scholarly journals Abruptio placenta: a retrospective study on maternal and perinatal outcome

Author(s):  
Subha Sivagami Sengodan ◽  
Mohana Dhanapal

Background: Abruptio placenta is separation of a normally situated placenta after 20 weeks of gestation and prior to the birth of the fetus. It is an important cause of antepartum haemorrhage and presents as an acute abdomen in the third trimester of pregnancy. Obstetrical haemorrhage is one of the triad (Haemorrhage hypertension and infection) of causes of maternal deaths in both developed and underdeveloped countries.Methods: This is a retrospective study of Abruptio Placenta cases carried out between January 2015 and December 2015 at Government Mohan Kumaramangalam Medical College Hospital, Salem and about its perinatal and maternal outcome.Results: Incidence of Abruptio placenta is 0.5%. It is most common in the women of age group 26-30yrs. 67% of cases were associated with severe pre-eclampsia. Live births were 69.8% while stillbirths were 30.2%. PPH occurred in 19.6% of cases. DIC accounts for 16.7% of the complication.Conclusions: Abruptio placenta is associated with poor maternal and fetal outcome. Hence early diagnosis and prompt resuscitative measures would prevent both perinatal and maternal mortality and morbidity.

Author(s):  
Ritu Mishra ◽  
Aditya Prakash Misra

Background: Abruptio placenta is one of the common cause of antepartum haemorrhage and is defined as premature separation of normally implanted placenta. It is more common in second half of pregnancy. Abruptio placenta is serious complication of pregnancy and causes high maternal and neonatal morbidity and mortality.Methods: This retrospective study of abruptio and its maternal and perinatal outcome was carried out between July 2016 and October 2017 at Rama Medical College Hospital and research centre.Results: Incidence of Abruptio placenta is 1.6%. It is most common in the women of age group 30-35 years. 75% of cases were associated with severe pre-eclampsia. Live births were 75% while stillbirths were 25%. PPH occurred in 30% of cases. DIC accounts for 25% of the complication.Conclusions: Abruptio placenta is life threatening complication of pregnancy and it is associated with poor maternal and fetal outcome if not managed appropriately. Hence early diagnosis and prompt resuscitative measures would prevent both perinatal and maternal mortality and morbidity.


Author(s):  
Kamrun Nessa ◽  
Sumia Bari ◽  
Sanjida Khan ◽  
Ferdowsi Sultana ◽  
Tania Akbar

Background: Globally postpartum haemorrhage remains a leading cause of maternal death. It affects only 1-2% of postnatal women. This low incidence of secondary PPH and linkage to maternal morbidity rather than mortality was the reason for the little attention among obstetricians, but it is recently gaining importance and interest with the increase morbidity and mortality related to secondary PPH.Methods: A retrospective study was conducted on the diagnosed patients of secondary PPH admitted in Enam Medical College and Hospital, Dhaka, Bangladesh, from January 2015 to December 2016. Among 33 cases of secondary PPH age of the patients, parity, mode of delivery, causes and management were noted from medical records. All data was analyzed by SPSS16.Results: Among 33 patients 14 (42.4%) were primi and 19 (57.6%) were multipara, age between 18 to 38 years, majority admitted 2nd and 3rd week after delivery. Among 33 patients 12% delivered vaginally at home and 30% vaginally at hospital and 58% undergone LUCS. We found 34% retained bits of placenta, 27% uterine wound dehiscence, 24% retained clots and 15% endometritis as causes. Less than 3 units blood needed in 22 (66.7%) patients and 11 (33.3%) needed more than 3 units. About 6 (18%) patients were treated conservatively, MVA were needed in 18 (55%) patients, repair of wound in 4 (12%) and TAH was in 5 (15%).Conclusions: Secondary PPH is increasing may result in significant maternal morbidity as well as mortality. More study needed to identify the risk factors and causes to reduce maternal mortality and morbidity.


2020 ◽  
pp. 80-82
Author(s):  
Shweta Shah ◽  
S.K. Suri ◽  
Ami Shah

Background: Most frequently performed gynaecological surgery is hysterectomy. The prevalence of hysterectomy varies within different regions. There are mainly two types of hysterectomies according to which part of uterus is removed. The main types of hysterectomy are total and subtotal or partial hysterectomy. The hysterectomy can be performed by three routes abdominal, laproscopic and vaginal hysterectomy. The main objective of our study is to know most common pathology and different age groups of the patients underwent hysterectomy. Materials and Methods: In this retrospective study was carried during period 6 months, at GCS medical college, hospital and research centre, Ahmedabad. Total 100 hysterectomy specimens were analyzed for histopathological lesions. We had taken the clinical and histopathological findings of these cases from the records of department of pathology, GCS medical college , hospital and research centre. Results: In our study of 100 cases, most common age group underwent hysterectomy was 40-49 years and least common age group was 20-29 years. Type of hysterectomy performed most commonly in this study was total abdominal hysterectomy with bilateral salpingoophorectomy. Most of lesions were seen in the myometrium 42 cases (42%), Endometrium 32 cases (32%), Cervix 16 cases (16%) and Ovary 10 cases (10%). Hysterectomy remains the widely used treatment modality.


Author(s):  
Sona Singh ◽  
Nagendra Singh ◽  
Jagriti Kiran Nagar ◽  
Sarvesh Jain

Background: Maternal mortality is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of pregnancy from any cause related to or aggravated by the pregnancy, but not from accidental or incidental causes. The aim of this study is to find out the causes of maternal mortality and the complications leading to maternal death.Methods: A retrospective study was conducted by reviewing the hospital records to study the maternal deaths and complication leading to maternal death over the period of one year from July 2016 June 2017 in the Department of Obstetrics and Gynecology, Bundelkhand Medical College, and associated hospital Sagar, Madhya Pradesh. All the maternal deaths were scrutinized for various aspects likely to be related to death such as age, locality of residence, antenatal care, admission death interval and the cause of death.Results: The maternal mortality ratio in the present study is 292.33/100,000 live births. There were 28 maternal deaths out of 9578 live birth during the study period. The majority of deaths occurred in the 20-30 age group. hemorrhage (32.14%) and hypertensive disorders (14.28%) are two most common direct cause of maternal deaths. 42.85% of maternal deaths occurred within the first twenty-four hours of admission. Post-operative and post abortal sepsis, amniotic fluid embolism and pulmonary embolism are other direct causes. Indirect causes of maternal deaths account for 21.42%. Severe anemia was the leading indirect causes of maternal deaths.Conclusions: Hemorrhage, hypertensive disorders, and anaemia remain the major cause of maternal deaths. Delay in decision making, provision of treatment and referral to tertiary centre contributed higher maternal mortality. This requires more efforts to recognize the direct and indirect causes of maternal deaths.


1970 ◽  
Vol 17 (2) ◽  
pp. 80-83 ◽  
Author(s):  
Marina Khanum ◽  
Fatema Ashraf ◽  
Humaira Sahrin

Eclampsia is the occurrence of one or more convulsion in association with the syndrome of pre eclampsia. It is relatively uncommon in developed countries where it complicates about one in every 200 deliveries. Eclampsia can be 20 times more common in developing countries and it probably accounts for more than 50,000 maternal deaths worldwide each year. Which anticonvulsant for women with eclampsia Evidence from the collaborative Eclampsia Trial lancet 1995, 345, 1445-63. The main objective of this study was to observe the clinical profile of antepartum eclampsia cases. The study was carried out with 100 cases that were selected randomly during year 2004. 58% of the patients were primigravida; among them 25% patients were in age group 15-14 years. About 95% patients were illiterate, low socio economic group, and in 53% patients' convulsion occurred in 32-37 weeks of pregnancy.Among 100 patients, 71 patients had normal vaginal delivery and 25% patients needed Caesarean section. Maternal mortality rate was 2%, perinatal mortality was 38%. Perinatal mortality was higher in vaginal group (12%) than LSCS group (7%). doi: 10.3329/taj.v17i2.3450 TAJ 2004; 17(2): 80-83


2019 ◽  
Vol 31 (2) ◽  
pp. 50-53
Author(s):  
Most Merina Akhter ◽  
Mst Shaheen Nawrozy ◽  
Abu Hena Mostafa Kamal ◽  
Sahela Jesmin

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


2013 ◽  
Vol 7 (2) ◽  
pp. 79-81 ◽  
Author(s):  
Dr Mahbuba ◽  
Irin Parveen Alam

Rupture uterus is a rare and often catastrophic condition. It is associated with a high incidence of fetal and maternal mortality and morbidity. Our objective in this study is to determine incidence, etiology, trend, management, maternal and fetal outcome of uterine rupture in Faridpur Medical College Hospital. This is a prospective cross-sectional study  of patients with ruptured uterus from the period of January 2011 to December 2011 admitted at Faridpur Medical College Hospital. All the cases of ruptured uterus who were either admitted with uterine rupture or who developed it  in hospital were included in the study. Patients having ruptured uterus due to congenital anomaly were excluded from  the study. Patients were initially assessed in labour ward, relevant sociodemographic data, previous antenatal and  surgical history recorded. Ways of management, maternal and fetal outcome were taken for analysis. There were 30 cases of ruptured uterus out of total 3606 deliveries (including 1809 caesarian sections) over a one year time period, with a prevalence of 0.83%. The most common age group was 21-30 years. A majority of patients 16(53.3%) were cases of unscarred uterus presenting with rupture; the common cause of rupture in scarred uterus was injudicious use of oxytocin (13,43.33%). Proper antenatal care, appropriate counseling of patients with history of previous caesarian section for hospital delivery, training of skilled birth attendant can reduce mortality and morbidity due to rupture uterus. DOI: http://dx.doi.org/10.3329/fmcj.v7i2.13504 Faridpur Med. Coll. J. 2012;7(2):79-81


2014 ◽  
Vol 23 (Number 2) ◽  
pp. 9-14
Author(s):  
T Begum ◽  
Md. Murshed ◽  
T Akter ◽  
S S Duza ◽  
S Shahnaz

Pseudomonas is one of the most common gram negative microorganism identified in the clinical specimen of hospital indoor and outdoor patients. This was a retrospective study done among the patients attending Holy Family Red Crescent Medical College Hospital during January to December 2012. A total 457 patients with Pseudomonas were isolated of which 274 (60%) as indoor patient and 183 (40%) was outdoor patients. Males predominated being 251 (55%) while 206 (45%) was females. Majority of the patients were in the age group of 15-29 years. Urine was the most common specimens (70%) and others (pus, swab, blood etc) were (30%). Throughout our 12 years observation , it was found that imipenem and meropenem are the most effective drugs against Pseudomonas followed by amikacin and ciprojloxacin.


Author(s):  
Anubha Manu Prasad ◽  
. Manju Agrawal ◽  
Ankit Laddha

Background: The objective of the present study was to examine the etiological factors, both maternal and fetal, that caused IUFD. Methods: It was a hospital based prospective observational study conducted in the Department of Obstetrics and Gynaecology at Jhalawar Medical College from January 2020 to December 2020. 120 cases of IUFD of ?24 weeks of gestation or foetuses weighing ?500 gramswere included in the study. Results: The incidence of IUFD was 37.8/1000 total birth. IUFD occurredmainly in 25-35yrs age group (55%), unbooked cases (70%),multigravida (59.2%), preterm (<37 weeks of gestation). The risk factors were PIH (49.2%), infections (9.2%), hypothyroidism (5%), Rh negative with hydrops fetalis (5%),GDM (4.2%), chronic hypertension (2.5%), previous H/O LBW (2.5%), H/O prior stillbirth (5%), hyperthyroidism (1.7%), oligohydramnios (46.7%), APH (20.8%) and congenital fetal anomalies (19.2%). Conclusion: IUFD rate still remains high. Therefore, regular ANC check up and early identification of risk factors like PIH, anaemia, infections, genetic counselling and timely referral to well equipped centre may help prevent IUFD and maternal mortality and morbidity. Keywords: IUFD, ANC, Preterm


KYAMC Journal ◽  
2018 ◽  
Vol 9 (3) ◽  
pp. 120-124
Author(s):  
Fatema Begum ◽  
Bedoura Sharmin ◽  
Umme Hafsa Zakia ◽  
Farhana Dewan ◽  
SM Asaduzzaman

Background: Eclampsia is a leading cause of maternal mortality and morbidity and adverse neonatal outcome. Healthcare system must be enhance to improve fetomaternal outcome.Objective: To find out the proportion and fetomaternal outcome of eclampsia.Materials and Methods: A cross sectional descriptive study was conducted to assess the fetomaternal outcome of eclampsia. The study was carried out at the Eclampsia unit, Dhaka Medical College Hospital, Dhaka over aperiod of six months from 1st July 2008 to 31st December 2008. A total of 48 patients with diagnosis of antepartum and intrapartum eclampsia were consecutively taken in the study. The test statistics used to analyse the data were descriptive statistics.Results: About 7% of patients developed acute renal failure,16.7% CVA,14.6% HELLP syndrome and 39.6% pulmonary oedema. The mean hospital stay was 9.5 ± 3.3 days. Majority (93.8%) of the patients recovered while 6.3% died. Twenty-seven (54.2%) neonates had to be referred to neonatal intensive care unit for better management. Of them 24 recovered following resuscitation. The mean weight of baby was 2.2±0.3 kg.Conclusion: Eclampsia is still a major cause of maternal mortality and morbidity in Bangladesh. Monitoring of high-risk patients may reduce the complication rate.KYAMC Journal Vol. 9, No.-3, October 2018, Page 120-124


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