ABSTRACT
Background: Protective measures for children like restraints and booster seats are seldom used in developing countries. The thriving Indian economy has resulted in booming car sales, particularly in urban areas, unfortunately the number of car crashes and accidents on roads have also increased manifold. Objective of current study was to evaluate the awareness and usage of child safety measures in cars in an Indian city. Methods: 150 parents were given a self-report questionnaire and their views, practices and attitude towards child restraint seats and booster seats were assessed. Results: Only 22% of parents used child restraints and 11% used booster seats. Among the users, 73% (infant seats) and 84% (booster seats) admitted to inadequate knowledge about installation and utilization. Conclusion: Usage and knowledge about child safety measures in cars is abysmal. Measures to improve adoption of car safety devices will have substantial and tangible benefits.
ABSTRACT
Background: The amniotic fluid is a cocoon of protection in fetal life. Amniotic fluid volume is an indicator of fetal well-being. Too little amniotic fluid is called oligohydramnios and is associated with increased incidence of congenital malformations and neonatal mortality. Aims & Objective: To estimate the incidence of congenital malformations and to study the perinatal outcome in oligohydramnios. Material and Methods: This prospective study was conducted in the Neonatal intensive care unit and the maternity wards of Father Muller Medical College Hospital, Mangalore. Ultrasound assessment of amniotic fluid index was recorded and cases of oligohydramnios detected were followed up. Congenital malformations were observed both by ante natal and post natal ultrasounds, other relevant investigations were also done when necessary. The perinatal outcome in terms of fetal distress, mortality and intrauterine growth retardation were recorded. Results: 120 cases of oligohdramnios were recorded. Seven newborns with congenital malformations were detected (5.8%). The most common congenital malformation was hydronephrosis. Four neonatal deaths were recorded in the study (3.3%). Fetal distress was observed in nine neonates (7.5%) and thirty neonates (25%) had intrauterine growth retardation. Conclusion: Congenital malformations, neonatal mortality, fetal distress and intra uterine growth retardation are significant risks in oligohydramnios. The lower the amniotic fluid index more is the risk of both mortality and congenital anomalies.
ABSTRACT
Background: Emergency Peripartum Hysterectomy (EPH) is a lifesaving surgical procedure. The higher incidence of EPH in developing countries is because of the higher prevalence of risk factors of primary postpartum haemorrhage like, multiple pregnancy, grandmultiparity, cephalo-pelvic disproportion and prolonged obstructed labor/uterine rupture, previous caesarean section. The increasing incidence of the procedure in developed countries has been attributed to the increasing caesarean section rate which predisposes to placenta previa. Aims & Objective: To estimate the incidence, indications and complications associated with peripartum hysterectomy performed at a tertiary care hospital. Material and Methods: The retrospective observational analytical study was conducted at the Department of Obstetrics and Gynecology, Lady Goshen hospital, Mangalore from January 2012 to December 2012. Records of all patients who had undergone peripartum hysterectomy during the study period were explored for age, parity, booking status, indication and the type of operation performed. Maternal morbidity and mortality were also recorded. Results: During the study period there were 5497 deliveries, out of which 6 women had undergone an EPH. The incidence was 1.2/1000 deliveries. The main indication was uterine atony 4 (66.7%), followed by rupture uterus 1 (16.7%) and placenta previa with placenta accreta 1 (16.7%). Maternal complications included febrile illness (50%) and anaemia (33.3%). All women, 6 (100%) required blood transfusions, 2(33.3%) cases transferred to ICU. No maternal deaths occurred. Conclusion: The leading indications for emergency peripartum hysterectomy in our study are uterine atony, placenta previa with placenta accreta and uterine rupture. The higher incidence of emergency peripartum hysterectomy is because of the higher prevalence of risk factors like multiparity, previous caesarean section and cesarean section in the index pregnancy. Proper antenatal care, early identification of risk factors and timely intervention by an obstetrician are necessary in preventing this disastrous event.