"Recent years have seen technology playing a crucial role in enhancing the health and well-being of women. In this video, Dr. Nandayala R. Padmapriya sheds light on how cutting-edge technologies, including healthcare apps, telemedicine and advancements to the field of obstetrics and gynecology empower women to manage their health effectively and access essential medical resources easily"

"When water breaks patient comes to the hospital the doctor takes a history examines the patient and first sees whether there is an immediate need for delivery that is in cases of prolapse in such cases patients will be immediately shifted to the operation theater and a C-section will be performed after checking the baby's heartbeat another cases. We also see the color of the water that if the baby has passed motion if at all baby has passed motion then that patient will be considered as high risk under continuous electronic fetal monitoring. A patient will be induced labor and we can try for a vaginal delivery if the water breakage is before 37 weeks after 34 weeks such patients are admitted and we give a dose of steroid and keep monitoring the heartbeat and also repeat a second dose after 24 hours after that seeing the status of the condition of the baby we induce the patient for vaginal delivery then if the baby is between 24 to 34 weeks all those babies definitely will survive and we have to admit the patients and we do expectant management that is we admit the patients and try to prolong the pregnancy see as much as possible and stringent monitoring of blood counts and to see for infection we give steroids and also we cover them with antibiotics. So we monitor the heartbeat in case of any issues during pregnancy minimum of at least 14 days we have the baby's weight improve if there is any infection or fetal distress then we have to decide the route of delivery based on the condition"

"Vacuum-assisted delivery is a type of operative delivery. We use a vacuum in the second stage of labor whenever there is a prolonged second stage whenever there's fetal distress on the second stage or to cut down the second stage of labor in case the mother has a heart disease or severe anemia or the mother has a scar on the uterus. So these are very common indications where we use the vacuum. It is pretty safe with the advanced silicon cups vacuum is pretty safe for both the mother and the fetus if done under proper precautions. So the maternal complications could be perineal tears if episiotomies are not given properly there could be urinary retention, prolonged pain at the perineum and there could be bleeding. For the baby, the baby has a much larger exaggerated caput which is just a fluid accumulation under the scalp but which resolves spontaneously. There could be little more serious issues like capid oxum where there is a hematoma between the scalp and skull. So in these cases because of the hematoma, the baby can have long jaundice and also pain and there could be other infrequent but still very serious complications like you know hemorrhage inside the brain. That's called intracranial hemorrhage or even retinal hemorrhage"

"Uterus rupture can happen during normal delivery. There are two situations where it can happen one is if there is a scar on the uterus like if there was a previous cesarean delivery where there was a hysterotomy that is a second-trimester abortion by opening the abdomen or if there was myomectomy. Myomectomy means the removal of fibroids and suturing of the fall of the uterus. The other situation where uterine rupture can happen is in obstructed labor which is very uncommon these days but in rural settings, it's still there where patients stay at home for days together in labor and go to the hospital at the last minute. So it can be prevented. We have to select the cases where we're giving vaginal birth after a cesarean or on a scarred uterus where there was a myomectomy or a hysterectomy done. We need to select the patients carefully we have certain indications where we select the patients like if the cesarean was done for a non-recurrent indication like malpresentation"

"The labour has two stages. The first and second stages are from the onset of regular uterine contractions to full dilation of the cervix, and the second stage is from Full dilation of the cervix to the expulsion of the baby. Usually, in the first pregnancy, the first stage lasts not more than 24 hours. The second stage lasts not more than 2 hours without anaesthesia and not more than 3 hours with anaesthesia in a second pregnancy, so the first stage of labour does not last more than 10 to 14 hours, and the second stage of labour does not last more than 1 hour without anaesthesia and two hours with anaesthesia. So prolonged labour is when this period of the above has crossed, and still, the patient has not delivered. So, the causes of protracted labour could be a big baby and inefficient uterine contractions. The incidence of prolonged labour is around 8 to 10%. The leading causes are inefficient uterine contractions, big babies, and maternal obesity. The mental effects of protracted labour are that she can have postpartum haemorrhage. She can have maternal exhaustion, urinary retention, and so on. What are the fetal effects? Fetal effects could be due to prolonged labour. There could be fetal distress there could be birth asphyxia, and there could be shoulder dystocia. So how do we treat it? We need to correct the cause. The cause is most commonly inefficient uterine contractions. We give oxytocin inc, release the uterine contractions, and try to deliver the baby. If any of the measures fail, the last resort is to take up the patient for a C-section"

"Postpartum haemorrhage. It is still considered normal after the placenta delivery up to 500 ml. If bleeding is more than 500 mL, it is really serious and needs immediate intervention because it can cause severe shock and death. What are the causes of postpartum haemorrhage? The most common cause is defective uterine contractility. The uterus has to contract after the delivery of the placenta, which does not do that. The most common other causes are there could be cervical or vaginal tears or there could be bleeding disorders in the patient. So, what are the risk factors for postpartum haemorrhage? Whenever there are multiple pregnancies like twins wherever, there is a uterine distension, which happens in twins, which happens in excessive liquor, and which happens even in big babies. Whenever there are placental issues, whenever there are infections, whenever there is a prolonged labour. So these are the few conditions with risk factors where postpartum haemorrhage can happen. So how do we treat it? Antenatally, patients have to take iron supplements and make sure the haemoglobin is always above the normal level. 11 is considered to be the lower limit of normal. So, always above 11 or at least 12 is considered fine. And the second thing is if there are any bleeding disorders which are diagnosed in the patient or in the family, it has to be intimated to the doctor. When Postpartum Hemorrhage has been diagnosed in the OT. The whole team is being alerted. So, all management measures are done simultaneously. One person arranges for blood; one person starts another IV line. The patient is given oxygen and IV fluids. At the vaginal end doctor empties the bladder and checks the cause of any tears are there so that they can be sutured. Then, as I said, the most common cause is defective uterine contractility. The bimanual compression method and massage are done to contract the uterus, and simultaneously, there are a few medications, prostaglandins or ergot alkaloids, used to contract the uterus. If all the medical measures fail"