Peripartum cardiomyopathy (PPCM) is a rare form of heart failure with a reported Incidence of 1 per3000 to 1 per 4000 live births and a fatality rate of 20 -50%.Onset is usually between the last month of pregnancy and up to 5 months postpartum in previously healthy women. Although viral autoimmune and idiopathic factors may be contributory, its etiology remains unknown. PPCM is usually presents with signs and symptoms of congestive heart failure. Early diagnosis is important and effective treatment reduces mortality rates and increases the chance of complete recovery of ventricular systolic function.
Even though a certain percentage of these women do come with spontaneous labour, majority require some form of labour induction. Labour must be induced once the patient is initiated on MgSO4 therapy. In the absence ABSTRACT Background: To study the association between cervical favorability at admission and maternal, perinatal outcome. To study the association between mode of delivery and maternal, perinatal outcome in eclampsia.
Methods:This was a retrospective cohort study carried out in a tertiary hospital. All women (92) admitted with antepartum eclampsia from April 2015 to April 2016, with >32 weeks gestation, reassuring foetal heart and no other complications were included in the study. They were divided into two cohorts delivery, maternal and perinatal outcomes were compared between the two groups. Results: Group with favourable cervix achieved higher vaginal deliveries. Perinatal mortality and morbidity were significantly higher in patients with unfavourable cervix (mortality 39.6% and 20.5% respectively, p: 0.046: morbidity 25.6% and 7.8% respectively, p: 0.033), more so in vaginal delivery (RR 2.355). However there was no significant difference in maternal morbidity. Higher induction-to-delivery interval was the major contributory factor. Conclusions: Perinatal outcome was worse in patients with unfavourable cervix at induction. This can be attributed to increased induction to delivery time and vaginal route of delivery. Prolonged induction should be avoided in eclampsia.
Introduction: Peripartum hysterectomy is defined as a hysterectomy performed at the time, or within 24 hours, of delivery. It is a life saving procedure and becomes necessary when all medical and surgical methods fail to control bleeding. It is associated with significant maternal morbidity and mortality. Objectives: To determine the incidence, indications, maternal and perinatal outcome of peripartum hysterectomy Methods: A retrospective hospital based observational study of all women who underwent peripartum hysterectomy over a period of 2 years from January 2020 to December 2021 in the department of Obstetrics and Gynaecology, SIDDARTHA MEDICAL COLLEGE, VIJAYAWADA. Results: A total of 20 peripartum hysterectomies were done during the study period. Incidence was 1.08/1000 deliveries. Main indications of peripartum hysterectomy were uterine atony (45%), abnormal placentation (30%), and uterine rupture (10%). Total abdominal hysterectomy was done in 15% cases and subtotal hysterectomies were done in 85% cases. There was one maternal death (5%) and 5 perinatal deaths (25%). Conclusion: Atonic uterus is the commonest indication for peripartum hysterectomy. Previous scar, multiparity and abnormal placentation were the significant risk factors.
Infantile myofibromatosis is a rare, benign proliferative myofibroblastic tumour which occurs mostly in infants and young children. It may present as a solitary lesion most commonly involving skin, bone, muscle, subcutaneous tissue, in head, neck and trunk, with good prognosis, or a multicentric form of infantile myofibromatosis with or without visceral involvement (heart, lung, gastrointestinal tract, and kidney) with a poor prognosis. We report a case of one month old male child who presented with a subcutaneous nodule over the trunk. The mass was excised and histopathologically, immunohistochemically diagnosed as infantile myofibromatosis.
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