Background: Preterm birth is defined as birth between the age of viability and 37 completed weeks of gestation. The aim of this study is to evaluate the safety and efficacy of nifedipine, a calcium channel blocker, as a tocolytic in prolonging duration of pregnancy in case of preterm labor.Methods: This is a retrospective analytical study conducted in Department of Obstetrics and Gynaecology, SKNMC and GH, Pune, India conducted over a period of one year from June 2014 to May 2015. All uncomplicated, singleton preterm labor cases were given Cap. Nifedipine as tocolytic and Inj. Betamethasone for enhancing fetal lung maturity. Maternal parameters studied were Gravida and Parity, previous history of preterm labor, gestational age at delivery, mode of delivery, side effects. Neonatal parameters studied were weight at birth, APGAR score at birth, complications at birth, NICU admissions, mortality.Results: Out of total 4478 deliveries from June 2014 to May 2015, 252 women with preterm labor were treated with nifedipine. 214 out of 252 delivered at term with overall success rate of 84.92%. Out of remaining 38 cases, 36 cases delivered as preterm normal deliveries and 2 required Caesarean section. No major side effects observed in mothers receiving nifedipine. As regards neonatal outcome, 12 babies required NICU admission and mortality was of 2.Conclusions: Nifedipine is safe and effective in prolonging preterm labor and has minimal maternal and neonatal side effects. It eliminates the need for intensive maternal monitoring as required in case of betamimetics.
Background: To study the awareness and efficacy of Mirena (Levonorgestrel intrauterine system) in treatment of abnormal uterine bleeding.Methods: A prospective analytical study was conducted from January 2012 to June 2018 at Smt. Kashibai Navale medical college and general hospital, Pune, Maharashtra, India. Total 30 women between age of 35 to 45 yrs age were included in the study. Mirena was inserted post-menstrually in the operation room under sedation was done. The women were called for follow-up after 1 month, then 4 months, and then yearly (for maximum 2 years); and asked regarding the relief they have obtained from the antecedent menstrual complaints.Results: At end of study, Overall satisfaction rate among women was 76.67% and decrease menstrual blood flow observed in 20 (74.07%) cases. Most common side effect observed was irregular menses in 6 (22.22%) cases. Hysterectomy was required in 3 (11.11%) cases.Conclusions: Menorrhagia is a common gynaecologic problem often needing hysterectomy. The LNG-IUS reduces bleeding in women with menorrhagia due to benign causes. The patient acceptance and satisfaction is high. Main problem is irregular bleeding especially for the first 3 months after insertion. If the patients can be counseled before insertion, continuation rates for LNG-IUS are high. It has the potential to replace hysterectomy as treatment of choice in certain patients.
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