Background: Numerous adverse perinatal outcomes are associated with high-risk. The usage of doppler ultrasound bids a non-invasive way to study the fetal and maternal circulation and guide the clinical management. Objective of this study was to investigate the role of color doppler ultrasonography in effective management of high-risk pregnancies.Methods: A retrospective record-based study was carried out Department of obstetrics and gynecology. Record of antenatal women who belonged to the age group of 20-30 years with singleton pregnancy of gestational age of 26 weeks to term and presence of one of the high-risk factors were included in the study. The risk factors which were considered are pregnancy-induced hypertension (PIH), diabetes, anemia, oligohydramnios. Doppler study of umbilical artery was done. Epi-info 7 was used for analysis.Results: A total of 140 cases were studied in which high-risk pregnancy was most common in the age group of 20-25 years. The most common high-risk factor in pregnancy was PIH which accounted for 50% of cases. Out of 140 cases high-risk pregnancies, 40% of cases resulted in intrauterine growth restriction (IUGR). 43% of cases, umbilical artery findings were abnormal.Conclusions: Color doppler can be used as most effective for fetal surveillance in high-risk pregnancy cases. Most importantly it helps in guiding early intervention and improving fetal outcome.
Premature rupture of membranes (PROM), also called Prelabour Rupture Of Membranes, is classically dened as rupture of membranes before labour and accounts for 0.8-0.9% of all pregnancies at term. this study was conducted over a period of 14 months ( from March 2018 to May 2019) in a tertiary care medical college . A total of 100 term PROM patients were recruited in our study – and divided into two groups randomly--50 (Group A) patients were managed conservatively and 50 (Group- B) patients underwent induction of labour. Both these patient groups were studied to compare the feto-maternal outcome. Group-A (conservative management group) patients were observed to await the spontaneous onset of labour pains for at least 24 hours. Patients in group B were induced with either - PGE1 tab (misoprostol) 25 µgm 4 hourly orally or iv oxytocin infusion. the PROM-delivery interval was < 12 hours in 72 % of induced groups (Group B) and 10% (5) in group- A (conservative or expectant group). LSCS rate was 10 % in group-A (expectant group) & 15 % in group –B (induced group). Sepsis rate, maternal and fetal, hospital stay, NICU admission & duration of NICU stay were notably higher in group – A (expectant management group). therefore, from our study we concluded that immediate induction of labour in term PROM cases shortens the PROM- delivery interval, hospital stay, NICU stay and reduction in both maternal & neonatal sepsis
Mrs. A, 30 years, para 3 with three live children was an unbooked emergency admission on 6 April 2007 with history of severe postpartum haemorrhage (PPH). She was in a state of shock with hypotension, tachycardia, pallor due to anaemia. Examination revealed the uterine inversion, uterus visible as a fleshy red mass protruded outside the vaginal introitus. Puerperal uterine inversion was reduced by vaginal manual reposition under observation through a mini laparotomy incision. She was transfused 4 units of O positive blood. On the second postoperative day she had signs and symptoms of a haemolytic transfusion reaction (HTR). She developed jaundice, haematuria and worsening anaemia. She was later detected to be Bombay Oh phenotype. Total 6 units of Bombay phenotype blood was transfused in a couple of days. Case 2: Mrs. R, 22 years primigravida, term gestation was admitted in labour in government maternity hospital/Osmania medical college, Hyderabad on 26 July 2007. A resident from Mahaboob Nagar district of Andhra Pradesh, unbooked emergency admission in labour, had severe anaemia with 4 gms Hb%. Her blood group was diagnosed as Bombay phenotype. She was given a vaginal delivery and transfused with compatible Oh Bombay blood obtained from Red Cross, Warangal, Andhra Pradesh.
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