scholarly journals A clinical study of mode of delivery and perinatal outcome in iligohydramnios

2017 ◽  
Vol 6 (6) ◽  
pp. 2212
Author(s):  
U. S. Hangarga ◽  
V. G. Kulkarni ◽  
. Nikitha
Keyword(s):  
Perinatal Outcome ◽  
Maternal Age ◽  
Prospective Observational Study ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Research Centre ◽  
Maternal Complications ◽  
College Hospital ◽  
Medical College ◽  
The Mean

Background: To evaluate intrapartum sequale of sonographically diagnosed Oligohydrominos such as rate of caesarean section, fetal distress and condition of the new born.Methods: This Prospective observational study was conducted in the department of obstetrics and Gynecology, Navodaya Medical College Hospital and Research Centre between June 2015 to December 2016. The antenatal women with gestational age more than 34 weeks and above, attending our OPD or labor room were included in this study.Results: A total of 140 cases of Oligohydromnias were selected for present study and outcome were assessed. The mean maternal age is 24.42 years. 32.14% cases have delivered vaginally, 67.82% patients went for caesarean sections, 10.7% of babies needed NICU care and 1 was still birth. No adverse maternal complications were observed during the study.Conclusions: Oligohydromnia is one of the frequent complications during labor. The risk of muconium staining of liquor, intrapartum fetal distress, operative delivery and NICU admissions are more in Oligohydromnia cases.

scholarly journals Management and Outcome of Postdated Pregnancy at Rajshahi Medical College Hospital

2019 ◽  
Vol 31 (2) ◽  
pp. 50-53
Author(s):  
Most Merina Akhter ◽  
Mst Shaheen Nawrozy ◽  
Abu Hena Mostafa Kamal ◽  
Sahela Jesmin
Keyword(s):  
Perinatal Mortality ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Medical College Hospital ◽  
Maternal Complications ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
Medical College

Background: Postdated pregnancy complicates about 10% of all gestation and is associated with an increase in perinatal mortality and morbidity. This study was designed to observe fetal as well as maternal outcome in the management of postdated pregnancies admitted into Rajshahi Medical College Hospital. Methods: The study was carried out from July 2008 to June 2010. 100 cases of postdated pregnancies were included. Patients’ age, occupation, parity, mode of delivery, the indication of LUCS, fetal & maternal outcomes were recorded in a predesigned questionnaire. Results were expressed as Mean± SD, actual number and percentage of total where applicable. Results: Mean age (±SD) was 21.3 (±5.32) years. 90% were housewives, 5% were in service and 5% were in other occupations. 53% were nullipara, 21% para-2, 18% were para-3, 8% were para-4.57% of the study patients underwent caesarean section and 43% underwent vaginal delivery. Fetal distress (n=34), non-progression of labour (n=19), cord prolapse (n=1) & CPD (n=3) were the causes of LUCS. Regarding fetal outcome, healthy babies were 76%, meconium aspiration 13%, birth asphyxia 11%. Among birth asphyxia, neonatal death was 1% & still born was 2%. Maternal complications at delivery were tear in the genital tract 8%, PPH 5% & wound infection in 4% cases. Conclusion: Here, still-birth rate was 2% (normally about 1 in 3000 deliveries) and perinatal mortality rate is 3% (normally about 2-3 in 1000 deliveries). So, patients should be encouraged to attend regular antenatal check up to prevent postdated pregnancy and its complications. TAJ 2018; 31(2): 50-53

Laparoscopic Cholecystectomy for Acute Cholecystitis: Indication, Risk, and Outcome

2021 ◽  
Vol 8 (06) ◽  
pp. 5508-5513
Author(s):  
Dr. Shiladitya Shil ◽  
Dr. Ashutosh Deb Sarma ◽  
Dr. Md. Alomgir Islam ◽  
Dr. Md. Abdullah-Hel-Baki Abdul ◽  
Dr.Monira Begum
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Prospective Observational Study ◽  
The Other ◽  
Surgical Indication ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
The Mean ◽  
Good Treatment Option

Background: A laparoscopic cholecystectomy is a fundamental approach to treating acute cholecystitis, and the timing of performing this given treatment is associated with clinical outcomes. It is unknown whether surgical indication, risk, and consequences of laparoscopic cholecystectomy for acute cholecystitis differ from those for the chronic form, making it questionable whether urgent laparoscopic cholecystectomy is the best approach even in severe acute cases. Objective: This study aimed to evaluate surgical indication, risk, and outcomes of laparoscopic cholecystectomy for acute cholecystitis. Methods: This prospective observational study was carried out at Bangladesh Medical College Hospital (Uttara Campus) from July 2006 to November 2008. A total of 103 acute cholecystitis patients were observed to evaluate the safety, risk, and outcomes (includes hospital stay, joining to routine daily works) of laparoscopic cholecystectomy. Result: Male and female ratio is 1:4, and the mean age in our series is 47 years. Acute calculas cholecystitis ultra-sonogram feature shows the highest percentage (85.4%) compare to the other four parts. The study also confirmations around 69% did not get any complications, and bleeding was the most frequently observed (16%) complication. The overall outcomes in this research were observed around 75% of total operated patients did not experience any difficulty and said they fit entirely. The other 19% who had some complications include Pain, RTI, Seroma, Jaundice, Cholangitis, Wound infection). Conclusion: Regarding bile duct injury and prolonged complications, laparoscopic surgery is not a very good treatment option for acute cholecystitis.

scholarly journals Study of Maternal and Fetal Outcome in Pregnancy with Heart Disease

2017 ◽  
Vol 8 (2) ◽  
pp. 112-116 ◽  
Author(s):  
Sharmin Abbasi ◽  
Sehereen Farhad Siddiqua ◽  
Shifin Rijvi ◽  
Salma Akhtar ◽  
Benozir Haque ◽  
...  
Keyword(s):  
Heart Disease ◽  
Cardiac Disease ◽  
Nyha Class ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Functional Class ◽  
Maternal Complications ◽  
College Hospital ◽  
Medical College ◽  
In Pregnancy

Background: Heart disease complicating pregnancy is an important indirect cause of maternal mortality and morbidity. Maternal heart disease comprises .2%-2% of pregnancies and responsible for 10%-20% of maternal deaths1. Our study was done to evaluate fetomaternal outcomes in pregnancy with heart disease.Objectives: Evaluation of fetomaternal outcome in pregnant patients with cardiac disease. Materials andMethods: This observational study was done in Bangabandhu Sheikh Mujib Medical University and Anwer Khan Modern Medical College Hospital among 51 pregnant women with known or newly diagnosed heart disease from January 2013-january 2015. Baseline data recorded demographic character, NYHA functional class, maternal complications, mode of delivery and neonatal outcome.Results: Among 51 cardiac patients, 32 (63%) were primigravida. Mostly 46 (90.6%) belonging to NYHA Class I and II. Rheumatic heart disease seen in 45 (87%) and congenital heart disease in 10% subjects. Mitral stenosis was the most common, seen in 22 (41%) cases. 47.33% patients were delivered vaginally and LSCS done in 41% patients. The fetal outcome were live births in (96.6%) cases, (27.4%) babies required NICU admission.Conclusion: An improvement in modern techniques of monitoring, better understanding of pathophysiology of cardiac disease and multi disciplinary care can lead to substantial improvement in the feto maternal outcome.Anwer Khan Modern Medical College Journal Vol. 8, No. 2: Jul 2017, P 112-116

scholarly journals Indications of Primary Cesarean Section In Multipara

2019 ◽  
Vol 09 (02) ◽  
pp. 105-108
Author(s):  
Shazia Aftab ◽  
Nazish Ali ◽  
Fehmida Saleh ◽  
Saira Ghafoor Ghafoor ◽  
Aasha Mahesh ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Fetal Distress ◽  
Morbidity And Mortality ◽  
Outcome Study ◽  
Obstetric Outcome ◽  
Cesarean Sections ◽  
Vaginal Route ◽  
College Hospital ◽  
Medical College ◽  
The Mean

Objective: To evaluate the indications of primary cesarean section in multipara and to assess the obstetric outcome including maternal, fetal morbidity and mortality, perinatal outcome. Study Design and Setting: It was a hospital based study of primary caesarean sections (CS) done on multiparous patients in duration of two years between January 1, 2016, and December 2017 at Jinnah medical college hospital Karachi. Methodology: Multiparous patients were those who had delivered through vaginal route one or more times (i.e. 28 weeks of gestation or above) or had 1–4children and grand-multiparous are those who had 5 or more children. All the cases included in the study were hospital based and cesarean section was decided by specialist. The procedure was performed by registrars and specialists. The selected patients were followed up till they were discharge from the ward with minimum hospital stay of three days. Data was compiled and results were carried out by SPSS version 23. Results: During the two years of study period, the number of total deliveries were 2064. The primary CS rate in multipara was 37.17%. These women have more likely to have an emergency cessarean sections compared to elective i.e. 85% and15%. The mean age of women was 29.5 years, booked cases were 72.5% and unbooked were 27.5%. Regarding indications for cesarean sections, non-progress of labour ranked first 25.5% followed by fetal distress 20%, pre eclampsia 12 % and ante partum hemorrhage 10.5% etc. Increase incidence of morbidity and mortality was seen in patients undergoing cesarean section due to different reasons. Conclusion: Primary caesarean sections in multipara comprise only a small percentage (37.17%) of total deliveries but were related to high maternal and fetal morbidity

scholarly journals Complications and Immediate Outcome of Pregnant Diabetic Women

2012 ◽  
Vol 30 (1) ◽  
pp. 10-16
Author(s):  
R Akther ◽  
T Hossain ◽  
M Rashid
Keyword(s):  
Gestational Diabetes ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Fetal Distress ◽  
Fetal Membrane ◽  
College Hospital ◽  
Obstructed Labor ◽  
Medical College ◽  
Induced Hypertension ◽  
Pregnant Diabetic

Aim: To see complications and immediate outcome among pregnant diabetic women. Methods: This observational retrospective study included sixty nine pregnant women with diabetes (both pregestational and gestational diabetes) those who got admitted and treated at Dhaka Medical College Hospital (DMCH), Dhaka Bangladesh from the 1st August 2007 to the 31st August 2008. Detailed analysis of their obstetric history, ante partum and intra partum complications and mode of delivery were performed. Results: Majority of the women (76.92%) were admitted through labor emergency. Mean age of the women was 28.9 (18-45) years. Fifty four (54%) percent of women belonged to 21-30 years age group. Sixty two (62.31%) percent of women had gestational diabetes whereas 37.68% had pregestational diabetes. All women were followed up both by obstetrician and diabetologist. Twenty five percent(25%) women developed pre-eclampsia and pregnancy induced hypertension, thirteen percent(13% )women developed premature ruptur of fetal membrane(PROM), twenty three percent (23.25% )women had fetal distress, three(2.88%) percent women present with ante-partum hemorrhage(APH) and one percent(1.44%) women develop acute polyhydromnios. Average gestational age was 36.83(41-28) weeks. Sixty percent (60%) delivered after 37weeks of gestation and forty one (40.58%) delivered before 37weeks of gestation. Ten percent women delivered vaginally and ninety percent (90%) women delivered by caesarean section (CS) because of post CS, repeat CS, breech presentation, preeclampsia, fetal distress and obstructed labor. Maternal mortality is 1.44% and peri-natal is mortality 8.62%. Conclusion: Ante-partum and intra-partum complications are more common among pregnant diabetic women. Knowledge of the importance of maternal glycemic control, as well as development of surveillance techniques to prevent complications, resulted in a decline in fetal and neonatal mortality. DOI: http://dx.doi.org/10.3329/jbcps.v30i1.11361 J Bangladesh Coll Phys Surg 2012; 30: 10-16

scholarly journals Umbilical Cord Abnormalities and Maternal and Perinatal Outcome: A Prospective Observational Study

2021 ◽  
Author(s):  
Kalpna Kulshrestha ◽  
Debbarma Sukla ◽  
Kalpana Verma
Keyword(s):  
Observational Study ◽  
Umbilical Cord ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Prospective Observational Study ◽  
Mode Of Delivery ◽  
Insertion Site ◽  
Circulatory System ◽  
P Value ◽  
Maternal Complications

Introduction: The umbilical cord is the vital extension of the fetal circulatory system which regulates blood flow in both directions, thus allowing mother-child communications viz., immunological, oxygenation, fetal nutrition, cardiac function. Umbilical cord abnormalities are associated with the adverse maternal and perinatal outcome.. Aim: To assess prevalence of various umbilical cord abnormalities and its association with maternal complications and perinatal outcome. Materials and Methods: This prospective observational study was conducted at Saraswathi Institute of Medical Sciences Pilkhuwa, Hapur, Uttar Pradesh, India from June 2019 till March 2020. The approval for the study was taken from the Institutional Ethical Committee. Total number of deliveries during this period were 1284. After satisfying exclusion criteria, total 600 deliveries of more than 37 weeks of gestation were included in the study at random. Examination of cord was done during delivery for presence of loops of cord around the neck or body, any knots, true or false. After the delivery, the cord was clamped 5 cm from the fetal end and the total length was measured from the cut end till the placental insertion site, and 5 cm added therein. Umbilical cord was examined for any abnormalities and numbers of coils recorded and Umbilical Coiling Index (UCI) measured. Apgar score and NICU admissions noted. Results: Out of 600 patients, umbilical cord abnormalities were seen in 194 (32.33%) patients, while in 406 (67.67%) no abnormality was detected. The mode of delivery was vaginal in 441 cases (73.5%) while 159 (26.5%) had Lower Segment Cesarian Section (LSCS). Out of 194 cases with umbilical cord abnormality, 89 (45.87%) had LSCS and out of 406 cases with no cord abnormality, only 70 cases (17.24%) had LSCS (p-value<0.0001). Mean UCI was 0.25±0.09. Total 269(44.83%) had maternal complications and 143 cases (53.16%) had umbilical cord abnormalities. While 126 (46.84%) cases with maternal complications did not show any cord abnormality. Apgar score of <7 at one minute was seen in 43 cases (22.16%) and 23 (11.86%) were admitted in Neonatal Intensive Care Unit (NICU) with umbilical cord abnormality. Conclusion: The umbilical cord abnormalities were associated with the adverse maternal and perinatal outcome and increased rate of LSCS (p-value <0.0001). The study shows the importance of knowledge of cord abnormalities. The cord abnormality should be looked for after each delivery, with the aim to reduce perinatal morbidity.

scholarly journals Mode of delivery and fetal outcome in meconium stained amniotic fluid in DMCH

2018 ◽  
Vol 9 (2) ◽  
pp. 304-307 ◽  
Author(s):  
Fazilatun Nesa ◽  
Fahmida Chowdhury ◽  
BH Nazma Yasmeen ◽  
Shabnam Rahman ◽  
Nasreen Begum ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Mode Of Delivery ◽  
Neonatal Resuscitation ◽  
Fetal Outcome ◽  
College Hospital ◽  
Medical College ◽  
Rh Incompatibility ◽  
Long Time ◽  
The Mean ◽  
Meconium Stained Amniotic Fluid

Background : Meconium is a dark greenish mass of desquamated cells, mucus, and bile that accumulates in the bowel of a fetus and is typically discharged shortly after birth. Meconium stained amniotic fluid (MSAF) has long been considered to be a bad predictor of fetal outcome.Objective : The aim of this study was to determine if the perinatal outcome is affected by mode of delivery in meconium-stained amniotic fluid.Methodology : This ovservational study was carried out in the department of Obstetrics and Gynaecology in Dhaka Medical College Hospital from July 2016 to June 2017. A total of 204 women who satisfied the inclusion and exclusion criteria were taken for the study. The study group comprised of 102 women admitted in labour and having meconium stained amniotic fluid and 102 women in labour but having clear amniotic fluid were taken as comparision group.Results : The mean age was found 26.6±5.9 years in MSAF group and 26.2±5.0 years in clear liquor group. The mean gestational age was found 38.9±1.8 weeks in MSAF group and 38.5±1.3 weeks in clear liquor group. Risk factors were not statistically significant (p>0.05) between two groups. Forty-one (40.2%) patients had caesarian section in MSAF group and 19(18.6%) in clear liquor group. APGAR score at 1 minute and at 5 minute were statistically significant (p<0.05) between two groups. About 100(98.0%) babies were alive in MSAF group and 101(99.0%) in clear liquor group.Conclusion : Meconium stained amniotic fluid group was associated with higher rate of cesarean delivery, increased need for neonatal resuscitation, increased rate of PIH, pre-eclamsia, Oligohydramnios, IUGR, Post dated pregnancy, Rh incompatibility, GDM and long time hospital stay and hospital mortality.Northern International Medical College Journal Vol.9(2) Jan 2018: 304-307

scholarly journals Efficacy of 50µg oral misoprostol versus 25µg vaginal misoprostol in induction of labor

2017 ◽  
Vol 6 (5) ◽  
pp. 1782
Author(s):  
Beenakumari R. ◽  
Radhamani Mavunkal Viswanathan ◽  
Nithya R.
Keyword(s):  
Mode Of Delivery ◽  
Induction Of Labor ◽  
Maternal Complications ◽  
Medical College ◽  
Oral Misoprostol ◽  
Misoprostol Group ◽  
Oral Group ◽  
Uterine Hyperstimulation ◽  
The Mean ◽  
Vaginal Misoprostol

Background: Misoprostol is the latest drug for induction of labour which is cheap and stable at room temperature. Our study was conducted to test the efficacy of misoprostol for labor induction through oral and vaginal route.Methods: 250 women who required induction of labor at Govt. Medical College, Kottayam was included in this study. Both oral misoprostol 50µg and vaginal misoprostol 25µg 4 hourly upto maximum of four doses were used for induction of labor as per consultant’s preference. Out of these 125 patients were selected for study in both groups. Singleton term pregnancies with cephalic presentation were selected. The mean induction pain interval, induction delivery interval, mode of delivery, maternal complications like uterine contraction abnormalities, neonatal complications were observed.Results: Induction to pain interval was shorter in oral misoprostol group compared to vaginal misoprostol group (2.48+1.3 hours vs. 3.91+2.17 hours P ≤0.001). But the mean induction to delivery interval was comparable in both groups (12.98±3.04hrs vs. 12.59±3.28 hrs.) Vaginal delivery and cesarean section rate in both groups were comparable. The oral group required more number of misoprostol (>2 misoprostol 38.4% in oral 25.6% in vaginal p=0.030). There was insignificant increased incidence of uterine hyperstimulation in vaginal group. The neonatal outcome was comparable.Conclusions: Misoprostol administered either by oral or vaginal route was equally effective in induction of labor and found to be safe.

scholarly journals Admission cardiotocography: Forecasting perinatal outcome

2021 ◽  
Vol 8 (2) ◽  
pp. 158-161
Author(s):  
Nity ◽  
Asima Das
Keyword(s):  
High Risk ◽  
Intrauterine Growth Restriction ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Prospective Observational Study ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
High Risk Pregnancy ◽  
Risk Pregnancy ◽  
Admission Test

The Admission test (AT) in high risk pregnancy for continuous monitoring of FHR (fetal heart rate) has become crucial in the modern day obstetric practice. As it senses the presence of fetal intrapartum hypoxia and assist the obstetrician in making decision on the mode of delivery to improve perinatal outcome in high risk pregnancy.A prospective observational study was carried out in 230 pregnant women with high risk pregnancy in KIMS BBSR, Odisha during period of 2018-2020 who were admitted to labor room with gestational age more than 33 weeks for continuous FHR monitoring with CTG (cardiotocography) for 20 minutes.Among 230 patients majority of them were primigravida in age group of 21-25 years. About 39.1% were postdated pregnancy followed by Pregnancy Induced Hypertension (PIH) (21.1%), Premature Rupture of the Membranes (PROM) (10.4%), Bad Obstetric History (BOH) (6.9%), PIH with IUGR (Intrauterine Growth Restriction) (6.5%), IUGR (5.6%), Oligohydramnios (4.3%), Diabetes (3.5%) and Rh negative pregnancy (2.6%). The admission test were normal in (68.7%), suspicious in (21.7%) and pathological in (9.6%). The incidence of fetal distress, meconium stained liqour, NICU (Neonatal Intensive Care Unit) admission and APGAR score less than 7 was significantly higher with pathological AT as compared with suspicious and normal AT.The admission CTG appears to be simple noninvasive tool for screening the high risk pregnancy and prioritizing fetuses and deciding the mode of delivery.

scholarly journals Prescription pattern and rationality of drugs study of patients of OPD (outpatient) of orthopedics Department of RKDF Medical College Hospital and Research Centre, Bhopal, MP, India

2016 ◽  
Vol 6 (1) ◽  
pp. 117
Author(s):  
Rajeev Dalela ◽  
Prashant Wadagbalkar ◽  
Hareshwar Kumar Mali ◽  
Swati Raipurkar
Keyword(s):  
Prospective Observational Study ◽  
Generic Drugs ◽  
Drug Prescription ◽  
Oral Route ◽  
Research Centre ◽  
Duration Of Treatment ◽  
College Hospital ◽  
Prescription Pattern ◽  
Medical College ◽  
Rational Drug

Background: To study the prescription pattern of drugs prescribed to patients of OPD of orthopedics department and to analyze the rationality of drugs prescribed by doctors of RKDF MCHRC, Bhopal, MP, India.Methods: A prospective, observational study was planned for 200 patients selected in the year 2015. Collected data were entered in a predesigned forms downloaded from WHO website. Rationality of drugs prescription was analyzed using WHO drug utilization and prescription indicators. For generic drugs reference NLEM 2011 and for cost analysis, Drug Today 2014 was used.Results: out of 200 patients, 41%were male and 59% were female. Average numbers of drugs prescribed per prescription was 3.3. Most commonly prescribed drug was Analgesics an Anti-inflammatory (37.1%) in oral as well as Intramuscular injections and Topical forms, Gastric acid inhibitors (15.4%), Muscle relaxants (12.1%) Calcium and Vitamin D, glucosamines (12.1%), Antimicrobials (8%), Steroids (1.8%), Enzyms serratiopeptidase (1.8%). Most commonly prescribed Analegsic was FDC of Trypsin+ Rutoside+ Bromelin+ Diclofenac (30.6%) followed by FDC Acceclofenac+ Paracetamol+ Seratiopeptidase (15.9%), followed by FDC Tramaodol+ Paracetamol (11%).Drugs prescribed in generic form were 0%.Average cost of treatment was INR 600 per prescription. Most common route of drug prescription was 1. Oral route 81.7%. 2. Topical 6.4%. 3. Injectable intramuscular 6.2% and intra articular 5.7%. Duration of treatment was prescribed in 81%. Frequency of drug administration was mentioned in 100% of prescriptions. EDL prescription was 81%. FDCs were 35%.Conclusions: There was Poly pharmacy. Drugs prescribed in generic form were very low. Drugs prescribed from NLEM were 81%. CMEs on Rational drug therapy to doctors working in orthopedics department should be conducted to promote rational use.

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