Rh-isoimmunised patients over a period of four years are analysed. The incidence of iso-immunisation is 3.3%. 5.7% cases were immunized inspite of receiving post-partum Anti-D immunoglobulin, and 2.8% cases were immunised in their first pregnancy. Spectrophotometry is invaluable, while antibody titres predict perinatal outcome reliably in the first affected pregnancy. The perinatal mortality of the registered cases is 15.5%. 46.1% o f the total perinatal deaths were due to premature still births which can be prevented only by mastering the technique of intrauterine transfusion.
The role of caesarean section in babies weighing less than 2,500 g was studied over a period of 6 months. These caesarean section births were studied with respect to their period of gestation, indications for caesarean section; then their Apgar scores, modes of resuscitation, neonatal complications and the perinatal outcome were compared to that of the babies delivered vaginally in the equivalent weight group. Out of the total 335 caesarean sections in the study period, 91 were done in those, where the baby weight was less than 2,500 g giving an incidence of 27%. Placenta praevia and preeclampsia— eclampsia formed the major maternal indications for section in the baby weight group of 1,000–2,000 g. Among the foetal indications, foetal distress was the commonest. Among the babies weighing less than 2,000 g, 27% of the section babies showed 5 minute Apgar (8–10) as compared to 3.2% of the babies in the vaginal delivery group. Sixty‐eight percent of the caesarean babies were discharged alive in below 2,000 g birth weight group, as compared to 41 % in vaginally delivered group.
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