Curs 4 - Sarcina Normala (NXPowerLite)

7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)

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CUPRINSULCUPRINSUL

CURSULUICURSULUI

Sarcina normalaSarcina normalaUNIVERSITA

TEA

”PETRE

ANDR

EI

”IASI;FACU

LTAT

EADE

MEDICINADE

NTARA

“APO

LLONIA”IASI

CURS NR. 4CURS NR. 4

Conf. Dr. Pavalan! Maricica

DIA"NOSTICUL DE SARCINADIA"NOSTICUL DE SARCINA

MODIFICARILE DE SARCINAMODIFICARILE DE SARCINA

CONSULTATIA PRENATALACONSULTATIA PRENATALA



# $arcina %!ra&' (n mo% normal )*+ &il, a%ic' -+ %

$'/'m0ni % la !l/ima mn$/r!a1i.

# aari1ia $arcinii %/rmin' a$!ra or2ani$m!l!i

ma/rn o $ri % mo%ific'ri c!m ar fi3

# amnora 4a5$n1a mn$/r!a1ii6.

# mo%ific'ri 2nral.

# mo%ific'ri local al !/r!l!i 7i $0nilor.

Curs nr. 4Curs nr. 4

SARCINA NORMALASARCINA NORMALA

MODIFICARILEMODIFICARILE

SPECIFICE DESPECIFICE DE

SARCINASARCINA

CONSULTATIACONSULTATIA

PRENATALAPRENATALA

Sli% 8 9 --



## Dia2no$/ic!l % $arcin' in $a/amanil :)+

## Dia2no$/ic!l clinic

# Anamn&'3# amnora $/ !n $mn % mar ro5a5ili/a/

la fmia c! cicl!ri r2!la/. Ea n! $/

rlvan/' a/!nci c0n% $arcina a a'r!/ (nain/a

mnar<i $a! (n mnoa!&', (n rioa%a %

lac/a1i, im%ia/ %!' con/rac/ivl oral $a!la fmi car a! cicl!l mn$/r!al nr2!la/.

# la aro=ima/iv -+ % &il % la !l/ima

mn$/r!a1i oa/ a'ra o mic' $0n2rar %

imlan/ar.





SARCINASARCINA


PRENATALAPRENATALA

Sli% - 9 --



# $in%rom!l n!rov2/a/iv % rim /rim$/r!,

rr&n/a/ % mo%ificari %i2$/iv 42r1!ri 7i v'r$'/!ri

ma/inal, iro&i$, $ialor, con$/ia1i, mo%ific'ri %

2!$/ 7i a/i/6, !rinar 4%i$!ri, ola>i!ri6, al

$i$/m!l!i nrvo$ cn/ral 4in$omni $a! $omnoln1',/!l5!r'ri % comor/amn/6.

# /mra/!ra 5a&al' (n la/o!, $/ 8?@C.





SARCINASARCINA


PRENATALAPRENATALA

Sli% 9 --



## E=amn clinic o5ic/iv

# la in$c1i $ o5$rv' mo%ific'ri al

/2!mn/lor, $0nilor, a5%omn!l!i, or2anlor

2ni/al =/rn 7i mm5rlor infrioar. La nivl!l/2!mn/lor aar <iri2mn/ara f1i

4cloa$ma 2ravi%ic'6, a cica/riclor, om5ilic!l!i, linii

m%ian.

# $0nii $!n/ m'ri1i % vol!m, aroll

<iri2mn/a/, /!5rc!li Mon/2omrB 42lan%

$5ac <ira/rofia/6 r&n1i, r1a allr

r&n/'.

# %in $'/'m0na a :)a $ oa/ con$/a/a o !7oar'5om5ar a <io2a$/r!l!i.





SARCINASARCINA


PRENATALAPRENATALA

Sli% 9 --



# or2anl 2ni/al =/rn $!n/ <iri2mn/a/,

violac, c! !7or %m.

# mm5rl infrioar o/ r&n/a circ!la1i

vnoa$' $!rficial' mai vi%n/a 7i varicl $ o/

accn/!a.

## Palara

# %!' $'/'m0na a :)a (n <io2a$/r! $

ala&' !/r!l 2ravi% 4IFU $/ % - cm la *

$'/'m0ni 7i * cm la :) $'/'m0ni, cr$c0n% c!

aro=ima/iv - cm l!n'6.

# =amn!l va2inal c! valv $ fac ma$a

2incolo2ic' 7i $ vi%n1ia&' m!coa$a va2inal'

violac, %ma1ia/', col violac!, !nori o

l!cor mai a5!n%n/'.





SARCINASARCINA


PRENATALAPRENATALA

Sli% ? 9 --







SARCINASARCINA


PRENATALAPRENATALA

Sli% * 9 --



# =amn!l va2inal %i2i/al $ fac com5ina/ c!

alara a5%ominala %!' 2olira v&icii !rinar.

# $ con$/a/'3 (nm!ira col!l!i, a i$/m!l!i 4%2/l

va2inal $ (n/0ln$c c! cl a5%ominal $mn!l

2ar6. Cor!l !/rin $/ 2lo5!lo$, '$/o$, mo5il 7i

cr7/ ro2r$iv % la %imn$i!na !ni man%arin

(n $'/'m0na a -a, la %imn$i!na !ni or/ocal (n $a/'m0na a *a, 2rafr!i/ (n $'/'m0na a

:)a, ca % fa/ (n $'/'m0na a :a.

# %!' : $'/'m0ni $ o/ rc 5alo/ara

va2inal' a f'/!l!i 7i mi7caril f'/!l!i la nivl!l !n!i

ovar $ oa/ ala cor!l 2$/a/iv.





SARCINASARCINA


PRENATALAPRENATALA

Sli% 9 --

C 4



# /$/!l im!nolo2ic % $arcin' vi%n1ia&'

r&n1a C" (n !rina ma/rn'; $ oa/, (n

an!mi/ ca&!ri 4$arcin' /!5ara, mol', $arcin'

ori/a in vol!1i6, rc!r2 la %o&ara mai

$cific' a C" (n !rin' $a! $an2.

# c<o2rafia lvin' $ fc/!a&' c! v&ica

!rinar' lin'3 la $a/'m0ni $ oa/ vi&!ali&a

7i m'$!ra $ac!l ov!lar in/ra!/rin, la

$'/amani m5rion!l, la ? $'/'m0ni cor%!l

f/al.

## Dia2no$/ic araclinic Curs nr. 4Curs nr. 4




SARCINASARCINA


PRENATALAPRENATALA

Sli% :+ 9 --

C 4C 4



# amnora % al/ ca!&3 amnora %in

<ir$/ro2ni$m in$!ficin1' /iroi%ian' $a!

ovarian', 5oli or2anic $a! carn1 alimn/ar.

# <ma/om/ria3 c0n% %a/ori/' !ni $/no&crvical, $an2l r'm0n (n cavi/a/a !/rin'

car o %$/in%, fiin% (n$o1i/' % %!rri.

# m/ri/' arnc<ima/oa$' cronic', (n car !/r!l

$/ m'ri/, %!rro$, (n$o1i/ % m/rora2ii 7i

$in%rom 5iolo2ic inflama/or.

# fi5rom!l !/rin !nic, car $ %o$57/ rin

con$i$/n1', forma $i li$a clorlal/ $mn %

$arcin'.

## Dia2no$/ic %ifrn1ial Curs nr. 4Curs nr. 4




SARCINASARCINA


PRENATALAPRENATALA

Sli% :: 9 --

C 4C 4



# /!mori ovarin car r&in/' 7an1 % %limi/ar

fa1' % !/r 4car $/ %via/ la/ral6, iar

amnora 4c0n% =i$/'6 n! $/ (n concor%an/a

c! %imn$i!nil !/r!l!i; (n l!$ n! =i$/' al/

$mn % $arcin'.# 2lo5!l v&ical, car %i$ar %!' vac!ara

v&icii.

# $!%ocB$i$ $arcina $i<ic'3 manif$/a/' rin

amnor $i $mn $!5ic/iv % $arcin' la

fmi infr/il car7i %or$c foar/ m!l/ o

$arcin'.

# $arcin' =/ra!/rin' 4/!5ar'6, (n car $/ !7or

m'ri/ % vol!m %ar ara!/rin $ con$/a/' oforma1i!n.





SARCINASARCINA


PRENATALAPRENATALA

Sli% :) 9 --

C 4C 4



# $/ !n %ia2no$/ic % cr/i/!%in car $ !n 3

## E=amn clinic

# anamn&a rlv' o amnor % $/ )+

$'/'m0ni, aari1ia mi$c'rilor f'/!l!i rc!/

la 2ravi% rimiar la :* )+ $'/'m0ni, iar

m!l/iar la : :* $'/'m0ni; %i$ari1ia

$mnlor n!rov2/a/iv % $arcin', a/!l5!r'rilor !rinar 4car vor ra'ra (n al IIIla

/rim$/r!6 3 a5%omn!l cr7/ ro2r$iv.

# 2ravi%a ia (n 2r!/a/ aro=ima/iv ++ 2

$'/'m0n', 0n' la /rmn cr7/ra on%ral'

fiin% % :) >2.

## Dia2no$/ic!l (n $'/'m0nil )+ G -+Curs nr. 4Curs nr. 4




SARCINASARCINA


PRENATALAPRENATALA

Sli% :8 9 --

I 1i C 4Curs nr 4



## In$c1ia# mo%ific'ril a'r!/ (n rim!l /rim$/r! la nivl!l

/2!mn/lor $i or2anlor 2ni/al =/rn $

accn/!a&'. Cr7/ra % vol!m a a5%omn!l!i $

oa/ m'$!ra 4)? cm la ? l!ni, 8+ cm la * l!ni, 88

cm la l!ni6.

# % a$mna, $ oa/ con$/a/a accn/!ara

i2mn/'rii, vr2/!rilor, %$/in%ra om5ilic!l!i,

rc!m 7i mi7c'ril f'/!l!i.

## Palara # in $'/'m0nil ): )*, la alara a5%omn!l!i $

con$/a/' o forma1i!n 2lo5!loa$', con/rac/il', car

con1in o forma1i!n mai %!r' car 5alo/a&'; $con$/a/' % a$mna 7i 5alo/ara va2inal'.





SARCINASARCINA


PRENATALAPRENATALA

Sli% :- 9 --

Curs nr 4Curs nr 4



# $ rc % a$mna 7i mi7c'ril f/al.

# %!' $'/'m0na )*, la alara $!rficial' $

con$/a/' o forma1i!n ovoi%al', con/rac/il', c! a=!l

mar % o5ici lon2i/!%inal; la alara rof!n%a $o/ rc 'r1il f'/!l!i.

# a$c!l/a1ia 5'/'ilor cor%!l!i f/al $/ $mn %

cr/i/!%in. E$/ o$i5il' %in $'/'m0nil ):

)-.





SARCINASARCINA


PRENATALAPRENATALA

Sli% : 9 --

Curs nr 4Curs nr 4



# =amn!l va2inal c! valvl vi%n1ia&' acla7i

$mn % la inc!/!l $arcinii car $!n/ (n$' mai

accn/!a/. S oa/ o5$rva (n aria orifici!l!i =/rn

al col!l!i %o!l 2la/ino$.

# =amn va2inal %i2i/al3 col!l $/ moal, orin/a/ $r

r/l o$/rior al va2in!l!i 4oa/ fi (n/r%$c<i$ la m!l/iar6.

# 5alo/ara lic<i%ian' $ oa/ rc 0n' la

$'/'m0na )*, %!' $a/'m0na )* $ oa/ ala

r&n/a1ia.





SARCINASARCINA


PRENATALAPRENATALA

Sli% : 9 --

Di i li i Curs nr 4Curs nr 4



# =amn!l c<o2rafic rmi/ $/a5ilira v0r$/i

2$/a1ional, a malforma1iilor, a via5ili/'1ii f/al, a

locali&'rii lacn/i, a arcirii can/i/'1ii % lic<i%

amnio/ic, a cor%on!l!i om5ilical.

# %ia2no$/ic!l %ifrn1ial $ fac c!3

# fi5rom!l !/rin 2i2an/ ;

# /!mori % ovar c! a$ci/';

# c<i$/ 2i2an/ % ovar;

# /!mori a5%ominal vol!minoa$;

# 2lo5 v&ical; # $!%ocB$i$.

## Dia2no$/ic araclinic Curs nr. 4Curs nr. 4




SARCINASARCINA


PRENATALAPRENATALA

Sli% :? 9 --

%ifi ' i % i l i l i Curs nr 4Curs nr 4



# in /im!l $arcinii aar mo%ific'ri morfof!nc1ional

al /!/!ror aara/lor 7i $i$/mlor or2ani$m!l!i

ma/rn mni/ $' a$i2!r a%a/ara ac$/!ia la

nc$i/'1il no! a'r!/ im!$ % %&vol/ara

ro%!$!l!i % conc1i, $' rmi/' vol!1ia $arcinii

7i $' r2'/a$c' fmia n/r! na7/r.

## Mo%ific'ri a%a/a/iv al or2ani$m!l!i

ma/rn (n $arcin'





SARCINASARCINA


PRENATALAPRENATALA

Sli% :* 9 --

M %ifi ' il %i l i i Curs nr 4Curs nr 4



# %a/ori/' ri%ic'rii %iafra2m!l!i, con$cin1' a cr7/rii

!/r!l!i, cor%!l $/ (min$ (n $!$ 7i ro/a/ (nain/,

a$/fl c' EH" a=a lc/ric' $/ %via/' la

$/0n2a.# %5i/!l car%iac cr7/ (n riml :+ $'/'m0ni 7i

r'm0n cr$c!/ 0n' la /rmn, c0n% a!n2 la

l9min. Cr7/ra %5i/!l!i car%iac $ fac $ama

cr7/rii %5i/!l!i 5'/ai 7i $c!n%ar $ama

cr7/rii frcvn1i car%iac 4c! :)+ 5'/'i 9 min.6.

## Mo%ific'ril car%iova$c!lar 7i $arcina Curs nr. 4Curs nr. 4




SARCINASARCINA


PRENATALAPRENATALA

Sli% : 9 --

# r$i!na ar/rial' a/0/ $i$/olic' c0/ 7i %ia$/olic' Curs nr 4Curs nr 4



# r$i!na ar/rial', a/0/ $i$/olic', c0/ 7i %ia$/olic',

$ca% c! :+ mm 2 (n rima !m'/a/ a $arcinii

ca aoi $' cra$c', a!n20n% la /rmn aroa la

valoril %in afara $arcinii.

# $c'%ra /n$i!nii ar/rial $/ %a/' % aari1ia

circ!la1ii f/olacn/ar, /ri/ori! c! r&i$/n1'

$c'&!/'.

# a oa/ fi =lica/' 7i % ac1i!na %irc/'

a $/ro2nilor a$!ra va$lor c! %imin!ara

caaci/'1ii % r'$!n$ la $/im!lii va$or$ori

fi&iolo2ici. S con$i%r' normal valoril % :-+

mm 2 /n$i!n ar/rial' $i$/olic' 7i *+ mm 2

/n$i!n ar/rial' %ia$/olic'.





SARCINASARCINA


PRENATALAPRENATALA

Sli% )+ 9 --

# ro2$/ron!l favori&a&' rla=ara vnoa$' 7i Curs nr 4Curs nr 4



# ro2$/ron!l favori&a&' rla=ara vnoa$' 7i

r/n1ia lic<i%ian'. Pr$i!na vnoa$' rifric'

cr7/ %a/ori/' comr$i!nii vnlor mari % c'/r

!/r!l 2ravi%.

# !n fnomn <mo%inamic imor/an/ (l rr&in/'mo%ific'ril DC l2a/ % o&i1i.

# a$/fl, c0n% !/r!l 2ravi% a!n2 la !n an!mi/vol!m, (n %c!5i/ %or$al =rci/' o an!mi/'

r$i!n a$!ra vni cav infrioar, an/rn0n%

%imin!ara (n/oarcrii vnoa$ Ia cor% 7i o $c'%r

a /n$i!nii ar/rial 0n' la $/ara $incoal'

4$in%rom % <io/n$i!n % %c!5i/6 car $ oa/

corc/a rin /rcra %in %c!5i/ la/ral.





SARCINASARCINA


PRENATALAPRENATALA

Sli% ): 9 --

Curs nr 4Curs nr 4



# vol!m!l $an2!in cr7/ c! +J, cr7/ra f'c0n%!$

con/in!! 0n' la /rmn, a/0/ $ama cr7/rii

vol!m!l!i la$ma/ic, c0/ 7i rin cr7/ra vol!m!l!i

2lo5!lar, %ar c! !n ri/m mai ln/.

# a$/fl, %in ac$/ mo/iv, <ma/ocri/!l $ca% la 88J,

iar <mo2lo5ina a!n2 la ?J fa1' % valoara %in

afara $arcinii.





SARCINASARCINA


PRENATALAPRENATALA

Sli% )) 9 --

Curs nr 4Curs nr 4



# %in !nc/ % v%r <ma/olo2ic $ con$/a/'

cr7/ra clor mai m!l1i fac/ori % coa2!lar3fi5rino2n, fac/or VII, fac/or VIII, IK, K.

# la aca$/a $ a%a!2' $c'%ra ac/ivi/'1ii

fi5rinoli/ic, fa/ c %/rmin' o $/ar %

<ircoa2!la5ili/a/.





SARCINASARCINA


PRENATALAPRENATALA

Sli% )8 9 --

Curs nr 4Curs nr. 4



# $!n/ ana/omic3 a$cn$i!na %iafra2m!l!i, l'r2ira

5a&i /oracl!i, $c'%ra /on!$!l!i m!7c<ilor

a5%ominali, 7i f!nc1ional3 cr7/ra vol!m!l!i c!rn/ 7i

$c'%ra vol!m!l!i r&i%!al, cr7/ra mo%ra/' a

frcvn1i r$ira/orii, cr7/ra %5i/!l!i vn/ila/or;

caaci/a/a vi/al' 7i frcvn1a r$ira/ori n! $

mo%ific'.

# %a/ori/' in/n$ific'rii vn/ila1ii cr7/ con$!m!l % O) 7i$ca% concn/ra1ia % CO).

## Mo%ific'ri r$ira/oriiCurs nr. 4Curs nr. 4




SARCINASARCINA


PRENATALAPRENATALA

Sli% )- 9 --

## M %ifi ' i %i /i Curs nr. 4Curs nr. 4



# =c/0n% riml $'/'m0ni % $arcin', cr7/

a/i/!l $i con$!m!l alimn/ar.

# % a$mna aar rvr/ira 2!$/!l!i 7i !nl

5i&arrii.# m!coa$a 5!cal' $!fr' mo%ific'ri carac/ri$/ic3

<irva$c!lari&a1i, %m, %$c!amar.

# oa/ a'ra 2in2ivi/a mar2inal' 2ravi%ic' cara/in2 ma=im!m (n l!na a Va 7i %imin!a $a! %i$ar

5r!$c %!' na7/r.

# &onl in/r%n/ar al 2in2iilor, mai al$

la nivl!l ma=ilar!l!i $!rior, o/ $!fri o <irla&ilocali&a/' 4!li$ 2ravi%ic6.

## Mo%ific'ri %i2$/iv Curs nr. 4Curs nr. 4




SARCINASARCINA


PRENATALAPRENATALA

Sli% ) 9 --




# al/r'ril 2in2ival (n $arcin' $!n/ foar/ frcvn/

4*J6, $!n/ r&i$/n/ la /ra/amn/ 7i %i$ar %!'

na7/r (n mara lor maori/a/.

# con/rar !nor afirma1ii mai vc<i, n! $ ro%!c %calcific'ri (n /im!l $arcinii.

# f!nc1ia 2a$/ric' $/ (nc/ini/' iar ac/ivi/a/a

$cr/ori 2a$/ric' $/ %imin!a/'.





SARCINASARCINA


PRENATALAPRENATALA

Sli% ) 9 --

## Mo%ific'ri rnal Curs nr. 4Curs nr. 4



# o/ a'ra %ila/a1ii al 5a&in!l!i 7i !r/rlor rin

imr2na1ia <ormonal' 7i rin comr$i!na

=rci/a/' % !/r!l 2ravi%.

# mo%ific'ril f!nc1ional car aar $!n/3

# cr7/ra %5i/!l!i $an2!in rnal.

# cr7/ra fil/r'rii 2lomr!lar c! +J4$c'%ra cra/inini 7i !ri (n $0n26.

# f!nc1ia /!5!lar' ar nmo%ifica/'3 (n $i/!a1ii

% =c1i o/ a'ra rioa% % in$!ficin1'

c! 2lico&!ri /ran&i/ori;

# cr7/ r/n1ia % $o%i! car %/rmin'cr7/ra vol!m!l!i la$ma/ic.

## Mo%ific'ri rnal Curs nr. 4Curs nr. 4




SARCINASARCINA


PRENATALAPRENATALA

Sli% )? 9 --

## S/a/!$!l <ormonal 7i $arcina Curs nr. 4Curs nr. 4



# %in !nc/ % v%r al c<ili5r!l!i <ormonal, (n

$arcin' =i$/' %o!a rioa%3

# rioa%a ovariano/acn/ar', car $ (n/in% %!ra/a rim!l!i /rim$/r! 7i $ carac/ri&a&' rin

ro%!c1i marca/' % C" 7i $/roi&i a cor!l!i

2al5n 4E, P6;

# rioa%a lacn/ar', car $ (n/in%

arc!r$!l !rm'/oarlor %o!' /rim$/r 7i $

carac/ri&a&' rin (nc/ara f!nc1ii cor!l!i

2al5n 7i ro%!c1ia % c'/r lacn/' a <ormonilor$/roi&i 4E, P6 7i ro/ici.

## S/a/!$!l <ormonal 7i $arcina Curs nr. 4Cu s




SARCINASARCINA


PRENATALAPRENATALA

Sli% )* 9 --

## ormonii $/roi&i Curs nr. 4Curs nr. 4



# =i$/' o ac1i!n comlmn/ar' (n/r c<iamn/!l

n&ima/ic f/al 7i lacn/ar, rali&0n% ca c $

n!m7/ !ni/a/a f/olacn/ar'.

# $/ro2nii $!n/ (n n!m'r % /ri3 $/rona,

$/ra%iol!l 7i $/riol!l.

# lacn/a folo$7/ col$/rol!l ma/rn carl/ran$form' (n r2nnolon car /rc (n

comar/imn/!l f/al !n% $/ $!lfa/a/ 7i (n

$!rarnal $/ /ran$forma/ (n $!lfa/ %

%<i%roian%ro$/ron 4SDEAA6 iar ac$/a (n

fica/!l f/al $/ %<i%ro=ila/ (n : <i%ro=iian%ro$/ronac/a/ 4:O DEA6.

## ormonii $/roi&i




SARCINASARCINA


PRENATALAPRENATALA

Sli% ) 9 --

# ac$/ rc!r$or /rc (n lacn/' !n% $/ Curs nr. 4Curs nr. 4



ac$/ rc!r$or /rc (n lacn/' !n% $/

aroma/i&a/ 7i /ran$forma/ (n $/ron' car /rc aoi (n

$/ra%iol.

# o ar/ a $/ra%iol!l!i /rc (n fica/!l f/al 7i

/ran$forma/ (n $/riol.

# valoril $/riol!l!i (n $arcin' $!n/ !n in%ica/or alf!nc1ionali/'1ii !ni/'1ii f/olacn/ar 7i a 5!ni $/'ri a

f'/!l!i.

# ro2$/ron!l $/ $in//i&a/ (n lacn/'

ornin% % la r2nnolon!l $in//i&a/

%in col$/rol!l % ori2in ma/rn'.




SARCINASARCINA


PRENATALAPRENATALA

Sli% 8+ 9 --




# C" <ormon 2licoro/ic, c! %o!' lan1!ri 7i

, cl %in !rm' fiin% $cific. Rol!l l!i $/ % amn1in (n f!nc1i!n cor!l 2al5n % $arcin'.

P r&n1a 7i %o&ara l!i $ 5a&a&'

%ia2no$/ic!l im!nolo2ic % $arcin'.

# $oma/o/roina corionic' $a! LP ar ac1i!n %

o/n1ar a $oma/o/ro!l!i <iofi&ar, lac/o2n'

7i mamo/ro'.

## ormonii ro/ici




SARCINASARCINA


PRENATALAPRENATALA

Sli% 8: 9 --

hCG uman

## Mo%ific'ril 2ni/al %in /im!l $arcinii Curs nr. 4Curs nr. 4



# $!fr' mo%ific'ri morfolo2ic 7i f!nc1ional

imor/an/ mni/ $a rmi/' rimira 7i con/n1ia

o!l!i, %&vol/ara 7i =!l&ia l!i la /rmn.

# %in !nc/ % v%r ana/omic !/r!l r&in/' /ri

or1i!ni3 cor!l, col!l 7i $2mn/!l infrior car

$/ o or1i!n car $ %&vol/' (n !l/iml l!ni %

$arcin', (n/r cor 7i col.

# cor!l !/rin cr7/ ro2r$iv $ama <ir/rofii

lmn/lor m!$c!lar 7i %i$/n$i. ir/rofia $

rali&a&' rin <irla&ia fi5rlor m!$c!lar=i$/n/ 7i m/ala&ia <i$/ioci/lor.

## Mo%ific'ril 2ni/al %in /im!l $arcinii# U/r!l




SARCINASARCINA


PRENATALAPRENATALA

Sli% 8) 9 --

# cr7/ra !/r!l!i $ fac (n %o!' /a3 Curs nr. 4Curs nr. 4



7 # (n2ro7ara r1ilor c! r%ominan1a

roc$lor % <ir/rofi m!$c!lar', !/r!l

c''/0n% o form' $froi%al';

# fa&a % %i$/n$i.

# convr$ia % la o /a' la al/a $ fac (n$'/'m0na )+.

# in c!r$!l $arcinii !/r!l cr7/ % la + 2 la ++

:)++ 2 iar vol!m!l % la ) 8 ml la - li/ri.

# %in !nc/ % v%r /oo2rafic, 0n' (n l!na a IlIa

$/ or2an lvin, aoi or2an a5%ominal.




SARCINASARCINA


PRENATALAPRENATALA

Sli% 88 9 --




# raoar/l la /rmn $!n/ !rm'/oarl3

# fa1a an/rioar' vin (n raor/ c! r/l an/rioral a5%omn!l!i 7i infrior c! v&ica !rinar' %ac'

$/ lin';

# fa1a o$/rioar' vin (n raor/ c! coloana

vr/5ral', va$l mari, cava la %ra/a 7i aor/a

la $/0n2a coloani vr/5ral, m!7c<ii $oa7i 7i!r/rl;

# $!rior3 colon!l /ran$vr$, $/omac!l, mar2ina

an/rioar' a fica/!l!i 7i colci$/!l;

# mar2ina %ra/'3 cc!l 7i colon!l a$cn%n/;

# mar2ina $/0n2'3 colon!l %$cn%n/, an$lin/$/in!l!i $!51ir.




SARCINASARCINA


PRENATALAPRENATALA

Sli% 8- 9 --




# $roa$a ri/onal' $ %ma1ia&' 7i $/ %cola5il'la nivl!l $2mn/!l!i infrior.

# m!$c!loa$a $/ forma/' %in /ri $/ra/!ri % fi5r

m!$c!lar3 =/rior, in/rior 7i miloci! 4l=iform6.

# va$l rin /rcra rin $/ra/!l l=iform r&in/'

%oar n%o/li!, m!7c<ii !/rini form0n% a%v'ra/

inl m!$c!lar n/r! ac$/a.

# fi5rl m!$c!lar rin <ir/rofi a!n2 la )+ fa1'% + (n afara $arcinii.




SARCINASARCINA


PRENATALAPRENATALA

Sli% 8 9 --

# m!coa$a, im%ia/ %!' imlan/ar, $ /ran$form' (n Curs nr. 4Curs nr. 4



, ,

ca%!c' 4%ci%!'6.

# =i$/' /ri /i!ri al ac$/ia3

# ca%!ca 5a&al', $i/!a/' (n/r r/l !/rin 7i

lacn/';

# ca%!ca rflc/a/' acor' or1i!na $!rficial'a o!l!i, $ar0n%!l % cavi/a/a !/rin';

# ca%!ca ari/al' 4vrra6 acor' r$/!l cavi/'1ii

!/rin.SARCINA NORMALASARCINA NORMALA



SARCINASARCINA


PRENATALAPRENATALA

Sli% 8 9 --

Curs nr. 4Curs nr. 4li% 9



# la $f0r7i/!l l!nii a IVa, rin cr7/ra o!l!i, ca%!ca

rflc/a/' $ acola&' la ca%!ca ari/al'.

# col!l !/rin $!fr' !1in mo%ific'ri (n c!r$!l

$arcinii3 $ ramol7/, %vin mai moal 4$mn

%ia2no$/ic % $arcin'6. M!coa$a n! $!fr'

/ran$formar %ci%!al', iar 2lan%l $cr/' !nm!c!$ a5!n%n/ car forma&' %o!l 2la/ino$ c!

rol ro/c/or fa1' % flora micro5ian' va2inal'.

# $/r!c/!ral, $!5$/an1l f!n%amn/al $!fr'

mo%ific'ri car (i vor rmi/ 7/r2ra 7i %ila/ara (n /im!l na7/rii.




SARCINASARCINA


PRENATALAPRENATALA

Sli% 8? 9 --

## S2mn/!l infrior Curs nr. 4Curs nr. 4Sli% 8* 9 --



# $/ ar/a infrioar' $i/!a/' (n/r cor 7i col. Ar

form' % $mi$fr', %$c<i$' (n $!$.

# $ forma&' (n !l/iml /ri l!ni % $arcin'.# limi/a infrioar' cor$!n% orifici!l!i in/rn, iar

limi/a $!rioar' cor$!n% !ni &on (n car

r/l $ (n2roa7' 5r!$c 4inl!l an%l6 7i car

$/ limi/a %cola5ili/'1ii ri/on!l!i !/rin.

# in /im!l /ravali!l!i forma&' c! col!l %ila/a/ canal!lcrvico$2mn/ar.

## S2mn/!l infrior




SARCINASARCINA


PRENATALAPRENATALA

Sli% 8* 9 --

# raoar/3 Curs nr. 4Curs nr. 4Sli% 8 9 --



# an/rior3 v&ica !rinar';

# o$/rior3 f!n%!l % $ac Do!2la$, carl $ar'

% rc/ 7i romon/ori!;

# la/ral3 /cil <io2a$/ric c! va$l !/rin 7i

!r/r!l.# in $/r!c/!ra l!i in/r' fi5r m!$c!lar 7i la$/ic 4$/ra/!l

m!$c!lar fiin% foar/ $!51ir6.

# rin $/r!c/!ra lor, % o ar/ cor!l !/rin a$i2!r'

ro!l$ia f'/!l!i (n /im!l na7/rii, 7i % al/' ar/

$2mn/!l 7i col!l %a/ori/' con$/r!c1ii !/rin 7imo%ific'rilor $/r!c/!ral $ %ila/' rmi10n% =!l&ia

f'/!l!i.




SARCINASARCINA


PRENATALAPRENATALA

Sli% 8 9 --

## Con$!l/a1ia rna/al'Curs nr. 4Curs nr. 4

Sli% -+ 9 --



# $/ o ac/ivi/a/ rofilac/ic' mni/' $' r%!c' ri$c!l

o5$//rical rin %i$/ara 7i rvnira !nor

afc1i!ni ma/rn $a! f/al, r2'/ira c!l!l!i

n/r! (n2riiril no!n'$c!/!l!i, r2'/ira $i<ic' a2ravi%i 7i lanificara familii.

# rima con$!l/a1i ar imor/an1' %o$5i/' 7i $/

rcoman%a5il $' $ fc/!& (n riml :+

$'/'m0ni % $arcin'.

## Con$!l/a1ia rna/al'




SARCINASARCINA


PRENATALAPRENATALA

Sli% -+ 9 --

# c! aca$/' oca&i $ fc/!a&'3 Curs nr. 4Curs nr. 4Sli% -: 9 --



# anamn&a.

# =amn!l clinic 2nral 7i o5$//rical, =amn

in/rclinic, =amn $/oma/olo2ic.

# =amn araclinic 4<mo2rama, $!mar %!rin', !r, 2licmi, ro5 <a/ic, 2r!a %

$0n2, R<, %/rmin'ri n/r! li$/ria, /o=ola$ma,

=amn c<o2rafic, R, IV, $, fro/i!

ci/o5ac/rian6.

# con$!l/a1iil !l/rioar $ vor fc/!a l!nar 0n' (n

$'/'m0na )*, 5il!nar 0n' (n $'/'m0na 8 7i

$'/'m0nal 0n' la na7/r, %in&0n% %

comlica1iil m%ical $a! o5$//rical.




SARCINASARCINA


PRENATALAPRENATALA

Sli% -: 9 --

## con$!l/a1iil con$/a! (n3 Curs nr. 4Curs nr. 4Sli% -) 9 --



con$!l/a1iil con$/a! (n3

# arcira $/'rii 2nral, =amn clinic

aara/ 7i $i$/m; # c!r5a on%ral' 42ravi%a ia (n 2r!/a/ -

>2 0n' la $'/'m0na )+, aoi c0/ +, >2

$'/'m0n'6;

# /n$i!n ar/rial', valoril $!5 :-+9+ fiin%

con$i%ra/ normal; # =amn o5$//rical3 IFU 4(n'l1ima f!n%!l!i

!/rin6, r&n/a1ia, MF 4mi7c'ril f/al6,

a$c!l/a1ia CF 45'/'il cor%!l!i f/al6, o&i1ia,

# lvim/ria =/rn' 7i in/rn';

# inv$/i2a1ii araclinic 4$ r/' !nl %incl rci&a/ la rima con$!l/a1i6.




SARCINASARCINA


PRENATALAPRENATALA

Sli% -) 9 --

Sli% -8 9 --Curs nr. 4Curs nr. 4



# o5ic/ivl con$!l/a1ii $!n/3

# %ia2no$/ic % $arcin', v0r$/a $arcinii, %a/a

ro5a5il' a na7/rii.

# ro2no$/ic!l % vol!1i a $arcinii.

# ro2no$/ic!l na7/rii.

# ro2no$/ic!l % l<!&i.

# ro2no$/ic!l % vol!1i a no!n'$c!/!l!i.




SARCINASARCINA


PRENATALAPRENATALA

Sli% -8 9 --

Curs 4 - Sarcina Normala (NXPowerLite)

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Transcript of Curs 4 - Sarcina Normala (NXPowerLite)