BACKGROUND Prolonged labour caused by cervical spasm is associated with many maternal and perinatal complications including infection. Various antispasmodic drugs relieve cervical spasm and facilitate cervical dilatation during the first stage of labour and thereby reduce the duration of labour. MATERIALS AND METHODS This is a prospective randomised study carried out over one year in a tertiary hospital. Two hundred patients in labour were randomly allocated into two groups as follows: Gr A-100 patients in labour (> 4 cm cervical dilatation) were given IV injection of drotaverine hydrochloride. Gr B-100 patients in labour were given Inj. Hyoscine Butylbromide. The efficacy of drotaverine with hyoscine for increasing the rate of cervical dilatation in first stage of labour were compared. The main outcome measures were the rate of cervical dilatation, time taken for full cervical dilatation, duration of first and second stage of labour and all calculated separately for nulliparas and multiparas in two groups. Statistical analysis was done by student's 't' test. RESULTS There was no statistically significant difference in two groups in regard to gestational age, parity, average dilatation of cervix at injection of antispasmodic agents. Average time for full cervical dilatation was significantly less in Gr. B in both multipara (p < 0.05) and nullipara (p < 0.01). Similarly, the average rate of cervical dilatation was significantly more in Group B, both in nulliparas (p< 0.007) and multiparas (p< 0.02). When Bishop's score was taken as baseline, the same finding was obtained. Regarding side effects, there was no significant difference between the two drugs. The difference in the duration of second and third stage of labour were statistically insignificant.
Conjoined twins, commonly referred to as Siamese twins, are babies connected physically to each other. Depending upon the point of connection, there are different types of conjoined twins. A targeted sonographic examination at midpregnancy can diagnose the entity in most cases. Fetal prognosis depends on the period of gestation at delivery, birth weight, extent of organ sharing by the fetuses and possibility of surgical separation. Viable conjoined twins should be delivered by caesarean section. Here we present a case of thoracopagus twin pregnancy where the fetuses were born alive by C Section but expired soon after delivery probably because of extreme prematurity and low birth weight.
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