Background:The rate of primary cesarean section (CS) is on the rise. More and more women report with a history of a previous CS. A trial of vaginal delivery can save these women from the risk of repeat CS.Aims:The study was conducted to assess the safety and success rate of vaginal birth after CS (VBAC) in selected cases of one previous lower segment CS (LSCS).Materials and Methods:The prospective observational study was carried out in a tertiary care teaching hospital over a period of two years. One hundred pregnant women with a history of one previous LSCS were enrolled in the study.Results:In the present study, 85% cases had a successful VBAC and 15% underwent a repeat emergency LSCS for failed trial of vaginal delivery. Cervical dilatation of more than 3 cm at the time of admission was a significant factor in favor of a successful VBAC. Birth weight of more than 3,000 g was associated with a lower success rate of VBAC. The incidence of scar dehiscence was 2% in the present study. There was no maternal or neonatal mortality.Conclusion:Trial of VBAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas.
Background: The modified WHO partograph is an inexpensive but valuable tool that provides a continuous pictorial overview of progress of labor. It helps to detect the abnormal progress of labor. It guides the obstetrician to decide about the need for augmentation of labor and helps to recognize prolong labour before obstruction occurs. Objectives: The objectives were to study the course of normal and abnormal labour, to study various types of abnormalities of active phase of labour and to evaluate the maternal and perinatal outcome in normal and abnormal labour. Methods: A prospective hospital based observational study of 100 selected cases coming for delivery during January 2010 to Dec 2010 was done. Progress of Labor was assessed by the use of Modified WHO Partograph. Various parameters like duration of normal and abnormal labor, type of labor abnormalities, mode of delivery, need for augmentation etc. were studied. Results: The average duration of active stage was 5.5 hours in normal labor. Protracted active phase and secondary arrest of labor were the commonest active phase abnormalities observed. Problems like prolonged and obstructed labor were avoided by timely intervention in the form of caesarean section and instrumental delivery .Perinatal outcome was satisfactory. Conclusion: Routine use of partograph helps in early detection of abnormal course of labour. It assures the best possible maternal and perinatal outcome .It is suggested that every woman in labour must be benefitted by this scientific approach of labour management i.e. with the use of Modified WHO partograph.
HIV seroprevalence among the pregnant population is declining steadily. More and more women are availing the facilities of ICTC centres. Integration of PPTCT (Prevention of Parent To Child Transmission) and RNTCP (Revised National Tuberculosis Control Programme) has improved the uptake of services. Free Anti-Retroviral Treatment (ART) for seropositives will help in controlling the disease progression and will reduce the vertical transmission.
Breast cancer continues to be the commonest cancers among women all over the world.Incidence is more in developed countries as compared to underdeveloped countries.Life style changes ,late marriages,genetic predisposition and unopposed action of oestrogen have been documented to be the risk factors.Infilterating ductal carcinomas form the most common pathological type. Diagnostic modalities like sonomamography,fine needle aspiration and histopathology of breast tumours help in the detection of breast carcinoma.Self breast examination and regular preventive check ups by trained health workers have helped in early diagnosis of cancers in developed countries.Ignorance,reluctance in examining own breasts and inadequate screening facilities are responsible for diagnosis in late inoperable stages in underdeveloped world.Early diagnosis and prompt treatment in the form of surgery,chemotherapy or radiation therapy can result into reduction in breast cancer related mortality.
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