ABSTRACT
Background: To study the Feto-maternal outcome in cases with previous surgical intervention for first trimester abortion on subsequent pregnancy and to compare with cases without history of previous abortion.Methods: A cross sectional observational study was conducted over a period of two years. Study included 80 consenting females at 28 weeks POG. Females with history of prior surgical abortion just before the present pregnancy were included as cases (n=40) and rest as controls (n=40). Detailed obstetric history was taken, subjects were then followed till delivery and feto-maternal outcomes such as period of gestation, mode of delivery birth weight, Apgar score, increased NICU stay at the time of delivery were recorded and analyzed.Results: We observed that the women with history of induced surgical abortion were at increased risk of Pre term birth (52.5%, p value0.006), Cesarean section (40%, p value 0.012), Low birth weight (47.5%, p value <0.001), increased NICU stay (32.5%, p value 0.027) compared to primi-gravida controls.Conclusions: We concluded that women with previous history of induced surgical abortions were at increased risk of preterm birth, very preterm birth and low birth weight babies, NICU stay in the subsequent pregnancies. The risk of caesarean was found to be increased in women with previous induced abortions exposing the women to the morbidity associated with the C-section. Hence patient with prior history of surgical first trimester abortion needs more vigilant monitoring during antenatal period in subsequent pregnancy.
ABSTRACT
Background: Present study was undertaken to do a comparative evaluation of artificial rupture of membrane (ARM) and spontaneous rupture of membrane (SRM) on the course of labour and feto-maternal outcome.Methods: It was prospective interventional randomized comparative study including 120 primigravidae (60 in ARM and SRM group each) with cervical dilatation ≥3 cm and intact membranes. Amniotomy was performed in ARM group after enrolment while no intervention in SRM group. Outcomes noted were duration of labor, mode of delivery, APGAR score, NICU stay.Results: Significant reduction seen in duration of labour in ARM group (p=0.0001). Mean duration of labor was 5.24 hours in ARM group while 6.94 hours in SRM group. No significant difference noted in mode of delivery (p=0.082). No significant adverse feto-maternal outcomes were seen with amniotomy. APGAR score and NICU admission had no significant difference among the two groups.Conclusions: ARM can be opted as an intervention with shorter duration of labour without adversely affecting the feto-maternal outcomes. It is safe, reliable and cost effective modality when employed in primigravida and may be considered as a low-cost accessible intervention to reduce prolonged labour and its associated complications.
ABSTRACT
Background: Increasing unintended pregnancies in post partum females in our country warrants urgent attention towards prevalence and efficacy of contraceptives used. This study was done to determine the prevalence of PPIUCD and its follow up in patients attending tertiary hospital in New Delhi, India.Methods: Prospective study was carried in Department of Obstetrics and Gynecology, Dr. RML Hospital, New Delhi, India over a period of 1 year from July 2017 to July 2018. The awareness and prevalence of PPIUCD was assessed. At 6 week follow-up visit, women with PPIUCD were asked for symptoms of unusual vaginal discharge, irregular or heavy bleeding per vagina, and any expulsions if noticed. All the data was recorded and assessed.Results: Out of 1478 deliveries, 1372 were eligible for PPIUCD. 335 patients got PPIUCD inserted. 295 patients were followed as 40 patients were lost to follow up. 79.3% women did not have any complaints. 11.8%, 1% and 7.4% women had only heavy menstrual bleeding, only lower abdominal pain and both symptoms respectively. Spontaneous expulsion rate was noted in one patient (0.3%) at 6 weeks. IUCD removal was done in 4 patients who had complaints of pain and heavy menstrual bleeding not conservatively managed.Conclusions: PPIUCD insertion is a safe, convenient and effective method of contraception. The benefits of contraception immediately after delivery outweigh disadvantage of complications. Antenatal counseling and follow up in hospitals need to be strengthened to increase awareness and acceptability of PPIUCD.