Study of fetomaternal outcome in eclampsia

Background: Eclampsia is a life-threatening emergency that continues to be a major cause of maternal and perinatal mortality. The purpose of our study was to analyse the trend of eclampsia in a tertiary care teaching institute and to find out the fetomaternal outcomes of eclampsia.Methods: A retrospective epidemiological study was undertaken in the department of Obstetrics and Gynaecology, Jhalawar medical college, Jhalawar during the period ‘September 2018 to August 2019’. Women who presented as eclampsia or developed eclampsia during hospital stay were included in the study. Data analysed included various maternal parameters, fetal parameters, and the outcome of the pregnancy.Results: The incidence of antepartum eclampsia was (0.92%). High risk associated factors were primigravida (65.90%), low maternal age (21-30 years), illiteracy, and inadequate antenatal care. Caesarean section was the mode of delivery in 48 cases (54.54%) most common indication was unfavourable cervix, 80.6% women had antepartum eclampsia and 68.18% women had severe preeclampsia. There was 6.8% maternal mortality, attributed to pulmonary edema and acute renal failure. Perinatal mortality was 14.77% with 8 still births and 5 neonatal deaths. Prematurity complicated 46.66% pregnancies. Thirty neonates were admitted to NICU.Conclusions: Eclampsia is one of the important causes of maternal and perinatal morbidity and mortality due to lack of proper antenatal care, low socio-economic status, and lack of education. It can be concluded that better antenatal care, early recognition of disease, timely referral, early initiation of treatment and termination of eclamptic patients improves outcome. Management of eclamptic patients should be performed at tertiary care centres, where ICU facilities, NICU facilities, and multidisciplinary units are available.

Clinical presentation, diagnosis and management of bacterial vaginosis: a hospital based cross-sectional study

Background: Bacterial vaginosis is most common cause of vaginal discharge. Clinical presentation varies from person to person. The management of bacterial vaginosis is largely syndromic and empirical, it is usually based on naked eye examination of vaginal discharge and that is unsatisfactory because the diagnostic accuracy is lost without microscopic examination. The modern management of bacterial vaginosis demands a specific diagnosis which is a combination of naked eye examination plus laboratory workup.Methods: The study was carried out on 183 females with complaint of vaginal discharge in the outpatient department of obstetrics and gynecology. Specimens were collected in outpatient department of Jhalawar Medical College in associated Zanana Hospital. The laboratory work was conducted in the department of microbiology in Jhalawar Medical College, Jhalawar, Rajasthan, India.Results: The prevalence of microbial positivity in our study was 79.9%. Bacterial vaginosis was the most common diagnosis seen in 86 (47.0%) cases. Maximum patients presented with complaint of copious amount of foul-smelling yellow discharge.Conclusions: The study concludes that it is important to know the various presentations, confirm the diagnosis by proper microbiological tests, and provide appropriate treatment to patients to prevent resistance and recurrence of bacterial vaginosis.

Unicornuate uterus with functional non communicating rudimentary horn: a refractory cause of dysmenorrhea

Mullerian duct anomalies are rare. Unicornuate uterus with a non-communicating rudimentary horn is a rare type of mullerian duct anomaly which occurs due to defective fusion of malformed duct with contralateral duct. The incidence is approximately 1:100000. Patient usually remain asymptomatic due to the absence of functional endometrium in most of the cases. If the rudimentary uterine horn has an endometrium lined uterine cavity and doesn’t communicate externally then the signs and symptoms of obstructed menstruation appears, as soon as menarche begins. It will be associated with severe dysmennorhoea and hematometra. Other complications may be abdominal lump, chronic pelvic pain, infertility, endometriosis, adenomyosis and ectopic pregnancy in rudimentary horn. Authors are presenting a case of refractory dysmenorrhea with lump abdomen in a patient with unicornuate uterus with functional non communicating horn. In a patient with refractory dysmenorrhea mullerian duct anomaly should be kept as differential diagnosis.