scholarly journals Anemia in antenatal patients and its outcome: an experience in tertiary care centre

2018 ◽  
Vol 7 (8) ◽  
pp. 3263
Author(s):  
Shabnam Ara ◽  
Cimona Lyn Saldanha ◽  
Insha Khan
Keyword(s):  
Vaginal Delivery ◽  
Serum Ferritin ◽  
Peripheral Blood ◽  
Post Partum ◽  
Tertiary Care ◽  
Deficiency Anemia ◽  
Normal Vaginal Delivery ◽  
Blood Picture ◽  
Co Morbidity ◽  
Term Delivery

Background: Anemia is the most common hematological abnormality detected during the pregnancy and forms a major problem in affecting the females especially in the developing countries.Methods: All pregnant females with clinical evidence of anemia without any other co-morbidity attending the antenatal clinic were included in the study. Patients were studied in terms of the age, parity, inter-pregnancy spacing, type of pregnancy, post-partum outcome along with the biochemical tests like peripheral blood picture, hemoglobin estimation, and serum ferritin levels.Results: Total no. of patients was 500, age ≤20 years were 60 and ≥35 years were 107, mild anemia (10-10.9 gm%) 160, moderate anemia (7-10 gm%) 250, severe anemia (<7 gm%) 90. Normal vaginal delivery with medio-lateral episiotomy was done in 385 patients, normal vaginal delivery without medio-lateral episiotomy in 35 while lower-segment caesarean section in 80 patients. Pre-term delivery was done in 95 patients, post-term delivery in 20. 90 babies delivered were low-birth weight (<2500 gm), antepartum hemorrhage was seen in 10 patients while 20 patients had Post-partum hemorrhage.Conclusions: The present study concludes that anemia is still rampant in the society especially in pregnant women. The main cause of anemia-in-pregnancy is still the iron deficiency anemia. The peripheral blood picture, hemoglobin estimation, and serum ferritin levels form the basic pillars in the evaluation of the etiology and type of anemia. The multiple government sponsored facilities are to be made available to each pregnant female and that requires community, government as well as healthcare professional’s participation.

scholarly journals Role of ferric carboxymaltose in the treatment of postpartum anemia in a tertiary care hospital in Andhra Pradesh

2021 ◽  
Vol 10 (10) ◽  
pp. 3889
Author(s):  
Kirtan Krishna ◽  
Achint Krishna ◽  
Divya Teja G. N.
Keyword(s):  
Iron Deficiency ◽  
Patient Compliance ◽  
Iron Deficiency Anemia ◽  
Serum Ferritin ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Deficiency Anemia ◽  
Ferric Carboxymaltose ◽  
Care Hospital ◽  
Parenteral Iron

Background: Postpartum iron deficiency anemia is common in India as a consequence of postpartum hemorrhage.  Recent studies have evaluated the use of parenteral iron as a better tolerated treatment modality. Compared with oral iron supplements, parenteral iron is associated with a rapid rise in serum ferritin and hemoglobin and improved maternal fatigue scores in the postpartum period.  Parenteral iron may be considered for the treatment of postpartum anemia. The objective of the study was to evaluate the efficacy, safety, and tolerability of intravenous ferric carboxymaltose, in women with postpartum anemia.Methods: A clinical observational study was undertaken in a tertiary care hospital,  50 women within six weeks of delivery with Hb ≥6 gm/dl and ≤10 gm/dl received 1000 mg/week,  over 15 minutes or less, repeated weekly to a calculated replacement dose (maximum 2500 mg) . Hemoglobin and serum ferritin levels were recorded prior to treatment and on day 21 after completion of treatment.Results: Ferric carboxymaltose-treated subjects achieved a hemoglobin greater than 12 gm/dL in a short time period (21 days), achieve a hemoglobin rise of ≥3 gm/dL more quickly, and attain higher serum ferritin levels. It is also associated with better patient compliance, and shorter treatment period. Drug-related adverse events occurred less frequently with ferric carboxymaltose. The only noted disadvantage was that it is more expensive when compared to other iron preperations.Conclusions: Intravenous ferric carboxymaltose was safe and well tolerated with good efficacy and better patient compliance in the treatment of postpartum iron deficiency anemia.

scholarly journals Induction of labour and its feto-maternal outcome

2019 ◽  
Vol 8 (7) ◽  
pp. 2748
Author(s):  
Mridu Sinha ◽  
Shashi Bala Arya ◽  
Shashi Saxena ◽  
Nitant Sood
Keyword(s):  
Vaginal Delivery ◽  
Statistical Tests ◽  
Post Partum ◽  
Tertiary Care ◽  
Relative Effect ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Time Period ◽  
Increased Risk ◽  
One Year

Background: Induction of labour is an iatrogenic deliberate attempt to terminate the pregnancy in order to achieve vaginal delivery in cases of valid indication. It should be carefully supervised as it is a challenge to the clinician, mother and the fetus. Aim of this study was to find out common indications for IOL in a tertiary care teaching centre and its feto-maternal outcome.Methods: An institutional based retrospective observational study was conducted to describe the prevalence of labour induction and factors associated with its outcome, during the time-period of one year from January 2018 to December 2018, at SRMS IMS, Bareilly. Logistic regression analysis was employed to assess the relative effect of determinants and statistical tests were used to see the associations.Results: Most of the patients were primigravidas of younger age-group. Idiopathic oligohydramnios and postdatism were the commonest indications for induction of labour and Misoprost was the commonest drug used for it. Though majority had vaginal delivery, as the method was changed to combined method it was significantly associated with increased likelihood of LSCS. Similarly there was increased association with maternal cervico-vaginal tear / lacerations as the method was changed to combined type. However there were no association between post-partum hemorrhage, meconium stained liquor or fetal distress.Conclusions: Common indications for induction of labour were oligohydramnios and postdatism. Misoprost can be safely used for induction of labour without any increased risk for LSCS or any fetal / neonatal risks.

scholarly journals Severe anemia and adverse pregnancy outcome in a tertiary care hospital in North India

2018 ◽  
Vol 7 (2) ◽  
pp. 483
Author(s):  
Premlata Yadav
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Peripheral Blood ◽  
Tertiary Care ◽  
Significant Risk ◽  
North India ◽  
Deficiency Anemia ◽  
Care Hospital ◽  
Severe Anemia ◽  
In Pregnancy

Background: Anaemia is commonest medical disorder in pregnancy with 88% prevalence in India mainly due to ignorance, poverty and gender bias. 40-60% of maternal deaths in developing countries. According to the recent standard laid down by WHO anemia is present when the hemoglobin (Hb) concentration in the peripheral blood is less than 11 gm/dl. The most common cause of anemia in pregnancy is iron deficiency. Anemia is diagnosed by estimating the hemoglobin concentration and examining a peripheral blood smear for the characteristic red blood cell changes. The aim of the study was to determine the association between severe anemia, maternal and perinatal complications.Methods: Case control study was done in department of Obstetrics and Gynecology, Rajendra Institute of Medical Sciences Ranchi, India from February 2016 to July 2016. 100 pregnant women, admitted for delivery and having severe anemia were studied and compared with 100 non-anaemic women of similar demographic features. Maternal and perinatal complications were observed. Pearson, chi-square and Fischer exact tests were used to calculate significance of results.Results: Of the severely anaemic mothers, 36% babies were low birth weight (p=0.042) and 20% were small for gestational age (p = 0.026), as compared to 18% and 10% of controls, respectively.Conclusions: Severe maternal anemia carries significant risk of hemorrhage and infection in the mother. It is also associated with preterm birth, low birth weight.

scholarly journals Study of cases of post-partum hemorrhage after spontaneous vaginal delivery in labour room of obstetrics and gynecology department of tertiary care center, Ranchi, Jharkhand, India

2020 ◽  
Vol 9 (4) ◽  
pp. 1540
Author(s):  
Bratati Moitra ◽  
Bulllu Priya Oraon
Keyword(s):  
Blood Loss ◽  
Vaginal Delivery ◽  
Maternal Death ◽  
Post Partum ◽  
Care Center ◽  
Tertiary Care ◽  
Spontaneous Vaginal Delivery ◽  
Lower Middle Class ◽  
Threatening Condition ◽  
Labour Room

Background: Postpartum haemorrhage is one of the common causes of maternal death worldwide. Whenever the amount of blood loss from or into genital tract is 500 ml or more after delivery of baby or any amount of bleeding that makes patients haemodynamically unstable is post-partum haemorrhage.Methods: In this study amount of blood loss after spontaneous vaginal delivery was measured in 100 cases by calibrated blood drape. Patients having high risk criteria for PPH were excluded.Results: In this study 55% patients were from 20-30 years age group. 82% cases were nontribal. 94% belonged to lower middle class. 67% patients were primigravida. 89% patients had atonic PPH and 11% had traumatic PPH. 85% patients had mild PPH. 60% of atonic PPH was managed by oxytocin only. 10% required oxytocin + Methergin, 6% required oxytocin + Methergin + Misoprostol. 6% required Oxytocin + Methergin + Misoprostol + Carboprost. In this study surgical intervention was required in 18% cases. Blood transfusion was required in 74% cases. 75% cases were from non-tribal ethnicity.Conclusions: PPH is a life-threatening condition. If it can be diagnosed early and managed properly then many maternal lives can be saved. In this study there was no maternal death.

scholarly journals Risk factors for post-partum hemorrhage in patients who underwent operative vaginal delivery in a tertiary care center

2021 ◽  
Author(s):  
Gayatri Devi Sivasambu ◽  
Sujani B. Kempaiah ◽  
Urvashi Thukral
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Vaginal Delivery ◽  
Post Partum ◽  
Tertiary Care ◽  
Significant Risk ◽  
Post Partum Hemorrhage ◽  
Second Stage ◽  
Operative Vaginal Delivery ◽  
Vaginal Deliveries

Background: Operative vaginal delivery is a timely intervention to cut short second stage labor when imminent delivery is in the interests of mother, fetus, or both. It reduces second stage cesarean section morbidity and uterine scar and its influence on future obstetric career. The possible structural neonatal adverse outcomes due to operative vaginal delivery are well quantified. However, its effects on maternal outcome need to be understood better. In this paper, we study the effect of operative vaginal delivery on maternal post-partum hemorrhage (PPH) and the associated risk factors.Methods: It was a retrospective study carried out for the period July 2016 to July 2020 at Ramaiah Medical College, Bengaluru. Total number of vaginal deliveries in this period were 6318. Out of these, 1020 patients underwent assisted vaginal delivery using vacuum/ forceps/ sequential use of instrument. Blood loss greater than 500 ml is considered PPH for the purpose of this study. 15% of the study population was noted to have PPH. We employ a multivariate logistic regression to identify statistically significant risk factors for PPH in women undergoing operative vaginal delivery.Results: The logistic regression model identifies multiparity, maternal age, neonatal birth weight more than 3.5 kg, application of forceps in women with hypertensive disorders, III-degree tear, cervical tear to significantly increase the risk of PPH in our study population.Conclusions: Certain factors seem to increase the risk of PPH in operative vaginal delivery. The risks and benefits must be weighed properly before use of instruments.

scholarly journals The Outcome of Vaginal Birth After Caesarean Section (VBAC): A Descriptive Study

2013 ◽  
Vol 25 (1) ◽  
pp. 14-17
Author(s):  
R Rahman ◽  
NN Khanam ◽  
N Islam ◽  
KF Begum ◽  
HH Pervin ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Post Partum ◽  
Tertiary Care ◽  
Breech Presentation ◽  
Vaginal Birth ◽  
Care Hospital ◽  
Lower Segment Cesarean Section ◽  
Medicine Today ◽  
Vaginal Birth After Caesarean

The study, conducted in the tertiary care hospital of Dhaka Bangladesh, describes the outcome of vaginal birth after caesarean section (VBAC) in women with a previous caesarean. A prospective study was carried out from 1st January 2007 to 31st December, 2007 on 126 women with one prior lower segment cesarean section (LSCS) for a nonrecurrent cause. All unbooked women and those with estimated fetal weight more than 3.5 kg, breech presentation, history of postoperative wound infection after previous LSCS, anemia (Hb < 10 gm%), pregnancy induced hypertension, diabetes, heart disease, renal disease, cephalopevic disproportion abnormal presentation and placenta praevia were excluded from the study. An informed consent was taken for allowing a trial of vaginal delivery. Spontaneous onset of labor was awaited up to 41 weeks. Induction of labor was considered only in highly selected cases. Labor was constantly supervised by competent staff and meticulously monitored by cardiotocography (CTG). Out of the 126 women enrolled for the study, 26 had to leave the station leaving a total of 100 patients; 72 patients underwent elective repeat C/S, 28 patients (28%) of these underwent trial of labour, among them 15 had successful vaginal delivery (53.57) but 13 patients failed the attempt and had to undergo emergency caesarean section. To assist in the 2nd stage of labour, 6 had ventouse application. In total 85 cases needed repeat caesarean section. Among the cases there was one case of scar dehiscence (6.6%), one case of cervical tear (6.6%), two cases of manual removal of placenta (13.3%), one case of post partum hemorrhage (6.6) and one case of puerperal pyrexia (6.6).Perinatal morbidity was comparable with the elective repeat C/S group. VBAC should be considered in cases of previous one cesarean delivery for nonrecurrent indication. DOI: http://dx.doi.org/10.3329/medtoday.v25i1.15902 Medicine Today 2013 Vol.25(1): 14-17

scholarly journals TO STUDY THE RISK FACTOR OF POST-PARTUM HEMORRHAGE IN TERTIARY CARE HOSPITAL IN NORTH WEST RAJASTHAN

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Santosh Khajotia ◽  
Kavita Choudhary ◽  
Moolchand Khichar ◽  
Manoj Gupta ◽  
Madhuri Sharma ◽  
...  
Keyword(s):  
Risk Factor ◽  
Placenta Previa ◽  
Post Partum ◽  
Tertiary Care ◽  
Multiple Pregnancy ◽  
Normal Vaginal Delivery ◽  
Care Hospital ◽  
North West ◽  
Medical College ◽  
Prolonged Labor

Introduction: Present study was conducted to evaluate the risk factor of PPH.  Methodology: Study group comprises of 100 females attending obstetrics and gynecology department in S.P. Medical College, Bikaner. Delivered women ? 28 weeks seen during the first hour of PPH with visual blood loss >500 ml in normal vaginal delivery and > 1000 ml during LSCS were included in the study.  Results: Out of 100 cases, 17(17%) had multiparity followed by 7(7%) each had previous LSCS and prolonged labor, 5(5%) each had multiple pregnancy and macrosomia, 3(3%) each had placenta previa and previous 2 LSCS, 2(2%) each had postdatism and precipitate labor and 1(1%) had breech. Conclusion: Multiparty was most common risk factor. Keywords: Hemorrhage, Post-partum, Risk factor

scholarly journals Profile of neonatal dermatoses in a tertiary care teaching hospital of Haryana

2018 ◽  
Vol 6 (3) ◽  
pp. 955
Author(s):  
Poonam Marwah ◽  
Ashish Marwah ◽  
Sunil Kumar ◽  
Rajesh Kumar
Keyword(s):  
Birth Weight ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Skin Lesions ◽  
Normal Vaginal Delivery ◽  
Care Hospital ◽  
Age Group ◽  
Common Skin ◽  
History Of ◽  
Recorded Data

Background: To assess the incidence and profile of neonatal dermatoses in a tertiary care hospital of Haryana and study its association with various perinatal risk factors.Methods: All inborn neonates (<28 days of life) including those seen in the outpatient department on follow up between November 2016 to April 2017 formed the baseline population and babies with skin lesions were included in the study. A detailed perinatal history and newborn examination of the baby was done by a pediatrician and all relevant details were recorded. Data was analyzed, and inferences were drawn using tables.Results: In our study, a total of 2760 newborn (1506 (54.6%) males and 1254 (45.4%) females) were studied. The incidence of neonatal dermatoses was found to be 94.1%. There were 1849 (66.9%) term, 853 (30.9%) preterm, and 58 (2.1%) post term neonates. 1901 (68.8%) had birth weight >2.5kg while 859 (31.1%) had birth weight ≤2.5kg. 1223 (44.3%) were born to primipara while 1537 (55.6%) were born to multipara mothers. Mothers of 54 (1.9%) neonates were < 20 years of age; 1157 (41.9%) in the age group of 20-25 years; 1324 (47.9%) in the age group of 25-30 years and 225 (8.1%) in the age group >30 years. 1806 (65.4%) neonates were born by normal vaginal delivery and 954 (34.6%) neonates were born by cesarean section. In 13 (0.5%) neonates, history of consanguinity was present while it was absent in 2747 (99.5%) neonates. Most common skin lesions observed were transient skin lesions among which Mongolian spots (62.9%), epstein pearls (48.8%), erythema toxicum (41.8%), milia (40.6%) and miniature puberty (35.9%) were the most common.Conclusions: Incidence of neonatal dermatoses was found to be higher (54.6%) among males as compared to females (45.4%); among term babies; those with birth weight >2.5kg; those born to multipara mothers; those born via normal vaginal delivery and those with maternal age 25-30 years.

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