ABSTRACT
Objective: This study was conducted to determine the frequency and indications of caesarian section [CS] at Combined Military Hospital [CMH] Abbottabad. Study Design: Descriptive cross sectional study. Place and Duration of Study: Obstetrics and Gynecology Department, CMH Abbottabad, from Sep 2016 to Mar 2017
Material and Methods: A total of 2, 340 females delivered during the study duration were enrolled in study. Medical records of all the patients were analyzed retrospectively to determine the CS rate. Patient's demographic data, obstetric history, and indications and type of CS were recorded. Data were entered, coded and analyzed in IBM SPSS Statistics 20 software. Descriptive statistics were produced
Results: Of 2340 births, 1093 [46.7%] were via CS with about 50.9% being emergency CS. Mean age of the patient who underwent CS was 26.7 years. The most frequently noted indication was previous CS [59.4%], followed by poor progression of labor [32.2%], and fetal distress [26.9%]. More than half of the women [57.7%] who underwent CS fell into Robson Group 5 i.e. were multiparous with at least one previous CS and had a single cephalic pregnancy at term
Conclusion: CS rate at our setting was comparable to rates at similar tertiary care hospitals in Pakistan. The most common indication was previous scar, the most frequently observed indication in literature
ABSTRACT
Objective: This study was conducted to determine the effectiveness of Foley catheter balloon tamponade in postpartum haemorrhage at Combined Military Hospital [CMH] Abbottabad. Study Design: Descriptive study. Place and Duration of Study: Obstetrics and Gynaecology Department CMH Abbottabad, from Sep 2016 to Mar 2017
Material and Methods: Patients who developed postpartum haemorrhage after caesarean section [CS] and were treated with intrauterine balloon tamponade [IUBT] using a Foley catheter were identified by review of medical records. Patient's demographic data, obstetric history, type of CS, cause of haemorrhage and transfusion history were extracted. Data was entered, coded and analyzed in IBM SPSS Statistics software. Descriptive statistics were produced
Results: A total of 26 patients were included with mean age of 29.2 +/- 5.23 years. More than two-thirds of the patients were multi-gravida and around three-quarters were at full term. The most frequent cause for postpartum haemorrhage [PPH] was placenta previa major. In 25 of the 26 [96.1%] patients the procedure was successful in stopping bleeding. There were no adverse effects related to the procedure
Conclusion: We found that IUBT with an inexpensive Foley catheter is likely to be effective in most cases of PPH associated with caesarean section, without causing additional adverse events
ABSTRACT
Objective: To identify risk factors predisposing to morbidly adherent placenta and to study obstetric outcome in such patients
Study Design: Retrospective descriptive study
Place and Duration of Study: Department of Obstetrics and Gynaecology Military Hospital Rawalpindi, from Jan 2014 to Dec 2014
Material and Methods: A total of 54 patients with morbidly adherent placenta were studied retrospectively. Patient's data including demographic data, previous obstetric history and outcome was collected from hospital records. Data was analyzed by using SPSS version 20
Results: The incidence of morbidly adherent placenta was 4.74 per 1000 deliveries. Mean age of patients was 33.33 +/- 2.82 years with mean gestational age of 35.13 +/- 0.91 weeks. All patients had history of prior caesarean section with 4 [7.40 percent] patients having four, 32 [59.25 percent] having three, 16 [29.62 percent] having two and 2 [3.70 percent] having one previous caesarean section. Associated placenta previa was present in 43 [79.62 percent] patients. Out of 54 patients 39 [72.22 percent] had placenta accreta, 11 [20.37 percent] had placenta percreta while 4 [7.4 percent] had placenta increta. Obstetric hysterectomy was done in 51 patients while in remaining 3 uterus was preserved. Out of these three, one died as a result of septicemia while methotrexate was started in remaining two cases. However an interval hysterectomy was performed in these two cases because of massive postpartum hemorrhage
Conclusion: Previous caesarean section and placenta previa are major risk factors for morbidly adherent placenta. Patient education, antenatal diagnosis with well planned surgical intervention and anticipation of blood loss are keys to successful management
Subject(s)
Humans , Female , Cesarean Section , Pregnancy , Heart Diseases , Asymptomatic Diseases , Mitral Valve Stenosis , Mitral Valve InsufficiencyABSTRACT
To share clinicopathological spectrum of hysterectomies performed at CMH Rawalpindi. A cross sectional descriptive study. This study was carried out at Obstetrics and Gynaecology department CMH Rawalpindi, from October 2010 to June 2012. Total of 54 patients who underwent hysterectomy were selected for the study. Detailed history and examination of the patient pre and post-operatively were carried out to observe the indications and complications of hysterectomy. In total 54 hysterectomies were carried out; all of which with the exception of one were total abdominal. The patients who underwent hysterectomies were in the 4th decade of life. The most common [48%] indication of hysterectomy in our study was found to be menstrual irregularities like menorrhagia, irregular vaginal bleeding, DUB and post-menopausal bleeding give frequently of complication as well. Delayed wound healing was the most common complaint [7%]. Histopathology carried out on the uterine specimen showed adenomyosis 17[31%] being the most common finding. Abdominal hysterectomies carried out in our setup are most commonly done for menstrual irregularities and complication rate is low