Caesarean Section is the second commonest surgery done in India after tubectomy and has great impact on maternal and neonatal health. Increasing Caesarean rates have raised the need to study its influencing factors. The objective is to analyse the different indications and frequency of caesarean sections in order to reduce such deliveries in a tertiary hospital. This retrospective study was conducted at the Department of Obstetrics and Gynaecology, Mahatma Gandhi Medical College, Jaipur, from October 1 to December 31, 2015. It comprised review of clinical records of all patients who underwent caesarean section during this period. This included booked, un-booked or referred cases and data regarding the indications, type of caesarean deliveries and demographic features. During the study period, there were 792 deliveries out of which 261 (32.95%) were caesarean. Emergency caesarean section was performed on 150(57.5 %%) and elective caesarean section was performed on 111(42.5%) patients. Overall, 122(46.6 %%) cases were booked and 139(53.3 %%) were un-booked or referred cases. Most of the caesarean sections were carried out due to previous caesarean sections 58(22.2%) followed by foetal distress 49(18.7%), non-progress of labour 32(12.2%), Pregnancy induced hypertension 17(6.51%), breech 15(5.75%), oligohydramnios 16(6.13%), intra uterine growth retardation 10(3.83%), placental abruption 4(1.53%) and placenta previa 5(1.91%). Audit and feedback is the best way to judge clinical practice and to reduce the frequency of caesarean section in any tertiary setup. Previous caesareans were the most common indication of repeat procedure in the study.
To study the various gynaecological problems which commonly affect the elderly population, their frequency, predisposing factors, management protocols and outcome. METHODS: The present study was conducted prospectively including all women at and above 60 years of age who were admitted to the inpatient department of Obst. and Gynecology in Panna Dhai Zanana Hospital, Udaipur. A detailed history, physical examination laboratory investigations and treatment were recorded. The data thus collected was analyzed. RESULTS: The most common disorder was uterine prolapse, responsible for 75% of the admissions. Neoplasms were present in 19 cases. Of these 17(89.4%) were malignant and 2(10.5%) were benign.Malignancies were the second most commonly encountered disease in this study. Out of the 100 cases studied 17 (17%) were malignancies. Of these 8(47%) were ovarian malignancies, 5(29.4%) were carcinoma endometrium and 4(23.5%) were carcinoma cervix.The most common surgical procedure that was performed was VH with PFR (74%). TAH with BSO was done in 13% cases. Werthiem's hysterectomy was done in 3% cases. Laprotomy f/b debulking was done in 5% cases. Le Fort's operation was done in 1 (1%) case. CPT repair was done in the case of CPT (1%). Anterior colporraphy with PFR was done in 1(1%) case. Abdominal sacrocolpopexy was done in 1(1%) case. Subtotal hysterectomy with BSO was done 1(1%) case. CONCLUSION: By the present study it is concluded that genital prolapse and malignancies are the most common gynaecological disorders in the geriatric age group. Most of the patients coming to the hospital have been suffering for months to years from their ailments. Cases of genital cancers also underwent major surgical procedures. Due to advancements in the field of anesthesia and availability of blood or transfusion any major surgical procedure can be undertaken safely in a majority of these elderly patients.
BACKGROUND: Occurance of meconium-stained amniotic uid (MSAF) during labour may be considered as a measure for prediction of poor fetal outcomes such as meconium aspiration syndrome and perinatal asphyxia ,resulting in perinatal as well as neonatal morbidity and mortality. It constitutes about 5% of deliveries with meconium stained amniotic uid and death results in about 12% of infants with MAS. METHODS: 40 cases of meconium stained liquor detected after spontaneous or artical rupture of membranes taken during labour from june 2020 to december 2020 and their outcome in terms of mode of delivery(whether vaginal delivery or lower segment caesarean section) and fetal outcome and associated maternal high risk were studied RESULT: Anemia was co existant in around 15%, pregnancy induced hypertension(PIH) in 25%and premature rupture of membrane in 10%.Pregnancies complicated with Pregnancy induced hypertension had signicant higher rate of meconium stained liquor among all cases. Caesarean Section was commonly performed in meconium stained amniotic uid cases and accounted for about 65%of all cases. CONCLUSIONS: Meconium Stained amniotic uid increases the chances of caesarean rates,leading to birth asphyxia ,Meconium Aspiration Syndrome and hence increases the chances of neonatal intensive unit admission.
Background: Fibroids are the most common benign tumours of the uterus. They can be asymptomatic or might present with different symptoms varied from heavy menstrual bleeding, dyspareunia, abdominal distension, or pressure-related bladder symptoms etc. Present study was done with the aim to assess the clinical features of uterine broids.Material &methods:It was a retrospective Hospital based study conducted over a period of six months in which 131 women who attended Gynecology OPD of a tertiary care teaching hospital in Rajasthan from January to June 2019 with complaints of menstrual disorders with anemia or abdomino-pelvic mass with pain and feeling heaviness in the abdomen were included.Results: Out of 131 women, 37 (28.2%) women presented to Gynecology OPD with abdomino-pelvic mass without any menstrual abnormality while 94 (71.8%) women were symptomatic. 53.4% women presented with Heavy menstrual bleeding while Dysmenorrhea (n=65; 49.6%), Fullness/heaviness in abdomen (n=61; 46.6%), Irregular period (n=57; 43.5%), Prolonged duration of menstrual bleeding (n=42; 32.0%), Constipation/bloating/diarrhoea (n=41; 31.3%) and non-menstrual pelvic pain/cramping (n=39; 29.8%) were other symptoms seen in women with broids. Conclusion : Uterine broids cause abnormal uterine bleeding and other symptoms which have negative impact on women's quality of life, affecting their sexual, social and professional life. Early diagnosis and treatment reduces morbidity and improves quality of life.
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