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Introduction on Medical Conditions
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Introduction on Medical Conditions
With the advancement of the modern medicine people have discovered more medial disorders and conditions that were unknown in older time. The advance treatment options, critical care, antibiotics and surgical advancements are very helpful in tackling such diseases.
Nowadays, information is available on causes, symptoms and signs, pathophysiology, anatomical abnormalities and genetic designs of every diseases and causative organisms. Vaccinations and prophylaxis measures are also available to prevent most disease.
This paper gives a bird’ view on a few medical conditions. A brief introduction on their signs and symptoms, pathology, treatments is also available in this paper.
During pregnancy women develop one of the type of diabetes which is usually named as gestational diabetes. It is defined as high blood glucose level of a pregnant lady who have never had diabetes before. Placenta which is a natural attachment between the mother and the baby, helps in the development of the baby by passing hormones and other major nutrient across it. These hormones in turn block the insulin action in the mother’s body which leads to a condition called as insulin resistance. This condition when mother’s body is unable to make and use sufficient insulin to continue pregnancy is gestational diabetes. (Diabetes.org)
According to WHO, usually in late pregnancy this condition is seen in the pregnant women, which means when the baby is almost formed and now is in the growing phase and hence doesn’t cause any birth defects unless in some cases when the baby’s mother has diabetes before pregnancy. Gestational diabetes if left untreated can hurt the baby because in this condition, pancreas of the mother starts working more to produce insulin, but this does not help to lower the blood glucose levels. Even though insulin is not able to cross the placenta, glucose and other nutrients do.
As a result extra blood glucose passes through the placenta, giving the baby high blood glucose levels. This presents the baby with a typical feature called as Macrosomia, or a "fat" baby. Macrosomia babies are abnormally large in size refers to abnormally large babies that may be born to women with diabetes. Treatments are Insulin injections to lower your blood sugar, Exercise, Healthy diet.
As per WHO, defined as seizures that cannot be attributable to other causes in a woman with preeclampsia. HELLP syndrome (hemolysis, elevated liver enzyme, low platelets) may complicate severe preeclampsia. Treatment of Seizure is achieved through some of the Base line treatment by maintaining airway, breathing, and circulation (ABC). Magnesium sulfate is the first-line treatment for primary and recurrent eclamptic seizures. Lorazepam and phenytoin can be used as second-line agents for other kind of seizures like refractory seizures. (Medscape)
Antihypertensive treatment is used for severe hypertension in pregnancy. Medications for blood pressure control are Hydralazine, Labetalol, Nifedipine and Sodium nitroprusside. Other precautions are Management of fluid, avoiding diuretics, restricting of fluids to patients when possible, central venous pressure (CVP) or pulmonary artery pressure monitoring and total fluids levels should be limited to 80 mL/hr or 1 mL/kg/hr.
A disorder of vascular endothelial malfunction and vasospasm. It usually occurs after 20 weeks of gestation and can continue 4-6 weeks post-partum. Defined by hypertension and proteinuria, with or with no pathologic edema. Under this condition we can see two sub-types and they are mild preeclampsia and severe preeclampsia. Mild preeclampsia is condition which is seen when there is presence of hypertension (BP ≥140/90 mm Hg) on two occasions, with a gap of six hours, but with no end-organ damage, in a woman who is normotensive before 20 weeks' of gestation whereas patient with chronic hypertension, preeclampsia is diagnosed if systolic blood pressure is increased by 30 mm Hg or if diastolic blood pressure is increased by 15 mm Hg.
Severe preeclampsia is seen by the presence of one of the following symptoms or sign. Systolic blood pressure of 160 mm Hg or higher or diastolic blood pressure of 110 mm Hg or higher on two occasions for 6 hours gap, Proteinuria if more than 5 grams in a 24-hour collection, Cyanosis, Oliguria (< 400 mL in 24 hours), Persistent headaches, Epigastric pain, Impaired liver function, Thrombocytopenia, Decreased fetal growth, or placental abruption.
Abortion is medical termination of pregnancy. It can happen automatically in some cases that is called as miscarriage. Miscarriage is also a type of abortion that is pathological occurrence. In the scenario of an abortion it is forced removal of the fetus before its full term. An abortion can be induced medically through various drugs and medication. Generally, abortion is a choice of the parents. In best case scenario, abortion is required when the parents have discovered unwanted pregnancy. With the consent of the mother and the father, and after making sure that there is no force or pressure used to induce it.
The procedure of abortion is done surgically through dilatation and curettage. There are some drugs called as abortifacients. These drugs are mostly prostaglandin analogs like mifepristone. Other surgical procedure is vacuum aspiration. Dilatation and evacuation is also another procedure for abortion. Depending on the situation, the surgeon uses one of the techniques to induce abortion.
Ectopic pregnancy is a pathological condition where the eggs from the ovaries do not attach to the uterus. Very common occurrence in ectopic pregnancy is the attachment of the eggs to the fallopian tube. When this happens, the growth of the eggs stops due to unsuitable environment of the fallopian tubes. Eggs cannot survive outside the uterus. The causes for this conditions varies from hormonal factors to genetic changes. Women having pregnancy after 35 years of age are ‘at risk population’ for this condition.
Diagnosis is easy for this condition, and can be done through physical examination also. It is advisable to remove the pregnancy as soon as possible. It can be harmful for the mother is ectopic pregnancy stays for a long term. If this incident doesn’t harm the fallopian tube, then there are good chances of having a normal pregnancy in future.
During pregnancy, it is important to have the location of the placenta on the upper part of the uterus. In placenta previa, the placenta is covering the lower part of the uterus near the cervix. This abnormal condition can be very harmful in pregnancy. It blocks the path of the fetus decent in pregnancy. In the later part of the term, it can cause bleeding. (Baby center, 2015)
There are major three types of placenta previa. If the placenta is completely covering the cervix, it is complete previa. If it is marginally covering, then it is marginal placenta previa. If it is a few centimeters, then it is low-lying placenta previa. Major complications of this condition is major bleeding and pain. It may lead to abortion. The treatment of this condition is surgical. Either patient can go for a C-section or medical termination of pregnancy.
Placenta is normally aligned and attached to the uterus lining. Not until the 20th week of pregnancy, it separates from the uterus. But in some cases, it may detach early. This condition is called as placental abruption. It may lead into bleeding, pain in the uterus, frequent uterine contractions, radiating pain in abdomen, abnormalities in fetal heart.
The placenta is important lifeline between mother and fetus. If it abrupt prematurely, it can lead to such complications. It can be treated according to the intensity of the abruption and the damage to the uterine wall. It can be diagnosed by USG, fetus monitoring, and blood tests. The treatment varies as per the condition.
Breech & Limb Presentations
Breech presentation is the condition during the birth when the baby comes out with the buttocks first from the vaginal canal. It is very rare condition. Such presentation is more harmful, and likely to cause severe injuries to mother as well as the baby. These are one of the many abnormal presentations of the fetus. The correct position is the head first during the delivery. Sometimes, due to unknown causes; the baby rotates inside the uterus and presents in such manner.
Another abnormal presentation is the limb presentation. In this case, one of the limb is the presetting part in the vaginal canal. When the limb presentation occurs, the child may suffer from dislocation of that limb, sometimes the doctors may opt for the caesarian section also.
Prolapsed & Nuchal Cords
In prolapse umbilical cord, the umbilical cord descends with the delivery of the baby. The pathological descend of umbilical cord before the baby’s delivery leads to many complications. This occurs during the water braking phenomena. When the amniotic fluid ruptures, it pushes the umbilical prolapse. The baby is deprived of the life support in such scenario. It suffers from oxygen loss. Baby may go in distress during prolapse. In such emergencies, C-section is recommended.
Nuchal cord is a condition when umbilical cord gets entangled around baby’s neck. It happens in two ways. One is where the cord can untangle itself and is much harmless. The other one is complete loop with a knot around the neck which can be threatening. It can cause hypoxia and lack of blood flow to fetus. In such conditions, the C-section is advisable.
This is a condition of abdominal organs where some acute or sudden pathology occurs that creates a life-threatening severe condition. Major symptom is pain, but some associated symptoms also may be accompanied like distension, flatulence, vomiting, diarrhoea, etc.
Causes can vary depending upon the organs involved. Major causes are cholecystitis, pancreatitis, gastritis, appendicitis and many others.
Acute hypo/hypertension crisis
Blood pressure is the pressure exerted on the vessels walls by the blood. This pressure in pathology creates two situations, one is hypo tension, described by low blood pressure (<100mm/hg). And high blood pressure, (>160mm/hg).
In crisis hypertension, some acute organ damage can be the causative factor. The symptoms are headaches, nosebleed, vision impairment, etc. In such cases, patient should be given oxygen, no sudden efforts to bring down pressure should be made. Once the crisis is over, the treatment to reduce the blood pressure like atenolol should be given. In hypotension crisis, patient will have weakness, vertigo, etc. symptoms. He should be given proper supplements and leg elevation.
It is a condition where the kidneys stop functioning normally. The common causes are renal stones, abdominal diseases, sudden injuries, etc. the symptoms are acute pain and tenderness, unconsciousness or shock, burning micturition, etc.
The treatment depends on the causes and pathology, the diagnosis is done through USG and blood tests. Preventive measures and diet changes can help rapid prognosis. Common treatment is Amicasin, diuretic medications, surgical removal of stones, ESWL, etc.
Fractures are broken bones. The most common cause is injury. Sometimes osteoporosis or bone cancer also leads to fracture. The signs of fracture include, redness, swelling, edema, occasional bleeding, disfiguration of the part. The symptoms of fracture include, pain and tenderness.
There are various types of fracture depending on various factors involved, for example, mechanism of fracture, tissue involvement, pattern of fracture and the treatment also depends on the types of fracture. Proper diet and exercises can help prevent them. Common treatment is immobilization by POP, and calcium, painkillers for pain.
In children the fracture are different than adults. Buckle fracture is where the metaphyseal locations are involved, for example long bones and rib cage. Greenstick fractures are the fractures where there is bend of the bone on one side and fracture on the other. It looks like a greenstick that is why it is called a greenstick fracture. In a Bend fracture, the bones like ulna or radius are bent like a stick due to multiple small fractures in the bone.
Infection of the whole body leads to septicemia. This results after chronic diseases, injuries or surgeries. The infection causes multi system failure leading to blood pressure drop to dangerous levels. It is a life threatening condition.
It requires Intensive care Unit treatment. The infection requires multi-level antibiotics. Symptomatic treatment with complete isolation can have good chances of survival. (NHS)
It is a critical condition where the damage to the nervous outflow in the autonomic nervous system occurs following spinal injuries. This leads to interruption of blood flow to major organs including brain. Hypotension, bradycardia and hypothermia are major symptoms.
The common causes for this are the central nervous system injury, brain trauma, spinal damage and vertebrae damage. Damage control treatments are the first goal. Symptomatic treatment to control shock symptoms is next.
Immobilization and rest is also needed for this situation. The intervention includes fluid supplement, Dopamine is given to restore the homeostasis of the nervous system. Hormonal therapy like anti diuretic hormone supplement along with vasopressors and atropine.
It is a condition where the invasion of the fluid occurs to the non-vascular area of lungs. It is a result of injury or infection. It might also be a result of cardiac anomaly. Major symptoms are pain, breathlessness, chest congestion and cough.
The treatment is wide range of antibiotics, fluid tap from lungs, and surgical removal of fluids. The procedure of fluid tap from lungs can be helpful, but there are chances of reoccurrence of fluid accumulation. If left untreated, it may give rise to secondary infections.
Acute pulmonary edema is a medical emergency that needs immediate care. Although pulmonary edema is deadly, the outlook improves when patient receives prompt treatment for the disease along with treatment for the associated problems. Treatment for pulmonary edema varies depending on the cause but generally includes supplemental oxygen and medications. (Mayo Clinic)
It is a condition where a blockage (air embolism or plaque) travels and blocks the main pulmonary artery that supplies to the lungs. Common symptoms are chest pain, breathlessness, palpitations, etc. (Thoracis.edu)
Diagnosis is done through angiogram, chest CT, PET scans. Treatment is majorly anticoagulant therapy. Oxygen and analgesics are given as symptomatic treatment. It is not a disease as such; rather it is complications of the other major disease or small embolisms in the blood vessels. Major symptoms are Seizures Syncope Fever Wheezing Decreasing level of consciousness and new onset of atrial fibrillation.
In children population also this may happen if the baby suffers from asphyxiation during pregnancy, fetal distress or damage to lungs during delivery. Diseases like pneumonia also causes this disease in pediatric population. Common treatment is surgical removal of the embolism, broad spectrum antibiotics, antitussive medications, pain killers.
It is a severe acute reaction due to allergy. Many people who are sensitive to some substance can have anaphylactic shock due to contact of allergens. It is an immunological disease. The symptoms and signs differ from various systems.
The treatment is immunosuppressant and symptomatic interventions. People with weak immunity are more prone to develop anaphylaxis shocks. Histamine antagonists are the first choice of drug in such cases. The best way to prevent such incidents of anaphylaxis is to avoid the trigger factors.
Tissues in different parts of the body release histamine. This causes the airways to tighten. Drugs like morphine and others may cause an anaphylactic-like reaction (anaphylactoid reaction) when people are first exposed to them. These reactions are not the same as the immune system response that occurs with true anaphylaxis. But, the symptoms, risk of complications, and treatment are the same for both types of reactions. This is very common I pediatric patients. Due to lack of proper immunological development in children, they become very sensitive to certain substances and develop anaphylactic reactions.
Angina means pain. Angina pectoris means discomfort or pain in chest due to coronary heart disease. This results from deprivation of blood to heart muscles. Due to blockage in the coronary artery of heart, this situation arises. (heart.org, 29 Jul. 2014)
The lack of blood supply in heart muscles can cause pain in surrounding areas of chest also. The diagnosis can be done through ECG, angiogram and CT/PET. The treatments include nitroglycerine, rest, aspirin and lifestyle changes.
The main cause for this is the coronary artery disease or atherosclerotic changes in the heart. Sometimes gastritis mimics as angina pectoris, but with proper differential diagnosis, the difference can be spotted easily. In children, duet VSD or ASD the angina can be present, with proper diagnosis and early intervention this issues can be resolved. Common treatment include aspirin like medications for vasodilatation, analgesics, controlled monitoring.
Acute Myocardial Infarction
Infarction is complete lack of blood supply to an organ or a part of the body. It is a result of untreated myocardial ischemia. Ischemia is partial lack of blood supply. When the muscles of heart are deprived of blood and oxygen, the muscles starts to die leading to heart attack. It is commonly known as the heart attack. The moment the blood supply of heart starts to diminish, the function of heart reduces leading to variety of symptoms and eventually death if left untreated.
Symptoms of ischemia. Electrocardiogram (ECG) changes indicative of new ischemia (new ST-T changes or new left bundle branch block (LBBB). Development of pathological Q-wave changes in the ECG. Imaging evidence of new loss of viable myocardium or new regional wall motion abnormality.
The causes are embolism, plaque, thrombosis, etc. pain is main symptom among other. The treatment may vary upon condition. Treatment of this condition is intensive care and surgical with cardio protective medications and antibiotics.
Congestive Heart Failure
It is a pathological condition of heart when it loses its ability to pump the blood. It may be a result of an arteriosclerosis or arthrosclerosis. The disease is acute as well as chronic. It is a leading cause of morbidity and mortality in many countries.
It can be diagnosed by proper history, medical examinations, physical examinations, ECG and cardiograms, angiograms, PET/CT.
The treatment is divided in emergency care, tertiary care, and lifestyle modification. Most common symptoms are breathlessness, angina, fatigue and weakness.
Ventricular and Aortic Aneurysm
Aneurism is enlargement of the vessels. Aortic aneurism is enlargement of aorta 1.5 times than its normal size. Such enlargement may lead to rupture of the artery. It can in turn lead to internal hemorrhage. Ultrasound is the tool for diagnosing this condition.
Major signs and symptoms are pain in chest and abdomen. The management is done through internal medicines and surgery. People with cardiac disease history are at risk people for this disease.
Ventricular aneurism is a condition that is defined by post effect of myocardial infarction. It is also a blood filled bubble in the ventricular walls of cardiac. It causes very restricted blood flow out of the heart. It is also a life-threatening condition. The treatment is vasodilators, antibiotics, analgesics and surgical.
Poisonings and Overdoses
Poisoning is the ingestion of any harmful lethal substances into the human body through any route. Major poisoning is snake poison, mercury poison, lead poison, insecticides poisoning, pesticides, etc. depending on the substance of poison, the treatment varies. In case of venom poisoning, the anti-venom is given. In case of substance poisoning, the gastric lavage is done.
Overdosing means ingestion of any controlled substance in more than tolerable doses. Overdose may be of medicines, substance abuse or accidental. The treatment is same as poisoning. The symptoms and signs vary depending upon the route and systems involved.
Narcan is indicated for the complete or partial reversal of opioid depression, including respiratory depression. Its poisoning or overdose leads to serious conditions. It is used as opoid reversal agent mainly.
Flumazenil is a GABA receptor antagonist, used commonly to treat the overdose of benzodiazepines, reducing daydreaming, drowsiness, etc. it is used majorly as an anesthesia. So, it has to be carefully monitored due to high side effects on various systems.
Blood is composed of blood cells and plasma. Hypovolemia or Hypovolemic Shock is a condition where blood plasma levels are decreased. In other words, the decrease in the blood volume. Dehydration or blood loss are the main causes for this condition.
Severe burn, loss of salt from the body can cause hypovolemic shock. The symptoms are, tachycardia, breathlessness, fatigue and weakness. The treatment is immediate replenishing of the fluids.
Acute respiratory failure
This is a condition described by a sudden disruption of organs and parts involved in respiratory process. There are many nerves, muscles, organs involved in breathing process, this condition may involve one or more than one in severe cases.
It can happen due to lung disorders like pneumonia, COPD, injuries, cardiac problems, shock, cystic fibrosis, etc. the treatment varies depending upon the causes. The major focus always remains to restore breathing and oxygen supply. Symptomatic treatment for infections, shock, analgesics and antibiotics. (National Institute of health, 2011)
COPD is also known as ‘Chronic Obstructive Lung Disorder’ or COLD. It is group of disorders of lower respiratory tract, comprising of lungs, bronchi, alveoli, and trachea. People with smoking addiction and alcoholism are more prone to develop this disease. People with high altitude environment exposure are also at risk. People with history of TB or HIV or any major system disorder can develop COPD. People with occupational exposure to the chemical are at risk, too. For example to mine workers, factory workers, etc.
According to studies, 80% or more case of COPD are caused due to smoking.
Apart from that exposure to pollutants and dust, allergy, genetic predisposition, chemical exposure are a few causes of the disease. COPD presents with breathing difficulty. The patient will have breathlessness on exertion, sometimes for old people it may happen with minimal activities, too. The treatment of COPD includes variety of interventions depending on the extent of the disease and age. It is easier to tackle with lifestyle changes and antibiotics if it is diagnosed early and the patient is young. It can be difficult to treat if it is in old age and diagnosed too late. The symptomatic treatments are the only option with this disease as there is no permanent cure is not available. To avoid the further spread of the disease, smoking and alcohol is not advisable.
It is a chronic respiratory condition described by inflammation of the respiratory tract. The causes are variable including immunological, genetic, allergens, environmental and lifestyle.
The symptoms are breathlessness, heavy breathing, pain in chest, etc. it is an incurable disease. It is however, manageable through vasodilators and bronchodilators. People with asthma are prone for other lung disorders also. (Medial News Today).
Patients of asthma have to depend life-ling o bronchodilators. The real causes for this disease are yet unknown. Research is going on to find more permanent cure for this disease. Lungs of children having asthma become even more swollen and the muscles around the airways can tighten when something triggers their symptoms. This makes it difficult for air to move in and out of the lungs, causing symptoms such as coughing, wheezing, shortness of breath and/or chest tightness.
It is a very infectious disease of lungs. It is also a leading cause of death in children worldwide. The causative organism for pneumonia can be virus, bacteria or fungi. Bacterial pneumonia is easily treatable through antibiotics. But the viral pneumonia is very hard to resolve.
The symptoms are pain, difficult breathing, cough and secondary infections. The risk factors are smoking, passive smoking, pollution, swimming in stale water, drowning, swine flu, etc. broad spectrum antibiotics can help treating pneumonia. Complete bed rest is very essential is such cases. Especially, in children pneumonia is very dangerous disease. (WHO).
Common treatment include antibiotics, analgesics, antipyretive and other symptomatic treatment.
Head Injury and Coma
Head injuries are mostly due to severe accidents. Road traffic accidents or concussions are some examples of head injuries. They can be mild to serious depending upon the intensity of impact and the area of impact. In occipital lobe injuries the chances of damage are more than temporal or frontal lobe.
The symptoms are unconsciousness, blood loss, pain, vertigo, memory loss, etc.
Coma is one of the result from the head injuries. People who have suffered severe head injuries may damage important nerves that control the consciousness. Leading to coms. In coma, a person loses the motor and sensory actions. The treatment is intensive care.
Head injuries and coma are seen commonly in children having been injured during playing sports or accidents. In children the development of the scalp is very premature, so the damage to the brain is high in such cases. The recovery in pediatrics is a bit faster than adults, but sometimes it may damage the grasping power of the children. The common treatment is intensive care and surgical intervention.
Mankind is facing numerous health issues nowadays regarding many organs and systems in the body; third most life threatening disease is STROKE after cancer and IHD. Common causes being road traffic accidents, sudden trauma to head, sudden emotional disturbance, long pervading stress and hypertension (50-60%) etc. Major symptoms are paralysis (partial or complete), loss of speech, hypertension and sometimes sudden death. When sudden trauma occurs to the head; due to rupture of major vessels or clot formation in the vessels the blood supply to the important part of the brain stops or reduces significantly to manifest ischemia or infarction in that part of bran. This in turn sends the message to the hypothalamus to increase the blood supply to that part; leading to hypertension. As there is infarction or ischemia; the blood is not reaching to affected part and blood pressure keeps on increasing leading to persistent hypertension. (National institute of health)
As the affected part is deprive of blood supply it starts degenerating and malfunctioning of motor and sensory activity occurs which finally leads to unconsciousness. This is a medical emergency and patient usually is brought in either semi-conscious state or paralytic state. The common treatment is intensive care and surgical intervention.
It is a condition in brain where sudden outpouring of electric activity happens. It is characterized by involuntary constriction and relaxation of muscles, vomiting, foam generation from mouth, choking, etc. there are many types of seizures, like absent seizure, atonic, tonic, clonic seizures, etc.
The treatment is muscle relaxers, phenobarbital, and rest. The causes of seizures are genetic, environmental, birth injuries to head, accidents, etc. epileptic seizures are more frequent in children than adults.
In children the seizures occurs mainly due to some of the causative factors during early infancy are hypoxic ischemic encephalopathy, CNS infections, injury and birth defects of CNS.
Burns are accidental contact of fire to the body parts. Depending upon the intensity of the fire, the burns degree may vary. 100% burning can lead to death. Treatments of burns is divided by percentages of burn. The immediate treatments are first aid. Later, depending on the parts and damage, surgery, medications, vaccinations and antibiotics are required. Plastic surgery is also an essential part of the burns treatment.
According to SJA, emergency treatments are proven to be very helpful in cases of major burns. Tissue reconstruction, graft, stem cells therapies are more advanced and effective therapies for burns.
Infectious diseases can be classified in to major three groups, Viral, bacterial and fungi. These germs are found in any medium, air, food, soil, water. Various organisms cause various infectious diseases. For example, viral diseases are AIDS, influenza, hepatitis, polio, etc. bacterial diseases are COPD, bacterial meningitis, etc. (national institute of health)
The treatment varies depending upon organisms. Viral infections can be controlled with anti-viral medications. Bacterial infections through antibiotics, and likewise, fugal through anti0fungal medications.
There are different levels of spine injuries, there is more dangerous, cervical injuries which can lead to coma or death. The thoracic injuries can lead to disabilities and spondylitis. Lumbar injuries can cause sciatica, paralysis, etc.
The cause for such injuries is primarily accidents. The treatment is medications and surgery. In severe cases emergency intensive care is needed. The patient with spinal injuries can go for neurogenic shock, permanent disabilities, motor and sensory dysfunctions. (Spinal injuries.org)
The main causes of spinal injuries are bullet or stab wound, traumatic injury to the face, neck, head, chest, or back (for example, a car accident), diving accident, electric shock, extreme twisting of the middle of the body, etc. it can be even more dangerous if it happens in children. The developmental age of children make it more damaging than adults especially in such critical areas like spinal cord. The treatment of spinal injuries is like any other injury and is dealt with intensive care and surgical intervention.
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