INTRODUCTIONCesarean section is one of the most commonly performed abdominal operations on women in most countries. Cesareans section aims at reducing maternal and fetal mortality and morbidity by virtue of its cautions and careful approach. In many countries, C-sections have become the mode of delivery in over a quarter of all the birth. The World Health Statistics (WHS), 2012, released on Wednesday, said 9% of all births in India were by Caesarian section. The latest figure has gone up by 5% since nearly one in 10 women in India, who gave birth between 2005 and 2010, had gone under the surgical knife.1 Using the data of national family health survey India (1992-93) Mishra and Ramanathan found that among 18 large states two states has CS rate near 15 percent and the rest had less than 5 percent.
ABSTRACTBackground: Cesarean section is one of the most commonly performed abdominal operations on women. Because of increasing incidence of Cesarean sections the no. of patients with previous 1 LSCS is also increasing. Thus proper antenatal counseling and institutional delivery should be done. Methods: A prospective observational study was conducted at department of Obstetrics and Gynaecology, LLRM Medical College Meerut during one year period from Nov 2015-May 2016. Participants to study the maternal and fetal outcome in pregnant women with previous one LSCS. 200 pregnant women were included in the study and outcomes were studied. Results: Maternal Outcome: Out of 200 cases 122 patients underwent vaginal birth after Cesarean (VBAC) accounting for 61% and 78 patients underwent 2nd LSCS (76 emergency LSCS and 2 elective LSCS). Out of 76, 55 patients were given trial of VBAC but failed and end up in C-Section showing success rate of 68.92% for VBAC (122 out of 177). Adhesions were found in 21patients out of 78 (26.92%) who underwent LSCS. Uterine rupture seen in 2 patients out of 200 cases (1.0%). Scar dehiscence was seen in 6 out of 78 patients (7.69%). Post-partum Hemorrhage was seen in only 20 (10%) patients. Pre-term Pregnancy occurred in 16 (8%) patients. Caesarean Hysterectomy had to be done in 3 (1.5%) patients. Placenta Previa was seen in 6 out of the 200 patients (3%) and placenta accrete was seen in 1 patient (0.5%). Out of 200 patients, 2 twins were born. The total number of babies born was 201. 8 IUDs occurred out of 201 babies (3.98%) and a total of 25 out of 193 live babies (12.95%) required admission to Neonatal Intensive Care Unit out of which 2 babies died. Conclusions: Cesarean section should not be always followed by a repeat cesarean section. Patient should have hospital delivery in a well-equipped hospital and complications should be diagnosed at an early stage so that maternal and perinatal morbidity and mortality could be prevented.
Background: A high risk pregnancy is one in which mother, fetus or neonate is at increased risk of morbidity or mortality before or after delivery. Hence a relatively small percentage of high risk obstetric population gives rise to a disproportionately high percentage of perinatal and maternal morbidity and mortality. The perinatal outcome can be changed significantly by early detection and special intensive care to high risk pregnancies. Hence Identification of women at risk for these complicated pregnancies with poor outcome is fundamental to antenatal check-up.Methods: 86 high risk antenatal patients attending the outpatient department and labour room were recruited after informed consent.70 normal pregnancy was taken as control group. Perinatal outcomes were compared between high risk and normal pregnancies.Results: Adverse perinatal outcomes were more in high risk pregnancies as compared to normal pregnancies.Conclusions: This study emphasizes on pregnancy related complication leading to adverse perinatal outcome so evaluating patients for high risk factors, early diagnosis, proper antenatal care, prompt treatment, regular follow up, and timely management thus can improve maternal and perinatal outcome.
Background: This study was conducted to evaluate tocolytic effect of sildenafil citrate and nifedipine versus nifedipine alone for management of preterm labour.Methods: Prospective randomized study on 80 women aged 18-35 years with singleton pregnancy of 28-34 weeks gestation with preterm labour, fulfilling the inclusion criteria were randomly divided in two groups of 40 each. In regimen A women were given sildenafil citrate and nifedipine while in regimen B nifedipine alone for 72 hours as tocolysis.Results: Higher mean latency in sildenafil and nifedipine combination regimen compared to nifedipine alone regimen (28.23±18.3 versus 12.98±13.35 days, p<0.001). In regimen A, less days of hospital stay (3.23±0.92 versus 3.9±0.38 days, p<0.0001); improve perinatal outcomes in form of fewer deliveries during hospitalization or within 7 days after discharge (p=0.018); reduction in NICU admission (0.68±1.54 versus 3.18±4.61 days, p=0.002); improvement in birth weight (p<0.001) and fewer neonatal complications. Only minor side-effects like facial flushing (42.5% versus 22.5%, p=0.029), headache (40% versus 25%), dyspepsia (15% versus 2.5%, p=0.047), nasal congestion, palpitation, hypotension, constipation, nausea, dizziness were seen.Conclusions: Our study found combination of sildenafil citrate with nifedipine as superior and successful regimen with future potential as a tocolytic therapy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.