scholarly journals Changing trends in incidence, type, indication and maternal outcome of peripartum hysterectomy over 10 years at a tertiary care centre

2017 ◽  
Vol 6 (6) ◽  
pp. 2216
Author(s):  
Taru Gupta ◽  
Sangeeta Gupta ◽  
. Deepika ◽  
Nupur Gupta
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Maternal Outcome ◽  
Care Centre ◽  
Abnormal Placentation ◽  
Tertiary Care Centre ◽  
Peripartum Hysterectomy ◽  
Primary Indication ◽  
Gestational Age At Delivery ◽  
Life Threatening

Background: Peripartum hysterectomy is the most dramatic operation in modern obstetrics and is generally performed when all conservative measures fail to achieve haemostasis in the setting of life threatening haemorrhage. The objective was to review all peripartum hysterectomies performed at a tertiary care centre over a ten-year period from 2007 to 2016 to determine the incidence, types, indications and maternal outcome and also to study the changing trendsMethods: This was a retrospective, observational, analytical study of parturient women requiring peripartum hysterectomy (PH). We looked at data over a ten-year period, from January 2007 to December 2016. Case records were reviewed for socio-demographic characteristics of the patients, type and indications for the hysterectomy performed, booking status of patients, mode of delivery, gestational age at delivery and maternal outcome. Change in trends of the rate and indications of peripartum hysterectomy at the centre was also reviewed.Results: The overall rate of peripartum hysterectomy was 1/876 deliveries. The rate of peripartum hysterectomy had a 4-fold rise from 2007 to 2016.The primary indication was abnormal placentation which included morbidly adherent placentation 22/59 (37.2%) and placentapraevia 5/59 (8.4%), followed by intractable atonic haemorrhage in 35.6% of cases. Abnormal placentation as an indication for PH increased significantly form 34.6% (2007-2011) to 54.54% (2012-2016). After hysterectomy, 56% cases were admitted to ICU. All patients needed blood transfusion. Maternal mortality was 10.1%.Conclusions: Peripartum hysterectomy is a most demanding obstetric surgery performed in very trying circumstances of life threatening hemorrhage. The indication for emergency peripartum hysterectomy in recent years has changed from traditional uterine atony to abnormal placentation. 

scholarly journals To study pattern of obstetric cases referred at tertiary care centre in Central India

2017 ◽  
Vol 6 (6) ◽  
pp. 2370
Author(s):  
Prakriti Goswami ◽  
Jyoti Bindal ◽  
Niketa Chug
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Central India ◽  
Maternal Outcome ◽  
Child Health Services ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Common Diagnosis ◽  
Mode Of Transport

Background: Maternal morbidity and mortality remains a major challenge to health systems worldwide. Referral services for identification and referral of high risk pregnancies are an integral part of maternal and child health services. Timeliness and appropriateness of referral are challenge to obstetricians, since delay in referral affects maternal outcome adversely, hence the identification of at risk patients and obstetric emergencies and their timely referral is of immense importance. The aim of this study was to review the pattern of obstetric cases referred to tertiary care centre, to identify their clinical course, mode of delivery and maternal outcomes.Methods: It was prospective observational study carried out from January 2015 to July 2016. Study population was all Obstetrics patients referred to Department of Obstetrics and Gynecology of Kamla Raja Hospital, G.R. Medical College, Gwalior, Madhya Pradesh, a tertiary care centre during the study period.Results: The total number of referred cases in above study period was 4085.The proportion of referred cases in the tertiary care hospital was 20.86%. Mode of transport used by the referred patients were hospital ambulances (38%) and private vehicles (62%). Most common diagnosis at the time of referral was anaemia (27.8%). Out of the total referred cases, 48% had vaginal delivery (either spontaneous or induced), 28% had caesarean section and 24% were managed conservatively. Hypertensive disorders (25.4%) constitutes the leading cause of maternal deaths amongst the referred cases.Conclusions: Peripheral health care system needs to be strengthened and practice of early referral needs to be implemented for better maternal outcome.

scholarly journals Maternal outcome of term obstetric emergencies referred to tertiary care centre

2021 ◽  
Vol 10 (7) ◽  
pp. 2843
Author(s):  
Shivani Badal ◽  
L. Ranjit Singh
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Ground Level ◽  
Maternal Outcome ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Health Care Centre ◽  
Early Referral ◽  
Maternal Morbidity And Mortality ◽  
Obstetric Emergencies

Background: Lack of basic facilities at ground level in backward areas of country affect the outcome of obstetric emergencies thereby affecting maternal morbidity and mortality. This study was conducted to compare the outcome of term obstetric emergencies referred to tertiary care centre.Method: This prospective observational study was conducted to study the maternal outcome in obstetric emergencies referred to our institution.Results: Most of the patients were exhausted (59.47%). Majority were referred for prolonged labour (47.71%), previous cesarean section (16.33%), pre-eclampsia (13.07%) and eclampsia (1.96%). Most patients were given more than one intervention. Emergency LSCS was the common mode of delivery (39.86%).Conclusions: It is important to improve the conditions of peripheral health care centre with amenities like specialist doctors and transport. Awareness of population, attitude buildup is important for early referral to resist care centre to improve outcome of pregnancy.

scholarly journals Injury amongst Medicolegal Cases in Department of Forensic Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (244) ◽  
pp. 1277-1282
Author(s):  
Arbin Shakya ◽  
Jenash Acharya ◽  
Sunil Joshi
Keyword(s):  
Confidence Interval ◽  
Road Traffic ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Physical Assault ◽  
Care Centre ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Life Threatening

Introduction: Victim of injuries presenting to a hospital is a medico-legal issue. So, with medical management, proper documentation of injuries should be done as a legal duty by all physicians attending such cases. The study aims to find the prevalence of injury amongst medicolegal cases inthe Department of Forensic Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was done amongst 328 medicolegal cases presenting at a tertiary center, from January 2019 to February 2021. Ethical approval was obtained from the Institutional Review Committee (Reference number: 2603202101). Convenience sampling was used to select study samples. After detailed history regarding the incidence, injuries were examined and documented in a performa. The data were entered in Statistical Package for Social Sciences version 18. Point estimate at 95% Confidence Interval was calculated along with frequency and percentagefor binary data. Results: Among 328 cases presenting to hospital for medicolegal issues, 237 (72.25%) (67.40-77.09 at 95% Confidence Interval) had injuries, out of which 170 (71.73%) cases were due to physical assault, 64 (27%) cases due to accident; 2 (1.26%) were undetermined. Majority of victims of injury were adult males, with mean age of 32.41±13.96 years. In most accidental injuries internal organs were also injuries and life-threatening. Conclusions: The prevalence of injuries amongst medicolegal cases was found to be higher in our study in comparison to other studies done in similar settings. Most of the injuries were due to physical assault; however, the majority of road traffic injuries were life-threatening. These road traffic injuries could have been prevented by following a safe system approach to road safety.

scholarly journals Study of knowledge, attitude and practices of contraception in breast-feeding mothers

2019 ◽  
Vol 8 (4) ◽  
pp. 1473
Author(s):  
Aiyleen Shiza Shawl ◽  
Vidya Thobbi
Keyword(s):  
Breast Feeding ◽  
Rural Areas ◽  
Urban Areas ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Lower Class ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Knowledge And Attitude ◽  
The Government

Background: In India, as in many other countries, postpartum family planning is usually initiated after 6 weeks postpartum. Early resumption of sexual activity coupled with early and unpredictable ovulation leads to many unwanted pregnancies in the first year postpartum. Increase in hospital deliveries provides an excellent opportunity to sensitize women and provide effective contraception. Hence the present study was done at our tertiary care centre to assess the knowledge, attitude, practice regarding contraception and to find out the relationship between knowledge and attitude regarding contraception among breast feeding mothers.Methods: A hospital based observational study. The patients admitted at our tertiary care centre in the Department of Obstetrics and Gynecology.Results: Majority of the participants (72%) were in the age group of 21-25 years. 21.2% of the study group was educated up to primary level while 33.2% and 18.4% of the participants studied till SSC and HSC respectively. Majority of participants were from middle class (50%) followed by lower class (36.4%) and upper class (13.6%). 69.6% participants resided in rural areas while 30.4% participants were from urban areas. It was observed that age, education and mode of delivery were the significant factors.Conclusions: As the government gives incentives to couples who opt for permanent sterilization, which is an effective drive, it should also give incentives to couples who follow temporary methods and delay pregnancies. Couples who adopt one child norm or 2 children norm should be encouraged by benefits either in the form of children’s education or health insurance.

scholarly journals A retrospective study of obstetric hysterectomy cases at tertiary care centre

2020 ◽  
Vol 9 (7) ◽  
pp. 2813
Author(s):  
Khushi P. Joshi ◽  
Sapana R. Shah ◽  
Saumya P. Agrawal ◽  
Vishwa Goswami
Keyword(s):  
Analytical Study ◽  
Postpartum Haemorrhage ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Vaginal Deliveries ◽  
Threatening Condition ◽  
Life Threatening ◽  
Placenta Accreta Spectrum ◽  
Febrile Morbidity

Background: Postpartum haemorrhage (PPH) is a life-threatening condition. The objective of this study was to determine the incidence, demographic characteristics, indications, and feto-maternal outcomes associated with obstetric hysterectomy in a tertiary care centre.Methods: This is a retrospective analytical study conducted over a period of six years, from March 2014 to April 2020. A total of 68 cases of obstetric hysterectomy were studied at tertiary care centre in Ahmedabad, Gujarat, India.Results: Present study reported 68 obstetric hysterectomies per 44663 total deliveries (incidence - 0.15%), out of them 20 following 26446 vaginal deliveries (0.07%) and 48 following 18217 caesarean section (0.26%). Morbidly adherent placenta (29.41%) was the most common indication followed by atonic postpartum haemorrhage (25.00%) and uterine rupture (17.64%). The most frequent sequelae were disseminated intravascular coagulation (26.47%) and febrile morbidity (10.29%), maternal mortality was 16.17% whereas neonatal mortality was 26.47%.Conclusions: The incidence of obstetric hysterectomy has been found to be more following caesarean sections. There is a change in the indications of obstetric hysterectomy in the past two decades with placenta accreta spectrum being the commonest in present study. This is because of rising number of caesarean sections. Patients who underwent emergency obstetric hysterectomy due to atonic PPH had a higher mortality.

scholarly journals Role of granulocyte transfusions in combating life-threatening infections in patients with severe neutropenia: Experience from a tertiary care centre in North India

PLoS ONE ◽  
2018 ◽  
Vol 13 (12) ◽  
pp. e0209832 ◽  
Author(s):  
Akanksha Garg ◽  
Anshul Gupta ◽  
Ashish Mishra ◽  
Manoj Singh ◽  
Sanjeev Yadav ◽  
...  
Keyword(s):  
Tertiary Care ◽  
North India ◽  
Severe Neutropenia ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Life Threatening
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