scholarly journals Study of cases of double mishap in a tertiary care teaching hospital

Author(s):  
Fasiha Tasneem ◽  
Vijayalakshmi Shanbhag

Background: “Make every mother and child count”- the slogan for World health day 2005 reflects the reality and need of the society even today. In India, many women die due to pregnancy-related complications and those who survive suffer from severe maternal morbidity. Authors have been impressed that the same obstetric conditions that kill mothers are also responsible for most of the stillbirths and many of the neonatal deaths as well. This is the study to identify the risk factors that has an effect on the health of both mother and baby, to evaluate the complications leading to maternal and perinatal morbidity or mortality so that timely interventions to prevent maternal and perinatal morbidity and mortality can be made.Methods: All the cases getting admitted in Dr SCGMC Nanded are analysed for maternal and foetal outcome over the study period of 18 months. The cases with both maternal and perinatal morbidity or mortality are included in the study. The associating factors and comorbidities if associated with the cases of double mishap are studied.Results: During the study period of 18mths, there were 21905 deliveries conducted in the study hospital and 742 reffered cases of outside hospital deliveries, it was found that there were 204 cases of double mishap. Out of 204 cases of double mishap, 71.56% had preeclampsia, 29.41% were anaemic, 6.86% had febrile illness, 4.41% were of placenta praevia, 33.33% had abruptio placenta.Conclusions: Authors can conclude by stating that through better antenatal care, early detection and proper management of risk factors like pre-eclampsia, anaemia and active management of third stage of labour with careful feto maternal monitoring the absolute goal of Obstetrics of having a healthy mother and healthy baby at the end of delivery can be achieved.

2021 ◽  
Vol 11 (1-s) ◽  
pp. 102-107
Author(s):  
T. Lakshmi Susheela ◽  
Meda. Venkata Subbiah ◽  
M. Ahamadi Tabasum ◽  
P. Amreen Khan ◽  
M.V. Swetha Kumari ◽  
...  

Background: Preterm is a major obstetrical challenge of health care. It is the top most cause of perinatal morbidity and mortality of neonatal deaths. The births of these neonates are at a greater risk of developmental disabilities, health and growth problems than neonates of full term. Aim and objective: To assess the risk factors and management associated with preterm deliveries and their outcomes. Materials & Methods: “A prospective observational cohort study” was conducted over a period of 6 months on 80 Preterm subjects, who were enrolled based on inclusion and exclusion criteria. A detailed questionnaire was used to record socio-demographic, clinical profile and prescribing management. Statistical analysis was performed by percentage method using parameters like mean, standard deviation. Results: The impact of incidence range in the present study was 31.52%. Maximum preterm deliveries were observed in the age group of 18-23 years (44%). Multiparous woman was at more risk for preterm i.e., about 51%. The commonest risk factor for preterm was Anemia (45%) followed by Pre-eclampsia (24%). The treatment prescribed for preterm was Betamethasone, Tidilon, Magnesium sulphate, Progesterone. The commonest neonatal outcome was found to be low birth weight with KMC and supplements of vitamins, iron, calcium as a therapy for their better recovery. Conclusion: The study suggests an urgent need for strengthening effective guidelines and appropriate counselling for prevention of preterm. Maintenance of good hygiene, adequate   bed rest and proper antenatal care visits for the better outcomes.  Keywords: preterm, multiparous, risk factors, neonatal outcomes, antenatal care, cohort.


2021 ◽  
Vol 15 (9) ◽  
pp. 2451-2453
Author(s):  
Shahid Iqbal ◽  
Muhammad Fareed Khan ◽  
Raja Imtiaz Ahmed ◽  
Shahab Saidullah ◽  
Nisar Ahmed ◽  
...  

Objective: To find out the pattern of CHD and associated risk factors among children presenting at a tertiary care hospital. Study Design: A case-control study. Place and Duration of the Study: The Department of Pediatrics and Department of Cardiology, Sheikh Khalifa Bin Zayed Al Nahyan Hospital, Rawlakot from July 2020 to June 2021. Material and Methods: A total of 207 children of both genders, screened by ECG along with chest x-ray and further confirmed with the diagnosis of CHD through echocardiography were enrolled as cases. Same number of healthy controls (n=207) were recruited from immunization center of the study institution. Among cases, types of CHD were noted. For cases and controls, demographic, antenatal and maternal risk factors including maternal age, gender of the child, history of consanguinity, history of febrile illness in pregnancy, use or multi-vitamin or folic acid in pregnancy, bad obstetrical history and maternal diabetes mellitus were noted. Results: In a total of 414 children (207 cases and 207 controls), there were 219 (53.8%) male. In terms of CHD types among cases, VSD was the most noted in 62 (30.0%), ASD 35 (16.9%), TOF 33 (15.9%) and PDA in 30 (14.5%). Cases were found to have significant association with younger age (78.3% cases below 1 year of age vs. 64.7% in controls, p=0.0085), bad obstetrical history (p=0.0002), history of febrile illness in 1st trimester of pregnancy (p=0.0229) and lack of multivitamins and folic acid in the 1st trimester of pregnancy (p=0.0147). Conclusion: Majority of the children with CHDs were male and aged below 1 year. VSD, ASD, TOF and PDA were the most frequent types of CHD. Younger age, bad obstetrical history, history of febrile illness in 1st trimester of pregnancy and lack of multivitamins and folic acid in the 1st trimester of pregnancy were found to have significant association with CHDs among children. Keywords: Congenital heart disease, echocardiography, ventricular septal defect.


Author(s):  
Gabkika Bray Madoue ◽  
Souan Nguele Sile ◽  
Foumsou Lhagadang ◽  
Abdelsalam Saleh

Author(s):  
Abhishek Sharma ◽  
Aditya Mathur ◽  
Cecilia Stålsby Lundborg ◽  
Ashish Pathak

Diarrhoea contributes significantly in the under-five childhood morality and mortality worldwide. This cross-sectional study was carried out in a tertiary care hospital in Ujjain, India from July 2015 to June 2016. Consecutive children aged 1 month to 12 years having “some dehydration” and “dehydration” according to World Health Organization classification were eligible to be included in the study. Other signs and symptoms used to assess severe dehydration were capillary refill time, urine output, and abnormal respiratory pattern. A questionnaire was administered to identify risk factors for severe dehydration, which was the primary outcome. Multivariate logistic regression modeling was used to detect independent risk factors for severe dehydration. The study included 332 children, with mean ± standard deviation age of 25.62 ± 31.85 months; out of which, 70%(95% confidence interval [CI] 65 to 75) were diagnosed to have severe dehydration. The independent risk factors for severe dehydration were: child not exclusive breast fed in the first six months of life (AOR 5.67, 95%CI 2.51 to 12.78; p<0.001), history of not receiving oral rehydration solution before hospitalization (AOR 1.34, 95%CI 1.01 to 1.78; p=0.038), history of not receiving oral zinc before hospitalization (AOR 2.66, 95%CI 1.68 to 4.21; p<0.001) and living in overcrowded conditions (AOR 5.52, 95%CI 2.19 to 13.93; p<0.001). The study identified many risk factors associated with severe childhood dehydration; many of them are modifiable though known and effective public health interventions.


2013 ◽  
Vol 1 (2) ◽  
pp. 65-70
Author(s):  
Farhana Kalam ◽  
Mohammad Omar Faruq ◽  
Saleha Begum Chowdhury

Objective: To determine the maternal & perinatal morbidity and mortality associated with Placenta Praevia in Bangladesh. To assess the risk factors of antepartum hemorrhage associated with Placenta Praevia. Design: A cross sectional observational hospital based descriptive study. Setting: Obstetric inpatient units of two tertiary care teaching hospitals of Dhaka. Participants: One hundred pregnant mothers with diagnosis or Placenta Praevia proven by pelvic ultra sonography presenting with ante partum hemorrhage . Outcome: Incidence of maternal and fetal morbidity and mortality and risk factors of ante partum hemorrhage in Placenta Praevia. Results: 38% study mothers had no ante natal care. There was no maternal death. 96% of mothers were delivered by Caesarean Section. Incidence of primary post partum hemorrhage was 38%. There were 21% still birth and 16% neonatal death. 47% mothers had no complication after delivery. 22% mothers presented with hemorrhagic shock. 59% delivered babies had birth weight below 2.5 kg and 55% delivered babies had no complication. 57% mothers belonged to low socio economic group. Conclusion: The study reflects status of mothers presenting with Placenta Praevia with perinatal morbidity and mortality in a small urban population of Bangladesh treated at two tertiary care hospitals of Dhaka. It is recommended that mothers with Placenta Praevia need to have access to prenatal care and at the same time need to be educated about the benefit of prenatal care. Emergency management of ante partum hemorrhage with hemorrhagic shock should be widely available to improve the outcome of Placenta Praevia in our population. DOI: http://dx.doi.org/10.3329/bccj.v1i2.17197 Bangladesh Crit Care J September 2013; 1 (2): 65-70


Author(s):  
Zenab Tambawaala ◽  
Deepali Kale

Background: Abruptio placentae is an obstetric emergency where placenta completely or partially separates before delivery of the baby. It occurs approximately in one in 120 deliveries. It is an important cause of perinatal morbidity and mortality.Methods: This was a prospective hospital-based study design conducted over a period of 2 years, in the Department of Obstetrics and Gynecology at a tertiary care hospital in Mumbai comprising of 60 cases.Results: The incidence of abruption placentae in Present study is 0.51%. Authors had perinatal mortality in 6.6% of the cases. Out of 60 cases, 2 deaths occurred in utero. Out of the remaining 58 cases, 24 babies needed NICU care, out of them, 22 went home alive and 2 had neonatal deaths. Perinatal morbidity in the form of hyperbilirubinemia, CNS depression, septicemia, neonatal anemia and neonatal DIC were noted.Conclusions: High incidence of perinatal mortality in abruptio placentae is because of increased number of still births. In our studies, the perinatal mortality is 6.6% as compared to all other studies. This decline in perinatal mortality is due to improved obstetric care and excellent NICU facilities which are required for a majority of the cases.


Author(s):  
Bandaru Sailaja ◽  
Vijayalakshmi Cooly ◽  
Bhuvaneswari Sailcheemala ◽  
Surayapalem Sailaja

Background: Hypertension in pregnancy remains still a major health issue for women and their descendants throughout the world but remains a major issue in developing countries rather than developed countries. Eclampsia accounts for 24% of maternal deaths during pregnancy in India according to FOGSI study in India. Changing trends in pregnancy globally with increased maternal age of conception, assisted reproductive technologies has contributed a significant impact in the risk factors for PE and eclampsia. The present study was aimed to investigate and determine the related risk factors in cases of PE and eclampsia. The maternal and foetal outcomes with major complications of the women with PE and eclampsia were also studied.Methods: A prospective cross sectional study for a period of two years was conducted at a tertiary care hospital among antenatal cases and all cases of PIH were recorded and studied. Cases were managed as per the existing obstetric protocol after clinical examination and investigations. Detailed socio demographic data and history of risk factors were collected and entered into Microsoft excel sheet and analyzed. Maternal and foetal outcome were noted in the cases of the study.Results: The incidence of PE and eclampsia in the study was 43.3% and 10.8%, 25-35 years age group being the most common. PE and eclampsia was associated with BMI>30, parous women with previous history of PE, diabetes mellitus and more in unregistered cases. PE and eclampsia were more in Illiterates and socio economic class 2 &3. The incidence of maternal complications was 32.99% with premature labour being the common and in case of foetal complications prematurity was the commonest with 16 cases. The maternal mortality was very less with only 4.64% in the study.Conclusions: Pregnancy induced hypertension with PE and eclampsia still remains a major problem in developed countries. Good antenatal care with increased awareness and increased antenatal visits may help in reducing the incidence and maternal and foetal complications. Increased incidence among illiterates and low socio economic status group provides the target group to be directed against any medical measures and national health programmes.


Author(s):  
Tanya Agrawal ◽  
Ruchi Kalra ◽  
Aabha Suryavanshi

Background: The common complications occurring during third stage of labor are PPH Retained Placenta, Morbid adherent placenta- placenta accreta, placenta increta, percreta, perineal tears, uterine inversion increasing the maternal morbidity and mortality. The objective of the present study was to evaluate percentage and spectrum of obstetrics complication occurring during third stage of labor.Methods: An observational study was done at Department of Obstetrics and Gynecology, People’s College of Medical Sciences and Research Center, Bhopal from January 2016 to December 2017. All women delivering vaginally including instrumental deliveries were included. The medio-lateral episiotomy was given to all primigravida and for multigravida decision was case based as big size babies, instrumental deliveries, rigid perineum. Active management of third stage of labor was practiced.Results: 899 women delivered vaginally during the study period of 2 years (Jan -Dec 2016 Jan -Dec 2017). Among these 6.45% (58 women) had various complications during third stage of labor . 55% were primigravida. Complications which were observed to occur during third stage of labor were perineal tear 4% (37/899 deliveries). Atonic PPH occurred in 0.5% (9/899 deliveries) Traumatic PPH was in 1.44% (13/899 deliveries and 0.3% cases had retained placenta. Associated condition in perineal tear cases were 92% had big size babies 5% cases were preterm labor and in 3% cases ventouse application was done.Conclusions: Common complications were 1st and 2nd degree perineal tears occurred in 4% deliveries and traumatic PPH were in 1.44% of cases.


2019 ◽  
Vol 54 (1) ◽  
pp. 1802256 ◽  
Author(s):  
Phuong T.K. Nguyen ◽  
Hoang T. Tran ◽  
Dominic A. Fitzgerald ◽  
Thach S. Tran ◽  
Stephen M. Graham ◽  
...  

Pneumonia is the most common reason for paediatric hospital admission in Vietnam. The potential value of using the World Health Organization (WHO) case management approach in Vietnam has not been documented.We performed a prospective descriptive study of all children (2–59 months) admitted with “pneumonia” (as assessed by the admitting clinician) to the Da Nang Hospital for Women and Children to characterise their disease profiles and assess risk factors for an adverse outcome. The disease profile was classified using WHO pneumonia criteria, with tachypnoea or chest indrawing as defining clinical signs. Adverse outcome was defined as death, intensive care unit admission, tertiary care transfer or hospital stay >10 days.Of 4206 admissions, 1758 (41.8%) were classified as “no pneumonia” using WHO criteria and only 252 (6.0%) met revised criteria for “severe pneumonia”. The inpatient death rate was low (0.4% of admissions) with most deaths (11 out of 16; 68.8%) occurring in the “severe pneumonia” group. An adverse outcome was recorded in 18.7% of all admissions and 60.7% of the “severe pneumonia” group. Children were hospitalised for a median of 7 days at an average cost of 253 USD per admission. Risk factors for adverse outcome included WHO-classified “severe pneumonia”, age <1 year, low birth weight, previous recent admission with an acute respiratory infection and recent tuberculosis exposure. Breastfeeding, day-care attendance and pre-admission antibiotic use were associated with reduced risk.Few hospital admissions met WHO criteria for “severe pneumonia”, suggesting potential unnecessary hospitalisation and use of intravenous antibiotics. Better characterisation of the underlying diagnosis requires careful consideration.


Author(s):  
Kanchan Rani ◽  
Nupur Nandi ◽  
Seema Singh Parmar ◽  
Priyanka Rathore

Background: Postpartum depression (PPD) is non-psychotic depressive episode that occurs between postpartum to fourteen months of childhood. It has adverse effect on mother and child health. Aim of this study was to analyze prevalence and risk factors for postpartum depression at tertiary care centre.Methods: This cross-sectional study was done in obstetrics and gynaecology department where 175 women between 10 days to 1 year of delivery were assessed using Edinberg postpartum depression scale. A score of 10 or more were taken as sign of postpartum depression. Various socio-demographic and obstetrics variables were assessed using SPSS (Statistical Package for the Social Sciences).Results: Prevalence of PPD was found in 11.4% patients. Common risk factors associated were intrauterine death (IUD) or early neonatal death, postpartum complications and lack of family support.Conclusions: Postpartum is common among postnatal women and is associated with various factors which can be modified. So early detection of associated risk factors is needed for early intervention and prevents its impact on mother and child health. 


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