ABSTRACT
To find out the difference between active and expectant management of third stage of labour in terms of amount of blood loss and duration of third stage of labour. This quasi experimental study was conducted in the Unit "B" of department of Obstetrics and Gynaecology, Lady Reading Hospital from June - December 2006. A total of 100 patients were included in the study, out of which 50 patients under went active management of third stage of labour [AMTSL] and 50 patients had expectant management. Formal consent was obtained from all the patients. Apart from the demographic data, details regarding the amount of blood loss and duration of third stage were recorded on a semi structured proforma and analyzed by using Chi Square test, with p value of <0.05 considered as significant. In the active management group most of the patients had blood loss less than 100ml while in the expectant group most of the blood loss was between 100-200ml. Mean blood loss in the active group was 72.5 +/- 36.83ml and expectant group was 177.4 +/- 59.65ml, p value <0.001. Similarly the difference in the duration of the third stage was statistically significant between the two groups [p value <0.001]. AMTSL was associated with statistically significant decrease in the blood loss and shorter duration of third stage of labour
ABSTRACT
To find out the effect of decreased amniotic fluid index [AFI] on adverse pregnancy outcome at term. This experimental study was conducted at Gynae [B] unit Lady Reading Hospital Peshawar from September 2004 to August 2005. A total of 100 pregnant women admitted in labour ward were included in the study. Fifty cases with an amniotic fluid index of <5cm comprised the patient group. Fifty controls having AFI>5cm were matched with the cases regarding age [ +/- 3years], parity and antenatal complication [hypertension, diabetes]. Apart from demographic details, maternal outcome measures such as induction of labour; mode of delivery; meconium stained liquor; and fetal outcome measures such as Apgar score and admission to neonatal intensive care unit were recorded on a semi structured proforma for both the groups and analyzed by Chi square test using SPSS v.ll. Labour induction was significantly higher in patients having AFI<5cm as compared to the control group [p-value=0.009]. Meconium stained liquor [p-value=0.023] and cesarean section rate for fetal distress [p-value=0.000] were higher in patients having AFI<5cm. Neonatal complications were found to be more frequent in the patients having AFI<5cm and these include, low Apgar score <7 [p<0.00l] and neonatal intensive care unit admission [p=0.078]. There was no perinatal mortality in both the groups. Amniotic fluid index of <5cm was associated with adverse pregnancy outcomes in the form of meconium stained liquor, induction of labour, cesarean section for fetal distress, low Apgar score and neonatal intensive care unit admission