Background: Abruptio placentae defined as the preterm partial or complete separation of normally situated placenta from the uterine wall, complicating 1 in every 200 pregnancies (0.5-1%) in western nations, with rates as high as 4% in developing nations.Methods: This was a descriptive observational hospital-based study design with a follow-up component conducted over a period of 16 months, from January 2015 to April 2016 in the department of Obstetrics and Gynecology at RZH, PDU Medical College and hospital, Rajkot comprising of 83 cases.Results: A total of 83 cases of abruption placentae were present out of 9102 deliveries at RZH, PDU Medical College, Rajkot between January 2015 to April 2016. The incidence of abruption placentae in our study is 0.9%. Overall global incidence of abruptio placentae ranges between 0.5 to 2 % with more in developing countries as compared to the developed nations. (1a,6a,17a). Fetal adverse outcomes of abruptio placentae observed during study period were perinatal mortality 75.9%, prematurity 71%, low birth weight 69.8% and asphyxia 3.6%. Out of 83 cases, 59 deaths occurred in utero while 4 died in the first week of life.Conclusions: Abruptio placentae is one of the gravest hemorrhagic complications of pregnancy. Incidence in alarmingly high in resource poor set ups of developing countries like ours.The predictors of maternal adverse outcomes were found to be malnutrition, anemia, , PPH, DIC and maternal shock. Predictors for perinatal death were low birth weight, birth asphyxia, low APGAR score, retroplacental clot volume more than 500 ML.
Background: Maternal mortality is one of the important public health challenges faced by India today. Being a country with highest number of maternal deaths worldwide, i.e. 63, 000 per year and having a Maternal Mortality Ratio of 230/1,00,000 live births, it is a matter of grave concern and high priority. Objective: To study the MMR and common causes leading to death, so that improving maternal health and reducing maternal mortality rate significantly. Methods:We have done Retrospective Observational study in Department of Obstetrics & Gynecology, P.D.U. Medical College, Rajkot between 1st August 2012 to 31 st July 2014. Results: There were 30 Maternal Deaths during Study Period of 2 years in the Institute. Maternal Mortality Ratio of the Study Centre was 219 per lakhs live births. Out of 30 maternal deaths 21-30 yrs age group having 77% of maternal death while 67% belongs to lower socio-economical class. Out of 30, 15 (50%) died within 24 hrs of delivery. Hemorrhage was the most common cause in 15(50%) cases while others were Eclampsia (13%), septicemia (11%), ARDS (13%), others (13%). Conclusions: Maternal Mortality Ratio of the Study Centre was 219 per lakhs live births. Hemorrhage was the most common cause. Early registration, regular antenatal care, early referral are key things in reduction of maternal deaths. Facility based maternal death review (FBMDR) should be done at every institute level to find out the deficit and thus helping in reduction of maternal deaths.
Background: Induced abortion is one of the safest procedures for unwanted pregnancies in medical practice. Vacuum aspiration is the preferred method for uterine evacuation before 12 weeks of pregnancy. Objectives: To study the efficacy of manual vacuum aspiration (MVA) in o8 wk versus 8-12 wk of pregnancy. Materials and Methods: A randomized comparative prospective study was performed at the Department of Obstetrics and Gynaecology, P D U Medical College, Rajkot, over a period of January 2012 to June 2013. Totally, 100 subjects were enrolled in the study, which were further divided into two groups (o8 wk and 8-12 wk of pregnancy, 50 in each). MVA was performed in both the groups, and comparison was done in view to evaluate completeness of procedure, requirement of add-on procedure, and complications. Results: Of 50 subjects in each group, perforation was found in two cases in group A and one case in group B. Requirement of oxytocics noted in only one case in group B, whereas incomplete abortion noted in two cases in group A and three in group B. All complications were found statistically insignificant (P = 1) between both the groups. Conclusion: This study focused on the efficacy of MVA in higher weeks of gestations, which was equal in both the groups. Thus, MVA is a safe and an acceptable procedure up to 12 wk of pregnancy.
Background: There has been a wide range of success rates reported for those achieving vaginal birth following a planned vaginal birth after cesarean (VBAC). Objective: (1) To find out the incidence of rupture uterus and dehiscence in patients with trial of labor after cesarean section, (2) to evaluate the incidence of vaginal delivery in women who had previously undergone a cesarean section, and (3) comparison of a trial of labor after cesarean with an elective repeat cesarean section (ERCS) in view of maternal outcomes.
Background: Preterm birth (PTB) is a leading cause of perinatal morbidity and mortality, henceforth being a major concern for the obstetricians and paediatricians as well being a major health care issue. Preventing and treating the associated risk factors could play a major role in curbing the perinatal morbidity and mortality. Methods: A total 100 women with preterm labour or an indicated preterm termination of pregnancy were enrolled in the study. They were evaluated by history taking, clinical examination, and ultrasonography. Corticosteroids were given to all the patients. Maternal risk factors, obstetric outcome and perinatal outcome till discharge were studied. Results: Of the 100 women studied, mean age of the cases was 27 years, 60% of the cases belonged to lower socioeconomic class, 74% of the cases were under 55 kgs weight group and 77% of cases were anaemic. 34% cases were below 34 weeks of gestation, 58% were multigravida, and 2% grand multipara with 35% labour being induced labour because of presence of various risk factors such as preterm premature rupture of membranes (PPROM), preeclampsia, eclampsia and chorioamnionitis. 6% cases had multiple pregnancies and 8% had history of preterm delivery in previous pregnancy. Out of 107 babies, 73% neonates required neonatal intensive care unit (NICU) admission and there was 12.14% neonatal mortality rate. Conclusions: Anaemia, malnutrition, infection, high order pregnancy are the preventable causes of preterm birth which can be prevented, screened and treated by specialised antenatal programs.
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