scholarly journals Obstetric and perinatal outcomes of expectant management and immediate induction of labour in term premature rupture of membranes: promising outcomes from expectant management cohort

2022 ◽  
Author(s):  
Sunil E. Tambvekar ◽  
Shobha N. Gudi
Keyword(s):  
Caesarean Section Rate ◽  
Perinatal Outcomes ◽  
Expectant Management ◽  
Fetal Outcome ◽  
P Value ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Chi Square ◽  
Group A ◽  
Group B

Background: Premature rupture of membranes (PROM) is common obstetric entity, the management even at term is controversial and there is no consensus for definite protocol of management. Objective of the present study is to compare the effectiveness, safety of expectant management of 24 hours and immediate induction with PGE2 gel in terms of maternal and fetal outcome in term PROM.Methods: 200 women were randomized to group A expectant management and group B immediate induction, after strict Inclusion and exclusion criteria. In expectant group waiting period was 24 hours. Multiple end points were examined throughout management. Chi square test and independent t tests were performed for statistical analysis. P value<0.05 was considered significant.Results: Demographic parameters of patients, maternal and gestational age were similar in both groups. Primigravidae were more in both groups A and B. Vaginal delivery rate is more in expectant group and Caesarean Section rate is high in immediate induction group. CS rate was 37% and 23% in group A and B respectively; the difference is statistically significant (p value=0.031). ‘ROM to delivery interval’ was more in group A (16.31±8.67 hrs and 13.85±5.46 hrs) (p value=0.0256). Hospital stay was comparatively more in group A (5.40±0.81 days and 4.11±0.86 days) (p value=0.435). Infective morbidity of mother and baby was low in both groups and no difference was seen.Conclusions: An expectant management allows a good number of women to go into labour and deliver vaginally without an increase in CS rate and infectious morbidity for mother and fetus.

scholarly journals Maternal Outcomes of Expectant Management In comparison with Induction of Labour within twenty four hours of Premature Rupture of Membranes (PROM).

2020 ◽  
Vol 27 (08) ◽  
pp. 1565-1569
Author(s):  
Saima Ashraf ◽  
Hajira Sultana ◽  
Saima Yasmin Qadir ◽  
Muhammad Khalid
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Controlled Trial ◽  
Expectant Management ◽  
Induction Of Labour ◽  
Maternal Outcomes ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Group A ◽  
Group B

Objective: this study is conducted to compare the maternal outcomes of expectant management versus induction of labour within 24 hours of premature rupture of membranes. Study Design: Randomized controlled trial. Setting: Obstetrics and Gynaecology Department, Nishtar Hospital, Multan. Period: From 15 March 2018 to 15 September 2018. Material & Methods: A total of 130 pregnant women with parity 0 – 4 having singleton pregnancy, ≥37 weeks pregnant and having premature rupture of membranes were taken in the study. Women having previous caesarean section, with history of hypertension or diabetes, features suggestive of chorioamnionitis, preterm pre-labour rupture of membranes and women with foetal distress were excluded from the study. Two groups were made. In Group (A) women were subjected to expectant management in which patients were observed for uterine contractions for a period of 24 hours. In Group (B) women were induced with tab dinoprostone 2 doses each 3 mg given 6 hours apart. Information regarding caesarean section, vaginal delivery and chorioamnionitis was recorded on a specially designed proforma. Results: In this study age range was from 18 to 35 years while in both groups most patients were 28 – 35 years old. In Group (A) mean gestational age was 38.246 ± 0.84 weeks while in Group (B) it was 37.953 ± 0.95 weeks. In Group (A) mean parity was 1.076 ± 1.16 and in Group (B) it was 1.815 ± 1.16. in Group (A) 2.092 ± 0.67 hours was mean duration of PROM while in Group (B) it was 2.092 ±0.67 hours. Mean BMI in Group (A) was 26.088 ±3.80 kg/m2 and in Group (B) it was 26.361 ±4.33 kg/m2. In Group (A), 24 patient (36.9%) delivered vaginally while 42 (64.6%) patient delivered vaginally in Group (B). 41 patients (63%) had cesarean section in Group (A) while in Group (B) 23 patients (35.4%) had cesarean section. Chorioamnionitis was seen in 14 patients (21.5%) in Group (A) while 3 patients (4.6%) had chorioamnionitis in Group (B). Conclusion: Our study concluded that induction of labour with twenty four hours of premature rupture of membranes does causes a reduction in occurrence of chorioamnionitis. By this approach patients are usually delivered within 24 hours and caesarean section rate is not increased. This approach also causes a reduction in augmentation of labour by oxytocin.

scholarly journals A COMPARITIVE STUDY ON INDUCTION OF LABOUR VERSUS EXPECTANT MANAGEMENT IN TERM PREMATURE RUPTURE OF MEMBRANES IN TERTIARY CARE HOSPITAL ,VISAKHAPATNAM

2019 ◽  
pp. 1-3
Author(s):  
Kavitha Gayak
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Expectant Management ◽  
Induction Of Labour ◽  
Care Hospital ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Management Group ◽  
Group A ◽  
Group B

Premature rupture of membranes (PROM), also called Prelabour Rupture Of Membranes, is classically dened as rupture of membranes before labour and accounts for 0.8-0.9% of all pregnancies at term. this study was conducted over a period of 14 months ( from March 2018 to May 2019) in a tertiary care medical college . A total of 100 term PROM patients were recruited in our study – and divided into two groups randomly--50 (Group A) patients were managed conservatively and 50 (Group- B) patients underwent induction of labour. Both these patient groups were studied to compare the feto-maternal outcome. Group-A (conservative management group) patients were observed to await the spontaneous onset of labour pains for at least 24 hours. Patients in group B were induced with either - PGE1 tab (misoprostol) 25 µgm 4 hourly orally or iv oxytocin infusion. the PROM-delivery interval was < 12 hours in 72 % of induced groups (Group B) and 10% (5) in group- A (conservative or expectant group). LSCS rate was 10 % in group-A (expectant group) & 15 % in group –B (induced group). Sepsis rate, maternal and fetal, hospital stay, NICU admission & duration of NICU stay were notably higher in group – A (expectant management group). therefore, from our study we concluded that immediate induction of labour in term PROM cases shortens the PROM- delivery interval, hospital stay, NICU stay and reduction in both maternal & neonatal sepsis

scholarly journals Hubungan Ketuban Pecah dengan Kejadian Asfiksia Neonatorum di RSUD Kabupaten Kediri Tahun 2016

2017 ◽  
Vol 3 (2) ◽  
pp. 19
Author(s):  
Yanu Yufita Lestariningsih
Keyword(s):  
Public Hospital ◽  
Simple Random Sampling ◽  
Fetal Membrane ◽  
P Value ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Chi Square ◽  
Asphyxia Neonatorum ◽  
Chi Square Test ◽  
Almost All

Premature rupture of  membranerevolves 5-10% from all birth. Impact a birth premature that espoused broken fetal membrane early causess 12-15% asphyxia neonatorum. The purpose of the study to determine the correlation between premature rupture of  membrane with the incidence of asphyxia neonatorum. The research method used is analytic with retrospective cohort approach with independent variable of premature rupture of membrane, dependent variable asphyxia neonatorum. The study was conducted on 7 June to 12 July 2017. The population of 1519 mothers inregional public hospital of Kediri regency 2016. Sample 139 respondents, taken by simple random sampling, was analyzed by Chi Square test with a significant of 0.05. Result of research most of respondent with rupture of membrane counted 46 respondents, almost all respondents that is 82.6% gave birth baby with asphyxia. From result of Chi Square test obtained by result of p-value equal to 0.000 (<0.05), result of coefficient of contingency (C) equal to 0.639 with closeness strong relation, so H1 received H0 rejected which means there is significant relation with closeness strong between premature rupture of membrane with asphyxia neonatorum inregional public hospital of Kediri regency 2016. Relative Risk (RR) 1.65 which means the possibility of a baby experiencing asphyxia neonatorum of 1.65 times in maternal who experience premature rupture of membranes compared to mothers who did not experience premature rupture of membranes.

scholarly journals 1035325 Hubungan Kadar Hemoglobin Ibu dan Letak Janin dengan Kejadian Ketuban Pecah Dini di Klinik Alisa Talang Kramat Kenten Tahun 2018

2019 ◽  
Vol 9 (1) ◽  
pp. 26-31
Author(s):  
Desi Hariani
Keyword(s):  
Univariate Analysis ◽  
Sampling Technique ◽  
Hemoglobin Level ◽  
Survey Method ◽  
Bivariate Analysis ◽  
P Value ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Chi Square ◽  
Fetal Abnormalities

ABSTRAK Ketuban pecah dini adalah pecahnya selaput ketuban pada setiap saat sebelum permulaan persalinan tanpa memandang apakah pecahnya selaput ketuban terjadi pada kehamilan 24 minggu atau 44 minggu. Kadar hemoglobin adalah ukuran pigmen respiratorik dalam butiran-butiran darah merah. Kelainan letak janin merupakan malpresentasi janin atau kelainan letak janin yang dapat membuat ketuban bagian terendah langsung menerima tekanan intra uteri yang dominan. Tujuan penelitian ini adalah mengetahui hubungan kadar hemoglobin ibu dan letak janin dengan kejadian ketuban pecah dini di klinik alisa talang keramat kenten Palembang Tahun 2018. Desain penelitian ini menggunakan metode survey analitik dengan pendekatan crossectional. Sampel berjumlah 63 orang. Pengambilan menggunakan teknik total sampling. Pengumpulan data menggunakan lembar checklist.Hasil analisis univariat didapatkan jumlah ibu yang mengalami ketuban pecah dini (22,3%), HB tidak normal (41,3%) dan letak sungsang (6,3%).  Dari hasil analisis bivariat dengan uji statistik Chi – Square ada hubungan bermakna antara kadar hemoglobin ibu p value  = 0,001 < α 0,05 nilai OR = 0,049 dan letak janin p value = 0,001 < α 0,05 nilai OR = 0,032 dengan kejadian ketuban pecah dini secara statistik terbukti. Melalui penelitian ini, diharapkan dapat memberikan pelayanan kesehatan yang lebih baik lagi pada ibu hamil dan bersalin sehingga tidak terjadi komplikasi.   Kata Kunci : Ketuban Pecah Dini, Kadar Hemoglobin, Letak Janin ABSTRACT Premature rupture of membranes isthe  rupture of the membranes at any time before the onset of labor, regardless of whether the rupture of the membranes occurs at 24 weeks or 44 weeks' gestation. Hemoglobin levels are the size of respiratory pigments in red blood granules. Fetal abnormalities are malpresentations of fetuses or fetal abnormalities that can make the lowest part of the membrane directly accept the dominant intrauterine pressure. The aim of this study is to know the correlation between maternal hemoglobin level and fetal location toward the incidence of premature rupture of membranes at klinik alisa talang keramat kenten The study design using analytical survey method with crossectional approach. The sample numbered 63 people. Taking by using total sampling technique. Data collection using checklist sheet. The result of univariate analysis showed that the number of mothers who had membranes rupturedearly was (22.3%), HB was not normal  (41.3%) and breech position was (6.3%). From bivariate analysis with Chi-Square statistical test there was a significant correlation between maternal hemoglobin level p value = 0.001 <α 0.05 value OR = 0.049 and fetal location p value = 0.001 <α 0.05 value OR = 0.032 with incidence of premature rupture of membranes was statistically proven. Through this research, it is expected to provide better health services in pregnant and maternity women so thereis no complications occur. Key word  : Premature rupture of membranes, Hemoglobin levels, Fetal Location

scholarly journals Comparison of efficacy of internal sphincterotomy versus topical 0.2 % glyceryl trinitrate ointment after hemorrhoidectomy.

2020 ◽  
Vol 27 (12) ◽  
pp. 2541-2547
Author(s):  
Muhammad Arif ◽  
Sabih Nofal ◽  
Ahsan Khan ◽  
Mariam Tariq Awana ◽  
Anum Arif
Keyword(s):  
Glyceryl Trinitrate ◽  
Controlled Trial ◽  
P Value ◽  
Chi Square ◽  
Male Predominance ◽  
Internal Sphincterotomy ◽  
Open Hemorrhoidectomy ◽  
Group A ◽  
Group B ◽  
Glyceryl Trinitrate Ointment

Objectives: To compare the efficacy of 0.2% glyceryl trinitrate ointment versus internal sphincterotomy after hemorrhoidectomy. Study Design: Randomized Controlled Trial. Setting: Department of Surgery Unit III, at Lahore General Hospital, Lahore. Period: 6 months (August 2017 to February 2018). Material & Methods: The OPD of the Department of Surgery included 124 patients who satisfied the inclusion criteria. There were two groups of patients, Group A and Group B. Group-A was told to use gloved finger three times daily for 0.2 percent GTN ointment topically. For Group B, lateral internal sphincterotomy was performed as day care procedure. On visit, patients were assessed for pain relief by using VAS. All data was collected using a pre-designed (attached) proforma. In SPSS v23.0 the data were input and analyzed. It was stratified for age, sex, disease duration and hemorrhoid stage. The effectiveness of both groups was compared by using a p-value of 0.05 as significant for a chi-square test. Results: Male predominance; in group-A, 41(66.1%) patients were male and 21(33.9%) were female, while in group-B, 52(83.9%) patients were male and 10(16.1%) were females. Efficacy was found in 11(17.7%) patients in group-A (0.2% GTN) while in 25(40.3%) patients in group-B (Internal sphincterotomy) with p-value of 0.006 which is statistically significant. Conclusion: Open hemorrhoidectomy internal sphincterotomy is an effective method to reduce pain after hemorrhoidectomy in contrast to Glyceryl Trinitrate (GTN) topical cream of 0.2 percent.

Combination Therapy Of Tadalafil And Pentoxifylline In Severe Erectile Dysfunction; A Prospective Randomized Trial

2015 ◽  
Vol 87 (8) ◽  
Author(s):  
Santosh Kumar ◽  
Rajesh Roat ◽  
Swati Agrawal ◽  
Kumar Jayant ◽  
Ravimohan S. Mavuduru ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Combination Therapy ◽  
Erectile Function ◽  
T Test ◽  
P Value ◽  
Chi Square ◽  
Significant Difference ◽  
Chi Square Test ◽  
Group A ◽  
Group B

Abstractwas to assess efficacy of Tadalafil alone versus Tadalafil plus Pentoxifylline in the treatment of erectile dysfunction by using self administered IIEF-5 questionnaire.Two hundred and thirty seven patients presenting with ED at andrology OPD were evaluated for ED by a self administered IIEF (International Index of Erectile Function) questionnaire. Patients were systematically randomized by computer generated random table into two groups groups namely, group A: Tadalafil only group, group B: combination of Tadalafil + Pentoxifyl-line. All the patients were re-assessed by IIEF-5 questionnaire after 8 weeks of medical therapy. Statistical analysis was performed using student’s unpaired t-test, paired t-test, chi square test. p-value < 0.05 was considered statistically significant.Two hundred and thirty seven patients were included in the present study, in group A: 92 patients (78.6%) showed improvement in their IIEF score after 8 weeks of tadalafil treatment. While in group B, overall 104 patients(86.6%) showed improvement after combination of Tadalafil and Pentoxifylline. There was a statistically significant difference of percentage change in IIEF score was seen in group B (group A 90.7±15.2%, group B 95.6±13.4%; p value – 0.014). We found this difference even more statistically significant in patients with severe ED (group A 72.7±47.2%, group B 132.3±54.3%; p value – 0.000). There was no significant difference in between the two groups with regards to occur-rence of side effects.Both tadalafil and combination of Tadalafil + Pentoxifylline improve erectile function in patients of ED. Patients with severe ED showed much significant improvement in erectile function with combination therapy.

scholarly journals Active Versus Expectant Management for Preterm Premature Rupture of Membranes at 34–36 Weeks of Gestation and the Associated Adverse Perinatal Outcomes

2020 ◽  
Vol 42 (11) ◽  
pp. 717-725
Author(s):  
Malú Flôres Ferraz ◽  
Thaísa De Souza Lima ◽  
Sarah Moura Cintra ◽  
Edward Araujo Júnior ◽  
Caetano Galvão Petrini ◽  
...  
Keyword(s):  
Gestational Age ◽  
Perinatal Outcomes ◽  
Expectant Management ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Management Group ◽  
Group I ◽  
Adverse Perinatal Outcomes ◽  
Group Ii

Abstract Objective To compare the type of management (active versus expectant) for preterm premature rupture of membranes (PPROM) between 34 and 36 + 6 weeks of gestation and the associated adverse perinatal outcomes in 2 tertiary hospitals in the southeast of Brazil. Methods In the present retrospective cohort study, data were obtained by reviewing the medical records of patients admitted to two tertiary centers with different protocols for PPROM management. The participants were divided into two groups based on PPROM management: group I (active) and group II (expectant). For statistical analysis, the Student t-test, the chi-squared test, and binary logistic regression were used. Results Of the 118 participants included, 78 underwent active (group I) and 40 expectant management (group II). Compared with group II, group I had significantly lower mean amniotic fluid index (5.5 versus 11.3 cm, p = 0.002), polymerase chain reaction at admission (1.5 versus 5.2 mg/dl, p = 0.002), time of prophylactic antibiotics (5.4 versus 18.4 hours, p < 0.001), latency time (20.9 versus 33.6 hours, p = 0.001), and gestational age at delivery (36.5 versus 37.2 weeks, p = 0.025). There were no significant associations between the groups and the presence of adverse perinatal outcomes. Gestational age at diagnosis was the only significant predictor of adverse composite outcome (x2 [1] = 3.1, p = 0.0001, R2 Nagelkerke = 0.138). Conclusion There was no association between active versus expectant management in pregnant women with PPROM between 34 and 36 + 6 weeks of gestation and adverse perinatal outcomes.

scholarly journals Open VS Closed Techniques for Laparoscopic Abdominal Surgeries

2021 ◽  
pp. 296-302
Author(s):  
Obaid Ul Haseeb ◽  
Haris Rashid ◽  
Afrin Ahmed ◽  
Mir Arsalan Ali ◽  
Shakil Alam ◽  
...  
Keyword(s):  
Controlled Trial ◽  
P Value ◽  
Open Approach ◽  
Chi Square ◽  
Closed Technique ◽  
Chi Square Test ◽  
Group A ◽  
Classic Technique ◽  
Group B ◽  
Surgery Department

Background: Laparoscopic surgery or "minimally invasive" surgery is a type of specialist surgery. The most crucial, demanding, and risky part of the laparoscopy is the creation of pneumoperitoneum. The two most prevalent methods for creating a pneumoperitoneum are the closed and open approaches. Despite the fact that there is no universal consensus on the best approach to gain access to the peritoneal cavity in order to create a pneumoperitoneum. The aim of present study was to compare the operative time and post-operative outcome associated with closed technique and open classic technique. Methods: This randomized controlled trial was carried out by recruiting patients presented in surgery department of Ziauddin Hospital North campus. The samples were divided into two equal groups A and B. Group A was operated for Laparascopic abdominal surgery by open technique while group B operated through closed technique. Effectiveness of procedures was measured by number of complications occurred during and after surgery. Chi-square test and independent T-test were applied for association. P-value of < 0.05 was considered as significant. Results: Mean age was found to be 45.5±16 years and mean weight was 68±10.5 kilograms. Mean time of operations was 84.5±18.5 minutes. 60 (69.8%) of patients included underwent the laparoscopic cholecystectomy while 15 (17.4%) patients had laparoscopic appendectomy. 13/86: 15.1% of patients had the minor complication including 12/43: 27.9% in group B and 1/43: 2.3% in group A. The comparative analysis between the two groups in terms of effectiveness of either method compared by means of development of the complications was found to be highly significant with p value 0.002. Conclusion: The open approach to laparoscopic entrance has been linked to fewer surgical problems than the closed approach.

scholarly journals HEMORRHOIDECTOMY;

2017 ◽  
Vol 24 (09) ◽  
pp. 1316-1321
Author(s):  
Shibber Ahmed ◽  
Ishtiaq Ahmad ◽  
Humayun Amjid ◽  
Aamir Furqan
Keyword(s):  
Hospital Stay ◽  
Severe Pain ◽  
Conventional Technique ◽  
Categorical Variables ◽  
P Value ◽  
Chi Square ◽  
Post Operative Pain ◽  
Group A ◽  
And Gender ◽  
Group B

Objectives: Is to compare outcomes in terms of mean post-operative pain andhospital stay between stapled versus conventional hemorrhoidectomy. Hypothesis: There isa difference in mean post-operative pain and hospital stay between stapled and conventionalhemorrhoidectomy, stapled technique is better than conventional technique. Study Design:Randomized control trial. Setting: Department of General Surgery Bakhtawar Amin MemorialHospital Multan. Period: February 2016 February 2017. Methodology: A total number of 60patients enrolled in the study, both genders. Statistical software SPSS ver.23 was used toanalyze the data. Mean and SD were calculated and presented for numerical variables likeduration of hemorrhoids, age and pain score while frequencies and percentage were calculatedand presented for categorical variables like ender and grade of hemorrhoids. Independent t-testand chi square test were applied to see effect modification. P value ≤0.05 was considered assignificant. Results: Total number of 60 (100%) patients in the study, 32 (53.3%) were maleand 28 (46.7 %) were female. Mean hospital stay in group A was 1.63 ± 0.71 and in groupB means duration of hospital stay was 1.73 ± 0.74. A P value was 0.001. On stratification ofdata it is concluded that in group A 9 patients have no pain 6 have mild and 6 have moderatepain and 5 patients have severe pain, similarly in group B, 3 patients have no pain 2 have mildpain 1 have moderate pain and no patient have severe pain. P value for male patients was2.65. Conclusion: This study confirms that stapled hemorrhoidectomy is associated with lesspostoperative pain with no effect of age and gender on outcome.

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