scholarly journals A comparative study of obstetrics outcome of placenta previa in scarred versus unscarred uterus at tertiary Hospital, Kathmandu, Nepal

2020 ◽  
Vol 9 (8) ◽  
pp. 3183
Author(s):  
Rakshya Upreti ◽  
Amit Rauniyar ◽  
Sumit Rauniyar ◽  
Shaheen N. Ansari ◽  
Madan Khadka
Keyword(s):  
Placenta Previa ◽  
Tertiary Hospital ◽  
Fetal Outcome ◽  
P Value ◽  
Retrospective Case ◽  
Threatening Condition ◽  
Fetal Complications ◽  
Life Threatening ◽  
Scarred Uterus ◽  
Control Study

Background: Placenta previa is an obstetric life-threatening condition with several maternal and fetal complications. The objective of this study is to compare the maternal and fetal outcome of placenta previa in scarred and unscarred uterus.Methods: A retrospective case control study was carried out on 85 cases of placenta previa in the department of obstetrics and gynecology, Paropakar Maternity and Womens Hospital (PMWH) Kathmandu from April 2019 to May 2020 of which 46 had scarred uterus and 39 cases had unscarred uterus.Results: Sixty-one of patients were less than 30 years of age, 62% presented with gestational age 28 to 37 weeks and 67% had parity between 1 to 5. Frequency of placenta previa in scarred uterus was 54% and that in unscarred uterus was 46%. Eighty percent cases with scarred uterus had anterior placenta compared to 33% of cases of unscarred uterus with p value of 0.009. 42% had grade 4 placenta previa on ultrasonography. 45 percent of patient with scarred uterus had PPH compared to 23% in unscarred group with p value of 0.03. Malpresentation was found in 7 cases in scarred group and in one case in unscarred. Cesarean hysterectomy was performed in 6 cases in scarred category compared to 2 in unscarred. Low birth weight was present in 28 cases in scarred category compared to 15 cases in unscarred category with p value 0.03.Conclusions: This study concluded that fetal and maternal outcome is adverse for cases of placenta previa with scarred uterus compared to unscarred uterus.

scholarly journals Consequences of antepartum hemorrhage and its maternal and perinatal outcome

2019 ◽  
Vol 8 (4) ◽  
pp. 1480
Author(s):  
Himang Jharaik ◽  
Bishan Dhiman ◽  
S. K. Verma ◽  
Aditi Sharma
Keyword(s):  
Perinatal Outcome ◽  
Placenta Previa ◽  
Developed Countries ◽  
Perinatal Morbidity ◽  
Antepartum Haemorrhage ◽  
High Risk Factors ◽  
Fetal Complications ◽  
Life Threatening ◽  
One Year ◽  
Life Threatening Event

Background: Antepartum haemorrhage, a life-threatening event, is defined as bleeding per vaginum occurring after the fetus has reached the period of viability, considered to be 20 weeks in developed countries and 28 weeks in countries with low resource settings. We evaluated the consequences of antepartum haemorrhage, their maternal and perinatal outcome so as to outline the proper management of patient in order to improve both maternal and perinatal morbidity and mortality.Methods: This one-year prospective study totaled 133 cases of APH fulfilling the inclusion criteria were studied. Data was recorded on the MS excel sheet for further analysis and processing.Results: Total 6693 deliveries were conducted out of which 133 presented as APH and incidence of APH was found out to be 1.98%. Placenta previa was most common. APH was commonly associated with multigravida and most cases were in age group of 26-30 years. Most of the PP and abruption cases were admitted at 34-37 weeks and 31-33 weeks respectively. High risk factors included previous LSCS and D and C, hypertension, multiple pregnancies and malpresentations. Most of the patients underwent preterm LSCS. Most fetal complications were due to prematurity. 58.6% patients were transfused blood. Overall perinatal mortality was 20.1% and maternal mortality was zero.Conclusions: Early diagnoses, timely referrals and transfusion facilities along with trained team of doctors with well-equipped ICU facility goes a long way in avoiding APH related maternak and fetal complications.

scholarly journals Incidental amniocele in a case of antepartum haemorrhage

2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Sheree C. Gray ◽  
Jacobus A. Pienaar ◽  
Zelia Sofianos ◽  
Jacob Varghese ◽  
Ilonka Warnich
Keyword(s):  
Case Report ◽  
Early Identification ◽  
Uterine Rupture ◽  
Placenta Previa ◽  
Morbidity And Mortality ◽  
Severe Morbidity ◽  
Antepartum Haemorrhage ◽  
Threatening Condition ◽  
Life Threatening

An amniocele, or contained uterine rupture, is a phenomenon in which there is herniation of the amniotic sac through a uterine defect, secondary to various causes. It is associated with severe morbidity and mortality. This case presents the findings in a 36-year-old female at 29 weeks gestation who was initially managed as antepartum haemorrhage secondary to placenta previa, based on ultrasound. Upon further imaging, an amniocele was diagnosed. This case report illustrates the importance of early identification of this life-threatening condition.

scholarly journals Association between Allogeneic Blood Transfusion and Wound Infection after Total Hip or Knee Arthroplasty: A Retrospective Case-Control Study

2019 ◽  
Vol 4 (2) ◽  
pp. 99-105 ◽  
Author(s):  
Ashish Taneja ◽  
Ahmed El-Bakoury ◽  
Hoa Khong ◽  
Pam Railton ◽  
Rajrishi Sharma ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Knee Arthroplasty ◽  
Case Control Study ◽  
Deep Infection ◽  
P Value ◽  
Receive Blood Transfusion ◽  
Retrospective Case ◽  
Superficial Infection ◽  
Total Hip ◽  
Control Study

Abstract. Background: To assess using a retrospective case control study, whether patients undergoing primary, elective total hip or knee arthroplasty who receive blood transfusion have a higher rate of post-operative infection compared to those who do not.Materials and Methods: Data on elective primary total hip or knee arthroplasty patients, including patient characteristics, co-morbidities, type and duration of surgery, blood transfusion, deep and superficial infection was extracted from the Alberta Bone and Joint Health Institute (ABJHI). Logistic regression analysis was used to compare deep infection and superficial infection in blood-transfused and non-transfused cohorts.Results: Of the 27892 patients identified, 3098 (11.1%) received blood transfusion (TKA 9.7%; THA 13.1%). Overall, the rate of superficial infection (SI) was 0.5% and deep infection (DI) was 1.1%. The infection rates in the transfused cohort were SI 1.0% and DI 1.6%, and in the non-transfused cohort were SI 0.5% and DI 1.0%. The transfused cohort had an increased risk of superficial infection (adjusted odds ratio (OR) 1.9 [95% CI 1.2-2.9, p-value 0.005]) as well as deep infection (adjusted OR 1.6 [95% CI 1.1-2.2, p-value 0.008]).Conclusion: The odds of superficial and deep wound infection are significantly increased in primary, elective total hip and knee arthroplasty patients who receive blood transfusion compared to those who did not. This study can potentially help in reducing periprosthetic hip or knee infections.

scholarly journals Study on Maternal and Immediate Fetal outcome of placenta previa

2017 ◽  
Vol 11 (2) ◽  
pp. 24-27
Author(s):  
Sushma Lama ◽  
S Ranjit
Keyword(s):  
Blood Loss ◽  
Medical Records ◽  
Placenta Previa ◽  
Fetal Outcome ◽  
Intrauterine Fetal Death ◽  
Dilatation And Curettage ◽  
Life Threatening ◽  
Study Population ◽  
Risks Factors ◽  
Caesarean Hysterectomy

Aims:  This study aimed to analyze the demographic profile, maternal and fetal outcome of placenta previa.Methods:  This was a retrospective study done at Patan Academy of Health Sciences. The study population  comprised of all the patients that had caesarean section   for placenta previa  from April 2012 to October 2015. All patients diagnosed with placenta previa clinically, ultrasonograph or incidentally  during caesarean sections were recruited in this study.  The data were obtained from medical records and hospital database system. Individual charts were reviewed  and data on various  parameters were collected.Results:  In Patan hospital, there were total 126 placenta previa cases out of 21,552 deliveries during the two and half year period hence the incidence  was 0.58 %.  We were able to retrieve patient records of only 108 of 126 cases. The incidence of placenta previa was higher with increasing maternal age ≥30 years (41.67%), more common in multigravida (65.74%). We found that associated risks factors  included previous CS, multiparity and dilatation and curettage (40.74%).  Eleven patients required blood transfusion, seven of them had blood loss of 1000-1400 ml, one had blood loss of 2000 ml. Also, Caesarean hysterectomy were performed in two patients. In term of fetal outcomes, 37.04% were preterm birth and 29.63% of the babies had low birth weight.  There was one incident of congenital anomaly, one intrauterine fetal death and six neonatal deaths.Conclusions: Placenta previa is an obstetrics complication that is potentially life threatening to both the mother and the baby.

Fetal Outcome in Lupus Pregnancy: A Retrospective Case-Control Study of 242 Pregnancies in 112 Patients

Lupus ◽  
1993 ◽  
Vol 2 (2) ◽  
pp. 125-131 ◽  
Author(s):  
Heikki Julkunen ◽  
Taneli Jouhikainen ◽  
Risto Kaaja ◽  
Marjatta Leirisalo-Repo ◽  
Eija Stephansson ◽  
...  
Keyword(s):  
Case Control Study ◽  
Fetal Outcome ◽  
Case Control ◽  
Retrospective Case ◽  
Control Study

scholarly journals A comparative study of pregnancy outcome among women with preeclampsia and normotensive at the Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria

2019 ◽  
Vol 7 (10) ◽  
pp. 3789
Author(s):  
Chuka N. Obi ◽  
Vitus O. Obi ◽  
Johnbosco I. Nwafor ◽  
Blessing I. Onwe ◽  
Victor U. Onuchukwu ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Teaching Hospital ◽  
Case Control Study ◽  
University Teaching ◽  
P Value ◽  
Perinatal Morbidity ◽  
Retrospective Case ◽  
Fetal Outcomes ◽  
Multisystem Disease ◽  
Control Study

Background: Preeclampsia is a pregnancy specific multisystem disease and it is associated with increased maternal and perinatal morbidity and mortality. Any factor(s) which could reliably predict the likelihood of serious complications would be very valuable in predicting the associated adverse outcome. Objective of this study compare maternal and fetal outcomes of preeclamptic patients with normotensive control in Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria.Method: This was a 4-year retrospective case-control study of the pregnancy outcomes among preeclamptic and normotensive women managed in our facility between 1st January 2012 and 31st December 2015. Data analysis was done using Epi Info software 7.2.1.Results: During the study period there were 6,585 deliveries among which 92 of the patients were managed for preeclampsia. This gives a prevalence of 1.4% or 14 per 1000 deliveries. There was no difference in the age and parity of the control. Most of the preeclamptic patients managed over the study period were unbooked for antenatal care in the facility (p value <0.0001). Preeclamptic patients were more likely to be delivered preterm (p value was <0.0001), and by caesarean section compared to the control. They were also more likely to have babies with low birth weights and poorer fetal outcomes. There was no difference in maternal mortality between both groups.Conclusion: Preeclampsia is associated with the unbooked status and poorer perinatal outcome compared with normotensive women. There is need to encourage women to book for antenatal care for prompt identification and management of these women.

CASE SERIES OF PREGNANCY-ASSOCIATED MYOCARDIAL INFARCTION: AN EPIDEMIC IN WAITING

2021 ◽  
pp. 28-30
Author(s):  
Shree Bharathi ◽  
Sasirekha Rengaraj
Keyword(s):  
Myocardial Infarction ◽  
Care Center ◽  
Tertiary Care ◽  
Case Series ◽  
Fetal Outcome ◽  
Therapeutic Implications ◽  
Threatening Condition ◽  
Life Threatening ◽  
Common Etiology ◽  
Artery Disease

Acute myocardial infarction during pregnancy or postpartum period is a rare but life-threatening condition associated with poor maternal and fetal outcome. Although atherosclerotic coronary artery disease is the most common etiology in general population, the causation is more diverse in pregnancy and this may have therapeutic implications. Early diagnosis and timely management with collaboration among Maternal-fetal medicine specialist, interventional cardiologist, cardiac anaesthetist, intensivist and neonatologist is essential to prevent maternal cardiac deaths. We present a case series of two patients with postpartum and antepartum acute MI, respectively and their diagnosis, management and outcomes in a tertiary care center.

scholarly journals Prediction of intraperitoneal adhesions using striae gravidarum and scar characteristics in women undergoing repeated cesarean sections

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohamed Elprince ◽  
Omima T. Taha ◽  
Zakia M. Ibrahim ◽  
Rasha E. Khamees ◽  
Mahmoud A. Greash ◽  
...  
Keyword(s):  
Scoring System ◽  
Predictive Performance ◽  
Tertiary Hospital ◽  
Control Group ◽  
P Value ◽  
Cesarean Scar ◽  
Intraperitoneal Adhesions ◽  
Almost All ◽  
Control Study

Abstract Background The current fact of increasing rates of cesarean deliveries is a catastrophe. Recurrent cesareans result in intraperitoneal adhesions that would lead to maternal morbidity during delivery. Great efforts are directed towards the prediction of intraperitoneal adhesions to provide the best care for laboring women. The aim of the current study was to evaluate the role of abdominal striae and cesarean scar characters in the prediction of intraperitoneal adhesions. Methods This was a case- control study conducted in the emergency ward of the obstetrics and gynecology department of a tertiary hospital from June to December 2019. The study was carried on patients admitted to the ward fulfilling particular inclusion and exclusion criteria. The study included two groups, group one was assessed for the presence of striae, and the degree of intraperitoneal adhesions was evaluated during the current cesarean section. Group two included patients without evidence of abdominal striae. They were evaluated for the severity of adhesions also after evaluation of the previous scar. Evaluation of the striae was done using Davey’s scoring system. The scar was assessed using the Vancouver Scar Scale. The modified Nair’s scoring system was used to evaluate intraperitoneal adhesions. Results The study group included 203 women, while the control group included 205 women. There were significant differences in the demographic characters of the recruited patients (p-value 0.001 for almost all variables). The mean Davey score in those with mild, moderate, and severe striae was 1.82 ± 0.39, 3.57 ± 0.5, and 6.73 ± 0.94, respectively (p-value < 0.001). Higher scores for the parameters of the Vancouver scale were present in patients with severe striae (1.69 ± 1.01, 1.73 ± 0.57, 2.67 ± 1.23, and 1.35 ± 1.06 for scar vascularity, pigmentation, pliability, and height respectively with a p-value of < 0.001 each). Thick intraperitoneal adhesions were noted significantly in women with severe striae [21 (43.75%), p-value < 0.001)]. The Davey’s and Vancouver scores showed highly significant predictive performance in the prediction of intraperitoneal adhesions (p-value < 0.001). Conclusion Abdominal striae and cesarean scar were significant predictors for intraperitoneal adhesions.

scholarly journals Prediction of intraperitoneal adhesions using striae gravidarum and scar characteristics in women undergoing repeated cesarean sections

2020 ◽  
Author(s):  
Mohamed Elprince ◽  
Omima Tharwat Taha ◽  
rasha khamees ◽  
khaled atwa ◽  
Ahmed gadallah ◽  
...  
Keyword(s):  
Scoring System ◽  
Predictive Performance ◽  
Tertiary Hospital ◽  
Control Group ◽  
P Value ◽  
Cesarean Scar ◽  
Intraperitoneal Adhesions ◽  
Almost All ◽  
Control Study

Abstract Background: The current fact of increasing rates of cesarean deliveries is a catastrophe. Recurrent cesareans result in intraperitoneal adhesions that would lead to maternal morbidity during delivery. Great efforts are directed towards the prediction of intraperitoneal adhesions to provide the best care for laboring women. The aim of the current study was to evaluate the role of abdominal striae and cesarean scar characters in the prediction of intraperitoneal adhesions.Methods: This was a case- control study conducted in the emergency ward of the obstetrics and gynecology department of a tertiary hospital from June to December 2019. The study was carried on patients admitted to the ward fulfilling particular inclusion and exclusion criteria. The study included two groups, group one was assessed for the presence of striae, and the degree of intraperitoneal adhesions was evaluated during the current cesarean section. Group two included patients without evidence of abdominal striae. They were evaluated for the severity of adhesions also after evaluation of the previous scar. Evaluation of the striae was done using Davey's scoring system. The scar was assessed using the Vancouver Scar Scale. The modified Nair's scoring system was used to evaluate intraperitoneal adhesions.Results: The study group included 203 women, while the control group included 205 women. There were significant differences in the demographic characters of the recruited patients (p-value 0.001 for almost all variables). The mean Davey score in those with mild, moderate, and severe striae was 1.82 ± 0.39, 3.57 ± 0.5, and 6.73 ± 0.94, respectively (p-value <0.001). Higher scores for the parameters of the Vancouver scale were present in patients with severe striae (1.69 ± 1.01, 1.73 ± 0.57, 2.67 ± 1.23, and 1.35 ± 1.06 for scar vascularity, pigmentation, pliability, and height respectively with a p-value of <0.001 each). Thick intraperitoneal adhesions were noted significantly in women with severe striae [21 (43.75%), p-value <0.001)]. The Davey's and Vancouver scores showed highly significant predictive performance in the prediction of intraperitoneal adhesions (p-value < 0.001).Conclusion: Abdominal striae and cesarean scar were significant predictors for intraperitoneal adhesions.

scholarly journals Proton pump inhibitor: a risk factor for spontaneous bacterial peritonitis in Indian cirrhotics decompensated with ascites

2019 ◽  
Vol 7 (2) ◽  
pp. 378
Author(s):  
Akash Rajender ◽  
Priyanka Choudhary ◽  
Saumya Mathur ◽  
Rajat Bhargava ◽  
Shalini Upadhyay ◽  
...  
Keyword(s):  
Risk Factor ◽  
Spontaneous Bacterial Peritonitis ◽  
Beta Blockers ◽  
Bacterial Colonization ◽  
Study Groups ◽  
P Value ◽  
Retrospective Case ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients ◽  
Control Study

Background: Spontaneous bacterial peritonitis (SBP) is common complication of cirrhosis caused by bacterial translocation. Bacterial colonization and overgrowth may occur in GI tract on suppression of gastric acid secretion. Beta-blockers have been postulated to reduce intestinal permeability. There is no significant Indian study to evaluate association of PPI with SBP in cirrhotic ascites. We aimed to assess the effect of PPI in cirrhotic patients decompensated with ascites.Methods: A retrospective case control study (January 2016 to April 2018), evaluated subjects with cirrhosis and ascites. Two study groups of cirrhotic subjects with and without SBP were formed. In each of the two study groups, 143 subjects, were enrolled by matching for age, year of admission, Child-Pugh-Turcotte (CTP) class after considering the inclusion and exclusion criteria. PPI use and various other correlates were compared in both study groups. SPSS ver 24.0 was used for statistical analysis.Results: About 69.23% subjects were using PPI prior to admission in SBP group, which was significant compared to only 31.47% in cirrhotics without SBP (p 0.003). On multivariate analysis PPI use was an independent risk factor for SBP (OR 2.24, 95% CI: 1.01-4.24; p value 0.033) and beta blocker use was protective (OR 0.58; 95% CI: 0.4-0.8; p 0.001).Conclusions: PPI use doubles the risk of development of SBP in cirrhotics decompensated with ascites. In contrast, Beta blockers use significantly lowers the risk of SBP.

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