scholarly journals Overview of obstetric patients and their outcome in a tertiary hospital of Bangladesh

2021 ◽  
Vol 12 (1) ◽  
pp. 41-44
Author(s):  
Nahid Sultana ◽  
Shahana Shermin ◽  
Jesmin Jerin ◽  
Samsad Jahan
Keyword(s):  
Diabetes Mellitus ◽  
Cesarean Section ◽  
Fetal Death ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Hypertensive Disorder ◽  
Care Hospital ◽  
Still Birth ◽  
Number Of Patients ◽  
History Of

Background: In developing countries like Bangladesh major population lives in rural areas, lacking access to essential obstetric facilities. Timely referral can reduce maternal morbidity and avoid maternal death in many instances. However lack of structured referral system is a major hurdle that delays proper management of such cases. The objective of the study was to review the pattern of obstetric cases admitted in our hospital, to study the clinical course and management of women during the hospital stay and to study the maternal and perinatal outcomes in terms of live birth or still birth, intra uterine fetal death and neonatal admission. Methods: It is a retrospective observational study conducted in the department of Obstetrics and Gynaecology, BIRDEM General Hospital, Dhaka, from July 2018 to June 2019, including2880 obstetric cases admitted in the hospital. Detailed history of the patients were taken, frequency of each disease was calculated separately. Management of the patient and mode of delivery were noted. Fetal outcome parameters like live or still birth and intra uterine fetal death were noted. Results: Among 3953 admitted patients, obstetric cases were 2880 (73%).Maximum number of patients were booked cases(84.09%) and 75% were from urban area. The patients were in the age group from 18 to 40 years,32% were primigravida and 68% were multi gravida. Majority of our admitted patients had either diabetes mellitus or gestational diabetes mellitus, 58.19% and 23.95% respectively. Common co morbidities and obstetric complications were hypertensive disorder of pregnancy, anaemia, premature rupture of membrane, oligohydramnios and fetal growth restriction. Among the 2084 delivered cases were delivered by ceasarean section (86.42%) 13.53% were delivered vaginally. Commonest indication for cesarean delivery was history of previous cesarean section. Conclusion: Wide spectrum of complicated obstetric cases were admitted to our tertiary care hospital. Many complicated patients were referred from different centers for special management. But delayed referral sometimes could not help properly and also resulted in a high number of cesarean section. BIRDEM Med J 2022; 12(1): 41-44

scholarly journals GESTATIONAL DIABETES MELLITUS

2016 ◽  
Vol 23 (01) ◽  
pp. 015-019
Author(s):  
Afsheen Qazi ◽  
Amin Fahim ◽  
Aneela Qureshi3 ◽  
Mazhar ul Haque
Keyword(s):  
Diabetes Mellitus ◽  
Family History ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Tertiary Care ◽  
Oral Glucose ◽  
Care Hospital ◽  
Family History Of Diabetes ◽  
Number Of Patients ◽  
History Of

Objectives: The present study was designed to find the importance of properscreening and early diagnosis of gestational diabetes mellitus. Study Design: A prospective/descriptive study Place of Study: tertiary care hospital Hyderabad. Duration of Study: fromSeptember 2014 to November 2014. Materials and Methods: A total of 168 pregnant femalesbetween the ages of 20-40 years & in their 24th to 28th week of gestation were enrolled for thestudy. Oral Glucose Tolerance Test of all the participants was done after an overnight fasting of10-12 hours. All the participants were given 75gm of glucose per 100 ml of distilled water. Theblood samples were collected after two hours time for serum glucose levels. Results: Mostof the participants were below 26 years of age 47(27.9%) with the mean age of 30.2±5.83years. However the highest prevalence of GDM was observed in age group 31-35 years (36%).Among the 25 cases of gestational diabetes mellitus the highest number of patients with GDMwere multipara (40%) followed by parity of 3-4 gravida (32%). Twenty seven women (16%)women had family history of diabetes mellitus. Among these 12/27 (44.4%) women were foundwith GDM, compared to 15/141 (10.6%) who have no family history of diabetes mellitus. Total14 (8.33%) women were found obese, out of these 8 (57%) women had GDM while only 6(42.8%) women had no GDM. Conclusion: The prevalence of GDM in the present study isfound to be 14.8%. A prevalence of GDM was higher in the elderly multiparous females whowere overweight and had family history of diabetes mellitus.

EPIDEMIOLOGICAL AND ETIOLOGICAL PROFILE OF IUFD: A PROSPECTIVE STUDY AT TERTIARY CARE CENTRE

2021 ◽  
pp. 31-34
Author(s):  
Deepali Jain ◽  
Uma Jain ◽  
Japhia David
Keyword(s):  
Gestational Age ◽  
Fetal Death ◽  
Health Centre ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
National Level ◽  
Health Indicators ◽  
Fetal Mortality ◽  
Hypertensive Disorder ◽  
Tertiary Care Centre

Introduction:- IUFD occurrence without warning in a previously normal pregnancy is really a challenge to obstetrician and distressing situation for parents. It becomes crucial to identify specic probable cause of fetal death, to prevent the re-occurance and get the corrective measures. Prenatal mortality is still of one of the top most health indicators in measuring the quality and impact of health services in developing countries Still birth is a useful index to measure the values of antenatal and intranatal care. To decrease the fetal mortality rate, evaluation, documentation and audit of the etiology and the associated risk factors for stillbirth is required. Material and method :- The present study aims at studying the various causes related to IUFD. Prospective observational study conducted on 112 patients at Department of Obstetrics and Gynaecology, Kamla Raja Hospital, G.R. Medical College and J.A. Group of Hospitals, Gwalior (M.P.) for 18 months. All those cases who were diagnosed as intrauterine dead fetus at the time of admission with gestational age >24 weeks pregnancy were included in the study. All those investigation available at the centre of mother and father were noted and details were taken. Epidemiological evaluation of causes of fetal death was done. Record of the method of induction and mode of delivery taken. RESULTS :-Total 112 cases found during the study period were included . We found maximum cases unbooked - 71.43%, which were mainly emergency admissions. Majority of the IUFD cases- 77.67% were found to lie in the age group of 20-30 yrs, most of them were primigravida 62.5%., maximum cases of IUFD were of the gestational age 31-35 weeks- 47.32%. Hypertensive disorder of pregnancy- 23.3 % cases were found to be the major associated cause followed by Antepartum Haemorrhage 11.5%, Severe anaemia 15.1%, diabetes- 14.2% jaundice - 9.8%. congenital anomaly- 9.8%. Oligohydromnios- 8.9% and IUGR were also found to be associated with IUFD, forming an indirect reason. 39.29% cases were unexplained. 86.6% cases delivered vaginally. 10.7% cases had to undergo LSCS and only 2.68% cases underwent laparotomy for rupture uterus. 11.61% cases were of macerated IUFD baby indicating long term neglected IUFD. 39.78% and 38.39% IUFD were of 2.0-2.5 kg and 1.5-2.0 kg. This show strong corelation with LBW and IUGR. CONCLUSION:- Unexplained cases, hypertensive disorder, anemia and diabetes were the major causes for IUFD. In spite of advances in diagnostic and therapeutic modalities a major cause of fetal death remain unexplained because of poverty, illiteracy, unawareness and inaccessibility of a health centre. Undoubtedly, continued surveillance of stillbirth rates is wanted for both high- and low-risk pregnancies at a state and national level.

scholarly journals A study of the prevalence of gestational diabetes mellitus and its maternal and fetal outcomes in a tertiary care hospital

2017 ◽  
Vol 6 (9) ◽  
pp. 4011 ◽  
Author(s):  
Manisha R. Gandhewar ◽  
Binti R. Bhatiyani ◽  
Priyanka Singh ◽  
Pradip R. Gaikwad
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Tertiary Care ◽  
Significant Risk ◽  
Care Hospital ◽  
Family History Of Diabetes ◽  
Significant Difference ◽  
History Of

Background: The aim of this study was to study the prevalence of gestational diabetes mellitus (GDM) using Diabetes in Pregnancy Study group India (DIPSI) criteria to diagnose patients with GDM and to study the maternal and neonatal outcomes.Methods: 500 patients attending the antenatal clinic between January 2013 to September 2014 with singleton pregnancies between 24 and 28 weeks of gestation were evaluated by administering 75g glucose in a nonfasting state and diagnosing GDM if the 2-hour plasma glucose was more than 140 mg/ dl. Women with multiple pregnancies, pre-existing diabetes mellitus, cardiac or renal disease were excluded from the study.Results: 31 women were diagnosed with GDM (prevalence 6.2%). The prevalence of risk factors such as age more than 25, obesity, family history of Diabetes Mellitus, history of GDM or birth weight more than 4.5kg in previous pregnancy and history of perinatal loss were associated with a statistically significant risk of developing GDM. Though the incidence of Gestational hypertension, polyhydramnios and postpartum haemorrhage was higher in the GDM group, it did not reach statistical significance. More women in the GDM group were delivered by LSCS. There was no significant difference in the incidence of SGA or preterm delivery in the groups. The mean birth weight in GDM group was higher than in the non GDM group.Conclusions: Early detection helps in preventing both maternal and fetal complications. This method of screening is convenient to women as it does not require them to be fasting.

COVID-19: An Experience from a Tertiary Care Hospital of Nowshera

2020 ◽  
Vol 24 (2) ◽  
pp. 149-155
Author(s):  
Hamzullah Khan ◽  
Mohammad Zahid Khan ◽  
Mian Mohammad Naveed
Keyword(s):  
Tertiary Care ◽  
Relevant Information ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Epidemic Area ◽  
History Of ◽  
Severity Of The Disease ◽  
Age Range

Objective: To determine the frequency of COVID-19 and characteristics of patients presenting to the COVID-19 clinic at Qazi Hussain Ahmed Medical Complex (QHAMC) Nowshera. Methodology: This cross-sectional study was conducted from 21st Feb 2019 to April 8, 2020, in QHAMC Nowshera. Relevant information was collected on a pre-designed Performa prepared following the objectives of the study. Results: Out of 220 patients, 165(75%) were males, and 55(25%) females. 96(43.6%) of the patients were in the age range 18-30 years followed by 52(23.6%) in age range 31-45years and 17(7.7%) with age>60 years etc. Out of total the nasopharyngeal swabs of 26(11.6%) strong suspects were sent for PCR testing. 208(94.5%) were sent home while 12(5.5%) were advised quarantine. Forty-seven (21.4%) had a travel history to an epidemic area in the last 14 days. 51(23.2%) had a positive history of contact. Eighty-five (38.6%) had a fever and sore throat followed by 27(12.3%) with (fever & cough), 24(10.9%) with (cough and shortness of breath/dyspnea) and 14(6.4%) with a simple flue, etc. Out of 26 cases, 6(2.7%) were COVID-19 Positive, 12(5.5%) were negative and results of 8(3.6%) were still awaited. The PCR repeated the test for confirmed cases showed;  4(1.8%) negative, one died and one was refractory positive.  A positive correlation (p=0.03, r=0.4) of an increase in age with the severity of the disease/outcome was recorded. Conclusion: The frequency of infectivity with COVID-19 was 2.6%. A higher number of patients with mild symptoms attend the COVID clinic. The rate of infection and mortality was higher in age> 60 years.

scholarly journals Prevalence of Modifiable Risk Factors among Stroke Patients in a Tertiary Care Hospital in Dhaka

1970 ◽  
pp. 18-21 ◽  
Author(s):  
Md Badiuzzaman ◽  
Fazle Rabbi Mohammed ◽  
Fazle Rabbi Chowdhury ◽  
Md Shafiqul Bari ◽  
Md Billal Alam ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Modifiable Risk Factors ◽  
Care Hospital ◽  
Stroke Patients ◽  
Female Ratio ◽  
History Of ◽  
Arachnoid Hemorrhage

Background: An event of stroke can be ignited by a number of risk factors, some of which are nonmodifiable and some are modifiable. Hypertension, diabetes mellitus, different heart diseases, hyperlipidemia and smoking belong to the latter group and their prevalence shows immense diversity worldwide. In this study we tried to identify the most prevalent risk factor for stroke. Categorization of various types of stroke and history of noncompliance in medication has also been evaluated. Methods: This direct observational study was carried out on 400 patients of stroke admitted in different medicine units of Dhaka Medical College Hospital from July to December, 2007. Only patients having clinical diagnosis of stroke, confirmed by CT scan or MRI, were recruited. Patients were grouped into ischemic or hemorrhagic stroke or sub arachnoid hemorrhage. Results: The male, female ratio was found 1.2:1. In the study cerebral infraction, intra cerebral hemorrhages (ICH) and sub arachnoid hemorrhage (SAH) were found in 56.25%, 38.25% and 5.5% patients respectively. In case of Ischemic stroke and ICH males were predominantly affected but in case of SAH females were predominant. Among patients, hypertension was found in 58.62% followed by smoking (53.79%), lipid disorder (48.01%), heart diseases (25.75%), diabetes mellitus (20.01%), and previous history of stroke (10.61%). 40% patients were on irregular use of antihypertensive drug and it was 17.5% in case of anti diabetic drugs. Major groups (42.44%) of patients have two modifiable risk factors. Conclusion: Stroke is better to prevent than to cure. Identification of risk factors is the only way to achieve this goal. Implementation of screening programme in community to identify risk factors and educate people about primary prevention should be initiated in this regard. This way, we can reduce morbidity and mortality among stroke patients and alleviate the burden of stroke.   doi:10.3329/jom.v10i3.2011   J Medicine 2009; 10 (Supplement 1): 18-21

scholarly journals Prevalence and cause of gestational diabetes mellitus in a tertiary care center in Kolar district: a population based study

2019 ◽  
Vol 8 (7) ◽  
pp. 2709
Author(s):  
Poojita Tummala ◽  
Munikrishna M. ◽  
Kiranmayee P.
Keyword(s):  
Diabetes Mellitus ◽  
Family History ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Tertiary Care ◽  
Oral Glucose ◽  
Care Hospital ◽  
Family History Of Diabetes ◽  
History Of

Background: Gestational diabetes mellitus (GDM) is carbohydrate intolerance at the onset of pregnancy which induces pathological short term or long term outcomes for both mother and baby. The aim of the present study was to know the prevalence of GDM in pregnant women who were attending the antenatal care (ANC) center at a tertiary care hospital in Kolar, Karnataka, India.Methods: This prospective study was conducted in Department of Obstetrics and Gynecology, Sri Devaraj Urs Medical College, a constituent of Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India. The duration of the study was two months. In this study, 108 pregnant women above 24 weeks of gestation were screened for GDM by oral glucose tolerance test. Fasting 2 milli liter blood was collected and were given 75 grams of glucose in 200 milli liters of water and asked to drink within 5 minutes. Again 2 milli liters venous blood was collected after 1 hour and 2 hours from all participants. Plasma sample was used for the estimation of glucose by glucose oxidase and peroxidase (GOD-POD) method.Results: Out of 108, 12 women (11.1%) were diagnosed with GDM. The prevalence rate was higher in the age group of 26-30 years (41.6%).  Among 12 diabetic women, five (47.2%) exercised regularly and seven (58.3%) did not doing exercise. Out of 12 GDM subjects, eight of them had family history of diabetes in first degree relatives; among which one was hypertensive and five were suffering from thyroid problems.Conclusions: In the present study, the prevalence of GDM was found to be 11.1%. Prevalence of GDM might be influenced by increasing age, pre pregnancy weight, family history of diabetes, past history of pregnancy complications, status of literacy and exercise.

scholarly journals A prospective study of intrauterine death cases at a tertiary care hospital

2021 ◽  
Vol 10 (2) ◽  
pp. 638
Author(s):  
Nabila N. Tai ◽  
Rinku Mulchandani ◽  
Dipti A. Modi ◽  
Bijal Rami
Keyword(s):  
Prospective Study ◽  
Fetal Death ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Intrauterine Fetal Death ◽  
Intrauterine Death ◽  
Care Hospital ◽  
Risk Pregnancy ◽  
A Prospective Study ◽  
Death Cases

Background: Intrauterine fetal death is defined as foetus with no signs of life in utero after 20 weeks of gestations. Stillbirth is a useful index to measure the values of antenatal and intra-natal care. Intrauterine fetal death is due to various causes whether it be maternal causes, fetal causes or placental causes.Methods: It was a prospective study, conducted at SSG hospital, Vadodara over a period of 1 year from January 2019 to December 2019. All pregnant women coming to labour room with intrauterine fetal death with gestation age more than 28 weeks were included in study. It included complaints on admission, obstetric profile, mode of delivery, fetal outcomes, placental examination, condition of cord and investigation reports.Results: During the study period of one year, a total of 462 intrauterine fetal deaths were reported amongst 7295 deliveries conducted during the study period. Incidence rate calculated was 63/1000 births. Many of the intrauterine fetal death cases were associated with pregnancy induced hypertension and antepartum hemorrhage. Out of all intrauterine death cases, 410 cases delivered vaginally. Congenital anomalies were also found to be associated with intrauterine death cases.Conclusions: High risk pregnancy cases should be identified during routine antenatal check-ups so that intrauterine fetal death can be prevented. The mode of antepartum and intrapartum surveillance for fetal wellbeing should be advanced to prevent fetal demise.

scholarly journals Prevalence of Cesarean Section and Its Indications in A Tertiary Care Hospital

2019 ◽  
Vol 57 (216) ◽  
Author(s):  
Smrity Maskey ◽  
Manisha Bajracharya ◽  
Sunita Bhandari
Keyword(s):  
Cesarean Section ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Hypertensive Disorder ◽  
Care Hospital ◽  
Previous Cesarean Section ◽  
Common Indication ◽  
Vaginal Deliveries ◽  
Previous Cesarean

Introduction: Cesarean section is a surgical procedure performed to deliver fetus through abdominal route. Increasing rate of cesarean section worldwide is an alarming concern for public health and obstetricians due to increase in financial burden and risk to health of the mother in comparison to vaginal delivery. The aim of the study was to find the prevalence of cesarean section and its most common indication in a tertiary care hospital. Methods: This descriptive cross-sectional study was done in a tertiary care hospital, from July 2016 to June 2018 after taking ethical clearance from institutional review board. Convenience sampling was done to reach the sample size. Data was collected and entry was done in microsoft excel, point estimate at 95% CI was calculated along with frequency and proportion for binary data and analysis was done. Results: Out of total deliveries conducted, 862 (36.8%) were CS deliveries, 1477 (63.1%) were vaginal deliveries, and 12 (0.51%) were instrumental deliveries. Prevalence of CS is 862 (36.8%) at 95% CI (34.82%-38.78%). Mean age±S.D of delivering mother was found to be 26.1±0.25 years. Primi cesarean section was more than repeat cesarean section. Most common indication of cesarean section was fetal distress 243 (28%) followed by previous cesarean section 165 (18%), non-progress of labour 106 (12%), oligohydramnios 59 (7%), malpresentation 59 (7%), cephalo pelvic disorders 52 (6.5%), and hypertensive disorder in pregnancy 33 (4%). Conclusions: Prevalence of cesarean section in a tertiary care hospital is high compared to WHO data. The most common indication of cesarean section are fetal distress and previous cesarean section.

scholarly journals Comparative assessment of the efficacy of voglibose and metformin combined with insulin in patients with type 2 diabetes mellitus

2019 ◽  
Vol 10 (3) ◽  
pp. 2255-2258 ◽  
Author(s):  
Kothai Ramalingam ◽  
Veenah Ganesan ◽  
Sooraj Sasi ◽  
Surya Shanmugam ◽  
Arul Balasubramanian
Keyword(s):  
Diabetes Mellitus ◽  
Tamil Nadu ◽  
Tertiary Care ◽  
Type Ii Diabetes Mellitus ◽  
Care Hospital ◽  
Number Of Patients ◽  
Group A ◽  
Group B ◽  
Tertiary Care Hospitals ◽  
Salem District

The present study was conducted to assess the efficacy of metformin and voglibose combined with insulin in patients with type II diabetes mellitus. It is a retrospective study was conducted in tertiary care hospitals of Salem district Tamil Nadu with 120 patients who are taking either metformin and insulin or voglibose and insulin according to the inclusion and exclusion criteria. The total number of patients were divided into two groups each consist of 60. Group A was the patients prescribed with metformin and insulin and group B was the patients prescribed with voglibose and insulin. The average efficacy of metformin and voglibose combined with insulin for 10 days, 20 days, 30 days & 40 days were compared using FBS, PPBS, RBS and HbA1C values. The result shows that patients treated with metformin and insulin, the average efficacy of FBS levels on 10, 20, 30 and 40 days were 22.96%, 27.46%, 30.49% and 36.78% respectively. Whereas in the case of voglibose and insulin the efficacy was 23.48%, 28.38%, 32.57%, 40.47% for 10, 20, 30 and 40 days respectively.In the same way, the PPBS, RBS and HbA1C levels were also calculated. While comparing both the groups of patients, the average efficacy of treatment with voglibose and insulin was more effective than metformin and insulin in the tertiary care hospital of Salem district.

scholarly journals Evaluation of causes of still birth in a tertiary care teaching hospital

2018 ◽  
Vol 7 (3) ◽  
pp. 911
Author(s):  
Shivani Kothiyal ◽  
Anjoo Agarwal ◽  
Vinita Das ◽  
Amita Pandey ◽  
Smriti Agarwal
Keyword(s):  
Teaching Hospital ◽  
Health Centre ◽  
Tertiary Care ◽  
Morphological Characteristics ◽  
Hypertensive Disorder ◽  
Care Hospital ◽  
Still Birth ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Obstructed Labour

Background: Whenever pregnancy occurs there is an expectation that every pregnancy will end with the birth of a healthy baby, yet in a developing country like India 22 in every 1000 births are stillborn. The objective of this study was to evaluate the rate and causes of still birth in a tertiary care teaching hospital, Queen Mary, King George Medical college and university, Lucknow, Uttar Pradesh, India.Methods: Present study was an observational study in a tertiary care hospital. 7024 births occurred in the institution over a period of 1 year out of which 550 were stillbirths. Stillbirths which weighed over 500 grams were included in the study. After informed consent, details of history about epidemiological factors, obstetric history and medical history were obtained. Antenatal investigations including imaging, delivery details and stillborn morphological characteristics were analyzed to identify the cause of stillbirthResults: Out of 7024 deliveries, stillbirth rate was 78.30/1000 total births. Cause of intrapartum stillbirth showed statistically significant correlation with patient’s place of residence (rural>urban), distance of health centre from her house, time taken to reach first point of contact and her parity. The major obstetrical causes of stillbirth identified were APH 22.36%, hypertensive disorders of pregnancy 19.27%, IUGR 15.27%, unexplained causes 11.09%, mal-presentations 9.64%, rupture uterus 9.09% and obstructed labour 6.36%. Severe anemia was found in 24.91% as an associated obstetrical cause of stillbirth.Conclusions: The rate of stillbirth is higher as compared to the Indian data (22/1000 total births). Antepartum obstetric complications (APH, hypertensive disorder of pregnancy, IUGR) were the most common. 15.45% cases showed intrapartum causes of stillbirth (obstructed labour and rupture uterus) which was significantly higher than developed countries where such cases are negligible. The higher number of intrapartum deaths indicate that better healthcare services can drastically reduce stillbirth rates in developing countries.

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