ABSTRACT
Acute puerperal inversion is rare but potentially fatal obstetric emergency and prompt recognition will enable immediate repositioning of uterus before it becomes edematous and incarcerated. Manual repositioning along with use of uterine balloon tamponade is simple and effective way for repositioning of inverted uterus as well as prevention of recurrence.
ABSTRACT
Background: Intrauterine fetal death is a major obstetrical complication and a devastating experience for parents as well as obstetricians. If the causes of IUFD can be found, an effective strategy for prevention of IUFD can be formed and maternal complications can thus be prevented. This study aims at identifying the various causes, etiological factors and complications of IUFD.Methods: Prospective observational study was carried out in a tertiary care hospital from 1st January 2016 to 31st July 2017.Results: Total number of deliveries during the study period was 3944 and still birth was 170. Still birth percentage was 4.31.Majority of patient belonged to maternal age group of 21-30 year of age that is 138 out of 170 around 68.5%. Only 8.82% of patients presenting with IUFD were having more than three antenatal visits. Among 61 cases (35.8%) cause was not identified while 109 cases cause was identified. Hypertensive disorder contributed to major cause of IUFD i.e. 34 out of 170 (20%) Maternal complications like hypovolemic shock occurred in 13 out of 170 (7.6%), Acute Renal failure 7 out of 170 (4.11), Sheehan syndrome. Maternal mortality was 3 out of 170 cases.Conclusions: Despite availability of modern interventions like ultrasonography, Non stress test, majority of the causes of IUFD remains unknown. Early diagnosis and delivery is important in cases of IUFD to prevent various complications like septicaemia, acute renal failure, DIC, hypovolemic shock etc.
ABSTRACT
Background: Teenage is a period of transition from childhood to adulthood. According to WHO, the period of teenage extends from 11-19 years. The objective of the present study was to find out the incidence and to evaluate the effect of pregnancy in teenage girls (13-19 years) and its maternal and neonatal outcome.Methods: Prospective observational cohort study, the duration from 1st January 2016 to 31st July 2017.Results: 216 teenage patients were studied; however medical termination and abortions were excluded as the study includes both maternal & neonatal outcome. 3944 pregnant patients were admitted for delivery and abortion related care. Out of this, pregnant adolescents were 216. Proportion of adolescent pregnancy was 5.47%. 170(78.7%) were booked, 32 (14.81%) were unmarried, while 50 (23.1%) were literate. Primigravida were 189 (87.5%) & multigravida was 27 (12.5%).39 (18.05%) were Anemic, Preterm labour occurred in 14 (6.5%) & PROM occurred in 41 (18.9%) patients. Preeclampsia and Eclampsia occurred in 27 (12.5%) and 14 (6.5%) respectively. There were 176(81.48%) normal vaginal deliveries.36 (16.66%) had Lower Segment Caesarean Section; commonest indication being Cephalopelvic disproportion (25%) & 4(1.85%) were instrumental deliveries 53 (24.3%) babies required admission at Neonatal Intensive care unit. Low Birth weight babies were 15 (28.3%).Conclusions: - Early ANC registration and good antenatal care with effective intrapartum & postpartum monitoring along with contraceptive advice on discharge help reduce maternal and neonatal morbidity & mortality associated with teenage pregnancy. However, it is evident that teenage pregnancy rates could be reduced by effective measures like sex education in schools, community-based programs, widespread awareness about contraception.