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.
Introduction: Labour is a physiological process characterized by onset of uterine contractions leading to progressive increase in frequency, intensity and duration of uterine contractions, effacement and dilatation of cervix with descent of foetus through birth canal resulting in delivery of foetus with placenta and membranes. Hyoscine butyl bromide is most commonly used in labour room and has variable results in both primigravida and multigravida. Aim and Objective: 1. To evaluate the efficacy of Hyoscine-n-butyl bromide (buscopan) suppository in the active phase of labour in a primigravida.2. To evaluate the maternal and fetal complications of using the buscopan suppository. Materials and Methodology: Primigravida with gestational age 37 completed weeks-40 weeks admitted in the labour ward with spontaneous onset of labour or induced labour who-fulfil the inclusion & exclusion criteria were randomly selected in this study after taking informed consent. Study group: 150 pregnant women at the initiation of active phase allowed forlabour with instillation of single dose of Buscopan rectal suppository (10 mg) in active phase for cervical dilatation. Control group: 150 pregnant women at the initiation of active phase allowed forlabour without any drug for cervical dilatation. Study Design: Prospective case control study. Result: The mean duration of active phase of labour in study group is 3 hours 10 minutes & in control 5 hours 44 minutes. The difference between both the groups was statistically significant ('p' value < 0.001). No significant difference in maternal and fetal complications between study group and control group. Conclusion: Buscopan suppository was very effective in reducing the duration of active phase of labour by promoting cervical dilatation. There was no significant second or third stage complication with the use of the drug. No untoward side effects were noted in the mother or foetus.
Introduction: Pre-eclampsia affects 3-5% of all pregnancies 1-9 and is a leading cause of maternal morbidity and mortality (12% of all maternal deaths) and also leads to perinatal consequences. The initial pathological changes of preeclampsia begin in the late first trimester leading to chronic placental insufficiency. Hence prediction of preeclampsia in early gestation is of great interest, as early therapeutical intervention such as aspirin 3-6 might reduce the risk of preeclampsia. So in our study, we aim to ascertain the role of mean arterial pressure (clinical), urine calcium creatinine ratio (biochemical) and uterine artery Doppler (radiological) parameters in predicting preeclampsia. Aims and Objectives: To study mean arterial pressure, spot urine calcium creatinine ratio, Doppler of uterine artery between 20-24 weeks of gestational age as predictor of preeclampsia and to know the effectiveness of combination of above parameters in predicting preeclampsia Materials and Methods: It was a prospective study involving 100 low risk pregnant women of any parity with gestational age of 20-24 weeks. All study individuals were followed till term and the end point of the study was considered to be the development of preeclampsia as per the ACOG criteria 2013. Results: All parameters (mean arterial pressure, urine calcium creatinine ratio and uterine artery Doppler) were individually found to be statistically significant predictor. Doppler of uterine artery was found to be a better predictor of preeclampsia when compared to mean arterial pressure and urine calcium creatinine ratio individually. Combination of all three parameters was found to be the better predictor than individual parameter.
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