scholarly journals Materanal and neonatal outcomes of triplet gestation in a tertiary care centre: a retrospective study

2019 ◽  
Vol 8 (11) ◽  
pp. 4453
Author(s):  
Neeraj Sharma ◽  
Deepika Kumari ◽  
Sonal Prasad ◽  
Akanksha Srivastava
Keyword(s):  
Retrospective Study ◽  
Birth Weight ◽  
Post Partum ◽  
Tertiary Care ◽  
Significant Rise ◽  
Triplet Pregnancy ◽  
Tertiary Care Centre ◽  
Maternal Complications ◽  
Neonatal Complications ◽  
The Mean

Background: A significant rise in triplet pregnancy rate has occurred recently. This rise is of concern, as these infants are frequently reported as a risk factor of adverse outcome. The aim of this study was to retrospectively study the outcomes of triplet births.Methods: A retrospective study was undertaken to analyze the clinical data of all patients with triplet gestation admitted to the labour room of Dr. Baba Saheb Ambedkar Hospital, Delhi to study the maternal and fetal outcomes. Authors retrospectively observed and analyzed the database to examine triplet gestations delivered between January 2014 and December 2018.Results: Over the five-year study period, there were total 44,011 deliveries. Out of these, there were 35 (0.079%) triplet pregnancies. Of all the triplet pregnancies studied 80% resulted from ovulation induction and assisted reproductive technology. The mean gestational age at delivery was 31.6±3.0 weeks, and the mean birth weight was 1,594±460 gm. The most common maternal complications were Preterm labour in 32 pregnancies (92%), anemia in 17 (49%), pre-eclampsia in 11 (31%), post-partum hemorrhage in 8 (22%). Of the total deliveries neonatal complications included Respiratory distress syndrome in 44 (42.2%), Hyperbilirubinemia in 41 (39%), Intrauterine growth restriction in 19 (18.1%). The perinatal mortality rate was 10.5%.Conclusions: Higher order pregnancies are associated with maternal and neonatal complications. These high risk women need more care and the neonates require intensive care and monitoring after birth, most commonly due to prematurity and low birth weight.

scholarly journals Accidental haemorrhage in third trimester: maternal and fetal outcome

2019 ◽  
Vol 8 (4) ◽  
pp. 1633
Author(s):  
Niranjan N. Chavan ◽  
Vibhusha Rohidas ◽  
Hanumant Waikule
Keyword(s):  
Risk Factor ◽  
Mortality Rate ◽  
Post Partum ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Health Care Facilities ◽  
Warning Signs ◽  
Tertiary Care Centre ◽  
Maternal Complications ◽  
Abruptio Placenta

Background: Abruptio placenta or accidental haemorrhage is one of the obstetrical emergencies and is truly accidental with few warning signs. Present study is planned to study the maternal and fetal outcome in patients of abruption placenta in a tertiary care referral hospital in a rural set up which is helpful to plan management strategies and to decrease mortality and morbidity.Methods: A prospective observational study was conducted at Department of Obstetrics and Gynaecology at tertiary care centre during September 2015 to August 2019. A total of 270 cases of abruptio placenta coming to the labor ward and delivered were included in the study. The information collected regarding maternal and fetal parameters were recorded in a master chart in Microsoft Excel 2010 and analyzed using the statistical package for the social sciences software (SPSS) version 20.0.Results: In the present study there were a total of 29887 deliveries with 270 cases of abruptio placenta, incidence being 0.9%. Bleeding per vagina is the most common presentation (85.6%) followed by pain abdomen (70.7%). Common risk factors for accidental hemorrhage were: Pre-eclampsia (39.6%) and anaemia (32.2%). Rate of cesarean section was 40.7% (n-110) while rate of forceps delivery was 4.8% (n-13). Associated maternal complications include: post-partum hemorrhage (18.9%), DIC (10%), acute renal failure (4.1%) and puerperal sepsis (1.9%) while maternal mortality rate was 1.9%. Low birth weight (<2.5kg) was observed in 74.8% cases while still birth and neonatal mortality rate was 35.2% and 12.6% respectively.Conclusions: Abruptio placenta or accidental hemorrhage is major risk factor for maternal and perinatal morbidity and mortality, thus efforts should be taken to reduce risk factor for abruptio placenta. Strengthening of antenatal care, anticipation and evaluation of associated high-risk factor and prompt management of complication can improve maternal and perinatal outcome in these cases. Abruptio placenta should be managed in centers where there is advanced maternal and neonatal health care facilities are available.

scholarly journals Did general surgeons surgical spectrum changed over time? A retrospective comparative study in a South Indian tertiary care centre between 2009 and 2018

2020 ◽  
Vol 7 (10) ◽  
pp. 3321
Author(s):  
Veena Gade ◽  
Someswara Rao Meegada ◽  
Chakrapani Alavala
Keyword(s):  
Varicose Veins ◽  
Tertiary Care ◽  
Significant Rise ◽  
Tertiary Care Centre ◽  
The Past ◽  
South Indian ◽  
Dramatic Rise ◽  
General Surgeons ◽  
The Mean ◽  
Retrospective Comparative Study

Background: General surgery discipline has fragmented into several subspecialties over the past. This division has affected the surgical spectrum of general surgeons. Studies comparing the changes in the general surgeon's work spectrum were done in the ’90s but not in the recent past. Our study aims to compare the surgical spectrum of general surgeons between two time periods in our institute.Methods: We performed a retrospective study comparing the elective surgeries performed by general surgeons in the year 2009 and 2018 in an academic tertiary care centre.Results: There was a 28.9% rise in the total number of elective surgeries (1567 vs. 2020) in our study. There was a significant rise in the mean age of surgical patients (39.7 years vs. 41.9 years) but with no change in M: F ratio (1.7: 1). There was a significant rise in Hernia surgeries and Varicose veins surgeries (p<0.001) along with a rise in anal surgeries (p=0.018). There was a significant decrease in Breast surgeries (p=0.02) and Thyroid surgeries (p<0.001). There was a dramatic rise in the laparoscopic cholecystectomy rate (23.2% vs. 52%) and a fall in the laparoscopic appendectomy rate (26.3% vs. 8%). Open inguinal hernia surgeries were the most common surgeries performed in both the years.Conclusions: There was an increase in the surgical volume for general surgeons but the surgical spectrum has narrowed. We recommend conducting periodic surgical audits in institutions to monitor and maintain the standards of surgeries performed by general surgeons. 

scholarly journals Morbidity and mortality associated with emergency obstetric hysterectomy: a three year retrospective study in a tertiary care centre of India

2018 ◽  
Vol 7 (9) ◽  
pp. 3534
Author(s):  
Swati . ◽  
Vineeta . ◽  
Ahmad Nadeem Aslami
Keyword(s):  
Retrospective Study ◽  
Post Partum ◽  
Tertiary Care ◽  
Near Miss ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Life Saving ◽  
Post Partum Haemorrhage ◽  
Live Baby

Background: Emergency obstetric hysterectomy (EOH) continues to remain an important life saving procedure in the era of modern obstetrics. EOH acts as a near miss marker as a proxy for maternal mortality. The objective of this study was to analyze 52 EOH done in a tertiary care centre of Ajmer, Rajasthan, India.Methods: A retrospective study was done using hospital records of 52 EOH done in a three year period in the Department of Obstetric and Gynaecology, LNJ Medical College, Ajmer, Rajasthan, India.Results: The incidence of obstetric hysterectomy was 1.25 in 1000 deliveries. The average age of the patients was 27.8 years. Most common reason for EOH was post partum haemorrhage (PPH). 86.5% patients went under subtotal hysterectomies. Several complications occurred in these patients, severe anemia being most common. 28.8% patients died after the operations. More than half patients delivered a live baby while 40.4% had still births.Conclusions: EOH is a life saving procedure. The outcome depends on timely decision and apt clinical judgement because delay can lead to high maternal as well as infant mortality.

EVALUATION OF COMPLICATIONS AND SUCCESS RATES OF PCNL,USING MODIFIED CLAVIEN GRADING SYSTEM: A SINGLE-CENTER EXPERIENCE

2021 ◽  
pp. 32-34
Author(s):  
Abhishek Shukla ◽  
F.A. Khan ◽  
Ravinder Pal ◽  
S.S. Chipde ◽  
Neelam. K.Soni
Keyword(s):  
Retrospective Study ◽  
Perioperative Complications ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Grading System ◽  
Transfusion Rate ◽  
Success Rates ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
The Mean

OBJECTIVE: The purpose of this retrospective study is to document the perioperative complications of percutaneous nephrolithotomy (PCNL) using the modied Clavien grading system at a tertiary care centre. MATERIAL & METHODS: A retrospective study of 133 patients who underwent standard PCNL in the department of Urology and Renal Transplant,during the period January 2019 to March 2020 at Sri Aurobindo Institute of Medical Sciences,Indore, India. A structured questionnaire was used to get relevant information,while peri-operative complications were recorded using the modied Clavien grading system. RESULTS: The mean age of patients was 38.2years,male: female ratio was 1.18:1. Stones were categorized as simple in 48.9% and complex in 51.1%. The lower calyx was the commonest site of stone location (45.5%) and puncture site (76.7%). The mean operative time was about 58 minutes and the mean haemoglobin drop was 1.5g/dl. The blood transfusion rate was 3% and the stone free rate after the procedure was 93.2%. The mean length of hospital stay was 3.4 days. CONCLUSION: PCNL is an effective treatment with good clearance rate and acceptable morbidity in experienced hands.

scholarly journals A retrospective study of the health profile of neonates of mothers with anemia in pregnancy and pregnancy induced hypertension in Lagos, Nigeria

2014 ◽  
Vol 5 (2) ◽  
Author(s):  
Olusola Funmilayo Sotunde ◽  
Silifat Ajoke Sanni ◽  
Oluseye Olusegun Onabanjo ◽  
Ibiyemi O. Olayiwola ◽  
Mure Agbonlahor
Keyword(s):  
Retrospective Study ◽  
Birth Weight ◽  
Sampling Technique ◽  
Neonatal Health ◽  
Pregnancy Induced Hypertension ◽  
Health Profile ◽  
Maternal Complications ◽  
Induced Hypertension ◽  
Anemia In Pregnancy ◽  
In Pregnancy

Our study assessed the health profile of neonates in relation to anemia in pregnancy and pregnancy induced hypertension (PIH). This was a retrospective study where a systematic random sampling technique was used to select a total of 1046 case records of pregnant women registered for ante-natal care at Lagos Island Maternity Hospital, Lagos, Nigeria, between 2005 and 2009. Socio-demographic characteristics of the mothers, prevalence of anemia and PIH, and neonatal health profile were obtained from the case records and were analyzed using both descriptive and inferential statistics. Pearson product moment correlation was used to show the relationship (P≤0.05) between maternal complications and neonatal health profile. Majority (68.8%) of the mothers had anemia and 6.7 % had PIH. Majority (97.12%) of the neonates were live births and 2.88% of the neonates were still births, 65.4% of the women with still birth pregnancy outcome had anemia, and 34.6% had PIH. Majority (74%) of the neonates had birth weight within normal range (2.5-4.0 kg) and majority (68%) had normal Apgar score at 5 min of birth (7- 10). A positive correlation existed between the packed cell volume of the mother and the birth weight of the neonates (r=0.740, P≤0.05). A negative correlation existed between the incidence of PIH and the birth weight of the neonates (r=

scholarly journals Thyroid status and Treatment Response of Hypothyroid Infertile Women in Tertiary Care Center of Bangladesh

2017 ◽  
Vol 31 (2) ◽  
pp. 86-89
Author(s):  
Farzana Deeba ◽  
Parveen Fatima ◽  
Jesmine Banu ◽  
Shakeela Ishrat ◽  
Nurjahan Begum ◽  
...  
Keyword(s):  
Subclinical Hypothyroidism ◽  
Early Stage ◽  
Care Center ◽  
Tertiary Care ◽  
Target Population ◽  
Fertility Treatment ◽  
Tertiary Care Centre ◽  
Infertile Women ◽  
The Mean ◽  
Tsh Levels

Objective(s): Aim of this study was to find out the prevalence of hypothyroidism in infertile women as well as to assess their response to treatment.Materials and methods: This descriptive study was conducted in Infertility unit of Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University, Bangladesh, a tertiary care centre from January 2014 to December 2014. Four hundred women who visited infertility clinic of the department for fertility treatment were the target population for this study. Routine investigations such as CBC, Blood sugar 2 hours postparandial or GTT, TSH and Prolactin was done. Subclinical hypothyroidism was diagnosed when there was increased TSH and normal FT4. Hypothyroid patients were given Levothyroxin depending upon TSH levels and continued until end of the study. Patients were followed up for six months even if pregnancy was attained.Results: Out of 400 women 55% were primary and 45% were secondary subfertility. Mean duration of infertility was 4.5 ± 1.2 years. Ninety two (23%) patients were hypothyroid. Among them 66 (16.5%) were subclinical hypothyroid and 26 (6.5%) were frank hypothyroid. The mean TSH levels were 7.34 ± 2.13 ìIU/ml, and the mean PRL levels were 52.46 ± 11.17 ng/ml. Out of 92 infertile women diagnosed as hypothyroidism 75 (81.52%) women conceived after treatment with drugs for hypothyroidism (dose depending upon severity of hypothyroidism, i.e. TSH levels). More than 90% women had regular ovulation for consecutive three cycles after initiation of treatment.Conclusion: The normal TSH levels are the pre-requisite for fertilization. The decision to initiate thyroid replacement therapy in both clinical and subclinical hypothyroidism at early stage is justified in infertile women.Bangladesh J Obstet Gynaecol, 2016; Vol. 31(2) : 86-89

scholarly journals The Pattern of Day Case (Ambulatory) Percutaneous (PCNL): A Descriptive Retrospective Study from a Tertiary Care Hospital

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Rehan Fareed ◽  
Huma Shamim
Keyword(s):  
Retrospective Study ◽  
Tertiary Care ◽  
Ureteral Stones ◽  
Transfusion Rate ◽  
Care Hospital ◽  
High Grade ◽  
High Grade Fever ◽  
Access Methods ◽  
The Mean ◽  
Staghorn Stones

Background: Percutaneous nephrolithotomy (PCNL) has experienced remarkable development and alteration since it was first described in 1976 by Fernstorm et al. It has also experienced miniaturization of equipment, improvement in operative systems, and refining renal access methods leading to the achievement of maximum clearance of stone while causing minimal morbidity. For example, in endourological practice, when the patient is subjected to PCNL, he traditionally needs programmed inpatient admission, as part of their recovery, it is applicable as an outpatient method in properly selected cases. Objectives: We aimed at evaluating the safety and applicability of the outpatient PCNL procedure. Methods: This retrospective study was done on 210 cases of tubeless PCNL performed by a single urologist at our institute from January 2016 to January 2019. Patients’ mean age (134 males and 76 females) was 57 ± 11.8 years, and 7 patients aged 8 - 12 years. There were 71 pelvic or calyceal solitary stones, 62 non-complete staghorn stones, 17 ureteral stones, 32 renal + ureteric stones (simultaneous renal and ureteral stones) , and 28 complete staghorn stones. The average stone size was 3.5 ± 2.8 (range: 0.7 to 11.8 cm). Results: The mean operation duration was 85.0 ± 29.4 min, and the mean hospital stay was 21.7 ± 3.4 h. Out of 210 patients, 6 patients had longer stay due to high-grade fever and 3 patients due to severe pain, and also 7 patients refused discharge due to personal and social reasons. Our ambulatory PCNL rate was 97 % ( 194 out of 210). Within 72 h, 5 patients were readmitted due to high-grade fever, 3 patients due to haematuria, and 4 patients due to pain and dysuria, and all patients were discharged 2 - 4 days after conservative treatment. Thus, the readmission rate was 6.18% (12 cases were readmitted out of 194 cases). Patients showed a blood transfusion rate of 1.4 %. Also, 19 cases (9.02%) were found with post-operative fever, and no urosepsis was reported. No pulmonary complications and mortality were noted. No re-exploration was done, and no major leak was noted. The angio-embolization rate was 0.59%. We did not use HEMO-SEAL technology, cautery, or suture in the tracks. Conclusions: In conclusion, the outpatient PCNL procedure is an applicable and feasible procedure under selected criteria; however, more investigations using a larger sample size are needed.

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