Background: The most common cause of prolonged first stage of labour is cervical spasm leading to cervical dystocia. Many times it is observed that inspite of good uterine contractions; cervix fails to dilate or dilates very slowly. This is functional cervical dystocia.Methods: On admission detailed history was taken, complete general physical examination was made. Careful obstetric examination confirmed the lie, presentation, position of the foetus and FHP. Vaginal examination was made and the state of cervix (Dilatation, consistency and effacement) station of the vertex and type and adequacy of the pelvis was noted.Results: A slight increase in the cervical tear is noted in the multrigravida in Group II. The incidence of PPH was double that of Group III. This was observed specifically when the drug was given after 5cms of dilatation of cervix.Conclusions: The maternal adverse effects were more with valethamate. Though there was transient fetal tachycardia with valethamate, the fetal outcome remained the same in all the groups.
Our purpose is to determine whether oligohydramnios has an impact on fetal outcome, increasing neonatal morbidity. We performed a prospective analysis of 138 cases of oligohydromnios diagnosed at term, out of 2180 antenatal cases. IUGR (42%), Non-reassuring FHR (60%), malpresentations (15%), meconium stained liquor and neo-natal admissions (42%) were increased with oligohydramnios. Our study show drastic increase in cesarean deliveries (44%). The management of oligohydramnios includes individualized care and strict intrapartum monitoring is required considering maternal and fetal risk factors.
Introduction: Nutrient intake and weight gain are the two main modifiable factors during pregnancy that influence maternal and infant outcome. Body Mass Index (BMI) derived from weight and height is a marker of metabolic and endocrinal status and is used to classify people from underweight to obese. Pregnancy complications related to maternal BMI is a growing problem. Both lean and obese mothers carry an increased risk of adverse perinatal outcome. Aim: To assess the effect of maternal BMI on labour and mode of delivery, neonatal outcome and to detect the obstetric complications in relation to different BMI’s. Materials and Methods: A prospective study was conducted in Mahadevappa Rampure Medical College, Kalaburagi, Karnataka, India, from August 2014 to July 2016 in which total of 200 primigravidas with singleton pregnancy; in labour after 28 weeks of gestation were included. BMI was calculated using the formula by Quetelet. The women were categorised into underweight, normal, overweight and obese according to World Health Organisation (WHO). Results: Out of 200 cases, 111 (55.5%) were of normal BMI, 61 (30.5%) overweight, 16 (8.0%) obese and 12 (6.0%) underweight. Pre-eclampsia, oligohydramnios, Intrauterine Growth Restriction (IUGR), anaemia, foetal birth weight <2.5 kg, increased incidence of Neonatal Intensive Care Unit (NICU) admissions and early neonatal complications were commonly seen in underweight which was statistically significant (p<0.01). Gestational hypertension (n=5), increased incidence of caesarean sections (n=13), foetal birth weight >3.5 kg (n=5), failed spinal anaesthesia (n=2), postpartum haemorrhage (n=4), post Lower Segment Caesarean Section (LSCS) wound gape (n=2) and prolonged hospital stay (n=3) were the complications seen in obese individuals. Conclusion: Maternal BMI showed a strong association between pregnancy complications and outcomes. Therefore, all the pregnant women need to be advised to maintain normal BMI in order to achieve a healthy outcome as both underweight and obese women carry risk for adverse pregnancy outcome.
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