ABSTRACT
Background: Hypertensive disorders are the second most common cause of maternal death worldwide. Eclampsia is the extension of pregnancy induced hypertension to the point of conclusions, coma or both
Objectives: To find out the incidence of eclampsia among pregnant women and to identify the maternal and perinatal outcomes of eclamptic patients treated in a tertiary care referral hospital
Study Design: Discretional cross sectional study
Setting: Department of Obstetrics and Gynecology, Sheikh Zayed Hospital, Rahim Yar Khan
Period: January 2014 to December 2014
Methods: A total number of 96 patients out of 10513 who were diagnosed as being eclamptic during the study period were included in this study. While normal pregnant women and Patient's with uncertain diagnosis was excluded. All patient variables were entered and analyzed using SPSS v20. Frequency and percentages were used to express qualitative variables
Results: There were total ninety six patients [0.913%] out of 10,513 who presented with eclampsia. Most of eclamptic patients were of having age >21 years. Among patients who developed eclampsia 52 [54.16%] were in Ante partum period and 40 [41.66%] were in postpartum period. Out of 96, five patients died before delivery and thirteen after delivery, seventy eight patients developed one or more complications during delivery. Out of total 91 deliveries, 54 [59.30%] were delivered by cesarean section [C/S]. Main reason for C/S was unfavorable cervix. Out of total ninety one deliveries two were twins and eighty nine singletons. Fifty eight [62.36%] babies were born at a gestational age <37 weeks. Birth asphyxia occurred in sixty one [65.60%] newborns. There were twenty two [23.65%] perinatal deaths, fourteen [63.64%] were stillbirths and eight [36.36%] were early neonatal deaths
Conclusion: Eclampsia is found to be associated with very high rates of maternal mortality and morbidity as well as perinatal mortality. Early diagnosis of eclampsia and its timely management can reduce the risk of this mortality. This can be made possible by provision of basic facilities and improvements in the quality of basic care provided by our antenatal clinics
ABSTRACT
Background: Labour has challenging effects, on mother, with adequate hydration may have favorable effects
Objective: This study was carried out to determine the effect of intravenous fluids on the total duration of labour
Patients and Methods: This comparative cross sectional study was conducted in Obstetrics and Gynaecology department Unit-II, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan, from 1[st] April, 2013 to 30[th] September, 2013. A total of 63 women in true labour, gravida 2[nd] to 4 [th], age < 35 years, gestational age of 37 to 40wks, Hb% > 10g/dl with or without ruptured membranes were selected. These selected patients were randomly allocated in two groups. Group 1: oral fluid plus augmentation fluid. Group 2: Oral fluid plus intravenous fluid plus augmentation fluid. Confounders such as syntocinon dose and vomiting were controlled by stratification. Chi square test was used for comparing groups. Pearson correlation was used to corelate variables like duration of labour in hours and fluid intake in ml. Data was analyzed using SPSS version 16
Results: Mean age of the participants was 29 + 2.8 years, mean number of kids was 2 + 0.9, mean height in cm was 152 + 2.07, mean Hb% in gm/dl was 10.18 + 0.18, mean fluid in ml for augmentation was 284 + 43 ml with median of 250ml, mean amount of fluid in ml was 1814 + 1077 and a median of 1000ml. In fluid category of less than 2000ml, 42.9% have duration of labour 2000ml where 100% has duration of labour < 0.05]. It was noted that total fluid input was negatively corelated with duration of labour [r = 0.54] and it is significant at the 0.01 level. While controlling for syntocinon dose it was noted that increasing total amount of fluid intake of more than 2000ml has significant effect on reducing the duration of labour [P = 0.00]
Conclusion: Our study showed that adding intravenous fluids and so increasing hydration of labouring women has reduced total duration of labour
ABSTRACT
To describe maternal outcome in eclampsia the causes of death in those who could not survive this serious complication of pregnancy. This descriptive study was conducted over a span of one year i.e. from December 2001 to December 2002 at Nishtar Hospital, Multan. No specific sampling technique was observed. All cases meeting the inclusion criteria were included. The onset of eclampsia was antepartum in majority of patients [70%]. Almost all patients suffered some form of morbidity. Many patients had more than one complication. The most common problems encountered were tongue bite [60%]. No delivery related complications in the mother were encountered. Out of 60 eclamptic patients 8 expired. Four patients [6.7%] came in labour room with shock and died within 12 hours of hospitalization. Two of these four patients died due to disseminated intravascular coagulopathy [abruption placenta], one due to cerebrovascular accident and fourth died due to cardiac failure. Commonest cause of neonatal death was prematurity [>72%]. The present study clearly concludes that eclampsia can be prevented through concentrated efforts at the community level by improving antenatal services