7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 1/44
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 2/44
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
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 3/44
# $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 $0nilor.
Curs nr. 4Curs nr. 4
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% 8 9 --
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 4/44
## Dia2no$/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.
Curs nr. 4Curs nr. 4
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% - 9 --
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 5/44
# $in%rom!l n!rov2/a/iv % rim /rim$/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!, $/ 8?@C.
Curs nr. 4Curs nr. 4
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% 9 --
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 6/44
## E=amn clinic o5ic/iv
# la in$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.
Curs nr. 4Curs nr. 4
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% 9 --
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 7/44
# 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/'.
Curs nr. 4Curs nr. 4
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% ? 9 --
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 8/44
Curs nr. 4Curs nr. 4
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% * 9 --
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 9/44
# =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$/a/iv.
Curs nr. 4Curs nr. 4
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% 9 --
C 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 10/44
# /$/!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
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% :+ 9 --
C 4C 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 11/44
# 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
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% :: 9 --
C 4C 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 12/44
# /!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.
Curs nr. 4Curs nr. 4
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% :) 9 --
C 4C 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 13/44
# $/ !n %ia2no$/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 $'/'m0nil )+ G -+Curs nr. 4Curs nr. 4
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% :8 9 --
I 1i C 4Curs nr 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 14/44
## In$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'.
Curs nr. 4Curs nr. 4
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% :- 9 --
Curs nr 4Curs nr 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 15/44
# $ 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 ):
)-.
Curs nr. 4Curs nr. 4
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% : 9 --
Curs nr 4Curs nr 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 16/44
# =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.
Curs nr. 4Curs nr. 4
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% : 9 --
Di i li i Curs nr 4Curs nr 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 17/44
# =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
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% :? 9 --
%ifi ' i % i l i l i Curs nr 4Curs nr 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 18/44
# 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 $arcin'
Curs nr. 4Curs nr. 4
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% :* 9 --
M %ifi ' il %i l i i Curs nr 4Curs nr 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 19/44
# %a/ori/' ri%ic'rii %iafra2m!l!i, con$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 $arcina Curs nr. 4Curs nr. 4
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% : 9 --
# r$i!na ar/rial' a/0/ $i$/olic' c0/ 7i %ia$/olic' Curs nr 4Curs nr 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 20/44
# r$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'.
Curs nr. 4Curs nr. 4
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% )+ 9 --
# ro2$/ron!l favori&a&' rla=ara vnoa$' 7i Curs nr 4Curs nr 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 21/44
# 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.
Curs nr. 4Curs nr. 4
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% ): 9 --
Curs nr 4Curs nr 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 22/44
# 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.
Curs nr. 4Curs nr. 4
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% )) 9 --
Curs nr 4Curs nr 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 23/44
# %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/.
Curs nr. 4Curs nr. 4
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% )8 9 --
Curs nr 4Curs nr. 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
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# $!n/ ana/omic3 a$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
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% )- 9 --
## M %ifi ' i %i /i Curs nr. 4Curs nr. 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
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# =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
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% ) 9 --
Curs nr. 4Curs nr. 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 26/44
# 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' $/ %imin!a/'.
Curs nr. 4Curs nr. 4
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% ) 9 --
## Mo%ific'ri rnal Curs nr. 4Curs nr. 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
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# o/ a'ra %ila/a1ii al 5a&in!l!i 7i !r/rlor rin
imr2na1ia <ormonal' 7i rin comr$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
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% )? 9 --
## S/a/!$!l <ormonal 7i $arcina Curs nr. 4Curs nr. 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
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# %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
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% )* 9 --
## ormonii $/roi&i Curs nr. 4Curs nr. 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
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# =i$/' 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 $/roi&i
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% ) 9 --
# ac$/ rc!r$or /rc (n lacn/' !n% $/ Curs nr. 4Curs nr. 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
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ac$/ 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'.
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% 8+ 9 --
Curs nr. 4Curs nr. 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
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# 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
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% 8: 9 --
hCG uman
## Mo%ific'ril 2ni/al %in /im!l $arcinii Curs nr. 4Curs nr. 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
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# $!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
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% 8) 9 --
# cr7/ra !/r!l!i $ fac (n %o!' /a3 Curs nr. 4Curs nr. 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
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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.
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% 88 9 --
Curs nr. 4Curs nr. 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 34/44
# 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.
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% 8- 9 --
Curs nr. 4Curs nr. 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
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# $roa$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 $arcinii.
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% 8 9 --
# m!coa$a, im%ia/ %!' imlan/ar, $ /ran$form' (n Curs nr. 4Curs nr. 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
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, ,
ca%!c' 4%ci%!'6.
# =i$/' /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
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% 8 9 --
Curs nr. 4Curs nr. 4li% 9
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
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# 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.
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% 8? 9 --
## S2mn/!l infrior Curs nr. 4Curs nr. 4Sli% 8* 9 --
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
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# $/ 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$2mn/ar.
## S2mn/!l infrior
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% 8* 9 --
# raoar/3 Curs nr. 4Curs nr. 4Sli% 8 9 --
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
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# an/rior3 v&ica !rinar';
# o$/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.
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% 8 9 --
## Con$!l/a1ia rna/al'Curs nr. 4Curs nr. 4
Sli% -+ 9 --
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 40/44
# $/ 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'
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% -+ 9 --
# c! aca$/' oca&i $ fc/!a&'3 Curs nr. 4Curs nr. 4Sli% -: 9 --
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
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# 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.
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% -: 9 --
## con$!l/a1iil con$/a! (n3 Curs nr. 4Curs nr. 4Sli% -) 9 --
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
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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$!l/a1i6.
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% -) 9 --
Sli% -8 9 --Curs nr. 4Curs nr. 4
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 43/44
# o5ic/ivl con$!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.
SARCINA NORMALASARCINA NORMALA
MODIFICARILEMODIFICARILE
SPECIFICE DESPECIFICE DE
SARCINASARCINA
CONSULTATIACONSULTATIA
PRENATALAPRENATALA
Sli% -8 9 --
7/25/2019 Curs 4 - Sarcina Normala (NXPowerLite)
http://slidepdf.com/reader/full/curs-4-sarcina-normala-nxpowerlite 44/44