BACKGROUND Foetal weight is one of the greatest factor determining the survival of the foetus. Estimation of foetal weight predelivery helps to decide the mode of delivery and anticipate problems during labour. Aim of the study is to assess the foetal weight in term pregnancies by various methods, i.e. abdominal girth x symphysiofundal height (Insler's Formula), Johnson's formula and Hadlock's formula using USG to study the accuracy of these methods and to correlate these methods of estimation of foetal weight with actual birth weight of the baby after delivery. MATERIALS AND METHODS 200 cases having term pregnancies were selected from antenatal clinics and maternity wards in whom delivery was anticipated within one week of foetal weight estimation. Foetal weight estimation was done clinically by two methods, i.e. AG x SFH, Johnson's formula and by ultrasound using Hadlock's formula. Results were compared to the actual weight of the babies after delivery with respect to mean birth weight±SD and average error in estimating foetal weight and prediction of birth weight within 10% of actual birth weight. Statistical analysis was done using Student's t-test, Pearson's correlation. RESULTS The mean birth weight by symphysiofundal height * abdominal girth±SD was 2967.79±348.52 whereas mean of actual birth weight±SD was 2903±460.02. The p value calculated to be 0.118, which is statistically not significant. Average error in estimating foetal weight was 189.2 g by Hadlock's formula and 304.2 g by AG x SFH method. The difference is not statistically significant. Prediction of birth weight within 10% of actual birth weight was in 63.5% of cases by AG x SFH formula, 81% by Hadlock's formula and 49% by Johnson's formula. CONCLUSION AG x SFH (Insler's formula) has better predictable results is foetal weight estimation as difference between it and actual birth weight is not statistically significant making SFH * AG method more accurate for estimation of foetal weight if compared to actual birth weight. So, it can be of great value in a developing country like ours where ultrasound is not available at many healthcare delivery systems.
Objective: To compare the fetomaternal outcome in Patwardhan technique vs "Push" method when lower segment cesarean section (LSCS) done in second stage of labor. Materials and methods: A prospective analysis of all cesarean sections performed in advanced labor with deeply waged head in VSS Medical College and Hospital, Burla, Odisha, India, during the years from April 2012 to March 2015. The cases were divided into two groups randomly; group I (deliveries by Patwardhan technique) and group II (Push method). Results: Out of 420 number of LSCS needed operation in 2nd stage of labor, in 129 cases, babies were delivered by Patwardhan technique and in 291 cases, delivery was conducted by Push method. 11.5% of cases among push/pull group had unwanted extension of uterine incision, whereas none had extension in Patwardhan group (p < 0.0001). Thirteen percent cases in group II, whereas 4.5% in group I required blood transfusion (p < 0.0001). The mean duration of hospital stay was not significantly different in both the groups (p = 0.06). There was requirement of NICU care in 23.2% cases in group I vs 28.8% in group II. Conclusion:In cases with difficult extraction of the impacted fetal head during cesarean section in second stage, Patwardhan technique is very useful in reducing fetomaternal morbidity and is the preferred method as compared to push and pull method.
Background: Eclampsia continues to be a measure health issue in developing country. In order to get a comprehensive data on eclamptic patients we conduct a prospective observational study to address the maternal and fetal complication during pregnancy.Methods: It is a prospective observational study conducted in a tertiary care medical college between the periods September 2016 to February 2017. During the period all patients with eclampsia admitted to the labour room were taken. Any patients with known epilepsy were excluded from the study.Results: During the period 3780 women were admitted to the labour room, out of which 56 women had eclampsia with an incidence of 1.48%. Out this antenatal eclampsia was most common with an incidence of 91.08% followed by intra partum 4 (7.14%) and postpartum eclampsia 1 (1.78%). Majority of patients 54 (96.43%) were unbooked or inadequately supervised. Most of the patient had normalization of blood pressure after oral nifedipine 46 (82.14%), only 10 (17.86%) patient required additional injection labetalol for control of blood pressure. The maternal complications were placental abruption 8 (14.28%), HELLP 6 (10.71%), pulmonary edema 1 (1.78%), acute renal failure 1 (1.78%), DIC 1 (1.78%) and maternal death 2 (3.57%). Out of fifty six babies delivered 42 (75%) had live birth and 14 (25%) had still birth. A total of 17 (40.42%) had IUGR, 17 (40.47%) require SNCU admission post-delivery.Conclusions:Eclampsia still remains the major cause of maternal and fetal morbidity. In low resource countries improvement in health care facility, adequate antenatal supervision, and timely referral will reduce the maternal and fetal complication.
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