scholarly journals A study of maternal and perinatal outcome in patients of postpartum hemorrhage in a tertiary care hospital, Gujarat

2021 ◽  
Vol 10 (6) ◽  
pp. 2286
Author(s):  
Amit H. Shah ◽  
Divyesh N. Panchal
Keyword(s):  
Risk Factors ◽  
Maternal Mortality ◽  
Postpartum Hemorrhage ◽  
Medical Condition ◽  
Common Factor ◽  
Tertiary Care ◽  
Maternal Outcome ◽  
Normal Vaginal Delivery ◽  
Care Hospital ◽  
Common Etiology

Background: Postpartum hemorrhage (PPH) is significant factor for maternal mortality. Prevalence of PPH is 6.0% worldwide and highest prevalence was noted in Africa which is almost 10.1%. In India, maternal hemorrhage is the very common factor for maternal mortality. The objective of the study was to understand incidence of PPH and various risk factors for it, to study maternal morbidity and mortality associated with PPH and to study the effective mode of management in PPH.Methods: This prospective study was done among 50 cases of postpartum haemorrhage out of 13,628 deliveries at civil hospital, Asarwa, Ahmedabad during November 2008 to October 2010 and analysis was done regarding patients’ socio demographic characteristics, various risk factors, causes and maternal and perinatal outcome.Results: Incidence of PPH was 0.36%. Almost >85% cases were belonged to 20-34 years age group. Highest cases (38%) seen in primigravida and 72% cases have normal vaginal delivery. Anemia noted in highest cases (22%) and 68% cases have most common etiology was atonicity. Birth weight <2.5 kg found in 36% cases. Most common maternal outcome was fever (16%) and 72% cases delivered healthy and alive birth.Conclusions: The patients were mostly primiparous. The commonest associated medical condition was anemia. The commonest underlying cause of PPH was atonicity of the uterus. Commonest maternal outcome was fever. Out of total births, 72.0% were alive and healthy babies followed by 18.0% babies were still birth.

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 Impact of increase of caesarean section on postpartum hemorrhage in a tertiary care center of India over 6 years

2020 ◽  
Vol 10 (1) ◽  
pp. 192
Author(s):  
Shikha Madan ◽  
Neetu Sangwan ◽  
Smiti Nanda ◽  
Daya Sirohiwal ◽  
Pushpa Dahiya ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Maternal Mortality ◽  
Postpartum Hemorrhage ◽  
Health Workers ◽  
Care Center ◽  
Tertiary Care ◽  
Normal Delivery ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Common Etiology

Background: PPH (postpartum hemorrhage) is the leading cause of maternal mortality. Despite of all the medical advancement, maternal mortality rates have declined greatly in the developed world, PPH remains a leading cause of maternal mortality elsewhere. Caesarean section is an obstetric intervention where, normal delivery can pose a risk for mother or foetus. The rate of caesarean section has increased worldwide. A survey conducted by WHO found that the worldwide rate of caesarean section increased from 26.4% between 2004 to 2008, to 31.2% between 2010 to 2011.Methods: We collected data of the caesarean sections and patients who developed PPH over 6 years. We studied the association of temporal increase of caesarean section with PPH.Results: Uterine atonicity continues to be the most common etiology of PPH each year, however, there is an increase in tissue abnormality (retained placenta, placenta praevia, accreta, increta, percreta) over years as there is a significant increase in the incidence of caesarean section. Atonic uterus was the most common cause for obstetric hysterectomies and mortality due to PPH every year.Conclusions: Family planning advise is essential in developing country like ours to counsel patients to prevent multiparity, thus reducing PPH. It is also important to train all the health workers in periphery and referral centers to manage the third stage of labor and atonic uterus to save the mothers. Sagacious attitude towards the decision of caesarean section is needed to prevent maternal morbidity and mortality.

scholarly journals Analysis of risk factors influencing maternal mortality: A study at tertiary care hospital in Uttar Pradesh

2021 ◽  
Vol 5 (4) ◽  
pp. 103-107
Author(s):  
Dr. Najma Malik ◽  
Dr. Ruma Sarkar ◽  
Dr. Ankita Kumari ◽  
Dr. Vani Adtiya ◽  
Dr. Babita Vaswani Agarwal
Keyword(s):  
Risk Factors ◽  
Maternal Mortality ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Care Hospital ◽  
Factors Influencing

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.

Postpartum hemorrhage: An audit of one year at Tertiary Care Hospital

2020 ◽  
Vol 11 (4) ◽  
pp. 22-26
Keyword(s):  
Maternal Mortality ◽  
Postpartum Hemorrhage ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Uterine Atony ◽  
Care Hospital ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
One Year

Background: Postpartum hemorrhage (PPH) remains a leading cause of maternal mortality in developing countries. Objective: To determine the maternal outcome by an audit of one year among the cases of primary postpartum hemorrhage at a tertiary care hospital. Methodology: This cross-sectional study was conducted in the Department of Obstetrics and Gynecology, DHQ Teaching Rawalpindi from 1st January 2019 to 31st December 2019. A total of 9122 deliveries were conducted at the hospital. We reviewed the charts of all the patients who fulfilled our inclusion criteria and gathered data on a structured, pre-tested proformas prepared for the purpose. Results: A total of 9122 maternities were reported during the study period with the frequency of PPH 70 (0.77%). Booking status, 25 (35.7%), high parity 18 (25.7%), and uterine atony in 54 (77%) out of 70 PPH patients, were associated with PPH. Medical management of PPH with uterotonic drugs was successful in 23 (30%) of patients. Uterine packing was done in 27 (38%) patients and bleeding was successfully arrested in 24 (90%) of these 27 patients. Hysterectomy was performed in 9 (12.8%) patients. Maternal death due to PPH was reported in 1 (1.4%) cases. Conclusion: PPH is the leading cause of maternal mortality and morbidity, associated with booking status, parity, and uterine atony. Hospital management should emphasize the predefined protocol to be followed in managing a patient with postpartum hemorrhage.

scholarly journals Efficacy and Safety of Intrauterine Balloon Tamponadeversus Uterovaginal Roll Gauze Packing in Patient Presenting with Primary Postpartum Hemorrhage after Normal Vaginal Delivery.

2018 ◽  
Vol 24 (S) ◽  
pp. 889-892 ◽  
Author(s):  
Nomia Ashraf ◽  
Afroze Ashraf ◽  
Kiran Khursheed
Keyword(s):  
Vaginal Delivery ◽  
Postpartum Hemorrhage ◽  
Controlled Trial ◽  
Tertiary Care ◽  
Intrauterine Infection ◽  
Normal Vaginal Delivery ◽  
Coagulation Disorder ◽  
Care Hospital ◽  
Balloon Tamponade ◽  
Gauze Packing

Objective| To compare the effectiveness and safety profile of intrauterine balloon tamponade with uterovaginal roll gauze packing among patient of primary postpartum hemorrhage after normal vaginal delivery. Duration of Study| This study was conducted in the Department of Obstetrics & Gynaecology, of a Tertiary Care Hospital, Lahore from December 2015 to November 2016. Patients and Methods| In this Randomized controlled trial,212 patients of age range 20 to 40 years who presented with postpartum hemorrhage after a normal vaginal delivery (NVD) those who did not responded to medical treatment were included. Cases of PPH due to perineal, cervical or vaginal tear, episiotomy, retained placenta, coagulation disorder, secondary PPH and PPH with normal vaginal delivery after previous cesarean section were excluded from this study. Subjects were randomly assigned to either intrauterine balloon tamponade or uterovaginal roll gauze packing. Intrauterine packing (IP) was removed after 24 hours and balloon tamponade after 24 hours of insertion. Antibiotic coverage was also given to prevent intrauterine infection. All females were kept under observation in ward. Effectiveness was labeled if bleeding was stopped within 15 minutes after uterovaginal packing or balloon tamponade (BT) and patient remain hemodynamically stable and if no complications occur after applying or removing balloon tamponade or intrauterine packing safety was labeled. Data was analyzed by SPSS version 20.2.Frequencies and percentage of complications were calculated along with rate of successful cessation of bleeding were calculated. Result| Mean age group of woman in whom balloon tamponade and intrauterine packing was used was 29.22+6.52 and 29.05+ 6.802 years. Mean gestational age of woman in BT and IP group and was 39.95+1.304 and 38.98+ 1.428 years. Mean blood loss in woman in BT and IP group was 600.28+ 25.338 and 669.21+70.176 ml. Efficacy of group BT was 78(73.6%) and in IP was 63(59.4%).Safety of BT group was 97(91.51%) and IP group was 55(51.88%). Treatment of balloon tamponade was more effective and safe than intrauterine packing in female presented with PPH after normal vaginal delivery (p < .05). Conclusion| This study concluded that balloon tamponade is an effective and safe method than intrauterine packing for the management of PPH after normal vaginal delivery.

scholarly journals Postnatal bladder dysfunction

2020 ◽  
Vol 9 (7) ◽  
pp. 3025
Author(s):  
Swathi H. V. ◽  
Padmaja Y. Samant
Keyword(s):  
Risk Factors ◽  
Voiding Dysfunction ◽  
Bladder Dysfunction ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Management Strategies ◽  
Normal Vaginal Delivery ◽  
Care Hospital ◽  
Postnatal Women ◽  
High Index Of Suspicion

Background: Voiding difficulty and urinary retention is a common phenomenon in immediate postpartum period. Absolute or relative failure to empty the bladder resulting from decreased bladder contractility (magnitude or duration) or increased bladder outlet resistance or both are defined as voiding dysfunction. It needs high index of suspicion or else can go undiagnosed and can lead to magnitude of problems. The study aims to calculate the incidence of dysfunction of bladder in postnatal women and to study risk factors associated with development of bladder dysfunction and management strategies in cases of bladder dysfunction.Methods: Authors did a prospective observational study in a tertiary care hospital. 200 postpartum women were screened for complaints of voiding dysfunction within 6 hours of removal of catheter in post caesarean patients and of normal vaginal delivery. Authors found that the voiding dysfunction was relatively common with an incidence of 20.20%. Following risk factors were analyzed: parity, mode of delivery, pain at suture site, baby weight, para-urethral tear.Results: Postpartum voiding dysfunction was found to be relatively common with statistically significant association found for pain at suture site and para urethral tear. Intra partum events contributed to voiding dysfunction. 93% of patients who with voiding dysfunction could be managed conservatively, and only 7% had to undergo intervention in the form of re catheterization.Conclusions: The early identification and treatment can reduce the pain and discomfort. Majority of the cases resolves with conservative management and nursing staff plays a key role in early detection of the symptoms.

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