It’s any bleeding from or into the genital tract occurring after 28 weeks gestation which is unrelated to labor and delivery. • Any bleeding after 28weeks gestation and before 2nd stage of labour

Critical thinking Definition is a continuous process characterized by open-mindedness, continual enquiry combined with a willingness to look at each unique patient situation and determine which identified assumptions are true and relevant. Critical Thinking is a method of analyzing and looking at problems, decisions, and goals. This results in faster decisions, more creative and innovative solutions, and higher quality deliverables. Critical thinking Involves recognizing that an issue (e.g., patient problem) exists, analyzing information about the issue (e.g. clinical data about a patient), evaluating information and making conclusions.

Hyperemesis Gravidarum • It’s a condition characterized by excessive & persistent pregnancy related nausea or vomiting or both, associated with weight loss of >5% of body mass, & ketosis. • Ossurs between 4th -10th week and resolves before 20th week of pregnancy after interventions. • In its severe state, malnutrition and metabolic disturbance occur which may be fatal.

Endocrine system has far-reaching effects in the human body because of its links with the nervous system and the immune system. The nervous system and the interconnected network of glands known as the endocrine system control body systems Other tissues produce hormones that are secreted into body fluids and act on nearby cells and tissues. Hormones are important in regulation of the internal environment of the body and affect every aspect of life

A group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or cells don’t respond to the insulin that is produced. High blood sugar produces the classical symptoms of Polyuria (frequent urination), Polydipsia increased thirst) and Polyphagia (increased hunger).

Review of anatomy and physiology i) Nose A. Structure The nose and mouth allow air to flow in and out of the body. They also humidify inhaled air, which reduces irritation of the mucous membranes. B. Functions 1. Passage for incoming and outgoing air, filtering, warming and moisturizing 2. Organ of smell; the nares (nostrils) contain olfactory receptor sites and provide the body’s sense of smell.

The thyroid gland is a butterfly-shaped organ located in the lower neck anterior to the trachea. • It consists of two lateral lobes connected by an isthmus. • The gland is about 5 cm long and 3 cm wide and weighs about 30 g. • The blood flow to the thyroid is very high (about 5 mL/min per gram of thyroid tissue), about five times the blood flow to the liver. This reflects the high metabolic activity of the thyroid gland.

Parathyroid gland is located on the neck, embedded in the posterior aspect of the thyroid gland. • They are four in number • Parathormone, a protein hormone, regulates calcium and phosphate metabolism. • Increased production results in increased calcium absorption from the kidney, the intestines and the bones.

Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death worldwide, causing 3.23 million deaths in 2019 .Over 80% of these deaths occurred in low- and middle-income countries (LMIC).COPD causes persistent and progressive respiratory symptoms, including difficulty in breathing, cough and/or phlegm production. COPD results from long-term exposure to harmful gases and particles combined with individual factors, including events which influence lung growth in childhood and genetics. Environmental exposure to tobacco smoke, indoor air pollution, and occupational dusts, fumes, and chemicals are important risk factors for COPD. Early diagnosis and treatment, including smoking cessation support, is needed to slow the progression of symptoms and reduce flare ups.(WHO,2019)

Hypertensive disorders complicating pregnancy are common and are among the three (with hemorrhage and infection) leading causes of death. Pregnancy can induce hypertension (HTN) or aggravate pre-existing hypertension.