Caesarean section rates are increasing worldwide. It contributes to substantial maternal and perinatal morbidity and mortality. South Asian countries including Bangladesh have recorded substantial increases in caesarean section rates over the past decade. In Bangladesh, the caesarean incidence rate was 2.6 percent in 2001 and 12.2 percent in 2010. So, the incidence rate increased five times over the last decade. This descriptive cross sectional study was conducted at Combined Military Hospital (CMH), Savar, Dhaka during January 2014 to December 2015, aimed to assess the current trend of mode of deliveries of babies. A total of 1253 pregnant women who attended this tertiary level hospital, for their delivery, were enrolled in the study. The study subjects were selected by simple random sampling. A pretested structured questionnaire was used for data collection. The mean age of respondents was 25.81±4.46 years. Most (72%) of them were between 20-29 years of age. Some thirty nine percent of the respondents completed secondary level of education. The study showed that among 1253 respondents, 70.3% underwent CS and 29.7 % had normal vaginal delivery. Most common indication for caesarean section was previous CS (42.4%) that contributed an increase in total caesarean birth. Lowest incidence was antepartum haemorrhage (0.9%). Prolonged labour and cervical dystocia, hypertensive disorder, malpresentation were also contributing factors for caesarean section. So, previous caesarean birth was the most important factor in making decision about the way of delivery. Based on the study findings, to decrease the rate of caesarean section, careful monitoring of the foetus at all levels of health care facilities for critical decisions are suggested.
Induction of labour is considered justified when the benefits of prompt delivery outweigh the consequences of Caeserian Section (CS). Literature on the effectiveness and safety of surgical induction of labour in term and postdated pregnancy is limited in Bangladesh. This study was aimed to assess the effectiveness and safety of surgical induction of labour in term and postdated pregnancy. This prospective clinical study was conducted in the in-patient Department of Obstetrics and Gynecology, Combined Military Hospital (CMH), Dhaka from July, 2005 to June 2006. A total of 100 pregnant women with term and postdated pregnancy were selected for the study by simple random sampling. The particulars of the patient, detailed menstrual and obstetric history, induction delivery interval, mode of delivery and foetal outcome and maternal complications were recorded. The results were analysed by Statistical Package for Social Science (SPSS) version 16.0.The mean±SD age of the participants was 25.79±6.16 years with a range of 18-38 years. The indication of Induction of labour included term pregnancy (79%) and postdated pregnancy (21%).Normal vaginal delivery was done in 78% cases, CS in 17% cases and vacuum extraction in 5% cases.Ninety three percent babies were born healthy, 6% were asphyxiated, perinatal death 2% and still born 1%. Oxygen inhalation was needed for 6% babies. Prolonged second stage (7%), post-partum haemorrhage (8%), maternal distress during labour (10%) and manual removal of placenta (12%) were the observed maternal complications. No significant difference was observed between term and post term pregnancy in term of normal vaginal delivery, vacuum extraction and lower uterine cesarean section. Induction of labour is beneficial for both term and postdated pregnancy with associated complications. Foetal outcome was good and maternal complications were acceptable.
Introduction: Cerebral palsy (CP) is the most common motor neurodevelopmental disorder among children which incurs a huge economic burden in respect of treatment and rehabilitation. Aim: To assess the clinical profile of CP in the outdoors of tertiary level hospitals in Bangladesh. Methods: This cross-sectional study was carried out in two hospitals, namely Child Development Center, CMH Dhaka and Institute of Pediatric Neurodisorder and Autism, BSMMU, Dhaka from October 2019 to January 2020. A total of 134 cases were included by convenient sampling. Data were collected from the parents of the children by face to face interviews through a pretested semi-structured questionnaire. Results: CP was found more prevalent in male children (76.1%) than female children (23.9%). Most of the families (83.6%) belonging to CP children have monthly income ≤ Taka 24000.00. The majority of the parents were HSC qualified or less which accounted for 76.9% for father and 91.8% for mother respectively. Among the etiologies; perinatal asphyxia ranked highest (78.4%). The spastic variety was the most common (78.4%) presentation of which 41.0% suffered from quadriplegia. The majority of the CP cases (83.6%) were associated with intellectual disability. Conclusion: CP has a wide range of presentation, association and co-morbidities. Physicians should be aware of these diversified presentations and co-morbidities of CP and deal accordingly for better outcome of the patients. JAFMC Bangladesh. Vol 15, No 1 (June) 2020: 19-21
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