PATIENT DEMOGRAPHICS:

CASE NO: 2 BED NO:461 WARD: gynae

NAME: Mrs Maria Daniyal
ADDRESS: karimabad KARACHI
GENDER: Female AGE: 22 yrs STATUS
WEIGHT: 10 kg HEIGHT BSA:

PAST MEDICAL HISTORY

DNC

SOCIAL HISTORY
N\s

N\s

FAMILY HISTORY

PAST MEDICAL HISTORY

DRUG DOSE DURATION PURPOSE

PATIENT HISTORY
N\s

PRESENT COMPLAINTS
According to the patient she was alright 9 months. She develops gestational
amenorrhea and about pregnancy now she is in HR for EL-LSCS

VITALS
B.P: TEMP PULSE R/R
EDEMA ANEMIA CYANOSIS OTHERS:
abdominal pain in
umbilical region

POSITIVE FINDINGS
SLEEP: N APPETITE: N MICTURATION: N BOWEL: watery
stool
C.N.S: intact C.V.S ADDICTION: no

LABORATORY FINDINGS
BLOOD
RBC (Male)4.2-5.6M/uL Hemoglobin (Male)14-18g/dL
(female) 3.8-5.1M/uL (female)11-16g/dL
(Child) 3.5-5.0 M/uL (child)10-14g/dL
4.2610E12/L 10.9 gm/dl
E.S.R M=0-15mm/h MCV 80-100um3
F=0-21mm/h 75.3 fl
MCH 25.4-34.6pg/cell I,.N.R 0.9-1.2
25.7pg
PLATELETS 150000-400000/mm3 WBC 4500-11000/mm3
328 10E9/L
PT 11-15 sec Neutrophil 54-65%
72%
APTT: 25-30 sec Lymphocytes 22-33%
22%
RF 20-30 IU/mL Eosinophill 1-3%
02%
PCV/Hct 26-50% Monocytes 3-7%
32.1% 04%
Basophil 0-0.75%

ELECTROLYTES
Sodium 137-145m/Eq/L Osmolality 275-295mOsmol/kg
134 mmol/L
Potassium 3.5-5.0mEq/L Creatinine 0.6-1.2mg/dL
3.80mEq/L
Chloride 95-105mEq/L FBS 70-110mg/dL
100 mmol/L
Calcium 8.4-10.2mg/dL Iron 50-70ug/dL

Bicarbonate 22-28mEq/L Ferritin(M) 15-200ng/mL

22 mmol/L
BUN 7-18mg/dL Ferritin(F) 12-150ng/mL

Uric acid 3.0-8.2md/dL Magnesium 1.5-2.0mEq/L

RBC 120-190mg/dL Transferritin 221-300ug/dL

Urea (serum) 7-21mg/dL BHCG:

25mg/dL

LIVER FUNCTION TEST/CARDIAC TEST:

 Albumin 3.5-5.5g/dL ALP 80-306u/L
110 IU/L
Globulin 2.3-3.5g/dL AST 0-35u/L

T.protein 6.0-7.8g/dL GGT 8-78u/L

07IU/L
Bilirubin(t) 0.1-1.1md/dL LDH 45-90u/L
0.3 mg/dL
Bilirubin(D) 0-0.3mg/dL Amylase 25-125u/L
0.2 mg/dL
ALAT 10-40u/L ATP

ENZYMES:
CREATININE KINASE:
MALE 25-90U/L FEMALE 10-70U/L

OTHER ENZYMES

LIPIDS
CHOLESTEROL 200mg/dL LDL 100mg/dL
HDL 20mg/dL TG 200mg/dL

X-RAYS/ULTRASOUND/C.T.SCAN/MRI
N\s
DIAGNOSIS
38+ week gestation.

SURGICAL PROCEDURES (IF ANY)

N\s

TREATMENT PRESCRIBED
BRAND GENERIC DOSE& SIGNA THERAPEUTIC THERAPEUTIC
NAME NAME DOSAG CLASS USE
E FORM
Rulling omeprazole 10 mg OD Proton pump GERD,
I.V inj inhibiters zollinger-
(PPIs) ellison
syndrome,
H.pylori
Paracetamo panadol 10ml q6◦ Analgesic and Fever, mild to
l I.V inj antipyretic moderate
fever
intra-
Penro meropenem 250 mg TDS Antibiotics abdominal
infection,
I.V inj bacterial
meningitis
Flagyl metronidazol 15ml 8H◦ Antibiotic Vaginal
e I.V inj (nitroimidazole infection
)
Onset ondansetron 2mg SOS antiemetic Nausea,
I.V inj vomiting
½ st D/S Dextrose 1000ml OD Intravenous Fluid
 monohydrate I.V Iinj fluid replenishmen
solution t
Azomax azithromycin 5ml P.O×O Macrolide anti- Bacterial
syrup D bacterial infection
Spasler P Hyoscine 1ml TDS Antispasmodic Abdominal
syrup & pain, stomach
anticholinergic burning

PERSONAL NOTES:
N\s

DATE: STUDENT SIGN INTERNAL SIGN

---------------------- ------------------------
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INTROUCTION:

LOWER SEGMENT CAESAREAN S

Most commonly to deliver the baby a transverse incision is made in the lower uterine segment
above the attachment of the urinary bladder to the uterus.
A vertical incision in the lower uterine segment may be performed in the following
circumstances.

 presence of lateral varicosities

 constriction ring to cut through it
 deeply engaged head
The location of an LSCS is beneficial for the following reasons:

 peritoneum is more loosely attached to the uterus

 contraction is less than in upper part of uterus
 healing is more efficient
 sutures are intact (less problem with suture loosening)

A cesarean delivery might be planned in advance if a medical reason calls for it, or it might be
unplanned and take place during your labor if certain problems arise.

 Cephalopelvic disproportion (CPD):

CPD is a term that means that the baby’s head or body is too large to pass safely
through the mother’s pelvis, or the mother’s pelvis is too small to deliver a normal-
sized baby.

 Previous cesarean birth:

Although it is possible to have a vaginal birth after a previous Cesarean, it is not an

option for all women. Factors that can affect whether a cesarean is needed include the
type of uterine incision used in the previous cesarean and the risk of uterine rupture.

 Multiple pregnancy:
 Although twins can often be delivered vaginally, two or more babies might require a
cesarean delivery.

 Placenta previa:

In this condition, the placenta is attached too low in the uterine wall and blocks the
baby’s exit through the cervix.

 Transverse lie:

The baby is in a horizontal, or sideways, position in the uterus. In this condition, a

cesarean delivery is always used.

 Breech presentation:

In a breech presentation, or breech birth, the baby is positioned to deliver feet or

bottom first. If your doctor determines that the baby cannot be turned through
abdominal manipulation, you will need to have a cesarean delivery.

RISK factor:

 Loss of blood.
 A blood clot that may break off and enter the bloodstream (embolism).
 Injury to the bowel or bladder.
 A cut that might weaken the uterine wall.
 Abnormalities of the placenta in subsequent pregnancies.
 SUMMARY
Patient Maria Daniyal, age 22 years is admitted in the female gynae ward.
According to the patient she was alright 9 months. She develops gestational
amenorrhea and about pregnancy now she is in HR for EL-LSCS. She is passing
watery stools and having pain near umbilical cord region. Her gestational period
is 38+ weeks. She has history of DNC.

Her treatment plan include:

 Inj. Ruling
 Inj. Paracetamol
 Inj. Penro
 Inj. Flagyl
 Inj. Onset
 ½ st D/S
 Azomax syrup
 Spasler P syrup