scholarly journals Analysis of Uterine Rupture in Pregnancy at a Tertiary Care Hospital

2019 ◽  
Vol 14 (1) ◽  
pp. 29-31
Author(s):  
Beemba Shakya
Keyword(s):  
Maternal Mortality ◽  
Uterine Rupture ◽  
Perinatal Death ◽  
Tertiary Care ◽  
Patient Characteristics ◽  
Care Hospital ◽  
Cross Sectional ◽  
Peripartum Hysterectomy ◽  
Neonatal Deaths ◽  
In Pregnancy

Aims: To analyze patients with uterine rupture in pregnancy. Methods: This was a cross-sectional retrospective study undertaken at Paropakar Maternity and Women’s Hospital. Two years’ medical records of uterine rupture between 14 April 2017 and 13 April 2019 were reviewed. Information on patient characteristics, age, parity, mode of previous deliveries, onset of labour spontaneous or induced, type and site of rupture, maternal and perinatal outcome, management and complications associated with it were retrieved and was analyzed using SPSS version 16.0. Results: Among 29 uterine rupture cases, majority of cases occurred in 25-29 years (48.3%), para1 (79.3%) and unbooked cases (72.4%). Most of them occurred in previous scar 23(79.3%); rupture was complete in 13 and incomplete in 10 cases. Six (20.6%) were unscarred uterine rupture. Rupture repair was done in 24(82.7%) and peripartum hysterectomy (subtotal hysterectomy) in 5(17.2%) cases. The most common complications were postpartun hemorrhage (55.2%), hospital stay >7 days (55.2%), blood transfusion (48.3%) and ICU admission (41.3%). There was no maternal mortality. Perinatal death was 15 (51.7%)-13 stillbirths and 2 neonatal deaths. Conclusions:  Majority of the uterine rupture occurred in previous scar (79.3%). Most of the cases underwent repair of the uterus (82.7%) and remaining were peripartum hysterectomy (17.2%). There was no maternal mortality. However, perinatal mortality occurred in 51.7%. Keywords: peripartum hysterectomies, previous scar, repair of uterus, uterine rupture.

scholarly journals Emergency peripartum hysterectomy: a retrospective analysis in a tertiary care hospital in Jharkhand, India

2018 ◽  
Vol 7 (8) ◽  
pp. 3179
Author(s):  
Megha Bhagat ◽  
Bratati Moitra
Keyword(s):  
Retrospective Analysis ◽  
Uterine Rupture ◽  
Tertiary Care ◽  
Bladder Injury ◽  
Care Hospital ◽  
Peripartum Hysterectomy ◽  
Morbidly Adherent Placenta ◽  
Cesarean Deliveries ◽  
Adherent Placenta ◽  
Emergency Peripartum Hysterectomy

Background: Emergency peripartum hysterectomy (EPH) is a rare but a lifesaving procedure done as a last resort to save life of mother. We conducted this study to know the incidence, leading causes, and complications of obstetric hysterectomy.Methods: Authors conducted a retrospective analysis of all the patients who underwent emergency peripartum hysterectomy from January 2015 to December 2017 at RIMS, Ranchi.Results: There were 126 emergency peripartum hysterectomies, with deliveries during the same period being 21732 and the rate of EPH was 5.7 per 1000 deliveries. Most common indication for EPH was uterine rupture (54.6%), followed by uterine atony (18.2%) and morbidly adherent placenta (23.01%). Most of the patients (66.67%) had previous cesarean deliveries. EPH was done following cesarean in 66.67%. Subtotal hysterectomy was done in 88.09%. Intra-operative urinary bladder injury was seen in 11.11% of the patients.Conclusions: Uterine rupture and Morbidly adherent placenta continues to be the most common causes for EPH in our population. Multiparity is an important risk factor among patients with rupture uterus. Cesarean delivery and repeat cesarean deliveries are the likely risk factors for EPH.

scholarly journals Feto-maternal outcome in pregnancy beyond 40 weeks

2017 ◽  
Vol 6 (2) ◽  
pp. 527 ◽  
Author(s):  
Paras V. Dobariya ◽  
Parul T. Shah ◽  
Hina K. Ganatra
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Perinatal Morbidity ◽  
Maternal Complications ◽  
Cross Sectional ◽  
In Pregnancy

Background: Fetal, Neonatal and Maternal complications associated with pregnancy beyond 40 weeks have always been underestimated. However emerging evidence demonstrates that the incidence of complications increases after 40 weeks of gestation. The present study conducted to find out the fetomaternal outcome of such prolonged pregnancy.Methods: A prospective cross sectional study of 84 patients with uncomplicated prolonged pregnancy fulfilling the inclusion and exclusion criteria and admitted in department of obstetrics and gynecology at a tertiary care hospital. The aim of the study was to know fetomaternal outcome in pregnancy beyond 40 weeks in consideration of spontaneous and induced labour.Results: Out of 84 patients, 58 (69.05%) were in the age group of 20-30 years, 44 (52.38%) were between 41-42 weeks of gestation according to their LMP and 38(45.24%) were between 40-41 weeks of gestation. In 27 (32.14%) patients mode of delivery was caesarean section, in whom most common indication being fetal distress in 48.15% followed by failure to progress in 22.22%. In present study perinatal morbidity like IUFD, neonatal asphyxia, MAS, RDS were 4.76%, 9.52%, 7.14% and 3.57% respectively. Maternal morbidity like prolonged labor, PPH, fever, wound infection were 10.71%, 5.95%, 3.57% and 3.57% respectively.Conclusions: With Regular antenatal check-up, incidence of postdate pregnancy can be decreased and it is important because of definite risk to fetus as pregnancy continuing beyond 40 weeks of gestation is associated with increased perinatal morbidity and mortality especially those who do not come for regular antenatal check-up. Confirmation of diagnosis of exact term of pregnancy is very important as many patients don’t have regular menstrual history and LMP. Diagnosis can be confirmed by first trimester ultrasound which is most important non-invasive method and readily available.

scholarly journals Postpartum Hemorrhage in Pregnancy beyond 40 Weeks of Gestation in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (237) ◽  
Author(s):  
Rashmi Bastakoti Gaire ◽  
Suman Raj Tamrakar ◽  
Anjana Singh Dongol
Keyword(s):  
High Risk ◽  
Confidence Interval ◽  
Postpartum Hemorrhage ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
In Pregnancy

Introduction: Postpartum hemorrhage is defined as a blood loss of 500ml or more within 24 hours after birth. It is the leading cause of maternal mortality in low-income countries and the primary cause of nearly one-quarter of all maternal deaths globally. It occurs in up to 18% of total births. Post-dated pregnancy is a high-risk pregnancy with increased maternal morbidity. This study aims to determine the prevalence of postpartum hemorrhage in pregnancy beyond 40 weeks of gestation in a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted among pregnant women beyond 40 weeks in Dhulikhel hospital from October 2016 to March 2017. The study was conducted after ethical clearance from the hospital research committee (reference number#128/16). The sample size was calculated and convenient sampling was done. Statistical Package for the Social Sciences is used for analysis. Point estimate at 95% confidence interval was calculated along with frequency and percentage for binary data. Results: Out of 465 ladies enrolled in this study postpartum hemorrhage was seen in 6 (1.29%) (95% Confidence Interval = 0.267-2.31), and the mean age was 24.25+4.8. About 346 (74.4%) had a normal delivery, 104 (22.36%) had cesarean section and 15 (3.22%) had instrumental delivery. Conclusions: Postpartum haemorrhage prevalence is low among the pregnant women beyond 40 weeks compared to the standard study. Postpartum hemorrhage is the common leading cause of maternal mortality. So high-risk cases should be identified and active management should be done to reduce morbidity and mortality.

scholarly journals Eclampsia at a tertiary care hospital of Nepal: A five year study

2018 ◽  
Vol 6 (2) ◽  
pp. 14-21
Author(s):  
Shraddha Rana ◽  
Pramod Kattel
Keyword(s):  
Blood Pressure ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Health Care Professionals ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Mortality ◽  
Care Hospital ◽  
Cross Sectional ◽  
National Medical

Background and Objectives: Eclampsia poses a global threat in terms of feto-maternal morbidity and mortality and all medical practitioners fear the ailment. It is one of the major causes behind preventable maternal death. Etio-pathogenesis of the disease condition is ambiguous and is considered to be multi-factorial. This study was done to analyze cases of eclampsia in relation to maternal and fetal outcomes at a tertiary level care hospital. Materials and Methods: A descriptive cross-sectional observational study was carried out in patients developing eclampsia over a period of five years starting from July 2011 to June 2016 at National Medical College and Teaching Hospital, Birgunj. Relevant data were collected from the statistics section of hospital reviewing the case sheets. Results: There were 291 cases of eclampsia out of 16,445 deliveries and prevalence of eclampsia was calculated to be 1.77%. Fourty-five percent of eclamptic women had age less than 20 years and two-third was primigravida. Approximately 84% of women were unbooked. Antepartum eclampsia was observed in 78.8% followed by postpartum eclampsia (14.8%) and intrapartum eclampsia (6.5%).  At the time of admission systolic blood pressure more than 140 mmHg and diastolic blood pressure more than 90 mmHg were noted in 79% and 92.1% cases respectively. Caesarean section was the preferred mode of delivery and was performed in 62.9% cases. ICU admission was required in 35.7% and remaining cases were managed in general/eclampsia ward. Renal failure was the most common cause of maternal mortality seen in 29.4%. Still birth was noted in 13.4%. Conclusion: Institutional obstetric patients are gradually facing eclampsia as prime cause of maternal death and unfortunately most of the cases are primigravid at younger age. All health care professionals should be proficient to manage eclamptic women instantaneously. Key words: Eclampsia; Fetal Mortality; Maternal Mortality; Pre-Eclampsia

scholarly journals Profile of Obstetric Morbidity Among Maternal Intensive Care Unit Patients

2014 ◽  
Vol 9 (2) ◽  
pp. 46-50
Author(s):  
B Shakya ◽  
P Chaudhary ◽  
M Tumbahangphe
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Multiorgan Failure ◽  
Tertiary Care ◽  
Patient Characteristics ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Obstetric Hemorrhage ◽  
Cross Sectional ◽  
Hypertensive Disorders

Aims: The objective of the study was to determine the outcome of the obstetric admissions to Maternal Intensive Care Unit in the setting of a tertiary care hospital. Methods: This was a cross-sectional study undertaken at Paropakar Maternity and Women’s Hospital from April 1, 2012 to March 31, 2013. Patient characteristics, gestational age, booking status, indication for intensive care unit admission, intervention, length of stay and outcome were analyzed. Results: During the study period, 19,247 deliveries occurred and 247 women were admitted to maternal intensive care unit. This accounts for 1.28% of all deliveries. The most common indication of admission to intensive care unit was hypertensive disorders in pregnancy (45.3%) followed by obstetric hemorrhage (39.27%). Sepsis was the cause in ten (4.04%) cases. Ten cases (4.04%) of postpartum hemorrhage were managed by balloon tamponade, seven (2.83%) by B-Lynch compression sutures and three (1.21%) necessitated cesarean hysterectomy. Among 18 cases of ruptured uterus, 13 (5.26%) were repaired while five (2.02%) required hysterectomy. Maternal mortality occurred in four (1.61%) of the cases. One was a case of severe preeclampsia who died on 4th post-operative day due to pulmonary embolism, another due to anesthetic complication and the other two died of septic shock and multiorgan failure. Conclusions: Hypertensive disorders of pregnancy and obstetric hemorrhage appeared as the major risk factors for admission to an intensive care unit thereby influencing maternal outcomes in obstetric patients. DOI: http://dx.doi.org/10.3126/njog.v9i2.11762 

scholarly journals A Step Towards Lowering Maternal Mortality: Adoption of Elements of WHO’s Safe Childbirth Checklist at A Tertiary Care Hospital of Rawalpindi, Pakistan: A Cross Sectional Survey

2019 ◽  
Vol 3 (2) ◽  
pp. 91-98
Author(s):  
Saira Maroof ◽  
Zubaida Rashid ◽  
Imtenan Sharif ◽  
Marukh Alam ◽  
Rida Nawaz ◽  
...  
Keyword(s):  
Family Planning ◽  
Maternal Mortality ◽  
Sample Size ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Safe Childbirth Checklist ◽  
Safe Childbirth

Abstract Background: Use of the World Health Organization’s (WHO) Safe Childbirth Checklist (SCC) has been associated with a significant reduction of maternal mortality. Method: A descriptive cross-sectional survey conducted at a tertiary care hospital of Rawalpindi in labour room and postnatal ward from February 2018 to July 2018. A sample size of 359 was estimated using WHO sample size calculator and were enrolled using purposive sampling technique. A close ended WHO standardized questionnaire covering the 22 elements of WHO SCC was used. Frequencies and percentages were documented of variables and data was analysed using SPSS version 23. Results: Mean age of participants was 27 ± 4.25 years. On admission, it was observed that being centre of excellence and referral, there was 100% availability of gloves and supplies to clean hands before and after each vaginal examination. Just before pushing or caesarean, it was found that in 342 (95.3%) patients, assistant was identified to help at time of birth. Immediately after one hour of birth, it was noted that 79 (22%) patients were bleeding abnormally and were immediately addressed. We also found out that only 79 (22%) of the mothers were counselled regarding family planning. Almost half of the participant mothers 182 (50.7%) or their companions were counselled regarding danger signs and to seek care immediately which should have been 100%. Conclusion: Excellent adoption of some of the element up to 100% was observed while some of the elements of checklist were poorly adopted; noticeable was counselling regarding family planning options immediate postpartum.

scholarly journals Prevalence and risk factors of self-medication in pregnancy: A cross-sectional study from a tertiary care hospital in Eastern India

2021 ◽  
Vol 12 (12) ◽  
pp. 68-72
Author(s):  
Mayank Gupta ◽  
Chanchal Kumar Dalai ◽  
Shah Newaz Ahmed ◽  
Deblina Sarkar ◽  
Rajath Rao UR ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Antenatal Clinic ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Self Medication ◽  
Cross Sectional ◽  
Pregnant Mothers ◽  
In Pregnancy

Background: Self-medication in pregnancy is a common but unsafe practice. There is a possibility of surreptitious exposure of the developing fetus to the teratogenic and abortifacient effects of the drugs. Aims and Objectives: In this study, we assessed the prevalence and risk factors of self-medication in pregnant mothers visiting the antenatal clinic in our hospital. Materials and Methods: A standard questionnaire seeking information on the socio-demographic profile, clinical characteristics, laboratory data, and knowledge and habits was administered to the pregnant mothers (n=190). The risk factors of self-medication were determined using Fischer’s exact test. P<0.05 was deemed statistically significant. Results: The prevalence of self-medication in pregnancy was found to be 6.3%. Low education level (P<0.027), employed women (P<0.031), and history of miscarriage (P<0.036) in the previous pregnancy were the main determinants of self-medication in the present pregnancy. Conclusion: The prevalence of self-medication in the study sample was low as compared to contemporary studies. High literacy (94.2%) and easy availability of health facility (98%) may be the possible reasons. Further studies are warranted to confirm the prevalence and risk factors of self-medication in this part of the country.

scholarly journals Correlation of neonatal gestational age with foot length and right nipple to umbilicus distance

2020 ◽  
Vol 7 (6) ◽  
pp. 1319
Author(s):  
Ajay K. Keshwani ◽  
Swati S. Suroshe
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Tertiary Care ◽  
Large For Gestational Age ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Systematic Analysis ◽  
Neonatal Deaths ◽  
Foot Length

Background: India contributes to one fifth of global live births and more than a quarter of neonatal deaths. A systematic analysis of global, regional and national causes of child mortality in 2013 identified preterm birth complications and infections to be the two major causes of neonatal deaths in India. So, there is need of a simple, easy to use and reliable screening tool for assessment of gestational age at peripheral level for early referral of a neonate to a tertiary care hospital, thereby reducing neonatal mortality.Methods: A hospital based observational cross-sectional study included 350 live new-borns within 48 hours of birth, from September 2018 to February 2019. Gestational age assessed by new ballard score, birth weight, foot length and right nipple to umbilicus distance were noted. Babies categorised as per the gestational age profile as small, appropriate and large for gestational age using fenton charts. Data analysis done, correlation coefficient, and p value calculated to obtain results.Results: Out of 350 babies, males (185) outnumbered females (165); 154 were LBW, 89 VLBW and 76 were ELBW. AGA neonates were 193, and 157 belonged to SGA. There were no post-term and large for gestational age newborns. Both foot length and right nipple to umbilicus distance correlated well with gestational age in all age groups (p<0.001).Conclusions: Foot length as well as right nipple to umbilicus distance can be used as a reliable tool for assessment of gestational age and birth weight of newborns by any health care professional to identify and refer high risk neonate.

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