scholarly journals The efficacy of cervical encerclage on the course of labour in well selected cases: a prospective study at a tertiary care hospital

2017 ◽  
Vol 6 (8) ◽  
pp. 3319
Author(s):  
Kunaal Shinde ◽  
Anand V. Karake ◽  
Gulabsingh Shekhawat ◽  
Hiralal Shivale
Keyword(s):  
Preterm Delivery ◽  
Preterm Labor ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Care Hospital ◽  
Perinatal Medicine ◽  
Short Cervix ◽  
Cervical Incompetence ◽  
A Prospective Study ◽  
Salvage Rate

Background: The two major problems for modern obstetrics and perinatal medicine are recurrent second trimester abortions and preterm delivery. Cervical insufficiency or incompetency is defined as the inability of the uterine cervix to retain a pregnancy in the absence of contractions or labor. Cervical encerclage is a simple but a resourceful procedure for improving the fetal outcome in cases proven with cervical incompetence, is a boon to modern obstetrics.Methods: A prospective analytical study was carried out at tertiary care teaching hospital for a period of ten years. Three hundred and twenty cases of bad obstetric history (repeated abortions, preterm labor) with previous pregnancy losses probably due to cervical incompetence or ultrasonographical evidence of short cervix were included in the study. These cases were subjected to cervical encerclage operation in the second trimester.Results: Out of the 289 cases, who underwent McDonald’s procedure, 12 women had abortion, 66 had preterm labor and 211 women reached term. Out of the 31 cases who underwent Wurm’s procedure; 4 had abortion, 17 had preterm delivery and 10 women reached to term.  In the present study, the average interval from cerclage to delivery was 115 days. It was observed that the fetal salvage rate was unsatisfactory in women having short cervix with open internal os before encirclage. Infant salvage rate in this study after encerclage operation was 86%.Conclusions: Cervical encerclage when done in properly selected cases, results in improvement in fetal salvage up to eighty percent.

scholarly journals Study of maternal and fetal outcome in antepartum eclampsia in a tertiary care hospital

2018 ◽  
Vol 7 (3) ◽  
pp. 1108
Author(s):  
Aruna Rani R. ◽  
Dheeba Jayanthi R. ◽  
Eswari S.
Keyword(s):  
Gestational Age ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Care Hospital ◽  
College Hospital ◽  
Medical College ◽  
Obstetric Emergencies ◽  
One Year ◽  
A Prospective Study

Background: In modern obstetrics, the prevalence of Eclampsia and its complications are high, so we decided to study pregnancy outcome in all Antepartum Eclampsia patients. The present study was carried out to investigate the maternal and fetal outcome in patient with Antepartum eclampsia.Methods: A prospective study was conducted in Government Mohan Kumaramangalam Medical College Hospital, Salem, India over a period of one year from January 2016 to December 2016 in all Antepartum Eclampsia patients. Analysis was done regarding the age of women, parity, gestational age, imminent symptoms, mode of delivery, fetal outcome and maternal morbidity and mortality.Results: Incidence of Antepartum Eclampsia in our hospital is 0.7%. It is more common in age group of 20 to 25years (68.5%) and primigravida (56%) and gestational age >37 weeks (51.85%). Commonest mode of delivery was by caesarean section (72%). Out of 54 patients of Antepartum Eclampsia 3 (5.5%) died and 18 (33%) had complications. Out of 50 live babies, 16 (32%) died.Conclusions: Eclampsia is still one of the important and common obstetric emergencies and it has a significant role in maternal and fetal outcome. The early identification of risk factors and timely intervention is needed to improve maternal and perinatal outcome.

scholarly journals STUDY OF FETAL SALVAGE FOLLOWING MCDONALD'S ENCERCLAGE

2020 ◽  
pp. 42-43
Author(s):  
Krupa R. Mange ◽  
Vidyadhar B. Bangal
Keyword(s):  
Observational Study ◽  
Surgical Procedures ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Preterm Labour ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Second Trimester ◽  
Cervical Incompetence ◽  
Salvage Rate

Introduction - Mc Donald’s cervical encerclage is one of the surgical procedures, which has been proved beneficial in improving the fetal salvage in recurrent pregnancy loss in second trimester of pregnancy. Material and Methods-A retrospective observational study was carried out at tertiary care teaching hospital for a period of five years. Forty cases of bad obstetrical history that include repeated abortions and preterm labour probably due to cervical incompetence were included. Procedure was performed at various weeks of gestation ranging from 14-32 weeks. Results-Following Mc Donald’s procedure, 1 woman had abortion, and 6 had preterm labour and 33 women reached beyond 37weeks. In the present study, the average interval from Mc Donald’s encerclage to delivery was 130 days.Infant salvage rate in this study was 41% before and 88% after Mc Donald’s encerclage operation. Conclusion-Mc Donald’s cervical encerclage results in improving fetal outcome,when performed in properly selected cases.

The Upper and Lower Uterine Segment Thickness Ratio: A Simple Sonographic Tool to Triage for Preterm Delivery among Women with Threatened Preterm Labor

2020 ◽  
Vol 16 (3) ◽  
pp. 236-243
Author(s):  
Anapthi Anil ◽  
Sujatha Bagepalli Srinivas ◽  
Shripad Hebbar ◽  
Muralidhar Vaman Pai
Keyword(s):  
Preterm Delivery ◽  
Preterm Labor ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Thickness Ratio ◽  
Lower Uterine Segment ◽  
Care Hospital ◽  
Significant Difference ◽  
Threatened Preterm Labor ◽  
False Labor

Background: Preterm delivery is a predominant cause of neonatal morbidity and mortality. Below 20% of women with threatened preterm labor, progress to active labor and delivery. Identification of such women will help to improve neonatal outcome by an early intervention such as administration of steroids and in utero transfer to the hospitals with better neonatal care. Objective: To evaluate the importance of ultrasonographic measurement of the upper and lower uterine segments thickness ratio to distinguish between true and false labor in women with threatened preterm. Methods: A prospective cohort study was carried out at a tertiary care hospital in Southern India from June 2017 to July 2018 on 151 singleton pregnant women at 24-36 weeks of gestation with regular or painful uterine contractions. Transabdominal ultrasound was performed to measure upper and lower uterine segments wall thickness and then the thickness ratio was calculated. Delivery within 7 days was the primary outcome of study. Results: Out of 151 patients, 32 (21.2%) delivered within 7 days of presentation and the rest (78.8%) delivered after 7 days and had a significant difference in the ratio of upper/lower uterine segments thickness (p<0.001). The ROC curve showed a sensitivity of 81.3% and specificity of 84.2% when the cut-off value of the thickness ratio was ≥1.61. Conclusion: The sonographic assessment of upper and lower uterine segment thickness ratio may be helpful to differentiate true labor from false labor among women with threatened preterm labor.

scholarly journals Study of maternal and fetal outcome in various types of placenta previa

2018 ◽  
Vol 7 (11) ◽  
pp. 4652
Author(s):  
Sonal Bhuyar ◽  
Neha Dharmale
Keyword(s):  
Neonatal Outcome ◽  
Tertiary Care Hospital ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Intrauterine Death ◽  
Care Hospital ◽  
Institutional Deliveries ◽  
Life Threatening ◽  
A Prospective Study

Background: Placenta previa is one of the life-threatening complications in obstetrics which affects maternal and neonatal outcome. Now-a-days its incidence is increasing due to previous operative procedures. The objective of the present study was to study out maternal and fetal outcome in various types of placenta previa.Methods: A prospective study was conducted in our tertiary care hospital on 78 patients in order to know the cause and outcome of placenta previa.Results: Early termination was carried out in major PP group due to APH. 13 out of 17 patients presenting with APH had major degree of PP. Abnormal lie and presentation are commonly seen in cases of PP however cephalic constituted 83.3% cases of fetal presentations in present study followed by breech 10.2%, oblique 3.9%, face 1.3% and transverse 1.3%. In this study, 92.2% neonates were born alive while neonatal death and intrauterine death (IUD) was observed in 5.2% and 2.6% neonates respectively.Conclusions: Combined efforts for prevention of risk factors for PP, timely diagnosis and planned institutional deliveries can only reduce the morbidity and mortality associated with PP.

scholarly journals Outcome of Pregnancies with Fibroids and its Associated Complications: A Prospective Study

2020 ◽  
Vol 9 (4) ◽  
pp. 1-4
Author(s):  
Swarna Sudha Pullemalla ◽  
B. Bhargavi
Keyword(s):  
Preterm Labor ◽  
Tertiary Care ◽  
Uterine Fibroids ◽  
First Trimester ◽  
Premature Delivery ◽  
Care Hospital ◽  
Fetal Demise ◽  
Study Institute ◽  
A Prospective Study ◽  
Age Range

Background: Fibroids (leiomyomas) are benign smooth muscle cell tumors of the uterus. Although they are extremely common, with an overall incidence of 40% to 60% by age 35 and 70% to 80% by age 50, the precise etiology of uterine fibroids remains unclear. Some studies have shown a relationship between uterine fibroids and pregnancy complications, such as preterm birth, premature rupture of membranes (PROM), fetal malpresentation, placental abruption and intrauterine fetal demise. The aim is to study the outcome of pregnancies with fibroids and their associated complications. Materials and methods: The present study was conducted in the Department of Gynecology in a tertiary care hospital. For the study, a total of 40 patients were selected between the age range of 21 to 45 years from the outpatient list of the department of gynecology with pregnancy with fibroid after attending first-trimester ultrasonography examination which diagnosed them. The patients underwent both consequent antenatal care and delivery at the study institute in the study time. Ultrasonogram was done at successive visits to evaluate the change in the size of the fibroid and any associated complications either in fibroid or in pregnancy in general. Results: We observed that 15 patients had threatened miscarriage, 12 had preterm labor, 2 had antepartum bleeding, 3 had abdominal pain needing admission, 2 had laparotomy due to pain, 1 had a postpartum hemorrhage and only one patient needed a blood transfusion. Spontaneous abortion was observed in 2 patients, premature delivery in 15, delivery at 37-41 weeks in 37, vaginal delivery in 5 patients and cesarean section in 44 patients. Conclusion: Within the limitations of the present study, it can be concluded that pregnant women diagnosed with uterine fibroids are at a greater risk of complication during the antepartum, intrapartum, and postpartum periods.

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