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 Profile of neonatal dermatoses in a tertiary care teaching hospital of Haryana

2018 ◽  
Vol 6 (3) ◽  
pp. 955
Author(s):  
Poonam Marwah ◽  
Ashish Marwah ◽  
Sunil Kumar ◽  
Rajesh Kumar
Keyword(s):  
Birth Weight ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Skin Lesions ◽  
Normal Vaginal Delivery ◽  
Care Hospital ◽  
Age Group ◽  
Common Skin ◽  
History Of ◽  
Recorded Data

Background: To assess the incidence and profile of neonatal dermatoses in a tertiary care hospital of Haryana and study its association with various perinatal risk factors.Methods: All inborn neonates (<28 days of life) including those seen in the outpatient department on follow up between November 2016 to April 2017 formed the baseline population and babies with skin lesions were included in the study. A detailed perinatal history and newborn examination of the baby was done by a pediatrician and all relevant details were recorded. Data was analyzed, and inferences were drawn using tables.Results: In our study, a total of 2760 newborn (1506 (54.6%) males and 1254 (45.4%) females) were studied. The incidence of neonatal dermatoses was found to be 94.1%. There were 1849 (66.9%) term, 853 (30.9%) preterm, and 58 (2.1%) post term neonates. 1901 (68.8%) had birth weight >2.5kg while 859 (31.1%) had birth weight ≤2.5kg. 1223 (44.3%) were born to primipara while 1537 (55.6%) were born to multipara mothers. Mothers of 54 (1.9%) neonates were < 20 years of age; 1157 (41.9%) in the age group of 20-25 years; 1324 (47.9%) in the age group of 25-30 years and 225 (8.1%) in the age group >30 years. 1806 (65.4%) neonates were born by normal vaginal delivery and 954 (34.6%) neonates were born by cesarean section. In 13 (0.5%) neonates, history of consanguinity was present while it was absent in 2747 (99.5%) neonates. Most common skin lesions observed were transient skin lesions among which Mongolian spots (62.9%), epstein pearls (48.8%), erythema toxicum (41.8%), milia (40.6%) and miniature puberty (35.9%) were the most common.Conclusions: Incidence of neonatal dermatoses was found to be higher (54.6%) among males as compared to females (45.4%); among term babies; those with birth weight >2.5kg; those born to multipara mothers; those born via normal vaginal delivery and those with maternal age 25-30 years.

scholarly journals Maternal and fetal outcome in cases of eclampsia

2020 ◽  
Vol 9 (11) ◽  
pp. 4432
Author(s):  
Hetal N. Dodiya ◽  
Sapana R. Shah ◽  
Rupa C. Vyas ◽  
Purvi M. Parikh
Keyword(s):  
Vaginal Delivery ◽  
Public Awareness ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Normal Vaginal Delivery ◽  
Time Interval ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Initiation Of Therapy ◽  
Clonic Convulsions

Background: Eclampsia refers to occurrence of generalized tonic clonic convulsions (GTCS) followed by confusion or coma during pregnancy or puerperium in patients with preeclampsia excluding other neurological conditions. Purpose of this study was to evaluate the risk factors, management protocols and determine maternal and perinatal morbidity and mortality in patients of eclampsia.Methods: This is retrospective study of 180 cases of eclampsia carried out from June 2017 to December 2019 including all the antepartum, intrapartum and postpartum cases at tertiary care centre. Immediate management was focused to control the convulsion and lower the blood pressure followed by NST and USG foetus with Doppler study.Results: In this study, 72.2% cases reported antepartum eclampsia while 27.8% cases were postpartum and overall incidence was 0.91% of total deliveries conducted during the study period. Incidence was higher in primigravida (74.4%) and below 25 years age (68.8%). Magnesium sulphate was effective in 94.4% cases. Study reports 63 normal vaginal delivery, 5 assisted vaginal delivery, 110 caesarean section and 2 women expired undelivered. There were 10 maternal deaths.Conclusions: Time interval between eclamptic seizures and initiation of therapy is an important prognostic factor affecting maternal and perinatal outcome. Public awareness regarding the importance of regular antenatal visits can help in reducing chances of development of eclampsia. Even though various drugs and methods have been tried for the treatment of eclampsia, the definitive management is the delivery of foetus after control of convulsion, hypertension and should be managed at tertiary care hospital.

scholarly journals Indication and Outcome of Caesarean Section in Multigravid Women with a History of Vaginal Delivery in a Tertiary Care Hospital

2020 ◽  
Vol 14 (2) ◽  
pp. 86-89
Author(s):  
Poly Begum ◽  
Dipti Rani Saha ◽  
Dilruba Zeba
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Normal Vaginal Delivery ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Safe Delivery ◽  
Delivery Outcome ◽  
History Of

It is commonly believed that if the first child of a mother is born by normal vaginal delivery, all the subsequent deliveries will follow the same. As a result, such multiparous mothers often neglect routine antenatal check ups and intranatal care which may cause poor delivery outcome. For these reasons, attention should be given to analyze the indication of caesarean section (CS) in women who had history of previous vaginal delivery. Our objective was to know the indications and outcome of CS in multigravid women having a child previously delivered vaginally. This observational cross-sectional study was carried out in the Department of Obstetrics and Gynaecology in Diabetic Association Medical College Hospital, Faridpur. One hundred and ten multigravid women who had undergone elective as well as emergency CS for various indications were included in this study. Most common indication of CS was fetal distress (33.64%). Others were obstructed labour (10.9%), breech presentation (10.9%), and pre-eclampsia (9.09%). In the postpartum period, 75.5% patients were healthy. Others developed sepsis (10.9%) and URTI (8.2%). Most of the babies (95.5%) were alive. Understanding these insights may help both the mother and the caregiver an idea about the associated risks and what actions should be taken for a safe delivery outcome. Faridpur Med. Coll. J. Jul 2019;14(2): 86-89

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 Outcome Of Induction Of Labour By Intravaginal Prostaglandin Versus Intravenous Oxytocin In a Tertiary Care Hospital

2012 ◽  
Vol 17 (2) ◽  
pp. 30-33
Author(s):  
Mst Shahana Pervin ◽  
Shamima Haque ◽  
Jahanara Rahman
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Cost Effective ◽  
Induction Of Labour ◽  
Normal Vaginal Delivery ◽  
Care Hospital ◽  
Maternal Complications ◽  
National Medical ◽  
Unfavorable Cervix

Aim of the study was to determine the effectiveness and safety of intravaginal misoprostol VS intravenous oxytocin in induction of labour and to compare the induction delivery interval between prostaglandin induction and oxytocin induction and to detect maternal and foetal outcome between prostaglandin induction and oxytocin induction and also reduce the rate of caesarean section . A prospective, randomized trial was carried out in one hundred singleton pregnant women admitted in Dhaka National Medical Hospital during the period of January 2006 to December 2006. Women who had unfavorable cervix (Bishop’s score<) were selected. 50 of them received 50 mgm misoprostol intravaginally for three doses, 6 hourly. Another 50 patient received intravenous starting from 10 mU /ml up to 40mU.Thirty-nine patients out of 50 patients of misoprostol group achieved normal vaginal delivery. Rest eleven patients ended by caesarean section. 82% of this group delivered within 10 hours. The maximum required dose was 50-150mgm. Maternal complications were PPH 2%. Neonatal outcome were satisfactory. Thirty – six patients out of 50 patients of Oxytocin group achieved normal vaginal delivery. Rest fourteen patients ended by caesarean section. Only 66% of this group delivered within 10 hours. The maximum required dose was 40mU/ml. From the study it was found that intravaginal misoprostol is well tolerated and very effect then intravenous oxytocin in induction of labour in unfavorable cervix. It certainly reduces the number of caesarean section. It is cost effective. DOI: http://dx.doi.org/10.3329/jdnmch.v17i2.12213 J. Dhaka National Med. Coll. Hos. 2011; 17 (02): 30-33

scholarly journals Anemia in antenatal patients and its outcome: an experience in tertiary care centre

2018 ◽  
Vol 7 (8) ◽  
pp. 3263
Author(s):  
Shabnam Ara ◽  
Cimona Lyn Saldanha ◽  
Insha Khan
Keyword(s):  
Vaginal Delivery ◽  
Serum Ferritin ◽  
Peripheral Blood ◽  
Post Partum ◽  
Tertiary Care ◽  
Deficiency Anemia ◽  
Normal Vaginal Delivery ◽  
Blood Picture ◽  
Co Morbidity ◽  
Term Delivery

Background: Anemia is the most common hematological abnormality detected during the pregnancy and forms a major problem in affecting the females especially in the developing countries.Methods: All pregnant females with clinical evidence of anemia without any other co-morbidity attending the antenatal clinic were included in the study. Patients were studied in terms of the age, parity, inter-pregnancy spacing, type of pregnancy, post-partum outcome along with the biochemical tests like peripheral blood picture, hemoglobin estimation, and serum ferritin levels.Results: Total no. of patients was 500, age ≤20 years were 60 and ≥35 years were 107, mild anemia (10-10.9 gm%) 160, moderate anemia (7-10 gm%) 250, severe anemia (<7 gm%) 90. Normal vaginal delivery with medio-lateral episiotomy was done in 385 patients, normal vaginal delivery without medio-lateral episiotomy in 35 while lower-segment caesarean section in 80 patients. Pre-term delivery was done in 95 patients, post-term delivery in 20. 90 babies delivered were low-birth weight (<2500 gm), antepartum hemorrhage was seen in 10 patients while 20 patients had Post-partum hemorrhage.Conclusions: The present study concludes that anemia is still rampant in the society especially in pregnant women. The main cause of anemia-in-pregnancy is still the iron deficiency anemia. The peripheral blood picture, hemoglobin estimation, and serum ferritin levels form the basic pillars in the evaluation of the etiology and type of anemia. The multiple government sponsored facilities are to be made available to each pregnant female and that requires community, government as well as healthcare professional’s participation.

scholarly journals Comparison of maternal and perinatal outcome in pregnancy with altered thyroid profile and euthyroid patients: a prospective, observational and case control study in a tertiary care centre

2019 ◽  
Vol 8 (4) ◽  
pp. 1594
Author(s):  
Vandna Singh ◽  
Neeta Natu ◽  
Artika Sudhir Gupta
Keyword(s):  
Thyroid Dysfunction ◽  
Case Control Study ◽  
Tertiary Care ◽  
Case Control ◽  
Normal Vaginal Delivery ◽  
Care Hospital ◽  
Altered Thyroid ◽  
Thyroid Profile ◽  
Control Study ◽  
In Pregnancy

Background: Thyroid disease is one of the commonest endocrine disorder affecting women of reproductive age, and when untreated during pregnancy is associated with an increased risk of complications. The objective of this review was to increase awareness and to provide a review on adverse effect of thyroid dysfunction on maternal and perinatal outcome.Methods: This prospective, observational hospital-based case-control study carried on women coming for antenatal check-up in a Tertiary Care Hospital in INDORE from May 2018-December 2018. 50 known booked antenatal (case) patient with established thyroid disorder, more than 32 week of gestation, and 50-matched euthyroid patients (control) were taken.Results: Women suffering from overt and subclinical hypothyroidism and hyperthyroidism are nulliparous in 72% cases as compared to 32% in euthyroid patient. Increased maternal age was associated with higher incidence of thyroid dysfunction. Normal vaginal delivery by spontaneous labour seen in 56% of euthyroid, while it is reduced with thyroid dysfunction. 38% of altered thyroid profile patient undergo induction of labour and 24% cases undergo caesarean section as compared to control (17%). Adverse fetal outcome like intrauterine growth retardation, preterm birth and ICU admission seen increased with thyroid dysfunction  as compared to euthyroid patients.Conclusions: Thyroid dysfunction in pregnancy, although has a low incidence, but is associated with adverse maternal and fetal implications. Thus, thyroid screening should be done in antenatal period to improve fetomaternal outcome.

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