Introduction: Lower segment cesarean section is the commonest surgical procedure in obstetrics. Repeating a cesarean section in subsequent pregnancies is the usual method of termination which involves many complications. Our objective was to study these complications and difficulties observed in a repeat cesarean section. Material and methods: It was a prospective observational study of 241 cases of repeat cesarean section from October 2017 to September 2018 in department of obstetrics and gynecology of Hi-Tech medical college and hospital, Bhubaneswar, odisha. Results: In this study, total 1610 patients are taken. Among these most common indication for cesarean section is CPD i.e56 (23%).Most common incidence of intraoperative complication of previous cesarean section is adhesion i.e. 124(51.61%). Conclusion: Maternal morbidity is a cause of concern in repeat cesarean section because of the intraoperative complications encountered during surgery and thereafter. Reduction in primary caesarean rate can reduce the complications. Patients with previous cesarean section are categorized as high risk and counselled for VBAC in suitable cases.
BACKGROUNDUnplanned pregnancy is the reason behind majority of MTPs in a developing and overpopulated country like India. The unmet need for contraception still poses a challenge despite the best efforts of the Government and other Non-Government Organisations. So counselling regarding knowledge and use of contraception should be an integral part of post-abortion care. Only with counselling can the acceptance of contraceptive be increased in women of reproductive age. Thus, unwanted pregnancies and the risks involved due to unsafe abortion in many cases can be avoided.The aim of this study is to study the knowledge and awareness of contraceptives and assess their acceptability in women seeking medical termination of pregnancy (MTP) at two tertiary health centres in Bhubaneswar. MATERIALS AND METHODSA cross-sectional study of 257 women seeking MTP in two tertiary care hospitals in Bhubaneswar. Data regarding awareness of contraception and their acceptance in post-abortion period was collected using a pre-structured questionnaire. RESULTSMajority of women seeking MTP had two or more living children (68.1%) and were between 21 -30 years of age (64.2%). Most of them had prior knowledge of contraception excepting few (8.1%). Commonest reason for not using them was fear of side effects. All the women were counselled prior to discharge and most of them (89.2%) agreed to adapt birth control methods. CONCLUSIONUnmet need of contraception is the most common reason for women having unplanned pregnancy. Though the awareness of different methods of contraception is high, the actual acceptance rate is low. Hence, there is a need for community health education to inculcate proper knowledge and ensure their use in the target population.
BACKGROUND Preterm premature rupture of membranes is the rupture of membranes during pregnancy before 37 weeks' gestation. It occurs in 3 percent of pregnancies and is the cause of approximately one third of preterm deliveries. It can lead to significant perinata l and maternal morbidity. Appropriate evaluation of aetiology & risk factors helps in preventing PPROM and its related complications. We wanted to study the aetiology and risk factors of PPROM from 34-37 wks. of gestation. This is a descriptive study carried out in the
Background: The progress of labour can be graphically represented using the WHO partogragh, which helps in early detection and prevention of complication of labour, thus resulting in a better feto-maternal outcome especially in high risk cases.Methods: The study was undertaken at Hitech Medical College and Hospital, Bhubaneswar from March 2017 to February 2019 on 200 high risk patients. The progress of labour was plotted and assessed on Modified WHO partograph.Results: Majority of the cases were referred cases. Augmentation of labour was carried out in 56 cases. The mean duration of labour in the first stage was 5.4 hours and 4.1 hours in primi and multigravidas, whereas that of the second stage of labour are 37.5 minutes and 26.3 minutes respectively. 51 cases had prolonged labour and 15 cases had arrest of labour in the second stage. Maximum number of cases underwent LSCS due to abnormal labour progression. 8.7% of the cases had PPH and 2.3% had puerperal sepsis. Neonatal asphyxia was seen in 13.6% cases and 2.8% had early neonatal death.Conclusion: The results conclude that the WHO modified partograph is an inexpensive useful tool in monitoring the progress of labour and reducing foeto maternal morbidity in high risk groups.
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