Adverse fetomaternal outcome among pregnant overweight women

To compare the adverse fetometernal out come in overweight and normal weight pregnant women. This comparative cohort study was conducted from 1[st] October 2010 to 30 September 2012. Total 200 gravid women 100 were overweight and 100 normal weight pregnant women with gestational age for 08-40 weeks were included. Women having BMI [25 - 29.9 Kg/m[2]] were measured overweight and included in group A and 100 women having normal BMI of 18.5 to 24.9 as controls were in-group B. Chi-square test was applied to compare the proportion of maternal and fetal outcomes. Significant P - value of < 0.05 was considered. The age range was between 30 to 45 years with mean age of 30 +/- 4.1 years in both groups. Overweight pregnant women had significantly high frequency of pre-eclampsia [27% versus 9% in controls], PIH [24% versus 8% in controls], gestational diabetes mellitus [22% versus 5% in controls], prolonged labour [4% versus 6% in controls], Caesarean section [44% versus 16% in controls], Wound infection [3% versus 2% in controls] and Postpartum Hemorrhage [5% versus 2% in controls]. P-value < 0.001 was considered significance. Fetal complications in overweight pregnant women compared to controls i.e. Still birth [13% versus 2%], Early neonatal death [11% versus 1%], shoulder dystocia [5% versus 1%] and NICU admission [47% versus 10%]. Results were statistically significant except shoulder dystocia. We conclude that the result of present study indicates obesity exerts deleterious effect, both on fetal and maternal outcome

Pattern of perineal tears during vaginal delivery at a public sector university hospital of Sindh

To determine the pattern of perineal tears during vaginal delivery in a tertiary healthcare facility. It is a descriptive study done in the Department of Obstetrics and Gynaecology Unit-I at Liaquat University Hospital Hyderabad, Pakistan from 1st September 2004 to 31st August 2005. Women with full term singleton pregnancy either primi or multigravida, in active labour were selected for the study. An informed consent was taken from all the participants. Twin pregnancy and ante-partum haemorrhage were excluded Age, parity, type and degree of tear, mode of delivery, birth weight of baby, birth attendant, risk factors and complications were noted. There were 2563 deliveries, 256 patients had some degree of perineal injury giving a frequency of 9.9%. Out of them, 100 patients were selected, 37[37.0%] of multiparous and 63[63.0%] of primiparous sustained some degree of perineal injury. A higher incidence of first and second degree tears were noted and incidence was found to be more when vaginal delivery was conducted without episiotomy and fetal weight was more than 4kg. However duration of labour, perineal support, presence of perineal edema and experience of the birth attendant were important risk factors. Obstetric perineal tears are common as depicted by the high frequency in this study. Lack of perineal care, poor socio-economic conditions, poor intra-partum care with lack of experience were found to be contributing factors in the occurrence of perineal tears

Safety and efficacy of hyderalzine in hypertensive disorders of pregnancy

To find out safety and efficacy of IV bolus hydralazine in reducing blood pressure in severe hypertension during pregnancy. All pregnant patients with systolic blood pressure 160 or above and diastolic blood pressure 109 mmHg with eclampsia and hypertensive emergencies were included. The initial dose of hydralazine was 5 mg IV bolus then repeated 1mg at 20 minutes interval. Outcome measures to start treatment were, systolic and diastolic blood pressure, time required for achieving the desired BP level, total dose needed, side effects of drugs, maternal and fetal outcome in terms of safety and efficacy. One hundred and ten patients with eclampsia and hypertensive emergencies were included in the study. The mean + SD [range] of maternal age was 26.70 + 6.70[18 -45 years]. Blood pressure before starting therapy was systolic 165.5 + 16.65, and diastolic blood pressure was 115.45 + 8.25mmHg. After starting therapy, a significant difference [P=< 0.001] was observed with fall in systolic blood pressure 131.2 + 9.49 and in diastolic blood pressure 93.68+6.30mmHg. In 94[85.5%] patients, IV bolus hydralazine took 60 minutes, however, in 3[2.7%] > 180 minutes time was required to control the blood pressure. Total dose of drug required was <6mg in 40[38.4%] patients, 6 to 14mg in 44[40%] and in 17[15.5%] women 15 to 20 mg of dose was needed to control the blood pressure. Only 9[8.18%] needed dose between 21 to 30 mg IV bolus hydralazine. Hydralazine is safe and effective in controlling the blood pressure in severe hypertension during pregnancy and after delivery