ABSTRACT
The objective of this study was to determine the significance of pH and leukocyte count in the prediction of preterm labour. Case control study. This study was carried out at Department of Obstetrics and Gynaecology Nishtar Hospital Multan from 01-04-2008 to 30-09-2008 and 01-11-2008 to 01-05-2009. Women seeking antenatal care at outpatient department of Obstetrics and Gynaecology, Nishtar Hospital Multan between 22-28 weeks of gestation with singleton pregnancy were enrolled in this study. Vaginal pH was measured using a pH paper and leukocyte count by making a slide of vaginal secretions from posterior fornix and were sent to pathologist for counting number of leukocytes. Women with high pH and leukocyte count were enrolled to group A [cases] and those having normal pH were included in the group B [controls]. These women were followed till delivery and the number of women going into preterm labour were counted and matched with the results of pH and leukocyte counts. Mean age was 25.80 +/- 48 years in cases and 24.61 +/- 0.56 years in controls. Low socioeconomic status was evident in 43 [61.43%] cases and 34 [48.57%] controls, while 27 [38.57%] case and 36 [51.43%] controls had middle socioeconomic status. Preterm labour was observed in 42 [60%] cases and 7 [10%] controls, while preterm premature rupture of membrane was evident in 30 [42.86%] cases and 9 [12.86%] controls. Mode of delivery was vaginal in 44 [62.86%] cases and 54 [77.14] controls. 26 [37.14%] cases and 16 [22.86%] controls had lower segment caesarean section. Significantly more number of women with elevated pH and leukocyte count likely to have preterm delivery
ABSTRACT
The objective of this study was to determine the perinatal outcome in patients with eclampsia. Descriptive study. Department of obstetrics and gynecology Nishtar Hospital Multan. Two hundred and sixty four pregnant ladies admitted in labor ward of Nishtar Hospital Multan diagnosed as eclampsia fulfilling the inclusion criteria were selected. Non probability purposive sampling technique was used. All information like prematurity, intrauterine death, stillbirth, low birth weight, admission to neonatal intensive care unit [NICU] and early neonatal death was recorded on a specifically designed proforma. For perinatal complications ladies were followed for 7 days. Data were entered and analyzed by SPSS-11. Out of 6183 admissions 231[3.73%] were eclamptic. Majority of the patients 157[67.96%] were primigravida, 118[51.08%] were in groups 21-30 years. There were 117[50.61%] uneducated patients and 157[67.96%] patients belonged to poor socioeconomic conditions. Only 63[27.27%] were booked cases. Most of the patients 132[57.14%] were diagnosed at gestation less than 37 weeks and 120[51.94%] patients delivered vaginally. Prematurity was the most frequent complication i.e in 131 [56.70%] patients observed and 147[63.63%] neonates required admission to NICU due to various reasons. There were 13[5.62%] intrauterine deaths, 29[12.55%] stillbirths and 21[9.09%] early neonatal deaths. Eclampsia is still a major threat to the pregnant ladies in our institution and a major cause of perinatal morbidity and mortality. lt is mostly preventable by early diagnosis and management of pre eclampsia and hypertensive disease. As stillbirth, prematurity and birth asphyxia are the most important causes of perinatal loss, so in eclampsia early referral of patients, better obstetric management, early resuscitative measures and good neonatal care facilities can improve the perinatal outcome.
ABSTRACT
To describe perinatal outcome in patients with preeclampsia. Descriptive Hospital based study. Department of Obstetrics and Gynecology, Nishtar Medical College/Hospital Multan from September 2007 to September 2008. Patients admitted through the outpatient department and labour ward with gestation age >20 weeks and diasystolic blood pressure of >/= 90mmHg on more than one occasion 6 hours apart and proteinuria >/= 300mg/24 hours or two mid stream or catheter specimens of urine with >/= ++ proteins on reagent strip testing were included in the study. Besides detailed clinical history, complete blood count, renal function tests, liver function tests, coagulation screen and 24 hours urine protein were done. After the baseline obstetrical ultrasound, two weekly growth scans were done, growth charts were maintained along with umbilical artery Doppler studies, Patients were counseled for planned hospital delivery and time and mode of delivery was decided. Babies were managed by the Pediatricians and if needed shifted to neonatal intensive care unit. The babies were followed for 7 days after birth. 73 patients were managed during the study period. 22 patients had intrauterine growth restriction [IUGR] 23 babies were born preterm, 13 preterm babies had IUGR and 10 out of these were admitted to neonatal intensive care unit. There were 5 deaths [4 still births 1 early neonatal death]. IUGR and preterm births are the most frequent perinatal complications in preeclamptic patients. Health education of masses and regular antenatal care can improve the pregnancy outcome