ABSTRACT
Objective: To determine perinatal mortality rate and its related obstetric risk factors in our setup. Design: Observational study. Setting: Department of Obstetrics and Gynaecology [Unit-I], Liaquat University Hospital Hyderabad, from January to December 2006
Patients and Methods: All perinatal deaths including stillbirths [SBs] and early neonatal deaths [ENNDs] within 0-7 days of birth after 24 weeks of gestation were studied during the study period, while Pregnancies <24 weeks of gestation were excluded from the study. The relevant information was collected through a pre-designed proforma which contained variables including maternal demographics, obstetric risk factors and other details
Results: A total number of 2224 deliveries were analysed for perinatal mortality. Out of these, there were 224 perinatal deaths giving a PNMR of 100.7/1000 births. There were 196 SBs and 28 ENNDs. Among these, 88% women were unbooked. Commonest risk factors was antepartum haemorrhage [27.67%], followed by hypertensive disorders of pregnancy [23.21%] and mechanical factors affecting labour [14.28%]. Congenital abnormalities were found in 9.8% of PNDs while maternal medical disorders were seen in 6.25% cases. In 3.5% cases, chorioamnionitis/ neonatal septicaemia was the underlying cause and multiple pregnancies were seen in only 02 [0.89%] cases. However, in 32 [14.28%] cases, no cause was found
Conclusion: The high perinatal mortality rate in present study is comparable to the figures from other institutions. Main reason being lack of antenatal and pre-pregnancy care where from almost all obstetric risk factors can be picked up and treated / prevented
ABSTRACT
We report a very unusual case of secondary postpartum hemorrhage due to uterine rupture. Our case was a 23 years old lady who presented with heavy bleeding per vagina and gave history of home delivery. Rupture was most probably caused by injudicious use of oxytocic injection by a Traditional Birth Attendant at home. Surprisingly, after recovering completely from primary episode she again had heavy blood loss after 5 days. An emergency hysterectomy of the patient was performed to save the life