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Background: Hydrocephalus is a heterogeneous disease marked by abnormal dilatation of the cerebral ventricles secondary to varying etiologies. This study was aimed to determine the incidence, risk factors, severity, and outcome of hydrocephalic fetuses presenting to a tertiary healthcare hospital located in northern India.Methods: In this prospective observational study, pregnant women visiting the obstetrics outpatient department of our hospital from 01 July 2017 to 31 June 2018 were screened for hydrocephalic fetuses via ultrasonography along with a detailed history, and a comprehensive battery of diagnostic investigations. They were followed up for a minimum period of two months after delivery/termination of pregnancy.Results: A total of 3627 pregnant women were screened, of which 10 had hydrocephalic fetuses in the observed time period. The incidence of hydrocephalus was determined to be 2.75 per 1000 live births. Low socio-economic status was identified as a major risk factor. 50% of the hydrocephalic fetuses were severely afflicted and were discontinued. The remaining 50% were successfully delivered and were managed via a ventriculo-peritoneal shunt or are under close observation in the postnatal period without any adverse outcome.Conclusions: The burden of hydrocephalus is considerably high in India, as compared to western countries. In rural settings, low socioeconomic status and lack of folic acid supplementation have a major influence in the etiopathogenesis of hydrocephalus. Management of hydrocephalus requires a multidisciplinary approach and is tailored according to the severity of the presentation. Severe cases of hydrocephalus and cases with associated anomalies have a poor prognosis.
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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.
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Background: Labour is defined as the progressive dilatation of cervix with co-ordinate uterine contractions that effect in and expulsion of the products of conception. Experience has shown that providing pain relief to the mother allays fear, anxiety and provides a more favourable environment for improved obstetric outcome. Aims and Objectives: To compare the effects of programmed labour protocol with epidural analgesia and traditional method of labour. Materials & Methods: This study is a prospective, randomized controlled study conducted in the department of Obstetrics & Gynaecology at Teerthanker Mahaveer Medical College & Research Centre Moradabad. 90 pregnant women in active labour were enrolled in the study. They were allocated to three groups after randomization . Group-A- 30 pregnant women received epidural analgesia. Group-B - 30 pregnant women received programmed labour protocol. Group-C- 30 pregnant women with traditional labour management. Results: There was excellent relief of pain in group A patient compared to other methods with shortening of duration of labour. Conclusion: Labour analgesia is a simple, effective method for painless and safe delivery and thus can reduce the number of caesarean section
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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.
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Introduction: Th ere is increasing awareness and facilities provided by various government and non government organizations regarding antenatal care and safe delivery practices but it is still a public health concern due to high maternal and perinatal mortality. Th e aims of present study is to assess the availability of manpower which provided services to the mothers in the peripheries, role of demographic characteristics, educational status, common pregnancy complications and there maternal and fetal outcome along with the hospital stay. Material and Methods: It was a retrospective study carried out in the Teerthanker Mahaveer Medical College. All the patients who were admitted through casualty were analysed with respect to Age, parity, Socioeconomic status, antenatal check-up, reason for referral from periphery, maternal and fetal condition at the time of admission, mode of delivery, maternal and fetal outcome along with NICU admission & hospital stay. Result: It has been observed that most of the patients with poor obstetrical outcome are multiparous or grand multiparous with low socio economic status not receiving any antenatal care. Th e common obstetrical emergencies came out were PIH (18%), obstructed labor (10.3%) followed by APH (8.2%), fetal mal-presentation (7.5%) and anemia (7.2%). Conclusion: Illiteracy and ignorance of female regarding healthcare requirements came out to be a major contributor of poor pregnancy outcome. Early diagnosis and management of high risk pregnancies is one of the measures which can reduce poor pregnancy outcomes. It is to be emphasized that majority of the maternal death from pregnancy are preventable by sample priority intervention. Co-ordination between healthcare providers at gross root level to tertiary care centre is the need of time. Health care providers at PHC and CHC levels should have adequate knowledge of antenatal requirements and importance of immunization. Th ere must be referral of high risk cases for their early and timely management. Th ere must be adequate transport facility and systematic referral system as well as provision of immediate management of referred cases at tertiary care centre. So it is high time for urgent strategic planning and investment for upgrading eff ective obstetric and neonatal care.