ABSTRACT
Introduction: Lower segment cesarean section is thecommonest surgical procedure in obstetrics. Repeating acesarean section in subsequent pregnancies is the usualmethod of termination which involves many complications.Our objective was to study these complications and difficultiesobserved in a repeat cesarean section.Material and methods: It was a prospective observationalstudy of 241 cases of repeat cesarean section from October2017 to September 2018 in department of obstetrics andgynecology of Hi-Tech medical college and hospital,Bhubaneswar, odisha.Results: In this study, total 1610 patients are taken. Amongthese most common indication for cesarean section is CPDi.e56 (23%).Most common incidence of intraoperativecomplication of previous cesarean section is adhesion i.e.124(51.61%).Conclusion: Maternal morbidity is a cause of concern in repeatcesarean section because of the intraoperative complicationsencountered during surgery and thereafter. Reduction inprimary caesarean rate can reduce the complications. Patientswith previous cesarean section are categorized as high riskand counselled for VBAC in suitable cases.
ABSTRACT
Background: The progress of labour can be graphically represented using the WHO partogragh, which helps in early detection and prevention of complication of labour, thus resulting in a better feto-maternal outcome especially in high risk cases.Methods: The study was undertaken at Hitech Medical College and Hospital, Bhubaneswar from March 2017 to February 2019 on 200 high risk patients. The progress of labour was plotted and assessed on Modified WHO partograph.Results: Majority of the cases were referred cases. Augmentation of labour was carried out in 56 cases. The mean duration of labour in the first stage was 5.4 hours and 4.1 hours in primi and multigravidas, whereas that of the second stage of labour are 37.5 minutes and 26.3 minutes respectively. 51 cases had prolonged labour and 15 cases had arrest of labour in the second stage. Maximum number of cases underwent LSCS due to abnormal labour progression. 8.7% of the cases had PPH and 2.3% had puerperal sepsis. Neonatal asphyxia was seen in 13.6% cases and 2.8% had early neonatal death.Conclusion: The results conclude that the WHO modified partograph is an inexpensive useful tool in monitoring the progress of labour and reducing foeto maternal morbidity in high risk groups.
ABSTRACT
Objective :To study the clinico-social risk factors for preeclampsia in a tertiary care hospital in Bhubaneswar, Odisha. Methodology :Acase control study was done in a tertiary care hospital in Bhubaneswar. Clinical and socio-demographic data was collected from 167 inpatients with preeclampsia and similar number of controls and was analysed. Results : Majority of the women(63.9%) belonged to the low socioeconomic class with low education level. More than half were overweight(57.3%) and 61% of them were primipara. A significant number of patients(18.5%) gave a previous history of preeclampsia. Insulin resistance also presented as a risk factor. Conclusion: Though the aetiology of preeclampsia still remains obscure, there are certain risk factors which have remarkable association with the prevalence of the disease. Understanding these will enable the clinicians for early diagnosis and timely intervention.