Spinal anesthesia is widely used for emergency and elective C/S delivery. However its main drawback is hypotension which may cause nausea, vomiting and cardiovascular collapse and loss of consciousness in mother as well as fetal hypoxia and acidosis due to placental hypo perfusion. AIMS AND OBJECTIVE: To compare the incidence of hypotension in intraoperative period and to compare the fetal outcome in two groups (Preloading and co loading group). STUDY DESIGN: Prospective randomized double blind study. MATERIALS AND METHOD: This study was conducted in the obstetric emergency OT of Malda Medical College. 100 primi gravid mothers aged between 18-29 years with ASA-1 physical status posted for emergency C/S for fetal distress was randomly allocated for either preloading (Group P) or co loading (Group C). RESULT AND ANALYSIS: Fluid requirement is significantly less in group C. There was no significant difference in the incidence of hypotension and ephedrine use. Fetal outcome in 1 min Apgar score in group C is significantly better as the baby could be delivered quickly in group C. CONCLUSION: Our study revealed that preloading can be safely avoided for spinal anesthesia in C/S for fetal distress. By using co loading method we can save valuable time required to deliver the baby and avoid circulatory overload without increasing the incidence of hypotension.
Background: Prevalence of gestational diabetes (GDM) has increased tremendously in India. Prevention of the condition is possible through health education. However, knowledge regarding diabetes is poor among Indian women. Thus, examining the basic knowledge regarding diabetes among expectant mothers is necessary to identify areas of deficit. Methods: An observational, analytical study of cross-sectional design was undertaken to assess the knowledge regarding diabetes among 173 expectant mothers attending the ante-natal clinic of R. G. Kar Medical College, Kolkata using a pre tested schedule. Results: Mean score of the respondents were less than 3 out of 8 which was a poor score. The overall mean diabetic score was similar for the antenatal mothers irrespective of the number of pregnancy (p=0.3154) but the score was greater than that for the non-pregnant women (p=0.0000). The expectant mothers showed better response compared to the controls when asked whether a person can have diabetes but be unaware of the condition; whether diabetes can harm a person's body before diagnosis; long term complications of the disease(P<0.05). However, answers were similar across all groups with respect to queries like the age group in which the condition is more commonly diagnosed and whether diabetes is curable (p>0.05). The pregnant women had less reported leisure time physical exercise and first degree relative with diabetes (p<0.05). Conclusions: Mean knowledge score of the expectant mothers was more than the women controls though the overall score was poor. A structured awareness program is urgently needed which would first address diabetes in general and then the specifics of GDM.
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