scholarly journals Placental cord drainage during third stage of labour: a randomized control trial at a tertiary care centre

2020 ◽  
Vol 9 (3) ◽  
pp. 1143
Author(s):  
Megha Chaudhary ◽  
Maitri Shah ◽  
Nitin Makwana
Keyword(s):  
Blood Loss ◽  
Randomized Control Trial ◽  
Tertiary Care ◽  
Normal Vaginal Delivery ◽  
Control Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Third Stage ◽  
The Mean ◽  
Randomized Control

Background: Labour is a physiological process, but it is often associated with morbidity and mortality, with the most common cause being blood loss. Primary postpartum hemorrhage is commonly defined as a blood loss of 500 ml or more within 24 hours after normal vaginal birth. A prolonged third stage of labour (more than 20 min) is associated with postpartum hemorrhage. The present study was undertaken with the objective of assessing efficacy of placental cord drainage (PCD) during active management of third stage of labour.Methods: This is a randomized control trial in which full term primi gravida who were expected to have normal vaginal delivery, admitted in labour room of a tertiary care centre were evaluated for inclusion in the study. Total 126 participants were enrolled after having normal vaginal delivery. In study group (n = 63), placental cord drainage was used for management of third stage of labour while in control group (n = 63), third stage was managed without PCD.Results: The mean difference in duration of third stage of labour in study and control group was 1.79 minute and the mean difference in blood loss during third stage of labour in both groups was 57.86 ml which was statistically significant.Conclusions: The results of this study show small positive effects from cord drainage in reducing the length of the third stage of labour and in reducing the amount of blood loss when compared with those without cord drainage. The observed changes may be of clinical significance in reducing third stage related complications.

scholarly journals Effect of early maternal newborn skin to skin contact in labour room on third stage of labour and success at breastfeeding

2018 ◽  
Vol 7 (12) ◽  
pp. 5011
Author(s):  
Purvi M. Parikh ◽  
Saumya P. Agrawal ◽  
Rupa C. Vyas ◽  
Sapana R. Shah ◽  
Khushi P. Joshi
Keyword(s):  
Tertiary Care ◽  
Routine Care ◽  
Control Group ◽  
Study Group ◽  
Tertiary Care Centre ◽  
Skin Contact ◽  
Third Stage ◽  
Randomized Control ◽  
Labour Room ◽  
Skin To Skin

Background: Immediate postpartum period and birth pose many challenges for the mother and the new-born. Initiation of early skin to skin contact in the labour room can be beneficial to both of them.Methods: Randomized control trial conducted over a period of 7 months in a tertiary care centre enrolling 400 laboring women.200 in the control group were given routine care. In the 200women in the study group, the newborn was given immediate skin to skin contact by placing him/her on the mother’s chest.Results: Duration of third stage of labour was less than 10 minutes in 95%women of study group compared to 56% women in the control group(p<0.01). Placenta was expulsed as a whole in 98% cases in the study group compared to 81% in the control group. Successful breastfeeding was observed in 88% women in study group compared to 54%in the control group(p<0.01). Breastfeeding was initiated within 30 minutes of birth in 96%women in the study group compared to 41% in the control group.Conclusions: Uterus could contract faster with the complete expulsion of placenta and shortening of the third stage of labour with early skin to skin contact. The newborn showed early initiation, success at breastfeeding and longer first breastfeeding with early skin to skin contact.

scholarly journals OPTIONAL VACCINE UTILIZATION HAS A MALE GENDER PREFERENCE – A RECORD BASED ANALYSIS FROM A TERTIARY CARE CENTRE OF EASTERN INDIA

2020 ◽  
Author(s):  
Sandeep Kumar Panigrahi ◽  
Anumita Maiti ◽  
Venkatarao Epari
Keyword(s):  
Hepatitis A ◽  
Tertiary Care ◽  
Secondary Data ◽  
Gender Disparity ◽  
Measles Vaccine ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Important Place ◽  
Universal Immunization Program ◽  
The Mean

Background And Objectives: Optional vaccines find an important place in immunization today. This study attempts to find out the trend of optional vaccine utilization, over the past three years in the immunization clinic of a tertiary care centre and to find out the association of gender disparity with the utilization of these vaccines. Methods: The retrospective study was conducted during October to December 2016 using the register based secondary data of October 2013 to September 2016. Month wise utilization of optional vaccines (Pneumococcal, influenza, typhoid, varicella, hepatitis A and MMR) and measles was captured. Analysis was done using Stata 12.1 SE. Results: An increasing trend of utilization was seen for all vaccines including optional vaccines. The mean doses received by male children was significantly more for all optional vaccines (unlike all vaccines taken together) as well as for individual vaccines like Pneumococcal, influenza, typhoid, MMR, hepatitis A (p<0.05), but not for varicella and measles vaccine (p>0.05). Conclusion: Gender disparity (preference for male children) was present for all optional vaccines except varicella, and not in case of measles vaccine used in universal immunization program selected as control.

scholarly journals The effect and safety of placental blood drainage as a part of active management of third stage of labour in spontaneous vaginal delivery

2019 ◽  
Vol 8 (5) ◽  
pp. 1977
Author(s):  
Nidhi Gupta ◽  
Mohita Agarwal ◽  
Saroj Singh ◽  
Parul Gangwar
Keyword(s):  
Blood Loss ◽  
Uttar Pradesh ◽  
Active Management ◽  
Control Group ◽  
Study Group ◽  
Medical College ◽  
Third Stage ◽  
Placental Blood ◽  
The Mean ◽  
And Control

Background: In placental cord drainage facilitates placental delivery in both vaginal and caesarean section deliveries. The present study was done to evaluate the effect and safety of placental blood drainage as a part of active management of third stage of labour to reduce the duration and blood loss during third stage of labour.Methods: The study was conducted in department of Obstetrics and, SN Medical College, Agra, Uttar Pradesh, India on 400 term pregnant women, with single live intrauterine fetus in cephalic presentation, without any complication. They were randomly divided into to study and control group. Study group: It comprised of 200 Gynaecology cases, underwent active management of third stage of labour with placental blood drainage. Control group: It comprised of 200 cases, underwent active management of third stage of labour (AMTSL) alone. Duration and blood loss during third stage were noted.Results: The mean duration of third stage of labour was 3.61±0.972mins in study group and 8.15±1.711mins in control group. The mean blood loss during third stage of labour was 168.14±76.703ml and 287.40±85.808ml in study and control group respectively.Conclusions: Duration of third stage, blood loss during third stage, and hemoglobin deference between pre and post-delivery were reduced significantly in study group than control group.

scholarly journals Comparison of laparoscopic-assisted vaginal hysterectomy, total abdominal hysterectomy and vaginal hysterectomy: A four years retrospective study in tertiary care centre

2018 ◽  
Vol 7 (9) ◽  
pp. 3596
Author(s):  
Namrata Vasant Padvi ◽  
Jitendra Pundalik Ghumare
Keyword(s):  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Tertiary Care ◽  
Operating Time ◽  
Abdominal Hysterectomy ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Average Hospital ◽  
Intraoperative Complication ◽  
Estimated Blood Loss

Background: Hysterectomy is one of the commonest gynaecological operations performed in India. Traditional surgical treatments performed are abdominal hysterectomy and vaginal hysterectomy. Vaginal and laparoscopic procedures are considered “minimally invasive” surgical approaches because they do not require a large abdominal incision and, thus, typically are associated with shortened hospitalization and postoperative recovery times compared with open abdominal hysterectomy. With the aid of laparoscopic procedure, a potential abdominal hysterectomy can be converted to a vaginal one and a difficult vaginal hysterectomy can be converted into a fairly simple vaginal hysterectomy. Aim of the present study is to compare above methods of hysterectomy in terms of operating time, estimated blood loss, and postoperative hospital stay and complication, so as to provide best course of treatment to patient.Methods: A retrospective observational study was conducted in tertiary care centre. Four-year data was collected from January 2012 to December 2016. Cases of LAVH with benign gynaecological condition and up to 12 weeks size uterus, without any associated medical condition were selected in study randomly, and compare with cases of NDVH, TAH in terms of duration of operative procedure, blood loss during surgery, and postoperative hospital stay.Results: In present study we found that average duration of procedure in LAVH was 84.35 minute, which was maximum compare to other method. Estimated blood loss in LAVH was least as compare to NDVH and TAH it was maximum. The average hospital stays in LAVH and NDVH was less as compared to TAH.Conclusions: LAVH should be considered a better approach in view of the relatively less blood loss and intraoperative complication. Due to lack of large randomized controlled trials, the role of Laparoscopic hysterectomy is difficult to define.

scholarly journals Impact of COVID-19 on the patient visits in ortho emergency at a tertiary care centre

2020 ◽  
Vol 9 (1) ◽  
pp. 192
Author(s):  
Nitin Choudhary ◽  
Akhil Gupta ◽  
Sanjeev Gupta ◽  
Amar Saharan
Keyword(s):  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Patient Awareness ◽  
Notable Effect ◽  
Number Of Factors ◽  
Ed Visits ◽  
The Mean ◽  
Using Data ◽  
Record Section

Background: COVID-19 pandemic effects are still being elucidated. Stay-at-home orders issued during peak of COVID-19 and social distancing as lockdown measures compounded with COVID-19 concerns have caused significant disruptions in daily life. One notable effect of these variables may be a change in the number of emergency department (ED) visits. This study aims to investigate the effects of COVID-19 on ED visits, and possible reasons for changes.Methods: Retrospective analysis using data for ED visits and procedures performed in the orthopaedics department of GMC Jammu were collected from the record section of GMC Jammu for four months prior and post implementation of lockdown and results were deduced with regards to the comparison in the number of visits, admissions and surgeries done pre and post-lockdown period.Results: The mean number of ED visits/admissions per day for the last four months of available data post lockdown due to COVID-19 pandemic was significantly less than the four months prior to COVID-19 pandemic.Conclusions: A number of factors have likely contributed to the substantial decrease in ED visits observed in this study. In light of these findings, it is important to raise patient awareness regarding conditions that require urgent ortho consultation so as to avoid any type of deformity/disability whatsoever.

scholarly journals Prophylactic Administration of Per Rectal Misoprostol vs Intramuscular Injection of Oxytocin in Third-stage of Labour for Prevention of Postpartum Haemorrhage: A Randomised Controlled Trial

2021 ◽  
Author(s):  
Sougata Kumar Burman ◽  
Ritwik Samanta ◽  
Kumari Kanak Lata ◽  
Jayeeta Mukherjee ◽  
Tapan Kumar Dey
Keyword(s):  
Randomised Controlled Trial ◽  
Adverse Effects ◽  
Blood Loss ◽  
Postpartum Haemorrhage ◽  
Controlled Trial ◽  
Effective Control ◽  
Control Group ◽  
Third Stage ◽  
The Mean ◽  
Randomised Controlled

Introduction: In India, the routine Active Management of Third- Stage of Labour (AMTSL) with conventional intramuscular oxytocin, at the rural, resource-constrained areas, is often compromised due to lack of trained healthcare personnel and proper maintenance of cold chain system, causing maternal mortality and morbidity from Postpartum Haemorrhage (PPH). In these scenarios, tablet misoprostol, can be efficacious and convenient alternative. Aim: To evaluate efficacy and safety of misoprostol administered per rectum with respect to intramuscular oxytocin for effective control of PPH in a Randomised Controlled Trial (RCT). Materials and Methods: In this RCT, conducted in Sambhunath Pandit Hospital, kolkata, West Bengal, India from September 2015 to August 2016, total 80 eligible pregnant mothers in normal labour with prior consent and fulfilled criteria, were allocated to two separated groups (n=40) by computer generated randomisation table. Control group received 10 IU injection oxytocin and case group received 600 μg misoprostol tablet per rectally within one minute of cord clamping and cutting. The primary outcome measures were mean third- stage and mean postpartum blood loss up to eight hours after delivery. Secondary outcome variables were Mean Arterial Pressure (MAP) after eight hours postdelivery, haemoglobin and haematocrit after 24 hours of delivery and reported side effects. Data was entered into a Microsoft excel spreadsheet and statistical analysis was done by Statistical Package for the Social Sciences (SPSS) version 20.0.1 and Graph Pad Prism version 5.0. Results: Total sample size was 80 equally divided into two groups, with a mean age of 23.20±3.1558 years and 23.7750±3.8927 years in case and control group respectively. The mean third-stage blood loss (332.4105±72.6632 mL versus {vs} 329.0088±59.4503 mL, p=0.8193) and mean total blood loss (426.5575±80.0215 mL vs 424.8783±61.5808 mL, p=0.9165) were statistically indifferent between misoprostol and oxytocin groups by two-sample t-tests. The mean for eight hours postpartum MAP (p=0.0894), 24 hours postpartum haemoglobin (p=0.4534) and haematocrit (p=0.1325) were statistically insignificant between the two groups by two- sample t-tests. Incidence of adverse effects like shivering, diarrhoea, compared by Pearson’s Chi-square test, were found to be more but non significant in misoprostol group. Conclusion: This study concludes that per-rectal misoprostol is equally effective as intramuscular oxytocin to control PPH without significant adverse effects.

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