A patient with G1P0 status 38 weeks pregnancy with pain with no high risk delivered at PHC, Hatod, Madhya Pradesh (India). She delivered a male baby by spontaneous vaginal delivery of 3.1 kg. All of sudden after 2nd stage of labour, her 3rd stage of labour was eventful. Placenta did not come out spontaneously so controlled cord traction was given by the ANM over the PHC. She was given intramuscular oxytocin 5 IU. She did the traction with proper care but inspite of that while doing so placenta got separated but there was complete uterine inversion. ANM herself tried to reposit the uterus but could not do so. So ANM immediately referred her from PHC to MYH, Indore, Madhya Pradesh (India).
Background: Oligohydramnios is defined as when on ultrasonography the single largest pocket in horizontal and vertical diameter is less than 2cm or amniotic fluid index is less than 5cm. Normal amniotic fluid index is 5-25cm. The overall incidence is 0.5 to more than 5%. However, the incidence increases in post dated pregnancies as many as 11%. It is increasing these days because of changes in lifestyle and also reduced maternal fluid intake.Methods: A prospective randomized study was done in Dept of Obstetrics and Gynaecology, MGMMC and MYH, Indore during the period of 6 months from 1st July 2017 to 31st December 2017. It included 200 cases from all the antenatal patients attending Antenatal OPD in routine and emergency and who are admitted in MYH beyond 28 weeks of pregnancy.Results: Majority of cases i.e. 64% were handover, babies with 26% were IUDs (intra uterine devices) and Rest 10% requiring neonatal care in nursery. The color Doppler changes showed normal flow in 54% in cases with 26% showing early fetal hypoxia and 14% showing uteroplacental insufficiency. Rest of the 6% cases were IUD. Incidence of IUGR was 50% in babies most commonly being constitutionally small. About 8% cases were found to be associated with abruption and 24% cases were found to be associated with pregnancy induced hypertension. Most common mode of delivery was vaginal delivery in 68% cases. However, 32% cases underwent LSCS.Conclusions: There has been reported cases of sudden IUD in severe oligohydramnios presenting with loss of fetal movements.
Background: Women diagnosed with
Background: PPH is responsible for quarter of maternal deaths occurring worldwide and its incidence is increasing in developed world. According to Confidential Enquiries into Maternal and Child Health (CEMACH) report obstetric hemorrhage occurs in around3.7 per 1000 births. The objective of the study is that it was a prospective randomized comparative study of misoprostol and balloon tamponade via condom catheter to prevent postpartum hemorrhage in normal delivered patients at MYH.Methods: A sample size of 200 normal delivered patients between age group 18 and 45 years is chosen with excessive bleeding after third stage of labour and after administration of oxytocics. These 200 patients are divided into two groups: First group receiving Misoprostol and applying condom catheter in other group. Both groups are evaluated for PPH.Results: It was found that CG balloon condom catheter was a much better and more effective alternative in controlling PPH than Misoprostol as the failure rate with CG balloon condom catheter were much less than that with misoprostol. Due to its cost effectiveness and being easily available at primary health center and due to absence of any drug reactions and easy technique of formation makes it a better modality in controlling PPH even at PHC.Conclusions: Patients with condom catheter in situ must show better result than patients receiving misoprostol.
Background: Miscarriage is the inadvertent loss of a pregnancy before the fetus is viable. The World Health Organization defines this un-survivable state as an embryo or fetus weighing 500 grams or less, which typically corresponds to a fetal age (gestational age) of 20 to 22 weeks or less.Methods: The present study was conducted in the Department of Obstetrics and Gynaecology, M. G. M. Medical College and M.Y. Hospital, Indore from October 2013 to October 2014 on 100 patients.Results: The incidence of first trimester threatened miscarriage, in the Gynaec O.P.D. of M.Y. Hospital, Indore, was 8.8%. The most common risk factor was a history of previous miscarriages in 38% of cases while 9% had advanced maternal age and 35% had advanced paternal age. History of preterm labour was positive in 25% cases and that of congenital anomaly in previous pregnancy in 7% cases. UTI and vaginitis were diagnosed in 10% and 11% cases respectively. Systemic illness was in 24% cases while 6% cases had endocrine disorders. On USG missed miscarriage was found in 8% inconclusive ultrasound was found in 34% cases, rest were normal. Of the 38 cases giving history of previous 1, 2, 3 and more than or equal to 4 miscarriages were 22%, 6%, 8% and 2 % respectively. 36% of the patients presented with bleeding per vaginum. only while 30% had bleeding with pain and 33% cases had only pain in abdomen. On USG 58% had normal scans. USG scan was inconclusive in 34% and only 35% continued with viable pregnancy, rest aborted. 7 of the 100 cases had preterm labour and 51 cases continued to term. Rest 42 aborted. H/o contact, travel, trauma, heavy work did not have any statistically proven effect on outcome of pregnancy.Conclusions: Progesterone assays are currently available in most immunoassay platforms and have shown excellent performance in terms of assay sensitivity, specificity, accuracy and precision with rapid turnaround times. Furthermore, the cost per test for progesterone assay is affordable. Several studies have shown that progesterone is the most specific biomarker for distinguishing viable from nonviable pregnancies. The downfall of progesterone as a biomarker is due to the different cut-off values used by researchers. The cut-off values were also determined on different study populations.
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