scholarly journals Maternal outcome of term obstetric emergencies referred to tertiary care centre

2021 ◽  
Vol 10 (7) ◽  
pp. 2843
Author(s):  
Shivani Badal ◽  
L. Ranjit Singh
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Ground Level ◽  
Maternal Outcome ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Health Care Centre ◽  
Early Referral ◽  
Maternal Morbidity And Mortality ◽  
Obstetric Emergencies

Background: Lack of basic facilities at ground level in backward areas of country affect the outcome of obstetric emergencies thereby affecting maternal morbidity and mortality. This study was conducted to compare the outcome of term obstetric emergencies referred to tertiary care centre.Method: This prospective observational study was conducted to study the maternal outcome in obstetric emergencies referred to our institution.Results: Most of the patients were exhausted (59.47%). Majority were referred for prolonged labour (47.71%), previous cesarean section (16.33%), pre-eclampsia (13.07%) and eclampsia (1.96%). Most patients were given more than one intervention. Emergency LSCS was the common mode of delivery (39.86%).Conclusions: It is important to improve the conditions of peripheral health care centre with amenities like specialist doctors and transport. Awareness of population, attitude buildup is important for early referral to resist care centre to improve outcome of pregnancy.

scholarly journals To study pattern of obstetric cases referred at tertiary care centre in Central India

2017 ◽  
Vol 6 (6) ◽  
pp. 2370
Author(s):  
Prakriti Goswami ◽  
Jyoti Bindal ◽  
Niketa Chug
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Central India ◽  
Maternal Outcome ◽  
Child Health Services ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Common Diagnosis ◽  
Mode Of Transport

Background: Maternal morbidity and mortality remains a major challenge to health systems worldwide. Referral services for identification and referral of high risk pregnancies are an integral part of maternal and child health services. Timeliness and appropriateness of referral are challenge to obstetricians, since delay in referral affects maternal outcome adversely, hence the identification of at risk patients and obstetric emergencies and their timely referral is of immense importance. The aim of this study was to review the pattern of obstetric cases referred to tertiary care centre, to identify their clinical course, mode of delivery and maternal outcomes.Methods: It was prospective observational study carried out from January 2015 to July 2016. Study population was all Obstetrics patients referred to Department of Obstetrics and Gynecology of Kamla Raja Hospital, G.R. Medical College, Gwalior, Madhya Pradesh, a tertiary care centre during the study period.Results: The total number of referred cases in above study period was 4085.The proportion of referred cases in the tertiary care hospital was 20.86%. Mode of transport used by the referred patients were hospital ambulances (38%) and private vehicles (62%). Most common diagnosis at the time of referral was anaemia (27.8%). Out of the total referred cases, 48% had vaginal delivery (either spontaneous or induced), 28% had caesarean section and 24% were managed conservatively. Hypertensive disorders (25.4%) constitutes the leading cause of maternal deaths amongst the referred cases.Conclusions: Peripheral health care system needs to be strengthened and practice of early referral needs to be implemented for better maternal outcome.

scholarly journals Changing trends in incidence, type, indication and maternal outcome of peripartum hysterectomy over 10 years at a tertiary care centre

2017 ◽  
Vol 6 (6) ◽  
pp. 2216
Author(s):  
Taru Gupta ◽  
Sangeeta Gupta ◽  
. Deepika ◽  
Nupur Gupta
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Maternal Outcome ◽  
Care Centre ◽  
Abnormal Placentation ◽  
Tertiary Care Centre ◽  
Peripartum Hysterectomy ◽  
Primary Indication ◽  
Gestational Age At Delivery ◽  
Life Threatening

Background: Peripartum hysterectomy is the most dramatic operation in modern obstetrics and is generally performed when all conservative measures fail to achieve haemostasis in the setting of life threatening haemorrhage. The objective was to review all peripartum hysterectomies performed at a tertiary care centre over a ten-year period from 2007 to 2016 to determine the incidence, types, indications and maternal outcome and also to study the changing trendsMethods: This was a retrospective, observational, analytical study of parturient women requiring peripartum hysterectomy (PH). We looked at data over a ten-year period, from January 2007 to December 2016. Case records were reviewed for socio-demographic characteristics of the patients, type and indications for the hysterectomy performed, booking status of patients, mode of delivery, gestational age at delivery and maternal outcome. Change in trends of the rate and indications of peripartum hysterectomy at the centre was also reviewed.Results: The overall rate of peripartum hysterectomy was 1/876 deliveries. The rate of peripartum hysterectomy had a 4-fold rise from 2007 to 2016.The primary indication was abnormal placentation which included morbidly adherent placentation 22/59 (37.2%) and placentapraevia 5/59 (8.4%), followed by intractable atonic haemorrhage in 35.6% of cases. Abnormal placentation as an indication for PH increased significantly form 34.6% (2007-2011) to 54.54% (2012-2016). After hysterectomy, 56% cases were admitted to ICU. All patients needed blood transfusion. Maternal mortality was 10.1%.Conclusions: Peripartum hysterectomy is a most demanding obstetric surgery performed in very trying circumstances of life threatening hemorrhage. The indication for emergency peripartum hysterectomy in recent years has changed from traditional uterine atony to abnormal placentation. 

scholarly journals Three delay model: to find out the reason for maternal deaths

2020 ◽  
Vol 8 (4) ◽  
pp. 1273
Author(s):  
Neha Agrawal ◽  
Seema Patel ◽  
Mayank Badkur
Keyword(s):  
Tertiary Care ◽  
Delay Model ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Health Care Centre ◽  
Maternal Deaths ◽  
Adequate Treatment ◽  
Study Region ◽  
Delay In Diagnosis

Background: Each year in India, roughly 28 million women experience pregnancy and 26 million have a live birth. Of these, an estimated 67,000 maternal deaths and one million new-born deaths occur each year. A woman dies as a result of complication arising during pregnancy and childbirth every 90 seconds in the world, and every 7 minutes in India. The three delay model can be used to find the causes of delays in relation to maternal deaths.Methods: A retrospective study was carried out in a tertiary care centre. All cases of maternal mortality between July 2010 to June 2016 were included in the study. Then data analysis was done.Results: Out of the total 382 maternal deaths, Majority of maternal deaths 43% were due to type 1 delay. 150 patients had delay in seeking help, 9 patients refused treatment and 5 patients refused admission to health care centre. 13% maternal deaths were due to type 3 delay which include delay in receiving adequate treatment, Delay in diagnosis and intervention, Lack of facilities etc.Conclusions: Type-1 delay was major contributors of maternal deaths in the study region. Therefore, to prevent the preventable maternal deaths effective action should be taken.

scholarly journals Study of knowledge, attitude and practices of contraception in breast-feeding mothers

2019 ◽  
Vol 8 (4) ◽  
pp. 1473
Author(s):  
Aiyleen Shiza Shawl ◽  
Vidya Thobbi
Keyword(s):  
Breast Feeding ◽  
Rural Areas ◽  
Urban Areas ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Lower Class ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Knowledge And Attitude ◽  
The Government

Background: In India, as in many other countries, postpartum family planning is usually initiated after 6 weeks postpartum. Early resumption of sexual activity coupled with early and unpredictable ovulation leads to many unwanted pregnancies in the first year postpartum. Increase in hospital deliveries provides an excellent opportunity to sensitize women and provide effective contraception. Hence the present study was done at our tertiary care centre to assess the knowledge, attitude, practice regarding contraception and to find out the relationship between knowledge and attitude regarding contraception among breast feeding mothers.Methods: A hospital based observational study. The patients admitted at our tertiary care centre in the Department of Obstetrics and Gynecology.Results: Majority of the participants (72%) were in the age group of 21-25 years. 21.2% of the study group was educated up to primary level while 33.2% and 18.4% of the participants studied till SSC and HSC respectively. Majority of participants were from middle class (50%) followed by lower class (36.4%) and upper class (13.6%). 69.6% participants resided in rural areas while 30.4% participants were from urban areas. It was observed that age, education and mode of delivery were the significant factors.Conclusions: As the government gives incentives to couples who opt for permanent sterilization, which is an effective drive, it should also give incentives to couples who follow temporary methods and delay pregnancies. Couples who adopt one child norm or 2 children norm should be encouraged by benefits either in the form of children’s education or health insurance.

scholarly journals A study to know clinical characteristics and outcome of obstetrics patients requiring ICU admission

2018 ◽  
Vol 7 (7) ◽  
pp. 2639
Author(s):  
Pratibha Garg ◽  
Urmila Tripathi
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Good Health ◽  
Health Care Team ◽  
Severe Anaemia ◽  
Hypertensive Disorder ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Number Of Patients ◽  
Maternal Morbidity And Mortality

Background: Pregnancy poses unique consideration for critical care and it is imperative that obstetrician and other members of health care team have a working knowledge of these factors because these are women are usually young and in good health, their prognosis should be better than that of many other patients admitted to an intensive care.Methods: The present study was conducted in the Department of Obstetrics and Gynaecology, Gaja Raja Medical College and associate Kamla raja Hospital, Gwalior in the ICU from Oct. 14 to Oct. 15.Results: 678 obstetric women were admitted into the ICU of Kamla Raja Hospital, over a period of 1 year study period. Maximum number of patients belong to age group 21-25 years (54.8%), 398 (58.7%) patients were uneducated, 343 (50.59%) came directly to Kamla Raja Hospital. 362 (53.39%) belongs to urban area. The mean length of stay in ICU was 3 days. Maximum number of patients were postpartum 580 (85.55%). According to mode of delivery maximum number of patients 348 (51.33%) underwent LSCS. Most common obstetric indication for admission in ICU was hypertensive disorder of pregnancy 472 (69.61%). Most common medical indication was severe anaemia 128 (18.87%). Various type intervention like pulse oxymetry, O2 inhalation, BT, nebulisation and ventilation were done in ICU according to patients need. 43 maternal death happened during the study period with most common cause was cardiorespiratory arrest 9 (1.32%) and pulmonary edema 8 (1.17%).Conclusions: Establishment of a dedicated obstetric ICU at tertiary care centre with knowledge familiarity, experience and expertise of an obstetrician and a special team would be best place to monitor and treat the critically ill obstetric patients which will reduce the maternal morbidity and mortality.

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