scholarly journals ECLAMPSIA

2006 ◽  
Vol 13 (01) ◽  
pp. 27-31
Author(s):  
SHAHIDA SHERAZ ◽  
MOHAMMAD BOOTA ◽  
SOHAIL SHAHZAD

Objective: To evaluate incidence, morbidity and mortalityassociated with eclampsia. Design: A prospective study. Place and Duration: The study which was carried out at PAFHospital Rafiqui, Shorkot spanned over a period of 2½ years from Jun 2002-Dec 2004. Patients and Methods: Thestudy comprises of 55 eclamptic cases diagnosed out of 3391 consecutive deliveries, carried out in our hospital.Results: The incidence of eclampsia, in this study, was found to be 1.62%. Out of 55 cases 38(69.1%) patients wereprimigravida. Forty three (78.2%) of the patients were between the ages of 21 to 30 years. In 50(90.9%) patientsgestational age was less than 35 weeks. Thirty seven (67.3%) cases had antepartum eclampsia. Forty four (80%)patients received diazepam while the remaining 11(20%) received magnesium sulphate (MgSO4) as anticonvulsant.Commonest mode of delivery was spontaneous vaginal delivery \(31 cases, 56.4%) followed by lower caesareansection (21 cases, 38.2%). Fetal loss was seen in 12(20.7%) cases. Two patients died of eclampsia, maternal mortalityrate being 3.6%. Conclusion: Eclampsia is a life threatening complication of pregnancy. However an improvement inantenatal care, upgrading the neonatal facilities and early delivery by cesarean section can improve the perinataloutcome.

2020 ◽  
pp. 000486742095428
Author(s):  
Lei Sun ◽  
Su Wang ◽  
Xi-Qian Li

Background: Postpartum depression is one of the most common postpartum diseases, which has an important impact on the interaction between mother, infant, partner and family, as well as the long-term emotional and cognitive development of infants. However, there are still great disagreements on whether the delivery mode will affect the risk of postpartum depression. The purpose of this study is to explore whether the mode of delivery will affect the risk of postpartum depression through the comprehensive network meta-analysis of elective cesarean section, emergency cesarean section, instrumental vaginal delivery and spontaneous vaginal delivery. Methods: We searched in three electronic databases: PubMed, EMBASE and Cochrane Library. Results: This paper included 43 studies with a total sample size of 1,827,456 participants. Direct meta-analysis showed that the odds ratio of postpartum depression risk was 1.33 (95% confidence interval = [1.21, 1.46]) between cesarean section and vaginal delivery. The odds ratios of high Edinburgh Postpartum Depression Scale score between cesarean section and vaginal delivery in the three postpartum periods (within 2 weeks, within half a year and over half a year) were basically the same. There was no difference between cesarean section and vaginal delivery in the risk of severe postpartum depression at the Edinburgh Postpartum Depression Scale cut-off point ⩾13 (odds ratio = 1.07; 95% confidence interval = [0.99, 1.16]). Network meta-analysis showed that the risk of postpartum depression in the pairwise comparisons emergency cesarean section vs spontaneous vaginal delivery and elective cesarean section vs spontaneous vaginal delivery was odds ratio = 1.53 (95% confidence interval = [1.22, 1.91]) and 1.47 (95% confidence interval = [1.16, 1.86]). Conclusion: The mode of delivery has a significant effect on the occurrence of mild postpartum depression. Women who give birth by cesarean section, especially who give birth by emergency cesarean section, are at a higher risk of mild postpartum depression. We should carefully monitor the progress of postpartum mental disorders in women who delivered by cesarean section and make it possible for women to have a quick access to mental healthcare.


2020 ◽  
Vol 10 (1) ◽  
pp. 32-38
Author(s):  
Aisha Khan Jadoon ◽  
Arzu Jadoon ◽  
Sarosh Khan Jadoon ◽  
Shahina Ishtiaq

Background: Postpartum Depression is a serious issue that can lead to irreversible disasters if not timely recognized and diagnosed. There are various modes of delivery; which may contribute towards physical and mental trauma. Methods: It was a prospective descriptive cross- sectional study carried out to evaluate the alliance of postnatal depression with different modes of delivery i.e. vaginal or lower segment caesarean section. The study was conducted at Ziauddin University Hospital. A sample size of 200 was taken. It was carried out from June 2019 to December 2019. A Performa was designed that questioned about different socio-demographic characteristics and risk factors for post-natal depression (PND). Edinburg Post-Natal Depression Scale (EPNDS) was used for authenticated identification of women with depression in purpeurium. Results: Out of the total sample of 200 women, 100 were taken from the spontaneous vaginal delivery group and 100 from cesarean section group. Mean age was 21-34 years. It was noticed that 60% women who underwent cesarean section became a victim of depression and 40% women who had a normal vaginal delivery were identified to have post natal depression. Conclusion: The study identifies cesarean section to be one of the culprits of postnatal depression as compared to woman undergoing spontaneous vaginal delivery.  There is an exponential rise in the frequency of performing unexplained cesarean sections that would also boost up the graphs of postnatal depression; hence there is a dire need to instruct women to follow up postnatal so that they can be evaluated for post partum depression.


Author(s):  
Vinaya Goudar ◽  
Rashmi Naganagoudaru

Background: An acute and life-threatening complication of pregnancy is characterized by the appearance of tonic clonic seizures, in a patient with pre-eclampsia. Objective of the study was to study the efficacy and safety of a ‘single dose’ of magnesium sulphate in treatment of eclamptic convulsions.Methods: The present prospective study was undertaken among women aged between 18-35 years outpatient’s Department of gynecology in Karnataka Institute of Medical Sciences (KIMS) Hubli, Karnataka, India. The study was undertaken during December 2009 to November 2010.Results: The incidence of eclampsia in our study was 2.12%. Eclapmsia is more common in patients from rural (89%) as compared to urban areas (11%) in our study. In our study eclampsia is more common in unbooked cases (80%). Majority of patients (72%) in our study group were illiterates. 61%, 28% of patients had antepartum and intrapartum eclampsia respectively in our study. We had only 11 post-partum convulsions Table 2. 80% of patients in our study were more than 28 weeks of gestations. 65% of the patients had <5 episodes of convulsions. The number of convulsions did not affect the recurrence, and 35% had >5 episodes. In present study 5 Patients had Systolic Blood Pressure less than 140 mmHg. Majority (52) had more than 160 mmHg 42 had in between 140 and 160 mmHg. Diastolic arterial pressure was >110 in 81% of cases. The convulsions were controlled in 75% of women. Recurrence of convulsions occurred in 25% of women after receiving the single dose magnesium sulphate regime. In our study 75% of cases, there was no recurrence of convulsions and in 25% of cases, there was recurrence of convulsions, out of which 20 cases received low dose magnesium sulphate regime and the other 5 cases received Phenytoin regime as 2nd line of treatment.Conclusions: Hence the single dose Magnesium sulphate is safe and effective in controlling convulsions.


2017 ◽  
Vol 8 (4) ◽  
pp. 64-72
Author(s):  
Anastasia V. Koziy ◽  
Alexander I. Olesin ◽  
Vadim A. Litvinenko ◽  
Irina V. Konstantinova

Aim. The aim of the study was a clinical assessment of the integrated determination of predictors of life-threatening ventricular arrhythmias (LVA) in patients with ventricular extrasystole (VE) without structural changes in the heart to predict the development of cardiovascular disease in a prospective study. Material and methods. From 1997 to 2014 199 patients with neurocirculatory dystonia (NCD), complicated with VE II-V class EE at the age of 18-35 years (mean 27.3-2.6 years) were observed in District Military Clinical Hospital of the Ministry of Defense of the Russian Federation, City Hospital named after St. Martyr Elizabeth. All patients, in addition to a general clinical examination, determined late potentials of the ventricles (LPV), QT interval variability (QTd), heart rate turbulence (HRT), and also indicators reflecting the possible mechanism of VE development. Results. The results of the study showed that in patients with NCD complicated by VE, the detection of indicators reflecting the presence of VE caused by the mechanisms of early post-depolarization and re-entry is a predictor of the development of coronary heart disease (CHD) and hypertension (HB). The positive prognostic significance of the indicators showing the presence of VE with these development mechanisms for the development of CHD and HB averaged 74% and 44% respectively, and with the appointment of сlass III drugs for elimination of VE and (or) development of unstable ventricular tachycardia, the risk of developing CHD increased to an average of 93%. Identification of NDC patients with indicators reflecting the presence of VE due to delayed post-depolarization is a predictor of the development of gastrointestinal tract (GT) diseases with positive prognostic significance, averaging 61%. Positive prognostic significance with respect to the development of CHD, HB, GT diseases for the detected LPV, QTd > 80 ms, pathological values of HRT VE did not exceed 30%. Indicators and predictors, which characterize the mechanism of development of VE and the risk of LVA occurrence in patients with NCD complicated by VE, were highly correlated (r > 0.50) with risk factors for cardiovascular and gastrointestinal system diseases.


2021 ◽  
Author(s):  
Nobuhiro Suzumori ◽  
Takeshi Ebara ◽  
Hazuki Tamada ◽  
Taro Matsuki ◽  
Hirotaka Sato ◽  
...  

Abstract Background Postpartum depression is one of the most commonly experienced psychological disorders for women after childbirth, usually occurring within one year. This study aimed to clarify whether women with painless delivery, including epidural analgesia, spinal-epidural analgesia, and paracervical block, had a decreased risk of postpartum depression after giving birth in Japan. Methods The Japan Environment and Children’s Study (JECS) was a prospective cohort study that enrolled registered fetal records (n = 104,065) in 15 regions nationwide in Japan. Binomial logistic regression analyses were performed to calculate the adjusted odd ratios (aORs) for the association between mode of delivery with or without analgesia and postpartum depression at one-, six- and twelve-months after childbirth. Results At six months after childbirth, painless vaginal delivery was associated with a higher risk of postpartum depression (aOR: 1.218, 95% confidence interval: 1.067–1.391), compared with vaginal delivery without analgesia or cesarean section. Nevertheless, the risk disappeared one year after delivery. Among the pregnant women who requested painless delivery, 5.1% had a positive Kessler-6 scale (K6) score for depression before the first trimester (p < 0.0001), which was significantly higher than the proportions in the vaginal delivery without analgesia (3.5%) and cesarean delivery (3.5%) groups. Conclusions Our data suggested that the risk of postpartum depression at six months after childbirth tended to be increased after painless vaginal delivery, compared with vaginal delivery without analgesia or cesarean section. Requests for painless delivery continue to be relatively uncommon in Japan, and women who make such requests might be more likely to experience postpartum depressive symptoms because of underlying personality characteristics, including a tendency to worry.


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