ABSTRACT
Background: Amniotic fluid is vital to the well-being of the fetus. Severe oligohydramnios and polyhydramnios are associated with increased maternal morbidity and perinatal morbidity and mortality.Methods: This was prospective observational study conducted at tertiary teaching institute from July 2012 to July 2013. Total 200 patients were included in the study. On the basis of amniotic fluid index (AFI), patients were categorized in 3 groups, Normal AFI (8-24 cm), oligohydramnios (AFI <5cm) and polyhydramnios (AFI > = 25 cm). Results were analysed in the form of incidence, mode of delivery and perinatal outcome which includes preterm, low birth weight, still births, NICU admissions and neonatal deaths in all the 3 groups.Results: Out of 200 patients, there was 150 cases of normal AFI, 39 cases of oligohydramnios and 11 cases of polyhydramnios. Incidence of oligohydramnios was 4.1% and polyhydramnios was 1.1%. PIH was the most common etiological factor found in oligohydramnios (30.7%) and in polyhydramnios congenital anomalies (36.3%) followed by idiopathic cause (27.2%) was most common. Incidence of caesarean section was 58.9% in oligohydarmnios and 17.3% in normal AFI group. Incidence of NICU admission was 25.6% in oligohydramnios and 50% in polyhydramnios group in comparison to 9.3% in normal AFI group.Conclusions: Amniotic fluid index is an important part of antepartum fetal surveillance. Abnormalities of AFI are associated with high perinatal morbidity and mortality and maternal morbidity.
ABSTRACT
Background: The incidence of second stage caesarean section is more in developing countries. Caesarean sections done at full cervical dilatation with impacted fetal head are difficult and associated with an increased incidence of maternal and fetal complications.Methods: This was prospective observational study conducted at a tertiary teaching institute. All second stage caesarean sections performed between September 2017 to August 2018 were analysed in terms of incidence, indications of caesarean-section, intra-operative and postoperative complications, maternal and fetal outcome.Results: During the study period there were total 7270 deliveries. Out of this 1884 deliveries were done by caesarean section. Out of them 50 were 2nd stage caesarean sections contributing to 2.65% of total sections. Patwardhan method was used in 50% cases for deliveryof deeply engaged head. Intra-operative complications were higher in terms of atonic pph (8%), extension of uterine incision (16%), in 3 cases bladder injury was noticed. Obstetric hysterectomy was required in 4% cases. 14% cases had postoperative febrile illness and 8% cases had wound infection. 44% babies required NICU admissions and neonatal death was 18%.Conclusions: Caesarean section in the 2nd stage of labour is associated with significantly increased maternal morbidity. Neonatal morbidity and mortality also increases. A proper judgement is required by a skilled obstetrician to take a decision for caesarean section at full cervical dilatation.
ABSTRACT
Background: Iron deficiency anaemia (IDA) is the most common nutritional deficiency in pregnancy. Prophylactic oral iron is recommended during pregnancy to meet the increased requirement of iron. In India, more than 50% women become pregnant with low baseline haemoglobin level resulting in high incidence of moderate to severe anaemia in pregnancy where oral iron therapy cannot meet the requirement. This study was undertaken for critical evaluation of iron sucrose in terms of efficacy, safety, and feasibility along with any reduction in blood transfusion rate. Aims & Objective: To evaluate the efficacy of intravenous Iron sucrose in antenatal patients with Iron deficiency anaemia and to study the side effects of intra venous Iron sucrose. Material and Methods: This prospective study was conducted from Nov 2012 to June 2013 at VS General Hospital, Ahmedabad. 60 antenatal patients found to have anaemia having Hb level < 9 gm% were admitted and given intravenous iron sucrose therapy 100mg alternate day after calculating the dose of the iron requirement. Results: In patients having moderate anaemia (Hb 7-9 gm%), the rise in Hb found to be 2.17 ± 0.45 gm% from pre-treatment Hb of 7.88 ± 0.58 gm% to 9.9 ± 0.53 gm%. In patients with severe anaemia (Hb < 7 gm%), the rise in Hb was observed up to 2.73 ± 0.51 (SD) gm% after 1 month of iron sucrose treatment. No major side effects or anaphylactic reactions were noted during the study period. Conclusion: Parenterally administered iron sucrose elevates Hb and restores iron stores earlier and also that intravenous iron administration has led to the reduction in the rate of blood transfusion rate.