ABSTRACT
Background: Intrauterine fetal death (IUFD) occurs in 1% of pregnancies and has devastating consequences. Previous methods for inducing labor in IUFD involved oxytocin and prostaglandins. The combination of mifepristone and misoprostol is commonly used for early first-trimester termination. This study aimed to compare the effectiveness of mifepristone and misoprostol combination versus misoprostol alone for labor induction in intrauterine fetal death.Methods: A randomized controlled clinical trial was conducted at Sir Salimullah Medical College, Mitford Hospital, Dhaka, from January 2017 to June 2017. Sixty-four pregnant women with intrauterine fetal death after 28 weeks of gestation were included. Participants were randomly assigned to either group-I (mifepristone and misoprostol) or group-II (misoprostol alone). Statistical analyses were performed using statistical package for the social sciences (SPSS) version 20.0 for Windows.Results: The mean age was 27.7±5.6 years in group I and 27.5±4.3 years in group II. Majority of patients in group I were housewives (87.5%), while in group II, it was 78.1%. Most patients in group I (56.3%) came from lower-income families, compared to 65.6% in group II. The gestational age did not significantly differ between the groups. The induction to delivery interval was significantly shorter in group I (8.6±2.0 hours) compared to group II (15.1±3.5 hours). The dose administration pattern of misoprostol differed significantly between the groups.Conclusions: Both methods are equally safe and effective for managing intrauterine fetal death. However, the combination of mifepristone and misoprostol showed greater efficacy in terms of reducing the induction to delivery interval and requiring a lower dose of misoprostol.
ABSTRACT
Background: Severe acute malnutrition (SAM) is a major cause of morbidity and mortality in children around the world. It is critical to identify the factors that contribute to mortality to reduce SAM related mortality. This study aimed to analyze the risk factors of mortality in hospitalized children with SAM. Methods: This case-control study was conducted in the SAM unit, department of pediatrics, institute of child and mother health, Matuail-1362, Dhaka, from January 2021 to December 2021. Data analysis was conducted using SPSS version 22. Univariate analysis was done to determine factors affecting mortality, and multivariate logistic regression was used to determine significant independent risk factors. Results: Mean age of the study subject was 6.38±3.45 months and 10.90±10.00 months in the case and control groups respectively. So, death was more common in younger children. The percentage of death was more (61.5% vs 54.6%) in males. Mortality was more common in family income <10,000 Tk/ month, 53.8% in the case group and 21.9% in the control group. The mean age of the mother was 19.23±0.60 years and 21.78±4.78 years in the death and survived group. Among risk factors of mortality, dermatosis (46.2% vs 4.9%), oral ulcer (46.2% vs 5.5%), hypoglycemia (46.2% vs 3.8%), severe anemia (38.5% vs 2.2%), septicemia (76.9% vs 29.5%) in case and control group respectively. These risk factors were significantly higher in the death group compared to the surviving group. After doing multivariate logistic regression analysis it was observed that hypoglycemia (OR=9.17 with 95% CI 1.44 to 58.29) and severe anemia (OR=13.42 with 95% CI 1.42 to 126.13) were the strongest predictors of mortality among the hospitalized children with SAM. Conclusions: Hypoglycemia and severe anemia were the main contributing factors of mortal among the children with SAM in the hospital.
ABSTRACT
Background: Severe acute malnutrition (SAM) is a major cause of morbidity and mortality in children around the world. It is critical to identify the factors that contribute to mortality to reduce SAM related mortality. This study aimed to analyze the risk factors of mortality in hospitalized children with SAM. Methods: This case-control study was conducted in the SAM unit, department of pediatrics, institute of child and mother health, Matuail-1362, Dhaka, from January 2021 to December 2021. Data analysis was conducted using SPSS version 22. Univariate analysis was done to determine factors affecting mortality, and multivariate logistic regression was used to determine significant independent risk factors. Results: Mean age of the study subject was 6.38±3.45 months and 10.90±10.00 months in the case and control groups respectively. So, death was more common in younger children. The percentage of death was more (61.5% vs 54.6%) in males. Mortality was more common in family income <10,000 Tk/ month, 53.8% in the case group and 21.9% in the control group. The mean age of the mother was 19.23±0.60 years and 21.78±4.78 years in the death and survived group. Among risk factors of mortality, dermatosis (46.2% vs 4.9%), oral ulcer (46.2% vs 5.5%), hypoglycemia (46.2% vs 3.8%), severe anemia (38.5% vs 2.2%), septicemia (76.9% vs 29.5%) in case and control group respectively. These risk factors were significantly higher in the death group compared to the surviving group. After doing multivariate logistic regression analysis it was observed that hypoglycemia (OR=9.17 with 95% CI 1.44 to 58.29) and severe anemia (OR=13.42 with 95% CI 1.42 to 126.13) were the strongest predictors of mortality among the hospitalized children with SAM. Conclusions: Hypoglycemia and severe anemia were the main contributing factors of mortal among the children with SAM in the hospital.