Epidural analgesia in labour; maternal and fetal outcome

To evaluate the effects of epidural analgesia on the pain relief and maternal and fetal outcome. Comparative and analytical study. In Military Hospital Rawalpindi from Oct 1998 to Oct 1999. 100 full term healthy primigravida admitted for induction of labour. Fifty patients were given epidural analgesia and 50 served as control to whom no analgesia was given. Outcome measures observed were duration of labour, mode of delivery; Apgar score of the newborn; untoward reaction and intra-partum complications. The data analysis revealed that epidural analgesia significantly prolonged labour time and was associated with increased instrumental delivery rate. Significant reduction in intra-partum fetal complications was seen, while C-section rate was not effected by epidural analgesia. Apgar scores were higher in analgesia group as compared to control. Although accused of prolonging labour time, it's benefits in terms of great maternal satisfaction and reduced intra-partum complications still makes it an option for labouring patients

Eclampsia

To evaluate incidence, morbidity and mortality associated with eclampsia. A prospective study. The study which was carried out at PAF Hospital Rafiqui, Shorkot spanned over a period of 2% years from Jun 2002-Dec 2004. The study comprises of 55 eclamptic cases diagnosed out of 3391 consecutive deliveries, carried out in our hospital. The incidence of eclampsia, in this study, was found to be 1.62%. Out of 55 cases 38[69.1%] patients were primigravida. Forty three [78.2%] of the patients were between the ages of 21 to 30 years. In 50[90.9%] patients gestational age was less than 35 weeks. Thirty seven [67.3%] cases had antepartum eclampsia. Forty four [80%] patients received diazepam while the remaining 11[20%] received magnesium sulphate [MgSO4] as anticonvulsant. Commonest mode of delivery was spontaneous vaginal delivery [31 cases, 56.4%] followed by lower caesarean section [21 cases, 38.2%]. Fetal loss was seen in 12[20.7%] cases. T wo patients died of eclampsia, maternal mortality rate being 3.6%. Eclampsia is a life threatening complication of pregnancy. However an improvement in antenatal care, upgrading the neonatal facilities and early delivery by cesarean section can improve the perinatal outcome