scholarly journals Foetomaternal outcome in multifoetal pregnancy in a tertiary rural teaching hospital

Author(s):  
Sneha Gond ◽  
Partha Pratim Sharma ◽  
Narra Madhuri ◽  
Kasturi Barman

Background: Aim of the study was to find out foeto-maternal outcome of multifoetal pregnancy in relation to chorionicity and to analyse the associated risk factors.Methods: This study was a prospective observational study on multifoetal pregnancy conducted at Midnapore medical college and hospital. Statistical analysis was done by chi-square test and statistical significance was set at p-value<0.05.Results: Incidence of multifoetal pregnancy was 1.7%. Modal age group was 20-24 years age and 82% conceived spontaneously. Among chorionicity, Dichorionic diamniotic (DCDA) were 60% followed by 34% Monochorionic diamniotic (MCDA), 4% Monochorionic monoamniotic (MCMA) and 2% Trichorionic triamniotic (TCTA). Among maternal complications preterm labour were present in both twins and triplets followed by anemia. LSCS was required in 60.8 % of twins and common indication was malpresentation. Majority of MC and TC were delivered at gestational age of 31-33 weeks (47.1% MCDA, 50% MCMA and 60% TCTA) and dichorionic delivered at 34-36 week (48.7%). Statistical association between neonatal outcomes and chorionicity were significant in IUGR (p=<0.0001), stillbirth (p=0.0356), congenital anomalies (p=0.0017), discordant growth (p<0.0001), Apgar score <7 (p<0.0001), low birth weight (p=0.014), live birth (p≤0.0001) and NICU admission (p<0.0001).Conclusions: Maternal and perinatal outcome was significant in monochorionic and trichorionic pregnancies compared to dichorionic pregnancies with increased NICU admissions required in monochorionic and trichorionic gestations.

2020 ◽  
pp. 9-11
Author(s):  
Madhu Kumari ◽  
Kumari Bibha ◽  
Abha Sinha ◽  
Debarshi Jana

Objective: The objective of this study is to find out association between scar thickness, assessed sonographically, and intraoperative findings (IOF). Study Design: Descriptive study. Place and Duration of Study: Department of Obstetrics and Gynecology, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar from June 2019 to May 2020. Methodology: A total of 70 pregnant patients were included in this study. Transabdominal ultrasound was done for scarred uteri. Sonographic findings were co-related with introperative findings. All the given data were entered on SPSS version 23. Age was expressed as mean ± SD. Parity, gestational age, and interval between cesarean sections were expressed as frequencies with percentages. Statistical analysis was done by using Chi-square test for categorical data for association between sonographic scar thickness and intraoperative findings. The statistical significance was set at p-value <0.05. Results: The age range of the patients was 20- 36 years with a mean of 27.91 ±3.690 years. Gestational age at the time of cesarean section was between 27-40 weeks of gestation with a mean of 37 ±2.126 weeks. The interval from previous cesarean was 10 months at the minimum, and 6 years at the maximum with a mean of 2.29 ±1.0 months. Mean scar thickness was 2.5 mm. Association between scar thickness (<1-3 mm) and intaoperative findings of dehiscence and rupture showed a p-value of <0.001. Conclusion: Sonographic assessment of a uterine scar has a practical application to determine the thickness of previous scar, and assess its integrity.


Folia Medica ◽  
2020 ◽  
Vol 62 (3) ◽  
pp. 468-476
Author(s):  
Samantha Mc Kenzie Stancu ◽  
Manuela Cristina Russu

Introduction: Appropriate intrapartum conduct in a twin delivery remains a challenging aspect of obstetric practice. The objective of this study was to compare neonatal and maternal outcomes in twin pregnancies according to mode of delivery.&nbsp; Materials and methods: This is a single centre retrospective cohort study of all consecutive spontaneously-conceived twin deliver-ies (&ge; 24 weeks, estimated fetal weight &ge; 500 grams) over a nine-year period between 01/01/2007 - 31/12/2016 at a tertiary-level centre. Neonatal outcomes included survival, APGAR score, prematurity-associated pathology (PAP), admission to the neonatal intensive care unit (NICU) and length of stay (LOS). Maternal outcomes included postpartum complications and LOS. Statistical analysis comprised Chi-square test with subsequent p-value and odds-ratio with 95% confidence interval. Statistical significance was set at p<0.05. Results: A total of 173 consecutive women with spontaneously-conceived twin deliveries were enrolled in this study, 129 (74.6%) women delivered by caesarean section (CS). The success rate of vaginal delivery (VD) was 93.6% (44/47). A strong statistical correlation was identified between CS and NICU admission; 53.2% vs. 1.5% (p=0.0001). Neonatal LOS in the NICU was significantly longer in the CS group. Prematurity-associated pathology (PAP) was noted in 75 pairs of twins (75/173); 61 pairs were delivered by CS, bearing strong statistical significance (p<0.0001). Postpartum complications occurred in 14.7% of CS compared to 13.6% of VDs.&nbsp; Conclusion: Neonates delivered by CS had a higher rate of PAP, NICU admission, lower birth weight and longer LOS. This study showed that VD is safe, especially when the first twin is in cephalic presentation


Author(s):  
Prakruti P. Patel ◽  
Mittal V. Bhabhor ◽  
Pankti Jayswal ◽  
Saila A. Khatri ◽  
Grishma P. Brahmbhatt ◽  
...  

Background: Before the induction of labour cervical ripening is needed for the success of induction to reduce the complication and diminish the rate of cesarean section and duration of labour. Various mechanical methods like Foleys catheter are effective but not much popular because of infection and pharmacological preparations which have more side effects, are used for cervical ripening. Therefore study has been conducted to compare the efficacy and safety of intra cervical Foleys catheter versus PGE2 gel for induction of labour at term. The aims and objectives of this study was to success of induction of labour depends on the cervical status at the time of induction.Methods: A prospective comparative study was conducted in the department of obstetrics and gynecology, L.G. hospital (AMCMET Medical college), Ahmedabad, during period of July 2019 to December 2019. 100 patients at term with a Bishop’s score with various indications for induction were randomly allocated to receive (50 patients) intra cervical Foleys catheter or PGE2 gel (50 patients). Post induction Bishop’s score was noted after 6 hours, 12 hours, 24 hours. Statistical methods used were Student t test and Chi square test to statistically compare the two groups. Differences with a p value of <0.005 was considered statistically significant with confidence limit of 95%.Results: The groups were comparable with respect to maternal age, gestational age, parity, indication of induction and initial bishops score. Both groups showed significant change in the Bishops score, 5.10±1.55 and 5.14±1.60 for Foleys catheter and PGE2 gel, respectively, p<0.001. Fetal outcome was noted in NICU admission and fetal death. No significant difference between two groups.Conclusions: This study shows that both Foleys catheter and PGE2 gel were equally effective in pre induction cervical ripening.


2021 ◽  
Vol 30 (02) ◽  
pp. 103-106
Author(s):  
Ajeet Kumar ◽  
◽  
Naveed Iqbal ◽  
Javaria Farooq ◽  
Saad Uddin Siddiqui

OBJECTIVE: This study was performed to compare incidence of perforations in Latex and Nitrile examination gloves during Minor Oral surgical procedures performed under local anesthesia. METHODOLOGY: 100 pairs of latex and 100 pairs of Nitrile examination gloves where used to perform 200 minor oral surgical procedures under local anesthesia. After completion of every minor oral surgical procedure each gloves was examined by Water Inflation method to observe presence or absence of Perforations. A data sheet was used to collect data including type of Gloves used (Latex or Nitrile) presence of perforations, sites of perforations and nature of minor oral surgical procedures. Data was entered and analyzed using SPSS version 20. Descriptive analysis was conducted to calculate frequency and percentages of Number and sites of perforations for both Nitrile and latex examination gloves. Chi Square test was used to find out statistical significance of difference of perforations rate between Nitrile and Latex gloves. P value of < 0.05 was considered significant. RESULTS: Out of 200 latex gloves 23 (11.5) had 29 perforations whereas out of total 200 Nitrile gloves 28 (14%) had 22 perforations. Nitrile gloves had a statistically significant higher rate of perforations as compared to Latex gloves. (P value 0.043). For both Nitrile and Latex gloves left non dominant hand had highest frequency of perforations Latex 18 (81.81%) perforations and Nitrile 18(62.06%). Index finger and thumb were most frequent sites of perforations in both Latex and Nitrile gloves. CONCLUSION: Gloves perforations were more common in Nitrile examination gloves however total number of perforations was more in Latex examination gloves.


2019 ◽  
Vol 3 (9) ◽  
pp. 283-289
Author(s):  
Shuchi Sukul ◽  
Goldy Rathee ◽  
Parimal Anand ◽  
Sakshi Kataria ◽  
Pratibha Taneja

OBJECTIVES: The present research was conducted to assess incidences of root microcracks caused by hand and rotary file system at different lengths MATERIAL AND METHODS: This in-vitro study was undertaken to assess incidence of root microcracks caused by hand and rotary file system at different lengths In total, 100 the mandibular premolar with straight roots determined with intact, fully formed apices were taken. Samples were randomly distributed into 5 groups based on the file system used: a) Group A: Control, b) Group B: Reciproc, c) Group C: WaveOne, d) Group D: One Shape and e) Group E: ProTaper. Pearson Chi-square test was used to determine the differences between groups. The dentinal defects were expressed as percentage of samples with microcracks in each group. Level of statistical significance was set at p-value less than 0.05. RESULTS: The chi square test was used to compare the Distribution of the number of teeth in which cracks were observed on the horizontal sections. It was found to be significant with group ProTaper showing maximum cracks at 3,6,9 mm level as compared to other file systemCONCLUSION: Nickel-titanium instruments causes cracks on the apical root surface or in the root canal wall. ProTaper causes maximum dentinal cracks as compared to other file systems


2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Gamal Ejaimi ◽  
Abla Saab ◽  
Sittelnissa Ahmed ◽  
Areeg Ahmed ◽  
Hussain Abujamilah ◽  
...  

Induction of general anesthesia with propofol and fentanyl could result in hypotension and bradycardia. Various methods are being used to prevent these adverse effects. The aim of our study was to assess the efficacy and safety of a small dose of ephedrine in prevention of hypotension following administration of propofol and fentanyl. This prospective, randomized, comparative study was conducted among a total of 50 patients, both genders, age 18 years up to 60 years with ASA grade Ι and ΙΙ and some of class ΙΙΙ, presented for elective surgery under general anesthesia. Patients were randomly allocated into one of two groups (25 patients in each): CG (the control group), which received propofol in a dose of 2 mg/kg, intravenously, over 20–30 s mixed with 2 mL normal saline: and EphG (Ephedrine group), while received propofol in a dose of 2 mg/kg, intravenously, over 20–30 s mixed with 2 mL of ephedrine (10 mg). The Mean Arterial Blood Pressure (MAP) and Heart Rate (HR) were recorded before induction and then every 1 min up to 6 min after induction. The categorical data are presented as a number and percentage and were subjected to Fisher’s exact or Chi-square test for analysis. The statistical significance was p≤0.05. The significant differences in HR were observed in the 3rd,4th, and 5th minutes with P-value, 0.018, 0.000, 0.000, respectively. However, no patient in the study participants had bradycardia. The significant differences in MAP were observed in the 2nd, 3rd,4th, and 5th minutes with P-value, 0.035, 0.000, 0.000, and 0.000, respectively. The percentage of patient in CG who developed hypotension in the 3rd and 4th is 44% and 32% compared to 8% and 0% in EphG, with significant differences (P-value 0.004 and 0.002, respectively). Administration of small dose of ephedrine with propofol could attenuate propofol/fentanyl hypotensive and bradycardic effects.


JKCD ◽  
2019 ◽  
pp. 1-4
Author(s):  
Nadia Munir

Objective: This study aimed to find out the fr equency of the MB2 canal in maxillary first molars, using different diagnostic methods. Materials & Methods: 106 patients, clinically diagnosed with irreversible pulpitis and exposed pulp, requiring endodontic treatment were selected via random non-probability purposive sampling technique for the study . This cross-sectional study was conducted for 12 weeks in the dentistry department of Ayub Medical College from August 2018 to October 2018. A detailed history was taken and documented in the pro-forma. After administration of Local anaesthesia and rubber dam application, the access cavity was prepared and floor of the pulp chamber visualized. MB2 Canal location was done with a naked eye and under magnification (x2.0 to x6.0) Magnification and confirmed by inserting size 08 K file. The data obtained were analyzed using SPSS version 20. Chi-square test was run to determine the association of the presence of the MB2 canal with other variables. P-value of 0.05 was considered to be significant.


2019 ◽  
Vol 6 (6) ◽  
pp. 2571
Author(s):  
Anupama Vinayak Mauskar ◽  
Amrit Gopan

Background: India is the country with highest burden of TB. There is paucity of data as far as Pediatric TB is concern. TB in children directly reflects intensity of on-going transmission of TB in a given community. This study was done including indoor cases of Pediatric pulmonary TB in a medical college hospital, a tertiary care institute in the city of Mumbai. The aim and objectives of this study the clinical profile and outcome of Pediatric pulmonary tuberculosis/MDR TB in an indoor setting of a tertiary care center. It was a clinical observational study in a setting of medical college hospital.Methods: All admitted children with newly diagnosed pulmonary TB were included in study. A detailed clinical analysis was done. Statistical Analysis Association between two qualitative data was assessed by Chi-Square test, Fisher's exact test for all 2 X 2 tables where Chi-Square test was not valid due to small counts. Comparison of quantitative data measured between two outcomes was done using unpaired t-test. PSPP version 0.8.5 was used for statistical analysis.Results: Total of 41 patients with pulmonary TB were included in the study, making admission rate of 0.7% of total admission. Three out of 41 children had MDRTB making incidence 7% of total TB patients. Severe acute malnutrition was a major risk factor for dissemination of disease and mortality (p value 0.031and 0.0017).Conclusions: The study estimates 0.7% admission rate and 7% as incidence of MDRTB in indoor patients. Severe malnutrition was found to be risk factor for dissemination of disease [p value 0.031].


2011 ◽  
Vol 1 (2) ◽  
pp. 49-52
Author(s):  
Chidi Oliver Ihemedu ◽  
Charles Oluwole Omolase

Objective: This study was designed to determine the level of awareness and extent of use of computer shields among computer users in Owo, in South-West Nigeria. Material & Methods: The subjects were selected by a simple random sampling method. Data collection was through a combination of e-mail based on-line questionnaire using the survey monkey website, and the self administered semi structured hard copy questionnaire. The information obtained from the respondents with the questionnaire included their bio-data, extent of computer use, history of ocular symptoms, awareness and utilization of computer shields. The data obtained with the study instrument was collated and analyzed using the SPSS 15.0.1 statistical software, cross tabulation of attendants results were done with chi-square test and statistical significance was set at p ≤ 0.05. Results: 108 of 124 selected subjects filled their questionnaire to acceptable level. There were a large number of respondents who were aware of the various types of computer shields (70.5%) (p-value 0.002). However, the utilization level was not commensurate as only 39.8% (N= 43) utilized any of these shields, 49.1% (N= 53) were none users while 11.1% (N= 12) did not respond (p-value 0.062). Conclusion: Majority of the respondents were aware of computer shield. However, less than half of the respondents utilized computer shields. There is need to encourage all computer users on the use of computer shields to ensure better computer working time. Key Words: Awareness; Computer shields; Nigeria DOI: 10.3126/ajms.v1i2.2826Asian Journal of Medical Sciences 1 (2010) 49-52


Author(s):  
Uzma Kauser ◽  
Anjali Chaudhari

Background: Hypertensive in pregnancy is the second most common cause of maternal mortality in India. Among the hypertensive disorders that complicate pregnancy, pre-eclampsia and eclampsia stand out as major causes of maternal and perinatal mortality and morbidity. The majority of deaths due to pre-eclampsia and eclampsia are avoidable through the provision of timely and effective care to the women presenting with these complications. Objectives of this study were to find out the effectiveness of intravascular and intramuscular magnesium sulfate in management of eclampsia. To compare the side effects and complications of intravascular and intramuscular magnesium sulfate in management of eclampsia.Methods: A total 100 patients presenting with eclamptic fits reporting to the center that has been included in the study. The study has been conducted in the labor room of Nehru Chikitsalaya of B. R. D. Medical College, Gorakhpur, Uttar Pradesh for 12 months duration period. Statistical analysis of observations has been done by Chi-square test with p-value <0.05 has been considered in the study.Results: Majority of eclampsia patients belonged to 20-25 years age group (63%) followed by above 30 years of age (22%).  Nearly 16% patients in IM MgSO4 group and 12% patients in IV MgSO4 received recurrence of seizure after starting of treatment (p value >0.5). About 26% patients in IM MgSO4 group and 18% patients in IV MgSO4 group had mild side effects of MgSO4 but no patients in both the group had major side effects of MgSO4.Conclusions: The study concludes that intramuscular injection of MgSO4 is painful and the chances of abscess formation that's why compliance of intramuscular MgSO4 is not very good in compared to intravascular infusion of MgSO4. The chances of Mg toxicity are more MgSO4 regimen because of the dose required in IM MgSO4 regimen is more (44gm) that of IV MgSO4 (28 gm).


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