scholarly journals Epidural analgesia during labour: its influences on pain relief, progress of labour, mode of delivery, maternal and foetal

2020 ◽  
Vol 9 (2) ◽  
pp. 555
Author(s):  
M. Suneetha ◽  
A. Saritha
Keyword(s):  
Pain Relief ◽  
Epidural Analgesia ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Obstetric Care ◽  
Fetal Outcome ◽  
Control Group ◽  
Sitting Position ◽  
Tertiary Care Centre ◽  
Group 2

Background: Today, the availability of regional anaesthesia for labour is considered a reflection of standard obstetric care. This study is to be conducted in a tertiary care centre with all facilities available for proposed end of proving that epidural analgesia is a safe and effective method for both parturient and the foetus in abolishing pain during labour.Methods: A total of 60 parturients were studied. they were randomly divided into two groups Group 1 includes 30 parturients. In this group parturient received epidural analgesia. The loading dose consisted of 10 ml of Bupivacaine 0.1% and Fentanyl 0.0002% (20 mcg). The top up doses were 10 ml of 0.1% Bupivacaine and Fentanyl 0.0002%, administered whenever the parturient complained of pain. When parturients enters into second stage a further 12-15 ml was injected with parturient in sitting position or semi-sitting position. Group 2 - (control group) Includes 30 parturients. In this group parturient was monitored without any analgesia.Results: This prospective study was done to assess the effect of epidural analgesia on the progress of labour and its outcome, to evaluate its efficacy as an analgesic technique and to study the maternal and fetal outcome. The total number of 60 parturients were selected and randomly categorized into two groups. CASE-Those who received epidural analgesia, CONTROL-Those who did not receive any analgesia.Conclusions: Epidural analgesia provides a versatile method of administering effective and satisfactory pain relief to parturient women. The technique should not be considered as a single entity, because the type and the dose of epidural medication can be altered as needed.

scholarly journals Comparative study of efficacy of drotaverine hydrochloride and valethamate bromide with control in first stage of labour

2013 ◽  
Vol 11 (1) ◽  
pp. 38-42 ◽  
Author(s):  
P Dahal ◽  
B Banerjee ◽  
DK Uprety ◽  
BP Das ◽  
A Thakur ◽  
...  
Keyword(s):  
Side Effects ◽  
Mode Of Delivery ◽  
Active Phase ◽  
Fetal Outcome ◽  
Control Group ◽  
P Value ◽  
Drotaverine Hydrochloride ◽  
Group 2 ◽  
And Control ◽  
Group 1

Background: Labour is the most perilous journey a woman has to undertake. Painless and short labour is desired by every woman and is a constant aim for obstetrician.Objective: To analyze and compare the efficacy and safety of drotaverine and valethamate with control group on improving cervical dilatation and promoting progress of labour. Method: Three hundred demographically similar women, both primigravida and multigravida with a term pregnancy in established labour were randomly divided into three groups. One hundred women (group 1) were given injection valethamate intramuscularly,100 women (group 2) were given drotaverine and the rest 100 (group 3) were not given any drug. Comparative analysis was carried out as regards to duration of first stage of labour, mode of delivery, maternal side effects and fetal outcome. Results: The mean duration of active phase of labour in group 1, 2 and 3 was 254.29±96.621 min, 178.31±73.412 min and 346.31±123.351 min respectively. The duration of injection to end of first stage of labour in valethamate and Drotaverine group was 228.12±84.626min and 168.89±69.576min respectively (p value<0.0001). The duration of injection to delivery in Valethamate was 249.13± 88.321 min and in Drotaverine was 192.56±75.479min (p value<0.0001). There were no serious maternal and fetal adverse effects in any group but minor side effects were more common in valethamate group. Conclusion: The reduction of the duration of the first stage of labour was apparently more in drotaverine group as compared to valethamate and control group. Drotaverine was found to be safe with minimal or no adverse effect on the mother and the fetus. Health Renaissance, January-April 2013; Vol. 11 No.1; 38-42 DOI: http://dx.doi.org/10.3126/hren.v11i1.7600

scholarly journals Incidence of umbilical cord around the neck and its effects on mode of delivery and fetal outcome at tertiary care hospital

2021 ◽  
Author(s):  
S. Nandhini ◽  
C. R. Anuradha ◽  
S. Renuka ◽  
K. Vijayalakshmi ◽  
R. Sailatha
Keyword(s):  
Umbilical Cord ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Fetal Membranes ◽  
Control Group ◽  
Care Hospital ◽  
Exclusion Criteria ◽  
Nuchal Cord

Background: Umbilical cord is one of the fetal membranes. It is developed from the yolk sac. Umbilical cord is tubular structure. Approximate length of the cord is 50 cm. Umbilical cord around the neck is called as the nuchal cord. The aim of the study is to find out the incidence of umbilical cord around the neck at the time of delivery and its fetal outcomes.Methods: It is a retrospective observational study. This study was conducted in the department of obstetrics and gynecology at a tertiary care hospital over a period of 6 months (Feb-Jul 2020). Out of 542 patients, 388 were enrolled in this study after the inclusion and exclusion criteria, of which 101 were delivered with umbilical cord and the remaining were 287 patients in control group.Results: Present study showed 38.4% incidence of umbilical cord at the time of delivery. Incidence is more among the primigravida and it is statistically significant. Both intrapartum and postpartum risks are not related to umbilical cord around the neck. Mean length of the cord in patients delivered with cord around the neck is more when compared to the control group and has significant p value.Conclusions: This study concludes that the presence of umbilical cord, alone is not an indication for caesarean section. Umbilical cord with 3 loops was associated with increased operative delivery and low Apgar score, proper intrapartum surveillance and portogram leads to good fetal outcome.

scholarly journals Thyroid dysfunction in women with polycystic ovarian syndrome: a comparative study

2019 ◽  
Vol 8 (5) ◽  
pp. 1943
Author(s):  
Kshama V. Kedar ◽  
Monali M. Rewatkar ◽  
Monika D. Akare
Keyword(s):  
Polycystic Ovary ◽  
Normal Population ◽  
Tertiary Care ◽  
Reproductive Age ◽  
Control Group ◽  
Overt Hypothyroidism ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Pcos Group ◽  
Group 2

Background: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in reproductive age women. Some of the PCOS women show presence of hypothyroidism.Methods: This study was conducted at tertiary care centre Indira Gandhi Government Medical College and Hospital (IGGMC), Nagpur, Maharashtra, India. The study group had 50 diagnosed patients of PCOS and 50 age matched normal regular menstruating women were taken as controls.Results: In this study, PCOS patients showed higher mean TSH level than control group (4.024±1.09 and 2.84±0.83 respectively). And more women were diagnosed with overt hypothyroidism in the PCOS group (6%) than in the control group (2%).Conclusions: The findings of the study showed that PCOS is associated with hypothyroidism as compared to normal population.

scholarly journals A randomised single blind control study to assess the effect of intrapartum amnioinfusion on maternal caesarean section rate and fetal outcome in a tertiary care centre

2017 ◽  
Vol 6 (10) ◽  
pp. 4347
Author(s):  
Michelle Fonseca ◽  
Jyotsna S. Dwivedi
Keyword(s):  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Meconium Aspiration Syndrome ◽  
Control Group ◽  
Study Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Meconium Stained Amniotic Fluid

Background: The procedure of instilling normal saline/Ringer’s lactate into the uterine cavity is called amnioinfusion. Objective of present study was to assess the effect of intrapartum amnioinfusion on maternal caesarean section rate and fetal outcome in a tertiary care centre in cases of meconium stained amniotic fluid.Methods: A total of 160 women at term in labor with meconium stained amniotic fluid were randomized into two groups: study and control group. The study group received transcervical amnioinfusion at detection of MSAF. The control group was given the routine obstetric care. Both groups were started on O2 and intrapartum monitoring. The outcomes in both groups were analyzed statistically.Results: The control group had caesarean section rate of 45% and in the study group it was 31.25%. The difference was statistically significant. The outcome in the neonate was assessed on the parameters such as respiratory distress, neonatal intensive care unit admission, meconium aspiration syndrome, neonatal deaths.Conclusions: Amnioinfusion in cases of meconium stained amniotic fluid cases significantly reduces the risk of meconium aspiration syndrome. It also decreases the need for operative intervention thus reducing the risk of maternal morbidity and mortality.

scholarly journals Outcome of Eclamptic Mothers Attending Tertiary Care Centre from Home and those Referred from Primary Heath Care Site

2016 ◽  
Vol 4 (1) ◽  
pp. 24
Author(s):  
Upendra Pandit ◽  
Chittaranjan Das ◽  
Farhat Banu ◽  
Shakil Ahamad
Keyword(s):  
Primary Care ◽  
Magnesium Sulphate ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Hilly Region ◽  
Group 2 ◽  
Group 1

Introduction: Magnesium sulphate (MgSO4) is an effective and safe drug which stabilizes the patient within few hours of eclampsia and terminates subsequent seizures if it is given on time. The aim of this study was to compare maternal and fetal outcome between a group of eclamptic mothers who came to the tertiary care hospital directly without receiving MgSO4 (Group 1) and those referred from primary care centers after receiving loading dose of MgSO4 (Group 2).   Methods: This is a retrospective cohort study of eclamptic mothers who were admitted and managed from the period of 1st January 2012 to 31st March 2016 at Nepalgunj Medical College Teaching Hospital, Nepal. Sociodemographic characters and maternal and fetal outcome was compared between the two groups.   Results: Among 92 cases, 57 (62%) were from Group 1 and 35 (38%) were from Group 2. Most of the mothers attended from Banke district (n=52, 56.5%) followed by Bardia district (n=17, 18.5%). Brahmin and Chhetri were 20 (35%) and 10 (29%); Muslim 16 (28%) and 4(11%); Janajati from Terai 16 (28%) and 8 (23%); Janajati from hilly region 4 (7%) and 5 (14%); and Chaudhari 1 (2%) and 8 (23%) in Group 1 and Group 2 respectively.  More (n=26, 74%) mothers had baby with good Apgar score in Group 2 than in Group 1 (n=33, 58%). There were 14 (15.2%) still births; 9 (16%) in Group 1 and 5 (14%) in Group 2. Complication rate was observed more in Group 1 (n=16, 28%) than in Group 2 (n=7, 20%) and the most common complication in both groups was wound infection. The mean days of hospital stay was 5.96 (SD=3.32) and 5.91 (SD=3.38) in Group 1 and Group 2 respectively.   Conclusion: The group receiving magnesium sulphate in primary care centre have good fetal outcome and less maternal complications compared to those who were admitted directly in tertiary care centre and receive the treatment there.

scholarly journals Fetomaternal outcome in severe preeclampsia and eclampsia: a retrospective study in a tertiary care centre

2017 ◽  
Vol 6 (9) ◽  
pp. 3937
Author(s):  
Shobha Sreedharan Pillai
Keyword(s):  
Retrospective Study ◽  
Maternal Mortality ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Liver Function Tests ◽  
Fetal Outcome ◽  
Severe Preeclampsia ◽  
Near Miss ◽  
Tertiary Care Centre ◽  
Mortality And Morbidity

Background: Hypertensive disorders of pregnancy are a leading cause of maternal and perinatal mortality and morbidity worldwide. In India, they account for the third most important cause of maternal mortality. The objectives of this study were to evaluate maternal and perinatal outcome and complications in cases with severe preeclampsia and eclampsia.Methods: A retrospective study was carried out on 110 women with severe preeclampsia and eclampsia in a tertiary care referral centre over a period of 15 months. Only those cases with initial B.P reading of ≥160/110 mm Hg or presenting with eclampsia were included in the study. Investigations and management were carried out as per standardized department protocol and maternal and fetal outcomes were analyzed.Results: 42% of the cases were in the age group of 26-30 years, nearly 61% were primigravidae and the majority (64) were referred from peripheral hospitals. Liver function tests were deranged in 19% of the patients and 17% had abnormal renal function. Nifedipine was the most commonly used antihypertensive and magnesium sulphate was the anticonvulsant used in all the cases.  Lower segment caesarean section was the mode of delivery in 64.5% of the cases. Commonest maternal complication was atonic PPH. There was no maternal mortality but there were 3 maternal near-miss cases due to DIC. 65% of the cases had a preterm delivery and 39% of the babies needed NICU admission. There were 10 neonatal deaths.Conclusions: Accessible health care and health education and awareness regarding antenatal check-ups for all women will lead to early detection of severe preeclampsia.  Prompt treatment and management of its complications will certainly improve the maternal and fetal outcome. 

scholarly journals Observational study of maternal and fetal outcome in obstetric emergencies admitted to tertiary care centre

2021 ◽  
Author(s):  
Neelima Singh ◽  
Sreedevi . ◽  
Sushma .
Keyword(s):  
Maternal Mortality ◽  
Perinatal Mortality ◽  
Tertiary Care ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Fetal Outcome ◽  
Tertiary Care Centre ◽  
Cervical Injury ◽  
Mortality And Morbidity ◽  
Obstetric Emergencies

Background: Objectives of the current study were to evaluate the risks factors, clinical presentations, the management and maternal and fetal outcome of common obstetric emergencies encountered at Government general hospital Nizamabad, Telangana, from April 2019 to November 2019.Methods: It is an Observational, hospital-based study done department of obstetrics and gynaecology in 160 cases of obstetric emergencies managed in 8 months study period were reviewed.Results: Out of 3000 deliveries there were 160 cases of obstetric emergencies giving a percentage of 5.33%. About 84% had antenatal care and 16% had not taken ANC with perinatal mortality of 91.9% in booked cases. Out of 160 cases of obstetric emergencies, obstetric haemorrhage constituted 94 (58.75%) cases and among those cases, 23 cases (24.5%) were PPH including both atonic and traumatic, abruptio placenta constituted 35 cases (37.3%). Out of 160 cases of obstetric emergencies, obstructed labour constituted 29 cases (18.1%) being a frequent indication for emergency caesarean section, 1 case of septic abortion and 30 cases eclampsia. 29 perinatal deaths giving the perinatal mortality rate as 181 per 1000 live births. One maternal mortality due to rupture uterus. Maternal morbidity was in the form of wound infections which was found in 6 cases (3.75%), wound gaping in 2 cases (1.25%) PPH in 19 cases (11.81%), septicaemia in 17 cases (10.6%), puerperal pyrexia 6 cases (3.7%), vaginal or cervical injury 6 cases (3.7%), ICU admissions in 9 cases (5.6%). This morbidity increased the number of days of hospital stay to the patients.Conclusions: In majority of cases, the complications are preventable and treatable with proper antenatal and intranatal care. Identification of high risks cases, education of people about the importance of supervised pregnancy, delivery and emergency obstetric care will reduce the maternal mortality and morbidity and perinatal mortality and morbidity significantly.

scholarly journals Comparative study between levobupivacaine with clonidine and levobupivacaine with fentanyl in epidural labour analgesia in rural set up

2017 ◽  
Vol 5 (9) ◽  
pp. 4087
Author(s):  
Prashant K. Mishra ◽  
Anand K. Singh ◽  
Pragati Divedi
Keyword(s):  
Epidural Analgesia ◽  
Rating Scale ◽  
Breakthrough Pain ◽  
Numerical Rating Scale ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Labour Analgesia ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Background: Neuraxial techniques are the gold standard for intrapartum labour analgesia. Neuraxial labour analgesia using new local anaesthetics such as levobupivacaine has become very popular by virtue of the safety and lesser motor blockade caused by these agents. Multiple randomized controlled trials comparing epidural analgesia with systemic opioids, nitrous oxide or both have demonstrated lower internal pain scores and higher maternal satisfaction with neuraxial analgesia. The purpose of this study is to compare fentanyl and clonidine combination with levobupivacaine in terms of effect of epidural labour analgesia on fetal outcome and incidence of instrumental or caesarean delivery and duration of second stage of labour.Methods: A total of 50 primiparous with singleton pregnancy and vertex presentation and cervical dilatation of 3-5 cm were enrolled for the study in our hospital in department of obstetrics and gynecology. They were divided into group 1 and group 2 (25 patients in each group). Group 1 received 10 ml. of 0.125% isobaric levobupivacaine with 25µg fentanyl and group 2 received 10 ml of 0.125% isobaric levobupivacaine with 60 µg clonidine. Parturients were given epidural analgesia on numerical rating scale (NRS) Score >3. Breakthrough pain supplemented with 3-5 ml of 0.125% levobupivacaine. Data collected were demographic profile of the patients, analgesic qualities, 1st and 2nd stage labour duration, side effects and feto-maternal outcome.Results: Post treatment mean NRS were almost similar between two groups at all periods except at 15 minutes when it was significantly lower for group 2 (2.64±0.49). Onset of analgesia was earlier in group 2 (13.68±0.94) in comparison to group 1 (15.36±1.18) and was statistically significant.Conclusions: In conclusion Group 2 (levobupivacaine with clonidine) showed significant difference in early onset of analgesia but did not show any significant difference in duration of labour, maternal and fetal outcome and mode of delivery.

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.

Carnitine deficiency in chronic obstructive lung disease: A study in a tertiary care centre

2021 ◽  
Vol 6 (3) ◽  
pp. 183-187
Author(s):  
M Ravindranath ◽  
C H Raju
Keyword(s):  
Lung Disease ◽  
Obstructive Lung Disease ◽  
Tertiary Care ◽  
Chronic Obstructive Lung Disease ◽  
Carnitine Deficiency ◽  
Control Group ◽  
Chronic Obstructive ◽  
X Rays ◽  
Tertiary Care Centre ◽  
Regular Diet

Chronic Obstructive Lung Disease (COPD) is a condition where there is poor airflow to the lungs and over a period of time this condition worsen, resulting in severe morbidity. L-carnitine (LC) is a soluble qaurtenary amine and is essential for the tissues and lung tone to function normally. This study was therefore find out the association of L-carnitine in patients with chronic Obstructive Pulmonary Disease. 75 patients who came to the Department of Pulmonology of either sex between 40 to 75 years with confirmed COPD were included into patients group and 75 healthy patients were included into the control group. Blood was collected for Fasting blood sugar, AST, ALP, ALT, Urea, Creatinine, Albumin, pre-albumin, iron , magnesium, sodium, phosphorous, calcium, Acylcarnitines, total and free carnitine levels. X-rays were taken and pulmonary function test was done for all the patients. The mean age of the patients in our study was 62.53 and 61.86 years among the patients and controls respectively. Among the controls the Ph and Fe levels were 3.1 ± 0.9mmol/L and 21.69 ± 3.19 mcg/dL respectively and among the patients the same levels were 2.6 ± 1.9mmol/L and 43.82 ± 8.22mcg/dL respectively. The albumin and the prealbumin in the patients were significantly lower in the patients with 21.81 ± 2.88 and 23.53 ±2.58 mg/dL and in controls they were 32.61 ±3.87 and 26.87 ± 1.93 mg/dL respectively. There was a considerable carnitine deficiencies in COPD patients when compared to the controls and since carnitine can be found in regular diet, people can be educated to have a proper intake of foods containing carnitine in their regular diet.

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