Purpose of the Study To study the feasibility of blood pressure monitoring and to assess the feasibility of antihypertensive dose adjustment in postpartum women by teleconsultation in COVID 19 pandemic situation. Methods This was a descriptive longitudinal study conducted in the Department of OBGY, GMCH, Aurangabad between the study periods November 2020 to April 2021 with a sample size of 60. The feasibility of blood pressure monitoring in postpartum women by teleconsultation was measured by recruitment and retention through 12 weeks postpartum. The feasibility of anti-hypertensive dose adjustment through teleconsultation was measured by the number of women requiring hospital visit for uncontrolled blood pressure or those with warning signs and symptoms. The data were collected and analyzed. Results The feasibility of blood pressure monitoring in postpartum women by teleconsultation was 95.23%. During follow-up, the antihypertensive drug dose was required to be increased in 3 women. Not a single woman required hospital visit or hospital readmission either due to uncontrolled hypertension or warning signs/symptoms. This indicates that the feasibility of anti-hypertensive dose adjustment by teleconsultation was good. Conclusion We demonstrated feasibility and over all good satisfaction rate of Blood Pressure Monitoring in postpartum women by teleconsultation in COVID 19 pandemic situation and found that teleconsultation is a boon in management for postpartum hypertension to reduce readmissions and decrease maternal morbidity while ensuring social distancing and minimizing viral exposure. We recommend teleconsultation as a quality improvement initiative in maternity care.
Background: The study was conducted to evaluate clinical outcome of post abortion intrauterine contraceptive device (PAIUCD) insertion in terms of acceptability, complications, expulsion and continuation rate. Methods: A prospective observational study was conducted in GMCH, Aurangabad from 2018 to 2020 after Institution Ethics committee approval. Results:Total 250 women were recruited in study. Acceptance rate of PAIUCD was 13.13%. Their age ranges from 20-36years.Majority of women who underwent PAIUCD insertion (77.3%) were from lower middle socioeconomic class of Modied Kuppuswami scale. Around 54.8% were primiparas. Complication rates of immediate PAIUCD insertion were low. Not a single case of uterine perforation was noted. The complications associated with PAIUCD were heavy menstrual bleeding (7.94%), irregular bleeding (4.2%), dysmenorrhea (6.5%) and pelvic infection (1.4%). Expulsion rate was 7.47%. It was found to be higher (5.53%) in cases of mid trimester abortion than in cases of rst trimester abortion (1.87%). Continuation rate was78.97% at the end of 6 months. Conclusion: Higher rate of continuation with lower rate of expulsion, pelvic inammatory disease and minimal risk of perforation were noted after PAIUCD insertion. PAIUCD was safe and well tolerated by women.
Background: In order to reduce perinatal mortality, better understanding of aetiology of antepartum still births is very essential. Stillbirth rate according to the future years will be decided and UNICEF's goal of 'making every baby count' can be achieved only if; contributing factors of stillbirth are reviewed and assessed Aim:To estimate the incidence, factors related and delays responsible for still birth at tertiary care center. Method: A prospective observational study was conducted in Government medical college and hospital, Aurangabad from 2018 to 2020 after Institution Ethics Committee approval. Data of 1211 still birth cases were analysed and also classied as per CODAC classication system. Results: The incidence of still birth was found to be 3.09 %. As per CODAC classication, Intrapartum factors were observed in 13.21% cases, maternal factors in 40.21%, fetal factors in 26.34% and placental factors in 18.66%, cord related in 4.38% and unexplained factors in 11.72% of cases. Conclusion: In addition to disorders during pregnancy, low socioeconomic condition, poor referral services and suboptimal intrapartum care in referring facilities responsible for majority of still births which could have been prevented. We speculate that upgrading the existing health system performance, particularly high quality intrapartum care by skilled health personnel, will reduce stillbirths substantially.
BACKGROUND: To study the association between mode of delivery and maternal and perinatal outcome in eclampsia. METHODS: This was a tertiary care based prospective observational study conducted in the Department of Obstetrics and Gynecology, between the study period October 2018-September 2020.Atotal 165 cases of eclampsia, with >32 weeks gestation, reassuring foetal heart and no other complications were included in the study. They were divided into two groups; Group I undergoing planned vaginal delivery, Group II undergoing early caesarean delivery, maternal and perinatal outcome was analysed and compared between the two groups. RESULT: Maximum number 75 (45.45%) of the study participants were in between 37.1-40 weeks of gestation at the time of admission, Majority of the study participants 125 (75.76%) had an unfavorable cervix i.e., Bishop's score ≤5 on initial assessment at the time of admission. There was no maternal mortality in our study. There was no statistically signicant difference in maternal morbidity. The still births and perinatal deaths were seen to be higher in the planned vaginal delivery group (1 still birth and 3 perinatal deaths). Perinatal morbidity was affected by mode of delivery of delivery, gestational age, BISHOP's score, number of convulsions at time of induction and convulsion delivery interval. CONCLUSIONS:The maternal outcome was seen to be comparable between both the groups and there was no statistically signicant difference between them, the perinatal outcome was better in the early caesarean delivery group as compared to the planned vaginal delivery group, specically in those with an unfavorable cervix and away from term. Early caesarean section to expedite delivery cannot be recommended for all cases of ante partum eclampsia.
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