scholarly journals Fetomaternal outcome and effect of ursodeoxycholic acid in patients of obstetric cholestasis

Author(s):  
Poonam Laul ◽  
Soma Kumari ◽  
Urvashi Miglani ◽  
Anish Laul ◽  
Shalini Gandhi ◽  
...  

Background: The objective of this study was to determine fetomaternal outcome and effect of ursodeoxycholic acid in patients of obstetric cholestasis.Methods: This study was prospective observational descriptive study of 130 women, which was conducted in the department of obstetrics and gynaecology, Deen Dayal Upadhayay Hospital, New Delhi. Statistical analysis was performed using the z test when appropriate. A p value of <0.05 will be considered statistically significant.Results: Spontaneous onset of labour was present in 48.5% of patients, induction was done in 31.5% of patients and in rest 20% of patients LSCS was indicated. Normal vaginal delivery occurred in 97 of 130 patients while emergency LSCS done 33 of 130 patients. Emergency LSCS was done in 16 of 33 patients due to foetal distress. Pre-term delivery and PROM occurred in 8.5% and 9.2% of patients respectively while PPH occurred in 12.3% of patients. Among the 130 cases included in present study 34 patients (27.2%) had fetal distress, 41 patients (31.5%) had MSL and 40 neonates (32.0%) required NICU. 16 neonates out of 130 (12.8%) had birth weight below 2.5 kg. Apgar score was <7 after 5 min in 31 neonates.Conclusions: Ursodeoxycholic acid (UDCA) is useful in relieving symptoms and decreasing the biochemical markers. 

2021 ◽  
pp. 7-8
Author(s):  
Kumari Nisha ◽  
Renu Jha ◽  
Kumudini Jha ◽  
Debarshi Jana

Background: Caesarean section is the most commonly performed major surgery among women. The aims and objective of this study was to know the incidence of primary Caesarean section in multigravidas, its indications and to know the maternal and foetal outcome among these patients. Methodology: This was an observational study conducted at Department of Obstetrics and Gynaecology of Darbhanga Medical College and Hospital, Laheriasarai, Bihar. Aim of the study was to study the indication, maternal and fetal outcome in primary cesarean in multiparous women. All multiparous women admitted for delivery were included in the study Results: The total number of deliveries were 3064 and cesarean section were 1026 (33%).The total number of primary cesarean section in multiparous women were 84 constituting 2.7%. In this study, majority of women were Gravida 2. 91.6% of the cases were underwent emergency cesarean section and anesthesia was spinal. Majority of patients were between age group of 22 to 27 yrs (70%). Indications for cesarean section in our study were severe oligohydroamnios (22%), fetal distress (15.4%), and breech presentation (14%), premature rupture of membrane (12%).Intra operative ndings were meconium stained liquor, post partum hemorrhage, thinned out lower segment and extension of incision. Out of 84 cases, 48 cases needed intra operative or immediate post operative blood transfusion. The post operative morbidity was present in 6 cases i.e paralytic ileus, puerperal fever, urinary tract infection and wound gaping. Majority of babies, weighed in the range of 2-3kgs (55%).Out of 84 cases 7 were causes were placenta previa, obstructed labor and fetal distress. Conclusion: Many unforeseen complications occur in women who previously had a normal vaginal delivery. It is recommended that all antenatal patients must be booked and receive proper and regular antenatal care. Also 100% deliveries in multigravida should be institutional deliveries in order to reduce maternal and perinatal morbidity and mortality.


2018 ◽  
Vol 24 (1) ◽  
pp. 659-664
Author(s):  
Mumtaz Akhtar ◽  
Iffat Naheed ◽  
Khadija Waheed ◽  
Raana Mazhar

Abstract | This study was designed to determine the frequency of postpartum hemorrhage after administra-tion of per rectal misoprostol in females undergoing normal vaginal delivery. The study was conducted at the Department of Obstetrics and Gynaecology, Teaching Hospital, Lahore from 02-09-2014 to 03-03-2015.Non-probability and purposive sampling techniques were used. A total of 220patients undergoing normalvaginal delivery at term after administration of per rectal misoprostol were enrolled with 95% confidenceinterval (C.I). The error margin was 5% and the prevalence of postpartum haemorrhage was 16.5%. Datawas entered and analyzed through SPSS 17. In this study, the mean age of study participants was found tobe 29.89±5.89 years while the mean gestational age was 38.86±1.38 weeks. Postpartum haemorrhage wasobserved in 35.45% cases. Blood loss was recorded in patients with a mean of 374±134.91 mL. Statistically,a highly significant difference was observed between the blood loss and postpartum haemorrhageamong the patients (i.e. p-value=0.000). A low frequency of postpartum hemorrh agein women experiencing normal vaginal delivery after misoprostol was administered. The blood loss was recorded to be very low among females.


2018 ◽  
Vol 32 (4) ◽  
pp. 87-92
Author(s):  
Ravi Bhatia ◽  
Dinesh Rajwaniya ◽  
Indira S. Paul

Objective: To study the influence of antenatal and perinatal factors on umbilical cord blood thyroid-stimulating hormone (CB TSH) levels. Design: Cross-sectional study. Setting: Private Medical College. Methods: CB TSH levels were measured in 1147 neonates using chemiluminescence immunoassay. The effect of antenatal and perinatal factors on CB TSH values was analyzed statistically. Results: The mean TSH value was 6.811 mIu/mL. A total of 44 neonates (3.83%) had a CB TSH value greater than 20 mIu/mL and had to be recalled for a repeat workup. CB TSH was significantly raised in first-order births, those born via normal vaginal delivery, and in those whom the lower section caesarean section (LSCS) was done for fetal distress (all P value <.05). Male babies had a significantly higher CB TSH value as compared to the females. Babies having Apgar < 7 at 1 min also had a significantly higher CB TSH value. Maternal hypothyroidism did not have any significant effect. On multivariate analysis, we found a positive correlation between birth weight, Apgar, and gestational age with CB TSH values. Conclusion: The incidence of neonates having a CB TSH greater than 20 mIu/mL was 3.83%. Male children, those delivered via normal delivery, those delivered via LSCS where fetal distress was an indication, and those requiring resuscitation, were significant factors affecting CB TSH values.


2011 ◽  
pp. 112-117
Author(s):  
Thi Kieu Nhi Nguyen

Objectives: 1. Describe neonatal classification of WHO. 2. Identify some principal clinical and paraclinical signs of term, preterm, post term babies. Patients and method: an observational descriptive study of 233 newborns hospitalized in neonatal unit at Hue university‘ s hospital was done during 12 months from 01/01/2009 to 31/12/2009 for describing neonatal classification and identifying principal clinical and paraclinical signs. Results: Premature (16.74%); Term babies (45.5%); Post term (37.76%); Premature: asphyxia (43.59%), hypothermia (25.64%), vomit (30.77%), jaundice (61.54%), congenital malformation (17.95%); CRP > 10mg/l (53.85%); anemia Hb < 15g/dl (12.82%). Term babies: poor feeding (21.7%); fever (24.53%); CRP > 10mg/l (53.77%); Hyperleucocytes/ Leucopenia (35.85%). Post term: respiratory distress (34%); lethargy (29.55%); vomit (26.14%); polycuthemia (1.14%); hypoglycemia (22.73%). Conclusion: each of neonatal type classified by WHO presente different clinical and paraclinical. Signs. The purpose of this research is to help to treat neonatal pathology more effectively.


2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
A Fernández Candela ◽  
L Sánchez-Guillén ◽  
L García Catalá ◽  
C Curtis Martínez ◽  
M Bosch Ramírez ◽  
...  

Abstract INTRODUCTION The aim of this study is to evaluate the impact of laparoscopic colorectal surgery (LCS) on body image using the validated Body Image Scale (BIS) as a parameter of surgical quality. MATERIAL AND METHODS We conducted an observational descriptive study. Patients who underwent scheduled LCS between June 2015 and December 2019 by a General Hospital Coloproctology Unit were included. RESULTS The sample included 180 patients, 115 men (63.9%) and 65 women (36.1%) with a median age of 67 years. Right hemicolectomies (31.7%) and sigmoidectomies (28.3%) were the main procedures performed. In most patients, a suprapubic (69.4%) or transverse (19.4%) incision was made. 21.9% suffered some type of postoperative complication (13.9% wound complication, 10.6% incisional hernia). The general result of the BIS questionnaire was satisfactory, with a median of 0 in the responses (no alteration of body image). We found that 46.2% of the women had some alteration in body image, compared to 28.7% of the men (p = 0.018) and low and ultra-low anterior resection were the surgeries that obtained worst scores, with 13,5% and 12,5% respectively of patients with a BIS score above 5 (p = 0.044). Patients with a stoma also obtained worst punctuation (25% above 5 vs 6,1%, p = 0.001). No statistically significant differences were found regarding type of incision, presence of complications and anxiety or depression. CONCLUSION Study results show, in general, good post-surgical body image after LCS. However, patients with stoma and women were more dissatisfied. Interestingly, there is no worse body image due to type of incision, so we recommend the least iatrogenic one.


2021 ◽  
Vol 8 ◽  
pp. 237437352198924
Author(s):  
Jassem Almualem ◽  
Amal Darwish ◽  
Ahmed AlFaraj

Patients with cardiac conditions may suffer from anxiety related to prognosis and further rehabilitation. Anxiety could be exacerbated by different factors including miscommunication, which could be attributed to the linguistic barrier, that exists among health care providers. At Saud Al-Babtain Cardiac Center (SBCC), nurses who are non-native Arabic speakers could have difficulty communicating disease-related information at different stages of nursing care. Is it possible to identify the language barrier as a source of anxiety for admitted patients with cardiac diseases? In this cross-sectional, descriptive study, 50 patients were included following the diagnosis of cardiac disease and post-cardiac surgery. A questionnaire that measures anxiety level showed that patients who were handled by Arabic-speaking nurses reported less collective mean for the anxiety domain statements of (20.08) versus those who were handled by Non-Arabic-speaking nurses (28.55, P value = .041). Our finding indicates that anxiety levels increased when there was a language barrier between nurses and patients, which could affect the quality of care delivery at SBCC.


Author(s):  
Divya Gupta ◽  
Premlata Mital ◽  
Bhanwar Singh Meena ◽  
Devendra Benwal ◽  
. Saumya ◽  
...  

Background: Multiple pregnancy remains one of the highest risk situations for the mother, foetus and neonate despite recent advances in obstetrics, perinatal and neonatal care. Twin pregnancies have increased rates of obstetric and perinatal complications compared to singletons Objective of present study was comparative assessment of fetomaternal outcome in twin pregnancy with singleton pregnancy in Obstetrics and Gynaecology Department of S.M.S. Medical College, Jaipur.Methods: This was a hospital based, prospective observational study done in the Department of Obstetrics and Gynaecology. S.M.S. Medical College, Jaipur from April 2015 to March 2016. 150 women with twin pregnancy and 150 women with singleton pregnancies at gestation age of 28 weeks and above coming for delivery and consented for the study were included in the study. Women with chronic medical disorder or chronic hypertension were excluded from the study. Maternal and neonatal outcome recorded and analysed.Results: Occurrence of twin in our study was 2.82%. Risk of preterm labour was about nine times higher in twin pregnancies than the singleton (OR: 2.74, 95% CI; 1.4494-5.1884, P value 0.001). The risk of premature rupture of membrane was increased by 2.74 times in twin pregnancies (OR:2.74; 95% CI: 1.4494-5.1884, p value .001). There was 3-time increased risk of malpresentation (OR 3.14; CI:1.7184-5.7480, p value .00002) and 2.28 times increase in hypertensive disorder (OR 2.28; 95% CI: 1.0727-4.8823, p value .03) in twin pregnancies. The risk of asphyxia and septicaemia was 2.5 times more in twins.Conclusions: Twin pregnancy is a high-risk pregnancy with more complications in mother and foetus and is a great challenge for obstetrician. So, it should be managed carefully at tertiary care centre to reduce the maternal and perinatal mortality and morbidity.


Sign in / Sign up

Export Citation Format

Share Document