Post-partum pubic symphysis diastasis refers to an abnormally wide gap between the two pubic bones following delivery. It is an uncommon and under diagnosed condition resulting in acute pelvic pain. A case of pelvic diastasis in a 24-year-old G2A1 following normal vaginal delivery is reported. Management consisted of simple conservative treatment with binders and analgesics, which were sufficient in achieving a complete reversal of the condition. The low incidence of 1 in 3700 normal vaginal deliveries over a 5 year period at Public Health Centre, Chennai, coupled with the rarity of the condition renders it as a salient presentation in the practice of our profession.
BACKGROUND: INTRODUCTION: Carcinoma cervix is most common genital carcinoma in India. It accounts for 80% of female genital carcinoma. Invasive carcinoma of cervix is preventable as it is associated with pre-invasive stage which occurs 10-15 years prior to it, thus permitting early detection by screening and leading to effective treatment and thereby reducing mortality rate with greater impact on lives saved. AIM: Cytological and Colposcopic Evaluation of Unhealthy Cervix. OBJECTIVE: To compare the role of conventional Pap smear and Colposcopy (clinical impression) with Colposcopic guided biopsy as the gold standard. MATERIALS & METHODS: It's a prospective clinical comparative study of 100 women between 20-60 years attending the gynecological outpatient department at Sri Siddartha Medical College with clinically unhealthy cervix between, June 2013-May 2015. All the women with unhealthy cervix were subjected to pap and Colposcopy and findings noted. Biopsies were taken from Colposcopically abnormal areas and results were analyzed statistically. RESULT: In the present study 100 patient were subjected to Pap smear, Colposcopy and biopsy. Colposcopy sensitivity was 80.37%, specificity 81.06%, PPV 66.89%, NPV 90.52% accuracy 80.50%, respectively. Pap smear sensitivity was 24.3% specificity 98.3%, PPV 93.12%, NPV 74.36% and accuracy of 76%. CONCLUSION: Pap smear had poor sensitivity as compared to Colposcopy. Hence simultaneous use of Colposcopy has shown to increase in the rate of carcinoma cervix detection in women with unhealthy cervix.
Background: Globally 4 million newborn die every year before they reach the age of one month. To achieve the millennium developmental goals newborn survival is essential. Aim of the study was to assess the level of knowledge of antenatal women on essential new born care and danger signs during neonatal period, to find the association of sociodemographic and obstetric characteristics with maternal knowledge level. Settings and design included descriptive cross-sectional study was conducted in a tertiary care hospital.Methods: The study enrolled 439 antenatal women by convenient sampling technique. A pretested semi structured questionnaire was used to assess the knowledge. Statistical package for the social sciences (SPSS) 21 version was used to analysis the data. Chi square was calculated to find the association. P value of <0.05 was considered statistically significant.Results: The study shows that 16.7% respondents had adequate knowledge about danger signs during neonatal period. The maternal age, parity, socioeconomic status, parity had significantly associated with the maternal knowledge regarding new-born care (p<0.05).Conclusions: Majority of the ante natal mother had poor knowledge on new born care.
The most joyful moment for every mother is her pregnancy period. However, almost many mothers face unexpected complications during their pregnancy period which may lead to the death or injury to the infant or herself. Birth preparedness an complication readiness is a strategy developed and approved globally that encourages pregnant women along with their families to plan for birth and to be prepared if any emergency occurs.Aims: To assess the knowledge of birth preparedness and complication readiness among antenatal women.To find the association of sociodemographic and obstetric characteristics with maternal knowledge Settings and Design: A facility based cross-sectional study was undertaken for a period of four months from may to august, 2019 in a tertiary care hospital,Sivagangaidistrict, South Tamilnadu Methods and Material: A pretested semi structured questionnaire was prepared to collect data. The study participants were selected by convenient sampling technique. Statistical analysis used:Microsoft excel was used to enter data and SPSS version 21.0 was used for analysis. Univariate and bivariate analysis was computed. Chi square value was calculated and statistical significance was considered when p-value was <0.05. Results:The overall study participants who were well prepared was 48.8%. the level of knowledge about danger signs during pregnancy, postpartum and new born periods were 32.4%,23.5% and 18% respectively. The association between baseline characters and maternal knowledge revealed significant association of maternal age, socioeconomic status, parity, gestational age with maternal knowledge on BPCR Conclusions: Providing health education on pregnancy and its complications and birth plan during their antenatal visits would increase birth preparation and complication readiness plan.
A 23-years-old gravida three abortion two reported to my hospital at 28 weeks of gestation. The patient is from a local village near to Tumkur district. The patient came with complaints of sudden abdominal distension since two days and breathlessness since two days. On examination, patient was diagnosed to have severe pre-eclampsia. Her clinical examination revealed a uterus of 32-34 weeks gestation. Per vaginal examination showed well effaced cervix with patulous os. Her ultrasonography scan done on the same day reported twin intrauterine gestation with single placenta and a thin membrane separating the two foetuses-monochorionic diamniotic twins. Twin A of 26 weeks gestation with absent cardiac activity-suggestive of intra uterine foetal death with grossly increased liquor of 24 cm. Twin B was acardiac acephalus. Patient was counselled for termination of pregnancy and was induced with misoprostol and progressed to active labour and delivered a first twin A (Figure 1) dead female baby of weight 1000 gms and 12 minutes later followed by acardiac twin (Figure 2) of 700 gms. The second baby was acardiac acephalus. It had absent head, upper limbs and thoracic organs. The placenta was 300 gms (Figure 3) with two umbilical cords. In Twin A, cord was long and oedematous, and had three vessels. The acardiac twin had short cord. Both twins shared the same placenta. Patient was transferred to ward after treatment for severe pre-eclampsia and was discharged on the 8 th postpartum day. Multiple pregnancy accounts for 1.5% of all pregnancies with approximate perinatal morbidity and mortality of ten percent. The incidence varies widely. One percent of monozygotic twins accounts for monoamniotic twinning. Monozygotic twins have 2.5 times higher rate of congenital anomalies than in dizygotic or singletons.
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