Background and Aim:To evaluate the occurrence, indications, course, interventions, and outcome of obstetric patients admitted to the intensive care unit (ICU).Design:Retrospective study.Setting:ICU of a Medical College Hospital.Materials and Methods:The data collected were age, parity, obstetric status, primary diagnosis, interventions, and outcome of obstetric patients admitted to the ICU from Jan 2005 to June 2011.Results:Total deliveries were 16,804 in 6.5 years. Obstetric admissions to the ICU were (n = 65) which constitutes 0.39% of deliveries. Majority of the admissions were in the postpartum period (n = 46, 70.8%). The two common indications for admission were obstetric hemorrhage (n = 18, 27.7%) and pregnancy related hypertension with its complications (n = 17, 26.2%). The most common intervention was artificial ventilation (n = 41, 63%). The mortality among obstetric admissions in the ICU was (33.8% (22/65)). The patients appropriate for High Dependency Unit (HDU) care was (32.3% (21/65)). The statistical analysis was done by fractional percentage and Chi-square test.Conclusions:Hemorrhage and pregnancy-related hypertension with its complications are the two common indications for ICU admissions. The need for a HDU should be considered.
This review includes the validated antidiabetic effects of Jamun and some of its compounds. Emphasis is also placed on addressing the various mechanisms of action contributing to the pharmacological effects and the aspects that need future investigations for Jamun to be of clinical use.
IntroductionConjoined twins are identical twins with fused bodies, joined in utero. They are rare complications of monochorionic twinning. The purpose of this study is to describe the various types of conjoined twins, the role of imaging and recent advances aiding in their management.Material and methodsThis was a twin institutional study involving 3 cases of conjoined twins diagnosed over a period of 6 years from 2010 to 2015. All the 3 cases were identified antenatally by ultrasound. Only one case was further evaluated by MRI.ResultsThree cases of conjoined twins (cephalopagus, thoracopagus and omphalopagus) were accurately diagnosed on antenatal ultrasound. After detailed counseling of the parents and obtaining written consent, all the three cases of pregnancy were terminated. Delivery of the viable conjoined twins was achieved without any complications to the mothers, and all the three conjoined twins died after a few minutes.ConclusionUltrasound enables an early and accurate diagnosis of conjoined twins, which is vital for obstetric management. MRI is reserved for better tissue characterization. Termination of pregnancy when opted, should be done at an early stage as later stages are fraught with problems. Recent advances, such as 3D printing, may aid in surgical pre-planning, thereby enabling successful surgical separation of conjoined twins.
A rare case of a large fibroepithelial polyp (FEP) of the vulva is described. The polypoidal growth was 10 cm in its largest diameter, having a long pedicle with features of inflammation secondary to infection, and was found arising from the left labia majora. The patient did not manifest any signs of recurrence following excision. A large and infected FEP of the vulva is a rare occurrence and hence reported.
Reliable estimation of gestational age is important in providing appropriate obstetric care. The objective of the study was to compare the gestational age estimated by mean fetal kidney length and multiple biometric parameters (BPD, HC, AC & FL) with the actual gestational age derived from reliable last menstrual period. METHODS: A single third trimester ultrasound examination was done in a total of 100 well dated patients. Gestational age assessment was done by measuring multiple biometric parameters and mean fetal kidney length. RESULTS: Comparison of linear coefficient of mean fetal kidney length with gestational age demonstrated kidney length has high degree of correlation with an Intra class correlation coefficient of 0.860, which is the best of all the parameters in the overall third trimester. In the 38-41 weeks group, MKL (mean 38.272.523) in weeks) was close to actual period of gestation (39.260.867) in weeks. The other parameters in this sub group were more deviant and MKL had the best correlation. A very strong correlation was seen when mean fetal kidney length was added with multiple parameters (correlation co efficient r=.830). CONCLUSION: This study showed that ultrasonographic measurement of mean fetal kidney length is a reliable indicator of gestational age, in third trimester. Where there is discrepancy between the dates and the uterine size, it is better to include mean fetal kidney length in the multiple biometric parameters.
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