Obstetric and neonatal outcome in women with a history of recurrent miscarriage at tertiary care hospital, Karnataka: a retrospective cross-sectional study

Background: When clinical pregnancy is established, the risk of spontaneous pregnancy loss is ~12-14%, and therefore the incidence of Recurrent Pregnancy Loss (RPL) by chance alone would be in the order of 0.35%. It occurs in 0.5-3% of women. The objective of this study was to evaluate the obstetric outcome in pregnancies with history of one or more abortions.Methods: It is a retrospective cross-sectional study done at Obstetrics and Gynecology Department, Dr. B. R. Ambedkar Medical College and Hospital, Bangalore. Record review of cases was done from January 2005 to December 2009. Inclusion criteria were pregnancies with history of previous abortions.Results: There were 400 cases with previous history of abortions. There were 266 (66.4%) booked cases while 134 (33.5%) were unbooked cases. 272 (68.0%) patients crossed viable period of pregnancy (more than 28 weeks). Around 56 (14.0%) cases had repeat abortions, 276 (69.0%) cases underwent vaginal delivery and 124 (31.0%) underwent cesarean section. Almost 91 (22.8%) of Babies were low birth weight while others were above 2.5 kg. There were 52 (13.0%) preterm babies and 28 (7.0%) Intrauterine demise of fetuses.Conclusions: Patients with previous history of abortions are at increased risk of adverse maternal and perinatal outcome.

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The correlation between colposcopy, cervical cytology and histopathology in the diagnosis and management of cervical lesions: a cross sectional study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20202539 ◽

2020 ◽

Vol 9 (7) ◽

pp. 2729

Author(s):

Pooja Gupta ◽

Mariyam Faruqi ◽

Subrat Chandra ◽

Sameer S. Shah ◽

Rupita Kulshreshtha

Keyword(s):

Tertiary Care ◽

Cross Sectional Study ◽

Cervical Cytology ◽

Care Hospital ◽

Sectional Study ◽

Cervical Lesions ◽

Cross Sectional ◽

Diagnosis And Management ◽

History Of ◽

Excellent Tool

Background: The study was undertaken to see the correlation between cervical cytology, histopathology and colposcopy in the diagnosis and management of various cervical lesions.Methods: It is a cross sectional study conducted at a tertiary care hospital in Mumbai, in the department of obstetrics and gynecology from February 2007 to March 2008. A total 55 sexually active women were enrolled for the study who belonged to age group greater than 20 years with history of chronic leucorrhoea or post-coital bleeding/spotting, intermenstrual bleeding/spotting or examination findings of erosion, an unhealthy cervix, a lesion bleeding on touch or an abnormal or suspicious Papanicolaou smear. These women then underwent cytology, colposcopy and cervical biopsy.Results: The accuracy of cytology when compared to colposcopy was 81.82%. The accuracy of colpo-histopathology was 83.6%. The combined accuracy was 76.36%.Conclusions: The simultaneous use of cytological studies and screening colposcopy has been shown to increase the cervical cancer detection. Colposcopy offers an excellent tool in the hands of a gynaecologist to evaluate the uterine cervix and it is not possible to develop this kind of perspective by any other method.

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Various presentations of preeclampsia at tertiary care hospital of Sindh: A Cross-Sectional Study

Current Hypertension Reviews ◽

10.2174/1573402115666191009120640 ◽

2019 ◽

Vol 15 ◽

Author(s):

Feriha Fatima Khidri

Keyword(s):

Hellp Syndrome ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Previous History ◽

Cross Sectional Study ◽

Severe Preeclampsia ◽

Care Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Mild Preeclampsia

Background: Preeclampsia is the multi-systemic hypertensive pregnancy disorder accompanied by proteinuria. Objectives: To determine the frequency of different presentations of preeclampsia in tertiary care hospital and find out its risk factors. Materials and Methods: Present study was hospital based cross-sectional study and conducted from 1st August 2015 to 31st July 2016 in Gynaecology and Obstetrics department, Liaquat University of medical and health sciences (LUMHS), Hyderabad after ethical approval. A total of 112 pre-eclamptic women were enrolled during the study period by non-probability consecutive sampling. Patients were divided on the basis of their presentations into mild preeclampsia, severe preeclampsia, antepartum eclampsia, intrapartum eclampsia, HELLP syndrome, postpartum preeclampsia, postpartum eclampsia and atypical preeclampsia/eclampsia. All the socio-demographic factors and clinical variables were noted. Frequency and percentage were calculated for categorical variable and mean/standard deviation (SD) for continuous variables. Results: Of the 112 preeclamptic women, 54.5% admitted with antepartum eclampsia, 12.5% with severe preeclampsia, 8.9% with atypical preeclampsia/eclampsia, 8% with mild preeclampsia, 8% with postpartum eclampsia, 3.6% with HELLP syndrome, 2.7% with intrapartum eclampsia and 1.8% with postpartum preeclampsia. Over all, majority of the patients were primigravida (57%), had gestational age >34 weeks at presentation (58.9%) and <7 antenatal visits (88.3%) during their pregnancy. Over all 17.8% had previous bad obstetrical event, 11.6% had previous history of preeclampsia and 64.3% had consanguineous marriages. Conclusion: Different presentations of preeclampsia may help obstetricians to rule out high risk pregnancies and provide antenatal care to patients earlier to prevent complications to both mother and fetus.

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Cross sectional study on prevalence and medication adherence of hypertension and diabetes in a tertiary care hospital in Karimnagar, India

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20181191 ◽

2018 ◽

Vol 7 (4) ◽

pp. 807

Author(s):

S. Sre Akshaya Kalyani ◽

Srihitha Pendota ◽

Abhinay Sharma Katnapally ◽

Dharanija Porandla ◽

Sandeep Bheemreddy

Keyword(s):

Medication Adherence ◽

Health Care Professionals ◽

Past History ◽

Tertiary Care ◽

Previous History ◽

Individual Case ◽

Cross Sectional Study ◽

Care Hospital ◽

Sectional Study ◽

Cross Sectional

Background: The study aimed to assess the prevalence of Hypertension (HTN), Diabetes mellitus(DM) and other diseases along with comorbid conditions, disease complications and also to assess medication adherence in a tertiary hospital in Karimnagar, Telangana, India.Methods: A Cross sectional study is performed by analysing a total of 500 patient’s individual case safety reports (ICSR). Prevalence of Hypertension and Diabetes along with most prescribed drugs are analysed. Medication adherence is analysed by using Morisky Medication adherence questionnaire scale (MMAS-4).Results: Patients with past history of DM, HTN and other diseases which was found to be 245 (49%) patients. Patients with highest disease prevalence were found to be with HTN (56.73%), DM (31.83%) followed by other diseases like asthma (8.57%), Cerebrovascular accident (4.89%) etc., Total of 66 Patients were ruled out with comorbid diseases. Patients with HTN+DM (47) were found to be highest followed by DM+HTN+CVA (4). MMAS-4 revealed 208 patients were using medication out of 245 patients with previous history. According to MMAS-4 most of the patients were with medium adherence (76). Prevalent drug used for HTN include Amlodipine and for DM Telmisartan+Hydrochlorthiazide.Conclusions: The study revealed that almost half of the admitted patients were with HTN and DM. The patients were counselled properly to adhere strictly to the prescription. Medication adherence to HTN and DM was found to be good in this study. Since the disease complications were also ruled out, the health care professionals are recommended to spread awareness on DM and HTN and disease management in order to control disease and improve health outcomes.

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Causes of mid trimester pregnancy loss in a tertiary care hospital

Journal of Shifa Tameer-e-Millat University ◽

10.32593/jstmu/vol3.iss2.76 ◽

2020 ◽

Vol 3 (2) ◽

pp. 64-69

Author(s):

Bushra Zardad ◽

Anisa Fawad ◽

Ayesha Ismail ◽

Shazia Mehreen ◽

Sadia Bibi

Keyword(s):

Pregnancy Loss ◽

Tertiary Care ◽

Relevant Information ◽

Management Plan ◽

Cross Sectional Study ◽

Care Hospital ◽

Second Trimester ◽

Cross Sectional ◽

Trimester Pregnancy ◽

Increased Risk

Introduction: Mid trimester of pregnancy is relatively a safe time of pregnancy with minimal and no complications. Mid trimester pregnancy loss constitutes 1 to 5 % of total miscarriages. The purpose of this study is to evaluate the causes of second trimester miscarriages so as to improve the outcome in future pregnancies. Materials & Methods: This was a prospective cross-sectional study. Demographic features, relevant information and risk factors were recorded in a predesigned proforma. Detailed history was followed by thorough clinical examination and appropriate investigations were advised. Results: Total number of miscarriages admitted in the unit over the period of two years were 336 and among them 30 patients presented with second trimester miscarriages (8.9%). The mean age of the patients was 31.4 years. In 19 patients (63.4%) there were identifiable causes for the miscarriage. 7 patients (23.33%) had fibroids in the uterus, 5 patients (16.67%) had bacterial vaginosis, 4 patients (13.33%) had cervical incompetence and in 3 patients (10%) there were congenital abnormalities in the uterus. Conclusion: Patients with second trimester pregnancy loss are at significantly increased risk (10 times more likely) for recurrent second trimester loss. In 50 to 70% of patients no cause can be identified. After single loss there is 80% chance of successful pregnancy outcome in future. Even after two and three mid trimester losses still there is 60% chance of alive pregnancy next time, so thorough evaluation and management plan is needed to prevent this mishap in future pregnancies.

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Prevalence of Diabetes and Dyslipidemia in Hypertensive Young Adults in a Tertiary Care Centre in Nepal, a Cross Sectional Study

Journal of Institute of Medicine ◽

10.3126/jiom.v42i2.37530 ◽

2020 ◽

Vol 42 (2) ◽

pp. 21-25

Author(s):

Kamal Sharma Lamsal ◽

Keshab R Neupane ◽

Niranjan Acharya ◽

Dinesh K Lamsal ◽

Niraj Karmacharya ◽

...

Keyword(s):

Tertiary Care ◽

Fasting Blood Glucose ◽

Cardiovascular Complications ◽

Cross Sectional Study ◽

Care Hospital ◽

Sectional Study ◽

Tertiary Care Centre ◽

Cross Sectional ◽

Hypertensive Patients ◽

Increased Risk

Introduction Diabetes mellitus (DM) and lipid disorders (LD) in hypertensive patients are associated with increased risk of cardiovascular complications requiring close follow-up and more aggressive treatment. Hence, the present study was done to study the prevalence of diabetes and dyslipidemia in young hypertensive patients i.e. <40 years in a tertiary care hospital, Nepal. MethodsThis is a hospital based cross-sectional study carried out in Civil Service Hospital, Kathmandu. Study included 165 patients of <40 years who had hypertension, either newly diagnosed or undergoing antihypertensive treatment from September 2018 to September 2019. Blood pressure was measured two times on right upper arm in sitting position at interval of 30 minutes and the average was taken. Fasting Lipid Profile and Fasting Blood Glucose was measured after 12 hours of fasting and the prevalence of dyslipidemia and diabetes were analyzed from the data collected. All calculations and statistical analyses are processed by the SPSS 25.0. ResultsAmong 165 patients included, majority of patients, 107 (64.8%) were among 31-39 years, followed by 53 (32.1%) patients among 21-30 years. In total, 98 (59.4%) were male and 67 (40.6%) female. The prevalence of diabetes was 24 (14.5%) and pre-diabetes was 49 (29.7%). The prevalence of dyslipidemia was 125 (75.6%), high triglyceride being the most common disorder followed by low HDL in 87 (52.1%). Elevated total cholesterol was found in 53 (32.1%) patients and 48 (29%) had high LDL cholesterol level. ConclusionA high prevalence of diabetes, pre-diabetes and dyslipidemia was observed in the hypertensive patients <40 years of age.

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Acceptance of Vaginal Birth After Caesarean Section Trial in Shree Birendra Hospital, Kathmandu, Nepal: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.5781 ◽

2021 ◽

Vol 59 (233) ◽

Author(s):

Ratna Khatri ◽

Arju Chand ◽

Manish Thapa ◽

Sumana Thapa ◽

Shailaja Khadka

Keyword(s):

Cesarean Section ◽

Tertiary Care ◽

Previous History ◽

Cross Sectional Study ◽

Vaginal Birth ◽

Care Hospital ◽

Sectional Study ◽

Vaginal Birth After Cesarean ◽

Cross Sectional ◽

Trial Of Labor

Introduction: The rate of primary cesarean section is on the rising trend. Vaginal birth after cesarean section can be an alternative to reduce cesarean section worldwide. Antenatal examination and intrapartum monitoring are the most important factors for a vaginal birth after a cesarean section. This study aims to determine the acceptance of vaginal birth after cesarean section trial in a tertiary care hospital in Nepal. Methods: This is a descriptive cross-sectional study carried out in Shree Birendra Hospital, Kathmandu, Nepal, from March 2019 to March 2020. All pregnant women with a previous history of cesarean section meeting Royal College of Obstetrics and Gynecology criteria were included. A trial of labor was conducted on the patients who accepted vaginal birth after cesarean section. Results: A total of 85 cases with previous lower section cesarean section were included in the study. Out of which, 75 (88.2%) refused vaginal birth after cesarean section, and only 10 cases (11.8%) accepted to undergo a trial of labor. Five women (50%) had a successful vaginal birth. Complications were less among the vaginal birth after cesarean section group than the repeat cesarean section group. There was no maternal and neonatal mortality. Conclusions: The acceptance of vaginal birth after cesarean section is very low in this study. No complications were observed among vaginal birth after cesarean section in our study.

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