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 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 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 fetomaternal outcome in cases of placenta previa at tertiary care hospital

2020 ◽  
Vol 9 (8) ◽  
pp. 3326
Author(s):  
Parul T. Shah ◽  
Fiza Z. Saiyed ◽  
Kruti J. Deliwala ◽  
Priya Dhameliya
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Maternal Mortality ◽  
Perinatal Outcome ◽  
Tertiary Care Hospital ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Previous History ◽  
Care Hospital ◽  
Normal Delivery

Background: Placenta previa is defined as placenta implanted partially or completely in the lower uterine segment. It contributes upto 30% of the cases the antepartum hemorrhage. This catastrophic complication not only poses a risk to the fetus but also endangers the mother’s life. The objective of the study was to determine the incidence and risk factors, obstetric management, maternal mortality and morbidity and perinatal outcome in women presenting with placenta previa.Methods: It is the prospective study of 50 cases carried out to study the maternal and perinatal outcome in cases of placenta previa in tertiary care hospital. This study included antenatal patient diagnosed as placenta previa by ultrasound >28 weeks to full term pregnancy. This data was compiled and analyzed for maternal and neonatal outcome.Results: In the present study, the incidence of placenta previa is 0.8% among which 42% of cases having age group of 25-29 years and 72% cases are multigravida. In this study 60% cases have major degree of placenta previa and 66% cases have previous history of caesarean section. Out of total cases 96% cases delivered by caesarean section and 4% had Normal delivery. NICU admission in the study is 28 babies i.e. 56%. There is no maternal mortality seen in the present study.Conclusions: Risk factors that increase the cases of placenta previa are multiparity, previous caesarean section, previous abortion. Placenta previa is major risk factor for adverse maternal and perinatal outcome. Good antenatal care, availability of emergency obstetrics services with senior obstetricians, blood bank facility, ICU care and NICU services can improve maternal and neonatal outcome in high risk cases.

scholarly journals Maternal and perinatal outcome in placenta previa: an observational study at a tertiary care hospital in Mysore, Karnataka, India

2019 ◽  
Vol 8 (4) ◽  
pp. 1322
Author(s):  
Maunica Reddy Sorakayalapeta ◽  
Nandish S. Manoli
Keyword(s):  
Observational Study ◽  
Perinatal Outcome ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Perinatal Morbidity ◽  
Medical College ◽  
Clinical Complications ◽  
History Of

Background: 2-5% of the pregnancies are complicated by antepartum haemorrhage. About one third of them are due to placenta previa thus contributing to a significant amount of maternal and perinatal morbidity and mortality. In the present times with liberally increasing caesarean section rates, there is a changing trend in the incidence and complications of placenta previa. The objective of this study was to evaluate the obstetrical characteristics and maternal and perinatal outcome of cases of placenta previa.Methods: This was a prospective observational study conducted in the Department of Obstetrics and Gynaecology of JSS Medical College and Hospital, Mysore during the period January 2017 to June 2018.Results: Out of total 13,150 deliveries during this period, placenta previa was observed in 131 cases with an incidence of 1%. Majority belonged to the age group 25-29 years (48.8%). 66% of the cases presented with painless vaginal bleeding as their chief complaint. The major risk factor was previous caesarean delivery seen in 29.8% cases followed by history of abortion in 18.3%. 67% cases had major degree placenta previa. Remaining 33% cases had minor degree. One case was complicated by placenta accrete. Peripartum hysterectomy was performed in 3.1%. Preterm deliveries amounted to 29.8%. Maternal and perinatal mortality were 0.76% and 3.05% respectively. 10.7% cases had Postpartum haemorrhage and 3.8% required ICU admission. 25% neonates required NICU admissions and 10% had RDS.Conclusions: Placenta previa is a prime contributor to substantial maternal and perinatal morbidity and mortality. Early referral to tertiary care centres, anticipation of clinical complications and appropriate measures can avoid grave consequences. Such cases must always be managed at a higher centre with good NICU services and round the clock operation theatre and blood bank facility.

IMPACT OF GOVERNMENT SCHEMES ON MATERNAL HEALTH: AN OBSERVATIONAL STUDY IN A TERTIARY CARE HOSPITAL IN NORTH INDIA

2021 ◽  
pp. 63-65
Author(s):  
Neena Gupta ◽  
Uruj Jahan ◽  
Subhashini Singh
Keyword(s):  
Maternal Health ◽  
Observational Study ◽  
Maternal Mortality ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
North India ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
Maternal Mortality And Morbidity

BACKGROUND: Maternal health is an important aspect for the development of any country in terms of increasing equity and reducing poverty. For reduction of maternal mortality and morbidity Government of India launched National health mission (NHM). Some of the major initiatives under NHM are– ASHA (Accredited Social Health Activist), JSY/JSSK (Janani Suraksha Yojana / Janani Shishu Suraksha Karyakaram), National mobile medical units, National ambulance services. METHODS: A retrospective observational study was performed in department of Obstetrics and Gynaecology, G.S.V.M Medical College, Kanpur, Uttar Pradesh which is a low performing state, during the period of 2018 to 2019. A total of 5134 obstetric patients including 1032 low general condition patients were included over duration of 20 months since January 2018 to august 2019. This observational study collected information regarding number of deliveries in different years in this tertiary care hospital, effect on availability of health facilities and antenatal care to the antenatal women after introduction of JSY, ASHA and ambulance services. CONCLUSIONS: After JSY there is major difference in OPD admission and institutional delivery rate. Ambulance services had major contributory role in reducing maternal mortality and morbidity. There is need to improve performance of ASHA by proper supervision and monitoring.

scholarly journals A study of maternal mortality due to non-obstetric causes

2019 ◽  
Vol 8 (5) ◽  
pp. 2027
Author(s):  
Tejal N. Kansara ◽  
Tushar M. Shah ◽  
Foram R. Lalcheta
Keyword(s):  
Maternal Mortality ◽  
Medical Condition ◽  
Physiological State ◽  
Tertiary Care ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Common Cause ◽  
Medical College ◽  
Study Analyse ◽  
Surgical Condition

Background: Pregnancy, although being considered a physiological state, carries the risk of serious maternal morbidity and at times mortality, due to various complications that may arise during pregnancy, labour or thereafter. The existing medical condition, infection, and surgical condition which is collectively called as non- obstetric cause pre disposes a women for more complication than a non-pregnant women, so much so that it can lead to maternal mortality. Thus, Pregnancy is more vulnerable state and present study was carried out to study, analyse and review various non-obstetrics causes of death of women during pregnancy or within 42 days of termination of pregnancy in Tertiary care centre.Methods: This was an Observational study, conducted in the department of obstetrics and gynaecology, at a tertiary care hospital attached with medical college, from October 2016 to October 2018. The details of maternal deaths were collected from various departments with non- obstetric causes and analyzed.Results: The total number of deliveries in my study period was 15,208. There were 197 maternal mortality in our study period, of which 51 women died of non-obstetric causes. The most common cause of maternal mortality in our study was hepatic cause i.e. 33.33% amongst which viral hepatitis was the most common cause followed by respiratory (19.60%), infectious (15.18%), heamoglobinopathy (13.72%), cardiac (5.88%), neurological (5.88%), surgical (5.88%) causes.Conclusions: Looking into our study, maternal mortality can be reduced by identifying various different indirect medical causes which are preventable by proper pre-pregnancy evaluation for pre-existing comorbid conditions.

scholarly journals Study of maternal and perinatal outcome among twin pregnancies with one twin demise

2019 ◽  
Vol 8 (7) ◽  
pp. 2622
Author(s):  
Sunanda N. ◽  
Akhila M. V.
Keyword(s):  
Gestational Age ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Time Interval ◽  
Delivery Mode ◽  
Care Hospital ◽  
Monochorionic Twins ◽  
Medical College ◽  
Twin Pregnancies

Background: To study the incidence, management and to determine maternal and perinatal outcome in cases of twin pregnancy with one twin demise in the second half of the pregnancy.Methods: This retrospective study was carried out at Cheluvamba Hospital, a tertiary care hospital attached to Mysore medical college and research institute between September 2009 and 2014. 19 twin pregnancies complicated by single intrauterine fetal demise (IUFD) after 20 weeks of gestation were identified from the hospital records. Data collected included maternal age, parity, antenatal complications, cause of IUFD, gestational age at diagnosis, time interval between diagnosis of IUFD and delivery, mode of delivery, birth details, type of placentation and neonatal complications.Results: The incidence of twin with one twin demise was 2.056%. Mean gestational age at presentation was 33.86 weeks. Most common cause of death was growth discordance in 7 cases followed by placental insufficiency in 4 cases. 57.89% of cases had monochorionic placentation. Neonatal course was most commonly complicated by prematurity. Maternal course was uneventful in majority (63.15%) of cases with two maternal deaths due to intravascular coagulopathy sequelae.Conclusions: Single fetal death occurs more often in monochorionic twins. The main problem for the surviving twin is prematurity. It is very important to identify the chorionicity by ultrasound examination in early pregnancy and implement specific surveillance of monochorial pregnancies.

scholarly journals Perinatal outcomes in abruptio placenta

2019 ◽  
Vol 8 (3) ◽  
pp. 1070
Author(s):  
Zenab Tambawaala ◽  
Deepali Kale
Keyword(s):  
Perinatal Mortality ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Obstetric Care ◽  
Care Hospital ◽  
Perinatal Morbidity ◽  
Abruptio Placentae ◽  
Neonatal Deaths ◽  
Still Births ◽  
Abruptio Placenta

Background: Abruptio placentae is an obstetric emergency where placenta completely or partially separates before delivery of the baby. It occurs approximately in one in 120 deliveries. It is an important cause of perinatal morbidity and mortality.Methods: This was a prospective hospital-based study design conducted over a period of 2 years, in the Department of Obstetrics and Gynecology at a tertiary care hospital in Mumbai comprising of 60 cases.Results: The incidence of abruption placentae in Present study is 0.51%. Authors had perinatal mortality in 6.6% of the cases. Out of 60 cases, 2 deaths occurred in utero. Out of the remaining 58 cases, 24 babies needed NICU care, out of them, 22 went home alive and 2 had neonatal deaths. Perinatal morbidity in the form of hyperbilirubinemia, CNS depression, septicemia, neonatal anemia and neonatal DIC were noted.Conclusions: High incidence of perinatal mortality in abruptio placentae is because of increased number of still births. In our studies, the perinatal mortality is 6.6% as compared to all other studies. This decline in perinatal mortality is due to improved obstetric care and excellent NICU facilities which are required for a majority of the cases.

scholarly journals Maternofoetal Complications and Their Association with Proteinuria in a Tertiary Care Hospital of a Developing Country

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Archana Kumari ◽  
Avinash Chakrawarty ◽  
Abha Singh ◽  
Ritu Singh
Keyword(s):  
Maternal Mortality ◽  
Perinatal Mortality ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Neurological Involvement ◽  
First Episode ◽  
Care Hospital ◽  
Spot Urine ◽  
High Dependency ◽  
Developed World

Objective. To investigate association between maternofoetal complications and the amount of proteinuria measured by spot urine protein creatinine ratio in patients with preeclampsia.Methods. 200 consecutive patients with preeclampsia were recruited in the study. The complications like first episode of severe hypertension, renal insufficiency, raised level of aspartate transaminase, signs of neurological involvement, thrombocytopenia, eclampsia, and need to shift in intensive care units were studied. The maternal outcome was studied in terms of type of labour, outcome of pregnancy, mode of delivery, indication of cesarean section, and maternal mortality. The foetal complications and outcome parameters were birth weight, Apgar score at the time of birth and at five minutes, need of high dependency unit care, and perinatal mortality.Result. The frequency of various maternal and foetal complications was between 14–53% and 22–92%, respectively. Maternal mortality was 3%, whereas perinatal mortality was 23%. Statistically significant association was found between the frequencies of various complications in mother and newborn and spot UPCR.Conclusion. The rate of various maternofoetal complications in preeclampsia is higher in developing countries than in developed world. Maternofoetal complications and outcome correlate with maternal spot UPCR.

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