scholarly journals Study of fetomaternal outcomes in antepartum haemorrhage at tertiary care centre

2021 ◽  
Vol 10 (4) ◽  
pp. 1509
Author(s):  
Faaizah Husain Ghanchibhai ◽  
Sharda Goyal ◽  
Nalini Sharma ◽  
Ankita Pargee
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Perinatal Mortality ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Maternal Complications ◽  
Mortality And Morbidity ◽  
Antepartum Haemorrhage ◽  
Abruptio Placenta

Background: Antepartum haemorrhage (APH) is a challenge to obstetrician as it involves a question of life and death to mother and fetus. Antepartum hemorrhage is the 2nd most common cause of maternal mortality and morbidity as sepsis and obstructed labour has decreased now. The aim of the study is to find the prevalence of APH. And to study foeto-maternal outcomes in patients with antepartum haemorrhage, association of comorbidities and risk factors.Methods: This study was conducted at Geetanjali Medical College and Hospital, Udaipur after obtaining approval from institutional research ethical board and written informed consent during the period of February 2019 to July 2020. This was prospective observational study, sample size was 60 patients. All the APH patients who were admitted at GMCH Obstetrics and Gynaecology department after 28 weeks of gestation were included in study. Extrauterine or bleeding due to general pathology was excluded. Total number of delivery were 1900 in above duration and number of APH patients were 60, so our incidence is 3.1%.Results: Total number of delivery were 1900 in above duration and number of APH patients were 60, so our incidence is 3.1%. According to maternal complications rate, It was 66.66 % in abruptio placenta, 37.03 % in placenta previa and jointly 53.33%. In placenta previa group 100% patients discharged with good GC, In abruptio placenta group 96.96% patients discharged with good GC and 3.04% patients discharged with poor GC. Perinatal mortality was zero in placenta previa group and in abruptio placenta, it was 27.27% (24.24% IUD, 3.03% neonatal death).Conclusions: The main cause of APH was abruption which was seen in 33 (55%) of patients and placenta previa was seen in 27 (45%) of patients. Maternal and neonatal complications, both were very high in abruption group as compared to placenta previa group. Overall maternal mortality rate was 53.33% and perinatal mortality rate was zero in placenta previa group while in abruption placenta group, it was 27.27%. There was no maternal complications in booked placenta previa cases only there were very few complications in emergency cases. In abruptio placenta group also complications were more in emergency cases, irregular booked and uncontrolled pregnancy pathology cases. 

scholarly journals Study of antepartum hemorrhage and its maternal and perinatal outcome at a tertiary care hospital

2021 ◽  
Vol 10 (6) ◽  
pp. 2210
Author(s):  
Amruta R. Kulkarni ◽  
Arti S. Shirsath
Keyword(s):  
Maternal Mortality ◽  
Perinatal Mortality ◽  
Perinatal Outcome ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
Antepartum Haemorrhage ◽  
Medical College ◽  
Abruptio Placenta

Background: Antepartum haemorrhages are defined as bleeding from or into the genital tract after the period of viability untill delivery of the fetus. APH complicates 3-5% of pregnancies and is a leading cause of perinatal and maternal mortality worldwide. Objective of this study is to quantitate maternal morbidity, mortality and perinatal outcome in patients with APH at a tertiary care hospital.Methods: A retrospective observational study was carried out in the department of obstetrics and gynecology, Smt. Kashibai Navale medical college and general hospital, Pune. Patient information was obtained from the delivery records of 2018, 2019 and 2020. Patients presenting after the gestational age of 28 weeks with antepartum haemorrhage were included in the study.Results: Out of 100 cases of APH, abruptio placenta contributes to 60%, placenta previa to 37% and 3 cases were due to unknown cause. Overall maternal mortality was 3% and perinatal mortality was 23% in abruptio placentas compared to 13% in cases with placenta previa. Main cause of perinatal mortality was prematurity69%.Conclusions: Antepartum haemorrhage is one of the leading cause of perinatal mortality and morbidity. These cases should be deliverd at a centre with transfusion facility, NICU facility and by the obstetrician skilled in controlling intraoperative haemorrhage by stepwise devascularising sutures. Timely decision of uterine tamponade can also save few ceaserean hysterectomies.

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 Incidence of antepartum haemorrhage in pregnancy and its maternal-fetal outcome in admitted antenatal patients in tertiary care centre, Bhilai Durg, Chhattisgarh

2021 ◽  
Vol 10 (4) ◽  
pp. 1406
Author(s):  
Seema Khandasu ◽  
Pooja Singh ◽  
Rekha Ratnani
Keyword(s):  
Maternal Morbidity ◽  
Neonatal Intensive Care ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Expectant Management ◽  
Fetal Outcome ◽  
Perinatal Morbidity ◽  
Tertiary Care Centre ◽  
Mortality And Morbidity ◽  
Antepartum Haemorrhage

Background: Antepartum haemorrhage has always been one of the deadliest complications in obstetrics. Antepartum haemorrhage (APH) complicates about 2-5% of pregnancies. Maternal and perinatal morbidity and mortality associated with APH can be reduced significantly by aggressive expectant management. The present study was conducted to assess maternal and fetal outcome in patients with antepartum haemorrhage. Aims and objectives were to study the incidence of antepartum haemorrhage at SSIMS hospital. To highlight the importance of early diagnosis and treatment. To study the maternal and fetal outcome in antepartum haemorrhage. To study the associated risk factors contributing to maternal and fetal morbidity and mortality.Methods: The study was conducted in Shri Shakaracharya Institute of Medical Sciences, Bhilai, Durg, Chhattisgarh during the period of January 2020 to December 2020 after getting approval from the institutional ethical committee. 31 cases of APH with gestational age ≥28 weeks were included. They were distributed according to type of APH into abruptio placentae (AP), placenta previa (PP). Causes of APH were noted and maternal as well as perinatal outcome observed.Results: In the present study it was observed that incidence of APH was 2% out of 1503 deliveries. Out of 31 cases, 54.83% was AP followed by PP 45.16%. Abruption was the commonest cause of APH with its associated maternal morbidity and perinatal mortality and morbidity. Anemia was the most common complication in APH. Prematurity of the neonate was a serious complicating factor in APH. No maternal mortality was seen in this study.Conclusions: Overall incidence of APH has remained high. Though maternal morbidity is reduced with modern management of APH, but timely diagnosis and intervention is necessary. Perinatal morbidity can be reduced with good neonatal intensive care facilities.

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 Management of major degree placenta previa during LSCS operation - a new surgical technique (Dutta's)

2013 ◽  
Vol 4 (2) ◽  
pp. 1-7 ◽  
Author(s):  
Dilip Kumar Dutta ◽  
Indranil Dutta
Keyword(s):  
Surgical Technique ◽  
Maternal Mortality ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Polyglycolic Acid ◽  
Care Hospital ◽  
Artery Ligation ◽  
Mortality And Morbidity ◽  
Cesarean Hysterectomy ◽  
New Surgical Technique

Objectives: Evaluation of a new surgical technique (Dutta’s) to prevent postpartum hemorrhage due to major degree placenta previa during cesarean section. Methods:This study was conducted at tertiary care hospital(JNM,& NSGH) at Kalyani, Nadia, West Bengal, India from the period January 2004 to December 2009.Ninty four (94) cases diagnosed to be having major degree placenta previa, undergoing LSCS operation, were selected for this study. New surgical technique(Dutta’s) was adopted in a stepwise manner = delivery of baby > bilateral uterine artery ligation by chromic catgut no-1 suture >injection tranexamic acid (1000mg) IM > injection oxytocin in intravenous infusion(10 units 30 drop /min in 500 ml of 5% dextrose)>delivery of placenta and membranes> checked properly if any tear or laceration in placental site > closure of uterine wound was done after securing bleeding from placental bed >closure of abdomen in layers by polyglycolic acid no 1 suture. Results: It was observed from this study that good effectiveness to control bleeding and intra operative blood loss less than 300cc were seen in 89(94.68%) cases respectively. Six (6.3%) cases required underlying interrupted suture for bleeding from placental bed. Subtotal cesarean hysterectomy was advocated in 3(3.28%) cases due to failure to control uterine atony. Immediate post operative bleeding less than 200c.c was found in 81 (86.16%) cases. Maternal mortality was found to be absent. Maternal morbidity was seen in 12(12.76%) cases. Subsequent menstrual cycles were found to be normal in 80(87.91%) cases and repeated pregnancy was observed in 26(28.57%) cases indicating non effect on gonadal function. Conclusion: Dutta’s new surgical technique during LSCS for major degree placenta previa was found to be simple, safe and quick procedure. It reduces perfusion pressure, permits time for further steps, thereby avoiding unnecessary ligation of bilateral internal iliac arteries and cesarean hysterectomy. Maternal mortality and morbidity were also found to be reduced. This technique is suitable for rural based hospital in absence of adequate blood transfusion facility.DOI: http://dx.doi.org/10.3126/ajms.v4i2.7958 Asian Journal of Medical Sciences 4(2013) 1-7

scholarly journals STUDY OF MATERNAL MORTALITY IN A TERTIARY CARE CENTRE

2020 ◽  
pp. 30-32
Author(s):  
Anamika Anamika ◽  
Amrita Sharan
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Rural Areas ◽  
Health Workers ◽  
Tertiary Care ◽  
World Health ◽  
Care Hospital ◽  
Contributing Factors ◽  
Tertiary Care Centre ◽  
Maternal Mortality Rate

BACKGROUND Maternal death or maternal mortality is defined by the World Health Organisation (WHO) as the “death of a women while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.” AIMS AND OBJECTIVES 1. To study the causes of maternal mortality, 2. To identify the deficits to decrease the current rate of maternal mortality. MATERIALS AND METHODS This was a retrospective study done by analyzing hospital records of maternal mortality occurring in the department of obstetrics and gynaecology of a tertiary care hospital of Bihar from January 2019 to December 2019. RESULTS A total of 126 deaths occurred in this period of 1 year. The total number of live births was 5568 in this year making the maternal mortality rate (MMR) to be 2262.93. This may be due to the fact that being a referral institute most of the cases were referred from the peripheries. 76.19% of the women were referred from outside. The most common age group to be affected was 20 to 29 years (79.36%). Multiparous women were more affected than primiparous women (61.9% V/s 38.10%). The most common cause of maternal mortality was eclampsia seen in 26.98% cases followed by PPH seen in 22.22% cases, anemia in 8.73%, medical complications in 7.94% cases , APH in 7.14% cases , rupture uterus in 7.14% cases. The most common type of delay was type 1 and 2. More number of women were from rural areas. More number of women were illiterates. Most of the women had no ANC. CONCLUSION Illiteracy, poverty, lack of knowledge, delayed referrals, lack of ANC are major contributing factors causing such high maternal mortality rate. Health education, strengthening of peripheral health care and availability of trained health workers and essential drugs should be enforced.

scholarly journals Dengue infection in pregnancy and outcome in a tertiary care centre

2018 ◽  
Vol 7 (12) ◽  
pp. 5051
Author(s):  
Veena L. ◽  
Srinivas Srinivas ◽  
Aruna Aruna
Keyword(s):  
Pregnant Women ◽  
Multiorgan Failure ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Fluid Management ◽  
Close Monitoring ◽  
Tertiary Care Centre ◽  
Maternal Complications ◽  
Mortality And Morbidity ◽  
In Pregnancy

Background: Dengue is a mosquito borne viral infection with significant disease burden across the country. With the recent resurgence of the disease, increasing number of people are affected including pregnant women. Risk of exposure is 1% in a given pregnancy in highly endemic areas. The objective is to study the morbidity and mortality profile of dengue in pregnancy on mother and neonate.Methods: It is a time bound retrospective study conducted on 25 pregnant women with positive dengue serology in Department of Obstetrics and Gynecology BMCRI Bangalore India between May to October 2016.Results: 25 seropositive dengue infected pregnant women were diagnosed in the period. Multiorgan failure leading to intrauterine fetal and maternal death occurred in one case of dengue shock syndrome at 28 weeks. Perinatal outcomes of the other cases were satisfactory. No cases of perinatal transmission to the neonate occurred.Conclusions: Pregnancies complicated by dengue infection needs close monitoring in a tertiary care for potential fetal and maternal complications. Early detection of the critical phase, with judicious fluid management can decrease the mortality and morbidity associated with dengue infection. 

A study of complications in cases of placenta previa

2017 ◽  
Vol 6 (12) ◽  
pp. 5503
Author(s):  
Dhaval M. Khirasaria ◽  
Trupti C. Nayak
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Perinatal Mortality ◽  
Urban Areas ◽  
Placenta Previa ◽  
Neonatal Morbidity ◽  
Morbidity And Mortality ◽  
Prospective Clinical Study ◽  
Maternal Mortality Rate ◽  
Live Births

Background: Haemorrhage in obstetrics is almost life-threatening emergency especially in the last trimester. Placenta previa contributes to 1/5th of the cases of antepartum haemorrhage. This catastrophic complication not only poses a risk to the fetus but also endangers the mother’s life. The aims of this study were to estimate the incidence of placenta previa and to study the various complications and its impact on maternal and neonatal morbidity and mortality. Methods: An observational prospective clinical study was carried out in Department of OBG-GYN on total 30 cases-admitted patients coming from both rural and urban areas, presented with placenta previa after 28 weeks of pregnancy in duration of January 2012 to August 2013.Results: In the present study, the incidence of placenta previa contributed to 0.23% cases. The general perinatal mortality was 18 per 1000 live births and that due to placenta previa was 6.6 per 1000 live births. The maternal mortality rate due to placenta previa in this study was nil.Conclusions: A marked reduction in maternal mortality rate from placenta previa was achieved during the last half of the 20th century but still placenta previa is an important cause of perinatal morbidity and mortality. A good antenatal care, early detection of placenta previa by ultrasound and the conservative management may definitely contribute to the dramatic reduction in the perinatal mortality in placenta previa. 

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 Risk factors and outcome analysis of post-partum haemorrhage in a tertiary care centre

2019 ◽  
Vol 8 (2) ◽  
pp. 377
Author(s):  
Roopa Aravind K. ◽  
Priya Shankar
Keyword(s):  
Risk Factors ◽  
Maternal Mortality ◽  
Post Partum ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Outcome Analysis ◽  
Tertiary Care Centre ◽  
Mortality And Morbidity ◽  
Maternal Mortality And Morbidity ◽  
Risk Patients

Background: Maternal haemorrhage is the major cause of maternal mortality and morbidity all over the world and more so in developing countries. PPH is the commonest cause of maternal mortality in India. Identification of risk factors, early diagnosis and timely intervention can help in reducing maternal mortality and morbidity significantly. The aim of this study is to analyse the risk factors and causes and study the maternal and perinatal outcomes of PPH in North Karnataka.Methods: It is a retrospective study of 228 patients admitted with the diagnosis of PPH, at KIMS, Hubli during 2016.Results: Average age of the patients was 27 years. Commonest risk factor was PIH, followed by APH and prolonged labour. The commonest cause of PPH was atonicity followed by retained placenta. Majority of the patients recovered successfully with medical management. While 29 patients required Para cervical clamp. Sixteen patients underwent hysterectomy. Commonest complication was anaemia. Total maternal deaths were four; all of them were due to DIC, mostly due to late referrals.Conclusions: Maternal mortality and morbidity due to PPH can be reduced by encouraging regular anti natal visits, timely referral of high-risk patients, training of the health personals and timely intervention. Well stocked blood banks play an important role in management of PPH.

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