scholarly journals A study to know clinical characteristics and outcome of obstetrics patients requiring ICU admission

2018 ◽  
Vol 7 (7) ◽  
pp. 2639
Author(s):  
Pratibha Garg ◽  
Urmila Tripathi
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Good Health ◽  
Health Care Team ◽  
Severe Anaemia ◽  
Hypertensive Disorder ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Number Of Patients ◽  
Maternal Morbidity And Mortality

Background: Pregnancy poses unique consideration for critical care and it is imperative that obstetrician and other members of health care team have a working knowledge of these factors because these are women are usually young and in good health, their prognosis should be better than that of many other patients admitted to an intensive care.Methods: The present study was conducted in the Department of Obstetrics and Gynaecology, Gaja Raja Medical College and associate Kamla raja Hospital, Gwalior in the ICU from Oct. 14 to Oct. 15.Results: 678 obstetric women were admitted into the ICU of Kamla Raja Hospital, over a period of 1 year study period. Maximum number of patients belong to age group 21-25 years (54.8%), 398 (58.7%) patients were uneducated, 343 (50.59%) came directly to Kamla Raja Hospital. 362 (53.39%) belongs to urban area. The mean length of stay in ICU was 3 days. Maximum number of patients were postpartum 580 (85.55%). According to mode of delivery maximum number of patients 348 (51.33%) underwent LSCS. Most common obstetric indication for admission in ICU was hypertensive disorder of pregnancy 472 (69.61%). Most common medical indication was severe anaemia 128 (18.87%). Various type intervention like pulse oxymetry, O2 inhalation, BT, nebulisation and ventilation were done in ICU according to patients need. 43 maternal death happened during the study period with most common cause was cardiorespiratory arrest 9 (1.32%) and pulmonary edema 8 (1.17%).Conclusions: Establishment of a dedicated obstetric ICU at tertiary care centre with knowledge familiarity, experience and expertise of an obstetrician and a special team would be best place to monitor and treat the critically ill obstetric patients which will reduce the maternal morbidity and mortality.

scholarly journals Eclampsia: a retrospective study in a tertiary care centre

2017 ◽  
Vol 6 (8) ◽  
pp. 3604
Author(s):  
Mohana Dhanapal ◽  
Subha Sivagami Sengodan ◽  
Praveena Murugesan
Keyword(s):  
Retrospective Study ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Intrauterine Death ◽  
Tertiary Care Centre ◽  
Maternal Deaths ◽  
Medical College ◽  
Maternal Morbidity And Mortality ◽  
Late Referral

Background: This study was done to analyse the maternal mortality, morbidity and fetal outcome in eclampsia complicating pregnancy.Methods: This study was conducted in Government Mohan Kumaramangalam Medical College and Hospital, Salem. It was a retrospective study from May 2016 to May 2017.Results: Majority were referral 82.8%. 78.8% were in the age group of 20-30 years. Primi gravida was the commonest sufferer. In our study 67.02% had antepartum eclampsia and 31.2% had postpartum eclampsia. Only 1.8% patients had intrapartum eclampsia. While taking gestational age majority were preterm. Regarding mode of delivery 61.3% were delivered by LSCS. 29.2% of patients had pulmonary edema which was the commonest complication followed by Hellp syndrome (17.7%), Acute renal failure (10.6%), Cardiovascular accident (8.8%). There were 9 maternal deaths due to eclampsia (8.3%). Preterm delivery and Low birth weight were higher in eclamptic patients. Preterm birth occurred in 67.17% of patients. Intrauterine death occurred in 8 patients. Still birth occurred in 10.6% of patients.Conclusions: High maternal morbidity and mortality has been attributed to the late referral, delay in the timely management of preeclampsia. So coordinated efforts of medical and paramedical staffs and health education is needed to fight against eclampsia.

EPIDEMIOLOGICAL AND ETIOLOGICAL PROFILE OF IUFD: A PROSPECTIVE STUDY AT TERTIARY CARE CENTRE

2021 ◽  
pp. 31-34
Author(s):  
Deepali Jain ◽  
Uma Jain ◽  
Japhia David
Keyword(s):  
Gestational Age ◽  
Fetal Death ◽  
Health Centre ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
National Level ◽  
Health Indicators ◽  
Fetal Mortality ◽  
Hypertensive Disorder ◽  
Tertiary Care Centre

Introduction:- IUFD occurrence without warning in a previously normal pregnancy is really a challenge to obstetrician and distressing situation for parents. It becomes crucial to identify specic probable cause of fetal death, to prevent the re-occurance and get the corrective measures. Prenatal mortality is still of one of the top most health indicators in measuring the quality and impact of health services in developing countries Still birth is a useful index to measure the values of antenatal and intranatal care. To decrease the fetal mortality rate, evaluation, documentation and audit of the etiology and the associated risk factors for stillbirth is required. Material and method :- The present study aims at studying the various causes related to IUFD. Prospective observational study conducted on 112 patients at Department of Obstetrics and Gynaecology, Kamla Raja Hospital, G.R. Medical College and J.A. Group of Hospitals, Gwalior (M.P.) for 18 months. All those cases who were diagnosed as intrauterine dead fetus at the time of admission with gestational age >24 weeks pregnancy were included in the study. All those investigation available at the centre of mother and father were noted and details were taken. Epidemiological evaluation of causes of fetal death was done. Record of the method of induction and mode of delivery taken. RESULTS :-Total 112 cases found during the study period were included . We found maximum cases unbooked - 71.43%, which were mainly emergency admissions. Majority of the IUFD cases- 77.67% were found to lie in the age group of 20-30 yrs, most of them were primigravida 62.5%., maximum cases of IUFD were of the gestational age 31-35 weeks- 47.32%. Hypertensive disorder of pregnancy- 23.3 % cases were found to be the major associated cause followed by Antepartum Haemorrhage 11.5%, Severe anaemia 15.1%, diabetes- 14.2% jaundice - 9.8%. congenital anomaly- 9.8%. Oligohydromnios- 8.9% and IUGR were also found to be associated with IUFD, forming an indirect reason. 39.29% cases were unexplained. 86.6% cases delivered vaginally. 10.7% cases had to undergo LSCS and only 2.68% cases underwent laparotomy for rupture uterus. 11.61% cases were of macerated IUFD baby indicating long term neglected IUFD. 39.78% and 38.39% IUFD were of 2.0-2.5 kg and 1.5-2.0 kg. This show strong corelation with LBW and IUGR. CONCLUSION:- Unexplained cases, hypertensive disorder, anemia and diabetes were the major causes for IUFD. In spite of advances in diagnostic and therapeutic modalities a major cause of fetal death remain unexplained because of poverty, illiteracy, unawareness and inaccessibility of a health centre. Undoubtedly, continued surveillance of stillbirth rates is wanted for both high- and low-risk pregnancies at a state and national level.

scholarly journals Eclampsia: Feto-Maternal Outcomes in A Tertiary Care Centre in Eastern Nepal

2016 ◽  
Vol 54 (201) ◽  
pp. 24-28 ◽  
Author(s):  
Sita Ghimire
Keyword(s):  
Perinatal Death ◽  
Early Recognition ◽  
Tertiary Care ◽  
Obstetric Care ◽  
Maternal Outcomes ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Maternal Morbidity And Mortality ◽  
Common Causes

Introduction: Eclampsia is a preventable and treatable cause of maternal morbidity and mortality with poor feto-maternal outcome in developing countries. Despite development in the level of health education expertise in human resources and institutional obstetric care in our country, the delay in early recognition of the problem, transportation to proper health facility and getting proper expert care are major hurdles to reduce complications. Therefore we decided to study feto-maternal outcomes in our setting.Methods: A retrospective cross-sectional hospital based study carried out in Nobel Medical College, Biratnagar, from 17th June 2014 to 16th June 2015. Details and data obtained from Medical Record Section were analysed. All patients with eclampsia were included and fetomaternal outcomes measured in terms of complications. Simple descriptive statistical method was applied for analysis.Results: Among 8,066 deliveries, 112 had eclampsia with incidence of 13.8/1000 deliveries. Majority (41%) were of <19 years of age. Above 90% were unbooked. Aoubt 63.4% were primiparas and 83% had antepartum eclampsia. Eclamptic fits were more common (41.6%) in 37-40 weeks period of gestation. Fits to delivery interval was more than six hours in 89.1% women and 69.3% women underwent caesarean delivery. About 18.9% women developed eclampsia related complications. Common causes of maternal deaths (5.36%) were pulmonary edema, aspiration pneumonia, cerebrovascular accidents and HELLP syndrome. Perinatal death was nine percent.Conclusions: Although the obstetric care facilities are improving with time, the feto-maternal outcomes are still poor in our country. Therefore early recognition and proper management are vital to tackle this challenge. Keywords: eclampsia; fetomaternal outcomes; retrospective analysis. | PubMed

scholarly journals A comparative study of oral nifedipine and intravenous labetalol in control of acute hypertension in severe pre-eclampsia and eclampsia

2018 ◽  
Vol 7 (2) ◽  
pp. 719
Author(s):  
Yogita Gavit ◽  
Deepika Sharma ◽  
Pratibha V. Dixit
Keyword(s):  
Sample Size ◽  
Severe Hypertension ◽  
Tertiary Care ◽  
Hypertensive Disorder ◽  
Tertiary Care Centre ◽  
Acute Hypertension ◽  
Maternal Morbidity And Mortality ◽  
Life Threatening ◽  
Hypertensive Disorder Of Pregnancy ◽  
Labour Room

Background: This study was conducted to compare oral Nifedipine and intravenous Labetalol in control of acute hypertension in severe pre-eclampsia and eclampsia. This study was observational study with 80 sample size in which 40 sample size treated with intravenous Labetalol and other 40 sample size treated with oral Nifedipine. The maternal and perinatal outcome in two groups sample size with oral Nifedipine and intravenous Labetalol compared and found that nevertheless these results do establish oral Nifedipine as an alternative to IV Labetalol in lowering BP in acute severe hypertension. In summary oral Nifedipine may be preferable as it has a convenient dosing pattern orally.Methods: The present study was conducted in tertiary care centre Mumbai from June 2016 to October 2016. All pregnant woman diagnosed with acute hypertension in severe pre-eclampsia and eclampsia in labour room were enrolled in the study.Results: In the present study oral Nifedipine as an alternative to IV Labetalol in lowering BP in acute severe hypertension. In summary oral Nifedipine may be preferable as it has a convenient dosing pattern orally.Conclusions: A hypertensive disorder of pregnancy is one of the life-threatening complication encountered in obstetrics and globally is major cause of maternal morbidity and mortality. Management of acute severe hypertension in pregnancy is a challenging task. Present study compares the efficacy of oral Nifedipine and IV Labetalol in reaching the therapeutic goal. From the results of this study we can well conclude that oral Nifedipine is more efficacious.

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 Retrospective study of massive obstetric haemorrhage and its materno fetal outcomes in a tertiary care centre

2017 ◽  
Vol 6 (2) ◽  
pp. 554
Author(s):  
Anju Padmasekar ◽  
Shyamala Jothy
Keyword(s):  
Retrospective Study ◽  
Tamil Nadu ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Significant Risk ◽  
Perinatal Outcomes ◽  
Tertiary Care Centre ◽  
Fetal Outcomes ◽  
Medical College ◽  
Obstetric Haemorrhage

Background: Massive obstetric haemorrhage is defined as blood loss of >1500 ml, or a decrease in haemoglobin>4 gm/dl or acute transfusion requirement of >4 units of blood when need for further transfusion is foreseeable. The purpose of this study is to analyse the demographic, medical and obstetric risk factors for massive obstetric haemorrhage and it’s materno fetal outcomes.Methods: Criteria for patient selection was all patients who had an acute obstetric haemorrhage necessitating a transfusion of >4 units of blood at a stretch when there was a need for more. This is a retrospective study conducted for a period of one year January to December 2015. Data regarding all cases under study during this period was obtained from Medical Records Department with prior permission. This study was conducted in the Department of Obstetrics and Gynecology, Government Raja Mirasudhar Teaching Hospital, Thanjavur Medical College, Tamil Nadu. Maternal outcomes like mode of delivery, rate of hysterectomy, postpartum complications, maternal mortality and fetal outcomes like intra uterine death, still birth and preterm birth were analysed.Results: The rate of massive obstetric haemorrhage in our hospital during the study period was 5.7/1000 births. Massive obstetric haemorrhage contributed to 25% of all maternal deaths in 2015. Atonic PPH was the commonest cause. Multiparity and previous caesarean section were identified to be significant risk factors.Conclusions: We found an increased association of massive obstetric haemorrhage with multiparity, caesarean sections and pre-eclampsia. Atonic PPH was the commonest cause. Massive obstetric haemorrhage had contributed significantly to adverse maternal and perinatal outcomes.

scholarly journals Prevalence of oral mucosal lesions in a tertiary care centre: one-year prospective study

2020 ◽  
Vol 6 (9) ◽  
pp. 1704
Author(s):  
Smruti Milan Tripathy ◽  
Poonji Gupta ◽  
Akshay Jain ◽  
Probal Chatterji
Keyword(s):  
Oral Cavity ◽  
Early Stage ◽  
Tertiary Care ◽  
Outpatient Department ◽  
Research Centre ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Number Of Patients ◽  
Malignant Lesions ◽  
One Year

<p class="abstract"><strong>Background:</strong> Lesions of the oral cavity are very common among the general population and account for a significant number of patients in the outpatient department of otorhinolaryngology. The lesions of oral cavity can cause varied symptoms like pain, dysphagia, and difficulty in speaking. The lesions can range from simple benign conditions to life threatening malignancies.</p><p class="abstract"><strong>Methods:</strong> This study was conducted in the department of otorhinolaryngology, Teerthanker Mahaveer Medical College and Research Centre from January 2019 till December 2019. All the 256 patients who presented to the outpatient department with lesions in the oral cavity during the given time period were included in the study after getting informed and written consent.  </p><p class="abstract"><strong>Results:</strong> Aphthous ulcers were the most common lesion (18.7%) found in this study. Buccal mucosa (50%) and anterior 2/3<sup>rd</sup> of tongue (34.3%) were the most common sites involved. Total of 204/256 (79.6%) patient had some form of addiction which included both smoked and smokeless form of tobacco as the most common type of addiction. Among the tobacco smokers, 24/80 (30%) had pre malignant and malignant lesions while among tobacco chewers 37/76 (48.6%) had pre malignant and malignant lesions.</p><p class="abstract"><strong>Conclusions:</strong> Lesions of the oral cavity are common among Indian population due to high prevalence of tobacco addiction. A thorough history taking and examination can detect premalignant and malignant lesions at an early stage, so that timely treatment can reduce the mortality rates in such patients.</p>

Study of Hemoptysis in a Tertiary Care Center of Province 1: Causes and Recurrences

2020 ◽  
Vol 5 (2) ◽  
pp. 1050-1054
Author(s):  
Ram Hari Ghimire ◽  
Ashima Ghimire ◽  
Rupesh Kumar Shreewastav ◽  
Sushil Yadav ◽  
Bidesh Bidesh Bista
Keyword(s):  
Diagnostic Yield ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Number Of Patients ◽  
Chest Clinic ◽  
Telephone Calls

Introduction: Hemoptysis is a common but distressing and alarming symptom in a patient. Data related to detail clinical profile and follow up study of hemoptysis are lacking. Objective: This study was carried out to see the clinical profile of patients with hemoptysis and to study the recurrences in tertiary care centre of province 1 within the study period. Methodology: This was a prospective observational study conducted at the department of Pulmonary, Critical Care and Sleep Medicine of Nobel Medical College and Teaching Hospital, Biratnagar, Nepal. The study was carried out between 30th January 2017 to 1st February 2020. For follow up of recurrences of hemoptysis, the patients were asked for regular chest clinic follow up and regular telephone calls made to the patients, in case, patients could not attend the chest clinic for any reason. Results: A total of 150 patients were enrolled over the last 3 years. Among them 75% were male. The maximum number of patients (27%) were between 31-40 years of age group. Old sequelae of pulmonary tuberculosis (PTB) (32%) and bronchiectasis (28%) were the commonest cause of hemoptysis. Lung cancer (10%) and active PTB (10%) were other causes of hemoptysis. CT scan of the chest provided the highest (84%) diagnostic yield. Most of the cases were having mild hemoptysis (50%). 17% of the patients in our study had recurrences of hemoptysis. Conclusion: Old PTB sequelae with bronchiectasis (fibrobronchiectasis) were the commonest cause of hemoptysis. Conservative management worked most effectively in controlling hemoptysis, if used properly.

scholarly journals Retrospective study on the effect of Body Mass Index (BMI) on maternal and neonatal outcome

2018 ◽  
Vol 7 (3) ◽  
pp. 1070
Author(s):  
Pooja M. Shah ◽  
Anagha K. Chhatrapati ◽  
Pooja K. Bandekar
Keyword(s):  
Retrospective Study ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Maternity Hospital ◽  
Hypertensive Disorder ◽  
Tertiary Care Centre ◽  
Increased Risk ◽  
Nicu Admission ◽  
Prolonged Hospital ◽  
High Bmi

Background: Obesity has become health problem worldwide. Prevalence of obesity has increased globally with more incidence observed in female than male. Objective of present study was assessment of maternal outcome in term of associated medical disorder and mode of delivery and assessment of neonatal outcome.Methods: The retrospective study performed at Nowrosjee Wadia Maternity Hospital, a tertiary care centre between 1st January 2017 to 30th November 2017. Total 64 patients were enrolled. Maternal and neonatal outcomes were studied in all nulligravida women with high BMI using logistic regression adjusted for confounding variable.Results: Women with high BMI were at increased risk of hypertensive disorder of pregnancy (40.65%), diabetes (7.81%), induction of labour (62.5%), instrumental delivery (14.06%), operative intervention (42.18%), prolonged hospital stay and NICU admission (26.56%).Conclusions: This study observes increase risk of adverse outcome in pregnant women with high BMI.

scholarly journals Maternal Serum Uric Acid as a Predictor of Severity of Hypertensive Disorders of Pregnancy: A Prospective Cohort Study

2019 ◽  
Vol 15 (2) ◽  
pp. 154-160
Author(s):  
Naina Kumar ◽  
Amit K. Singh
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid ◽  
Gestational Hypertension ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Maternal Serum ◽  
Hypertensive Disorder ◽  
Hypertensive Disorders Of Pregnancy ◽  
Tertiary Care Centre ◽  
Hypertensive Disorder Of Pregnancy

Objective: To assess the relationship between maternal serum uric acid and severity of Hypertensive disorders of pregnancy in a rural tertiary care centre. Materials and Methods: Present study was conducted in Obstetrics and Gynaecology department of rural tertiary care centre of Northern India over seven months (October 2016-May 2017) on 110 women admitted with a Hypertensive disorder of pregnancy (Gestational hypertension, Preeclampsia, Eclampsia) at ≥;34 weeks gestation. Maternal serum uric acid levels were compared in three groups in relation to disease severity, mode of delivery, maternal outcome. Results: Of total 110 women with a Hypertensive disorder of pregnancy; 35 (31.81%) had Gestational Hypertension, 49 (44.54%) preeclampsia and 26 (23.63%) had eclampsia. Mean±SD values for serum uric acid were 5.47±1.93 mg/dl in women with Gestational Hypertension; 6.72±2.15 mg/dl in Pre-eclampsia and 8.71±2.97 mg/dl in the eclamptic group. Of 110 women 34(97.14%) with gestational hypertension, 27(55.10%) with pre-eclampsia and one (3.85%) with eclampsia remained stable in post-partum period, 17 (34.69%) women with severe pre-eclampsia and 15 (57.69%) with eclampsia required intensive care in postpartum period and one (2.86%) women with gestational hypertension, five (10.20%) with pre-eclmapsia and ten (38.46%) with eclampsia required ventilator support and high dependency unit care. Of these 16 women with the severe disease, ten succumbed to death. Also, in women with serum uric acid,>6mg/dl, most common mode of delivery was a lower segment cesarean section (50.90%). Conclusion: Significant correlation was observed between maternal serum uric acid, disease severity and maternal outcome.

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