ABSTRACT
Background: The objective of this present study was to compare the efficacy of oral mifepristone and balloon catheter for cervical ripening and induction of labour in women with previous caesarean section.Methods: This prospective study was conducted on 130 pregnant women with previous 1 caesarean section and term singleton pregnancy admitted for induction of labour. Sixty-five patients were induced with oral mifepristone (Group 1) and in another 65 transcervical balloon catheter (Group 2) was inserted for induction of labour. Both groups were than compared with respect to change in bishop score, induction to active phase interval, induction to delivery interval, dose of oxytocin in milliunits, mode of delivery, maternal complication and fetal outcomes.Results: Change in bishop score after induction was more in mifepristone group than balloon catheter group (p=0.002). Favorable bishop score was more in Group 1 (83.07%) than Group 2 (66%), p=0.05. There was significant difference in mode of delivery between two groups, 61.53% in Group 1, and 32.3% in Group 2 delivered vaginally (p<0.001).Conclusions: Present study showed that mifepristone is an alternative to balloon catheter for induction of labour in women with previous one caesarean section with poor bishop score.
ABSTRACT
Background: To compare the efficacy, safety and user satisfaction of levonorgestrel intrauterine system (LNG-IUS) with oral progestogen in medical management of heavy menstrual bleeding (HMB).Methods: This prospective study was conducted on 80 women with HMB in age group of 35-55 years. Patients were divided into two groups of 40 each and followed for six months. In Group I, LNG-IUS was inserted in post menstrual period and in Group II, patients received oral norethisterone 5 mg twice a day during 5th-25th day of cycle for 6 months. Patients were evaluated about amount and duration of blood loss by pictorial blood assessment chart (PBAC) along with haemoglobin estimation on each follow up visit. MMAS (Menorrhagia Multi-Attribute Scale) score comparison between two groups was done to measure the improvement in quality of life. The results were analysed by using Chi-square test and Student t-test.Results: Percentage reduction in PBAC score after six cycles of treatment was 89.3% in LNG IUS group as compared to 68% in norethisterone group. LNG-IUS was found to be more efficient in correcting anemia, lowering duration of bleeding and improving MMAS score as compared to norethisterone.Conclusions: Present study showed that LNG IUS was superior to oral progestogen in decreasing quantity and duration of bleeding and improving overall quality of life over time.
ABSTRACT
Heterotopic gestation, although common with assisted reproductive techniques, is very rare in natural conception. We report a rare case of heterotopic pregnancy, resulting from spontaneous conception, in a 30-year old woman with no known risk factors for heterotopic pregnancy. Emergency laparotomy followed by right salpingectomy, left salpingostomy and evacuation of non-viable intrauterine pregnancy contributed towards saving the patient's life.
ABSTRACT
Heterotopic gestation, although common with assisted reproductive techniques, is very rare in natural conception. We report a rare case of heterotopic pregnancy, resulting from spontaneous conception, in a 30-year old woman with no known risk factors for heterotopic pregnancy. Emergency laparotomy followed by right salpingectomy, left salpingostomy and evacuation of non-viable intrauterine pregnancy contributed towards saving the patient's life.
ABSTRACT
There were 5124 deliveries during January to December 2000 and of these 386 patients (7.53%) were severely anemic (Hb < 6.0 g/dl). 1083 units of blood were transfused to these patients, a mean of 2.80 units to each patient. There were 2 maternal deaths due to severe anemia. Of the 386 patients, 246 could be interviewed in detail and their demographic details were compared with 100 normal pregnant women with haemoglobin levels of 10 g/dl or more. In the anemic group 81.7% were illiterate, 62.1% had no antenatal check, 78.8% had no access to safe drinking water 90.65% had no toilet facilities and used open fields for defaecation, 63.1% reported having diarrhoea and pain in abdomen off and on. 20.73% reported history of passage of worms in the stools. History of previous menorrhagia was present only in 1.2%. The comparable figures in the non-anaemic group were 34% illiterate, 24% no antenatal checkup, 55% no toilet facilities, 38% unsafe drinking water, 6% diarrhoea, 2% (worms in stools) and 5% menorrhagia. Hence it is concluded that along with prophylaxis with iron and folic acid sufficient consideration should be given to sanitation facilities, safe drinking water, recurrent gastrointestinal infection etc.