A Perquisite for Atonic Post-Partum Hemorrhage - Uterovaginal Packing: A Clinical Study

Aim: To study maternal outcome in terms of morbidity andmortality following intrauterine packing in postpartum atonichemorrhage (PPH).Methods: The study was conducted over a period of 24months in our institution over post-partum patients withintractable PPH before resorting to invasive surgicalmanagement after vaginal delivery & caesarean section.Results: 92% success rate was observed among the patientswith uterovaginal packing.Conclusion: Timely management of patients with intractablepostpartum hemorrhage which is unresponsive to conventionalmedical treatment can be safely managed by uterine packingwith minimal maternal mortality and morbidity. Maternal deathrates and hysterectomies could be minimized using thisconservative method.

The Prospective study of the incidence, etiological factors and maternal outcome in pre-labour ruptured membranes (Term and Pre-term).

Background: Pre-labour rupture of membranes is one of the most challenging and controversial obstetric dilemma which occurs even in low risk pregnancies. Premature rupture of membranes is defined as rupture of Amniotic Membranes with release of amniotic fluid more than 1 hour prior to onset of labour. It may be term i.e. after 37 weeks and preterm i.e. prior to 37 weeks. Methods: This is an observational study carried out in Teerthankar Mahaveer Medical College & Hospital (Maternity Ward) over a period of 24 months from June ’14 to June ’15. 182 cases of prelabour rupture of membranes were collected for study. The incidence and maternal outcome of pre-labour rupture of membranes in both term and preterm pregnancies was observed and statistically analyzed. Results: The incidence of disease is more in primigravida in the age group of 20-30 years. Infection and coitus are one of the important causes, which are preventable to an extent. The most common organism grown in vaginal swab culture was E. coli, followed by Klebsiella, Staph aureus, Enterococci and Group Beta Streptococcus. There was no maternal mortality in the study group. Conclusion: Prelabour rupture of membranes and preterm prelabour rupture of membranes require good maternal – fetal monitoring and timely interventions which can provide the best of maternal outcomes.