delivery is main strategy to reduce fetal risk

This video is about latest GTG , 2022 , Intrahepatic Cholestasis of Pregnancy . It not only explains the similarities and differences between the previous ve...

02/04/2026

Early Pregnacy Ultrasound Scan

Early Pregnancy Ultrasound Scan is one of the most important investigations in obstetrics. In this video, we explain what to look for in an early pregnancy s...

01/04/2026

Oligohydramnios
💧 Definition
✨ ↓ Amniotic fluid volume
➡️ AFI < 5 cm OR Single deepest pocket < 2 cm
⚠️ Causes
🔹 Maternal ➡️ Dehydration 💦
➡️ PIH / Preeclampsia
➡️ Uteroplacental insufficiency
🔹 Fetal ➡️ Renal agenesis 🚫
➡️ Obstructive uropathy
➡️ IUGR
🔹 Placental ➡️ Placental insufficiency
🔹 Others ➡️ Post-term pregnancy (> 42 weeks)
➡️ PROM (leaking)
➡️ Drugs (ACE inhibitors, NSAIDs)
🚨 Complications
🔸 Fetal distress 😟
🔸 Cord compression 🧵
🔸 Meconium aspiration
🔸 Pulmonary hypoplasia (early cases)
🔸 Limb deformities
🔸 IUFD 💔
🔍 Diagnosis
✔️ Ultrasound → AFI measurement 📊
✔️ Non-stress test (NST)
✔️ Biophysical profile (BPP)
🩺 Management
✨ Depends on gestational age & cause
🔹 General
➡️ Maternal hydration 💧 (oral/IV)
➡️ Left lateral position
➡️ Treat underlying cause
🔹 Monitoring
➡️ Serial AFI
➡️ NST / BPP
🔹 At term (≥37 weeks)
➡️ Induction of labor
🔹 Preterm
➡️ Conservative management
➡️ Corticosteroids (if

Oligohydramnios means reduced amount of liquor around the baby. Quantitatively it is defined as an Amniotic fluid Index(AFI) of less than 5 cm or maximum ver...

30/03/2026

🩺 Appearance of Normal Uterus on Ultrasound
➡️ Position & Orientation
Usually anteverted and anteflexed
Lies centrally in pelvis, posterior to bladder
➡️ Size (Adult, non-pregnant)
Length: 7–9 cm
Width: 4–6 cm
AP diameter: 2–4 cm
➡️ Shape
Pear-shaped
Smooth outer contour
➡️ Myometrium (Muscle Layer)
*Homogeneous echotexture
Medium-level echoes (uniform gray appearance)
No focal masses or asymmetry
➡️ Endometrium
Central echogenic stripe
Thickness varies with menstrual cycle:
🩸 Early proliferative: thin (2–4 mm)
🌸 Late proliferative: trilaminar (“three-line sign”)
🌙 Secretory phase: thick, echogenic (7–14 mm)
➡️ Endometrial Cavity
Normally empty
No fluid collection (except minimal physiological)
➡️ Cervix
Continuous with uterus
Slightly hypoechoic compared to body
Endocervical canal may appear as thin echogenic line
➡️ Vascularity (on Doppler)
Normal moderate blood flow
Symmetrical uterine artery flow

In this video, we explain the normal ultrasound appearance of the uterus using clear animations and labeled diagrams for easy understanding.✨ What you’ll lea...

28/03/2026

Syphilis
✔️ Benzathine Penicillin G
Early syphilis:
2.4 million units IM single dose
Late / unknown duration:
2.4 million units IM weekly × 3 doses
👉 Give in two divided injections (1.2 MU each buttock)
👉 Treat partner also

Toxoplasmosis
✔️ If pregnancy 18 weeks)
Pyrimethamine 50 mg daily
Sulfadiazine 1 g every 6 hours
Folinic acid 10–20 mg 3×/week
⚠️ Avoid pyrimethamine in 1st trimester

Herpes simplex
✔️ Acyclovir
Primary infection:
400 mg orally 3 times daily for 7–10 days
✔️ Suppression (near term, after 36 weeks)
400 mg TDS until delivery.
👉 If active ge***al lesions at labor → C-section

25/03/2026

💥 Uterine Rupture

🎯 Definition

👉 Sudden tear in uterine wall during pregnancy or labor
👉 Leads to communication between uterine cavity & peritoneal cavity

⚠️ Risk Factors

➡️ Previous C-section (especially classical scar)
➡️ Previous uterine surgery (myomectomy)
➡️ Obstructed labor
➡️ Grand multiparity
➡️ Induction/augmentation (e.g., oxytocin misuse)
➡️ Trauma (external/internal)

🚨 Types

🔹 Complete rupture
→ Full thickness tear (endometrium + myometrium + serosa)

🔹 Incomplete rupture (dehiscence)
→ Serosa intact, less severe

🧠 Clinical Features

👩‍🍼 Maternal Signs

➡️ Sudden severe abdominal pain
➡️ Vaginal bleeding
➡️ Shock (tachycardia, hypotension)
➡️ Loss of uterine contractions
➡️ Palpable fetal parts easily

👶 Fetal Signs

➡️ Fetal distress (most common early sign)
➡️ Bradycardia
➡️ Absent fetal heart sounds (late)

🔍 Diagnosis

👉 Mainly clinical diagnosis
👉 CTG: fetal distress
👉 Ultrasound: may help but not reliable in emergency

⚡ Management (Emergency 🚑)

➡️ Immediate laparotomy
➡️ Resuscitation (IV fluids, blood transfusion)
➡️ Deliver fetus rapidly

Surgical Options:

🔹 Repair of uterus (if stable & future fertility desired)
🔹 Hysterectomy (if severe bleeding / no fertility needed)

❗ Complications

➡️ Maternal hemorrhage
➡️ Shock
➡️ Fetal death
➡️ Sepsis
➡️ Infertility

🛡️ Prevention

✔️ Proper trial of labor after C-section (TOLAC selection)
✔️ Avoid injudicious oxytocin use
✔️ Early detection of obstructed labor
✔️ Institutional delivery

Uterine rupture is spontaneous tearing of the uterus that may result in the fetus being expelled into the peritoneal cavity. Signs of Uterine Rupture includ...

24/03/2026

Uterine Transplantation / Scientific Impact Paper

This video summarizes the 2021 Scientific Impact Paper on uterine transplantation, an emerging treatment for absolute uterine factor infertility (AUFI). Publ...

21/03/2026

19/03/2026

🧾 Ultrasound – Kidney Stones (Renal Calculi)
➡️ 🔍 Basic Findings
⚪ Echogenic focus (bright white spot)
🌑 Posterior acoustic shadowing
📍 Seen in kidney / ureter
➡️ 📡 Secondary Signs
💧 Hydronephrosis
🚰 Dilated ureter (hydroureter)
⚠️ Reduced renal cortical thickness (chronic)
➡️ ✨ Special Signs
🌟 Twinkling artifact (Doppler)
🔊 Helps detect small stones
➡️ 📏 Size & Location
📐 Measure stone size
📍 Pelvis / calyx / ureter
➡️ ⚠️ Limitations
❌ Small ureteric stones missed
❌ Obesity / bowel gas interference
➡️ 👍 Advantages
☢️ No radiation
🤰 Safe in pregnancy
➡️ 🧠 Tip
⚪ + 🌑 shadow = Stone likely

Renal stones are small structures inside the kidneys visualized and diagnosed on ultrasound. Although CT scan can best diagnose renal calculi, but ultrasound...

19/03/2026

💧 Oligohydramnios – Causes
➡️ 👶 Fetal
🚫 Renal agenesis
🚫 Obstructive uropathy (PUV)
📉 IUGR
💔 Fetal demise
➡️ 🩸 Placental
⚠️ Uteroplacental insufficiency
📅 Post-term pregnancy
🚩 Preeclampsia
➡️ 🤰 Maternal
💧 Dehydration
💊 ACE inhibitors
💊 Ibuprofen
➡️ 💦 Membranes
💥 PROM / PPROM
➡️ ❓ Idiopathic
❔ Unknown cause

Oligohydramnios means reduced amount of liquor around the baby. Quantitatively it is defined as an Amniotic fluid Index(AFI) of less than 5 cm or maximum ver...

17/03/2026

Definition of Ovarian Cystectomy