The diary game 8/04/22 Ramadan Kareem to all my fellow Muslims on the Steem platform

Hello everyone
It’s been a while since I wrote a diary, been busy with research and other stuffs but now I’m back.
I’m going to share with y’all how my day went then I’m going to continue with the research like I did with my last post, you can check it out in the link below

https://steemit.com/hive-195150/@nafisatu/the-diary-game-21-09-22-working-on-research

Fellow steemians today was long day and a useful one though!!
I woke up at 3:30a.m and a few notes till it was 4 a.m I woke my mum up and went to the kitchen with her. It’s the month of Ramadan and we had to fast. My mum and I made breakfast then woke my kid sister up to come eat. By 5:15a.m we were done eating we performed the morning prayers then went to do house chores, my kid sis mopped the floor while I wash dirty dishes.
By 7a.m I was done the chores and had also taken my bath to step out for school. I collected transport fair from my mum and left for school
By 8:39a.m I arrived school the lectures were supposed to begin at 8:3am but by this time the lecturer wasn’t there yet. I took out my notes and began studying. By 9am the arrived, the lecturer apologized for being late and the lecturers begun. We had a we had a class for 4 house then went for break. My friends and I went to the school canteen to find something for lunch though I wasn’t eating cus I was fasting. My two friends ate then we went back to class and had rest for few minutes then the next lecturer came in we had lectures till 5 pm when we called it a day. My friends and I went to the roadside and boarded taxis to go home
By 6pm I was home performed my prayers and went to the kitchen my kid sister and I made food for the family to break fast

Dinner

After eating we prayed together and I took my notes to study.
Now I’m gonna continue with my research
Last timeI ended at the point of the causes of PPH which were Tissue, Tone, Trauma, and Thrombin.

• Tone
  Tone here refers to uterine atony and it is the most common cause of PPH as it is associated with hemostasis which is highly dependent on myometrial contraction.
  Poor myometrial contractions can also result from fatigue due to prolonged labor/Rapid forceful labor especially if stimulated.
  Other causes of uterine tone include;
  Hypoxia due to hypo perfusion or couvelaire uterus in abruption placentae. Prolonged uterine exteriorization, full bladder, polyhydramnios, multiple gestation, anesthesia.

• Trauma
  Injury to the general tract (uterus, cervix, vagina) may occur spontaneously or through manipulations used to deliver the baby. Incisions in the lower uterine segment should be avoided as contractions here are poor though it heals well but are reliant on suturing, vasospasm and hemostasis.
  Uterine rupture is most common in patients with previous cesarean section delivery scars. Any uterus that has undergone a procedure resulting in a total or thick disruption of the uterus wall should be considered a risk for rupture in a future pregnancy.
  Trauma may occur following very prolonged or vigorous labor, especially if the patient has relative or absolute Cephalopelvic Disproportion (CPD) and the uterus stimulated with oxygen or prostaglandins.
  Episiotomy and cervical laceration associated with forceps delivery also plays a role and hence should never be attempted if the cervix is not fully dilated.
  Lastly, Trauma may occur following extra-uterine or intra-uterine manipulations of the fetus especially in cases of compound presentation or rotation of the second child in twin pregnancies.

• Tissue
  Uterine contraction and retraction leads to detachment and expulsion of the placenta. Complete detachment and expulsion of the placenta permits continues retraction and occlusion of blood vessels. Hence the placenta should be very well evaluated following the third stage of labor to ensure no retained products.
  If fragments of the placenta remain in the uterus after delivery, small clots form around the retained parts sealing off bleeding. After a while the clots slough (death tissue separating from living tissue) and heavy bleeding occurs, sub involution (delayed involution) can be causative factor in late PPH
  Also, failure of complete separation of the placenta may be as a result of placenta accreta. In this condition, the placenta has invaded beyond the normal cleavage plane and is abnormally adherent. As such, attempts aimed at removing the placenta now imbedded deep within the myometrium can lead to significant bleeding. Retained blood may also cause uterine distension and prevent effective contraction.
  All patients with placenta previa should be informed of the risks of severe PPH. Complications of sub involution include hemorrhage, pelvic peritonitis, salpingitis and abscess formation

• Thrombin
  In the immediate postpartum period, disorders of the coagulation system and platelets do not usually result in excessive bleeding. This emphasizes the efficiency of uterine contraction and retraction for preventing hemorrhage. Fibrin deposition over the placenta site and clots within supplying vessels play a significant role in the hours and days following delivery. Hence abnormalities in these areas can as well lead to late PPH or exacerbate of bleeding from other causes, most notably trauma.
  Women may inherit bleeding disorders such as hemophilia or Von Willebrand disease that can lead to excessive bleeding following birth, other complications during pregnancy are preeclampsia, fetal death in utero, severe infection, amniotic fluid embolus and placental abruption can lead to problem with blood clotting.
  The abnormalities may be;
  Preexisting, related to thrombocytopenia or Sepsis.

Finally, delusional coagulopathy may occur following massive PPH and resuscitation is with crystalloid and packed red blood cells.
PPH can also be caused by infections. Endometritis occurs in 1.3% of woman after spontaneous vaginal delivery. It is the most common cause of postnatal morbidity between day 2 to day 10. Risk factors are C/S, prolonged rupture of membranes, severe meconium stain liquor, prolonged labor with multiple examinations, manual removal of placenta low social economic status, maternal anemia, prolonged surgery and retained products of conception.

I’ll end here thanks for taking out time to go through my diary. ❤️❤️❤️❤️

@majerius
@burrivenjah