Background: In the present times, the emphasis on minimally invasive surgery has lead to a resurgence of interest and importance of VH for non-prolapsed indications i.e. non-decent vaginal hysterectomy (NDVH) as the scar less hysterectomy. It has several benefits over abdominal hysterectomy in terms of cosmetic advantages, lesser post-operative morbidity and faster recovery. The objectives of the study was to compare and assess various factors like operative duration of surgery, intra operative blood loss, intra operative and post-operative complications, post-operative analgesia requirement, post-operative ambulation and duration of post-operative hospital stay and to put forward best route of hysterectomy.Methods: Hundred cases fulfilling, the selection criteria were included in the study. Patients were randomly divided in two groups-NDVH (non-decent vaginal hysterectomy) and abdominal hysterectomy.Results: Operative time, intra operative blood loss and post-operative morbidity was less in NDVH groups.Conclusions: Non-decent vaginal hysterectomy is a better alternative to abdominal hysterectomy in cases with benign pathology of the uterus, uterine size <14 weeks, uterus with good mobility and adequate vaginal access.
Background: The aim of induction of labour is to achieve vaginal delivery in advance of the normal timing of parturition and to avoid operative delivery. The objective was to study the incidence of instrumental delivery and cesarean section in nulliparous women with unfavourable bishops score at term.Methods: This study was conducted on 200 patients in nulliparous women with unfavourable bishop score, cephalic presentation and no previous history of abortion.Results: The most frequent cause of induction of labour was postdatism (47.5%) followed by PIH (25.5%) and PROM (13%). 143 (71.5%) women had normal vaginal delivery whereas in 54 women (27%) cesarean section was done. 2 women (1%) had forceps application for delivery and remaining 1 women (0.5%) had ventouse delivery. Out of 200 patients 9 had maternal complication of induction of labour.Conclusions: In present study 71.5% women had normal vaginal delivery, 27% had cesarean section. Mean bishop score at induction was 3.31 which improved to 4.0 after 12 hours of gel instillation. The mean induction to delivery interval was 13.38 hrs in present study, 54.5% patients were delivered within 12 hours of gel instillation in this study. Most common indication of cesarean section was failed progress followed by fetal distress.
BACKGROUND Pregnancy is affected by maternal age from conception till delivery. Various studies have been conducted globally to study this effect; few in developing countries. It is associated with decreased fertility and increased risk. Simultaneously higher advanced technique and better supported maternal and neonatal care also exist. Maternal age is increasing in developing countries as well, so we have conducted this study. METHOD: It is observational prospective analytic study, conducted in umaid hospital , Dr S N medical college ,jodhpur. Total 322 patients were included in study, fulfilling inclusion criteria over period of 6 months. RESULT : A total no. of 322 elderly pregnant patients were selected for the study. Most of the cases were in the age group 35 to 39 years (89.93%). Multi gravida (71.8%) and grand multi para (22.22%) constituted the largest group. Most of the cases belong to lower socio-economic status (90%). Percentage of unbooked cases was 82.98%. The causes of delay in pregnancy were preference for male child (25.1%) and unawareness of contraception (22.36%). The incidence of diabetes mellitus and chronic hypertension were increased. Overall caesarean rate was increased (35.4%). Incidence of abortions 21(6.5%), preterm delivery 18(5.6%), oligohydramnios 20(6.21%), APH 9(2.8%) and PROM 16(4.96%), low birth weight baby 33(10.25%), NICU admission 18 (5.6%), IUGR 14(4.34%) all were high. The preference for male child 81(25.1%) and lack of awareness 72(22.36%) were two major reason for continuing pregnancies and deliveries till late age. CONCLUSION The present study showed that pregnancy at advanced age is a higher risk pregnancy in term of increased maternal and perinatal morbidity and mortality.
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