ANTEPARTUM HAEMORRHAGE
A
ANTENATAL SCREENING PROCEDURES
When performed
Procedure
Reason for procedure
First visit
Medical history
and examination
To look for pre-existing risk factors, such as
long-term illnesses.
Urine tests
To check the urine for glucose, which may
indicate diabetes developing in pregnancy
and for protein, which may indicate pre-
existing kidney disease.
Blood test
To determine the woman’s blood type and
to check for anaemia; antibodies to rubella;
hepatitis B virus; and, sometimes, after
discussion, HIV infection which might be
transmitted to the baby. Genetic counselling
may be offered to couples with a family
history of inherited disease or from
ethnic
groups at high risk.
Weightand blood
pressure
To provide initial measurements against
which later ones are compared.
Between
11
and
2 0
weeks
Ultrasound scans
(one or more)
To check the age of the fetus and to look for
fetal abnormalities.
Follow-up visits at
regular intervals
from
11
weeks to
delivery
Weight (not
routine in women
of normalweight)
and examination
To assess the growth of the fetus and to see
which way it is lying in the uterus.
Urine tests
To detect diabetes or pre-eclampsia.
Blood pressure
To detect developing pre-eclampsia.
Blood tests (at
some visits only)
To lookfor anaemia and, in combination
with ultrasound scanning, to assess the risk
of fetal abnormalities such as neural tube
defects or Down’s syndrome. A test to
screen for diabetes mellitus in the mother
may also be necessary.
The woman is also advised on general
aspects of pregnancy, such as diet, exer-
cise, and techniques to help her with
childbirth. (See also
childbirth, natural.)
antepartum haemorrhage
Bleeding from the vagina after the 28 th
week of pregnancy.
Antepartum
haemorrhage
is
most
commonly due to a problem with the
placenta (the organ in the uterus that
sustains the developing fetus), such as
placenta praevia
(in which the placenta is
positioned too close to the birth canal)
or
placental abruption
(detachment of
part of the placenta from the wall of the
uterus). Bleeding can also be caused by
cervical erosion
or other disorders of the
cervix or vagina.
SYMPTOMS
The bleeding is often painless but may
be accompanied by abdominal pain if
the placenta becomes partly separated
from the uterus.
Investigation and treatment requires
hospital admission.
Ultrasound scanning
is
used to diagnose problems with the pla-
centa. In some cases, it is necessary only
to keep a careful watch on the condition
of the woman and her baby. If the
bleeding is severe, the woman is given a
blood transfusion
; the baby may be deliv-
ered immediately by
caesarean section.
anterior
Relating to the front of the body. In
human
anatomy,
the term is synony-
mous with
ventral
.
anterior knee pain syndrome
See
chondromalacia patellae.
anterior compartment
syndrome
See
compartment syndrome; shin splints.
anthelmintic drugs
COMMON DRUGS
• Albendazole •Diethylcarbamazine
• Ivermectin •Levamisole •Mebendazole
• Niclosamide •Piperazine •Praziquantel
• Tiabendazole
A group of drugs that are used to
eradicate
worm infestation
of the body.
Anthelmintic
drugs
kill
or
paralyse
worms in the intestines,
preventing
them from gripping the intestinal wall,
and causing them to pass out of the
body in the
faeces.
Possible side effects of anthelmintic
drugs include nausea, abdominal pain,
rash, headache, and dizziness.
anthracosis
An outdated term for coal workers’
pneumoconiosis.
Anthracosis is a lung
disease caused by inhalation of large
amounts of coal dust over many years.
anthrax
A serious bacterial infection of livestock
that occasionally spreads to humans.
The most common form of the infec-
tion in humans is cutaneous anthrax,
which affects the skin. Another form,
pulmonary anthrax, affects the lungs
and is potentially fatal.
CAUSES
Anthrax is caused by BACILLUS ANTHEACIS.
This bacterium produces spores that can
remain dormant for years in soil and
animal products and are capable of
reactivation.
Animals become infected by grazing
on contaminated land. Infection can
occur in humans via a scratch or a sore
if materials from infected animals are
handled. Pulmonary anthrax occurs as a
result of inhaling spores from infected
animal fibres.
SYMPTOMS AND TREATMENT
In cutaneous anthrax, a raised, itchy,
area develops at the site of entry of the
spores, progressing to a large blister and
finally a black scab, with swelling of the
surrounding tissues. Cutaneous anthrax
is treatable in its early stages with
antibi-
otic drugs.
Without treatment, infection
may spread to lymph nodes and the
bloodstream and may be fatal.
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