No abstract

Introduction: Intrauterine fetal death (IUFD) is a rare but devastating event for the mother and family. Rapid expulsion of the foetus is usually requested, although there are no medical grounds for it. Labour following IUFD often needs to be induced by medical means. Prostaglandin analogues, such as misoprostol and gemeprost, have been extensively studied and proven to be safe and effective in the induction of abortion in the second trimester of pregnancy. Hence, the aim of the present study was to compare the required dose of prostaglandin and induction delivery interval in Mifepristone with Prostaglandin and Prostaglandin alone in Intrauterine Foetal Death at or more than 28 weeks of pregnancy Material and methods: The present was a prospective study in which women came with ultrasonography confirmed intrauterine death were counselled and divided into two groups randomly. First group had Tab mifepristone (200mg) orally followed by Dinoprostone gel intracervically after 24 hrs and misoprostol (50mcg) 4 hourly thereafter, whereas second group had a multivitamin tablet orally and after 24 hours dinoprostone gel applied intracervically followed by misoprostol tab (50 mcg) 4 hourly upto maximum 6 doses in both groups. Results: The induction to delivery interval in hours was found to be higher in Group B than A. This was found to be statistically significant at p value 0.021. Number of dosage of misoprostol was also seen higher in majority of cases in Group B which was also found to be statistically significant. Conclusion: This study showed that combination of Mifepristone (200 mg) and prostaglandin was found to be more effective than Prostaglandin alone for induction of labour in intrauterine foetal death of 28 weeks or more.

HASH is associated with endothelial dysfunction in form of raised levels of sICAM-1 and VCAM-1.

INTRODUCTIONDespite therapeutic advances during this century and a growing perception of the safety of child birth, morbidity and mortality continue to occur in obstetric patients. More than one woman dies every minute from such causes; 585,000 women die each year. In addition to maternal death, women experience more than 50 million maternal health problems annually. As many as 300 million women-more than one quarter of all adult women living in the developing world currently suffer from short of long term illness and injuries related to pregnancy and child birth. For every maternal death, there are many serious life.1-4 Threatening complications of pregnancy. Yet relatively little attention has been given to identifying a general category of morbidity that could be called nearmisses. Stones et al were the first to use the term "near miss morbidity" to define a narrow category of morbidity encompassing "potentiality life threatening episodes". 5,6 Maternal near miss is said to have occurred when women presented with life threatening complication during pregnancy, child birth and within 42 days after delivery, but survive by chance or good institutional care. Currently maternal near-miss ratio is increasingly used to evaluate the quality of obstetric care in low income ABSTRACT Background: Maternal near miss is said to have occurred when women presented with life threatening complication during pregnancy, child birth and within 42 days after delivery, but survive by chance or good institutional care. For identifying near-miss cases five-factor scoring system was used. In 2009 WHO working group has standardized the criteria for selecting these cases. Methods: The study was conducted in the Department of Obstetrics and Gynecology at RIMS, Ranchi, Jharkhand, India, which is a tertiary care centre. For each case of near miss, data were collected on demographic characteristics including gestational age at the time of sustaining the near-miss morbidity, nature of obstetric complications, presence of organ-system dysfunction/failure, ICU admission and timing of near-miss event with respect to admission. Results: During the twenty-four months of the study period, 20000 deliveries at the institution and 480 women were identified as near-miss obstetrical cases by five factor scoring system. The prevalence of near-miss case in this study was 2.4%. Near-miss per 1000 delivery was 24%. Maternal death to near miss ratio was 1:7.2. The leading causes of maternal near miss were hemorrhage (42.5%) and hypertensive disorder of pregnancy (23.5%) The morbidity was high in unbooked cases. Conclusions: Maternal near miss is good alternative indicator of health care system.