ABSTRACT
In high risk pregnancies, there is a dire need to assess amniotic fluid volume. If values of amniotic fluid volume fall within normal limits, it reassures us regarding well being of fetus. The chronically stressed fetus is likely to have low amniotic fluid. Amniotic fluid index is a reliable fetal surveillance test and in some obstetrical units highly reliable parameter. Decreased amniotic fluid index has been considered as an indicator of poor neonatal outcome. AFI may be used to predict the occurrence of thick meconium stained liquor and need for intervention for fetal distress in post date pregnancies. Descriptive Study. Obstetrics and Gynaecology department of Fatima Memorial Hospital, Lahore affiliated with Fatima College of Medicine and dentistry Lahore. 6 month from 7/2/2007 to 7/8/2007. All pregnant women, meeting the inclusion criteria admitted in labour room either through emergency or OPD were selected. The AFI was calculated ultrasonically and these patients were followed till the time of delivery and the APGAR scores of newborn were compared with AFI. During the study period AFI was measured in 60 patients. Among these patients, 32 patients had AFI between 3-4 cm and babies were meconium stained, 23 patients had AFI of 5-6 cm and babies had normal APGAR at the time of delivery. AFI was < 2 cm in 5 patients and babies required resuscitation and admitted in nursery. The AFI is a reliable predictor of neonatal outcome
ABSTRACT
Placenta praevia is a major cause of maternal and fetal morbidity and mortality. It is a major cause of obstetrical haemorrhage in second and third trimester of pregnancy. Placenta pravia usually presents with antepartum haemorrhge and as a source of maternal morbidity, it remained a significant cause of hospitalization and caesarean section. The study was carried out to see the frequency of risk factors, maternal complications and perinatal outcome in major degree placenta praevia. I]. To Find out major risk factors and maternal complications in major degree placenta praevia. II]. Know perinatal outcome in major degree placenta praevia. It is a descriptive study. Patients were selected by simple random sampling techniques. The study was carried out at Gynae Unit-I, Allied Hospital, Faisalabad from March 2005 to February, 2006. Seventy five patients selected for the study after fulfilling the inclusion criteria for major degree placenta praevia. The included patients were examined thoroughly and relevant information was recorded into proforma giving detailed history, clinical examination, investigation and management. In this descriptive study, total 75 patients were included as a diagnosed a case of major degree placenta praeiva. There were 15 patients presented asymptomatically and the rest of 60 patients were symptomatic. Out of 75 patients, majority of the patients belonged to the age group of 24-35 years. The mean age was 31.5 years. 2 patients expired due to massive PPH, 10 patients underwent obstetrical hysterectomy. In these 10 patients, 3 patients had placenta accrete, 1 patient had placenta increta and 2 had placenta percreta. Predisposing factors were previous gynaecological operations in 15 patients, history of previous C-section in 14 patients, history of previous placenta praevia 8 patients, advanced maternal age 5 patients and history of myomectomy in 3 patients. The remaining 39 patients had no predisposing risk factor. The mean gestational age was 36 weeks. 57 babies were delivered by emergency C-section and the remaining 18 patients underwent elective C-section. Live birth account was 66. Out of 75 babies, 9 babies were IUD, 48 were preterm, 17 were IUGR, 25 babies were having RDS and 3 babies were abnormal congenitally and 13 perinatal deaths occurred. Significant improvement in the neonatal care should be achieved in our tertiary environment to improve expected survival rate together with a reduction in overall morbidity for the premature new born