ABSTRACT
Background: Puerperium is strictly defined as the period of confinement during and just after birth. It is the period following childbirth during which body tissues specially the genital organ reverts back approximately to the pre-pregnant state both anatomically and physiologically. At some stages some of these well-orchestrated changes can go away resulting in complications which can endanger life.Methods: Retrospective c study was conducted in Department of Obstetrics and Gynecology of M.G.M. Medical College and M. Y. Hospitals, Indore. The cases were selected randomly from the patient who were admitted in M.Y. Hospital who had either a vaginal or caesarean delivery (both in our institution as well as outside institution) during the study period, irrespective of age, parity and registration status. Data was recorded in predesigned coded case report forms and statistical analysis was performed.Results: Authors found that puerperal pyrexia was the most common complication, accounting for 38.96% of total cases. The second most common complication was perineal pain affecting 28.15% of cases. The other complication was wound gaping/discharge (11.71%), mastitis and breast abscess (6.81%), secondary postpartum hemorrhage (5.33%), episiotomy gaping and infection (4%), perineal hematoma (0.59%), wound dehiscence (0.3%) and other rare causes accounted for 4.15% of the complication.Conclusions: Puerperal period is as important as antenatal period. Anaemia, suboptimal personal hygiene as well as improper sterilization can resulted in severe health hazards such as septicemia, disseminated intravascular coagulation as well as death. So, risk factor should be treated vigorously.
ABSTRACT
Background: Estrogen therapy in younger postmenopausal women is associated with a decisive reduction in morbidity and mortality, but estrogen use in this population is low because of risk of side effects. Weekly intermittent therapy is a more patient friendly approach with reduced pill burden increasing compliance and adherence as well as reducing side effects. Therefore, authors wanted to study the effect of weekly intermittent fixed dose estrogen and progesterone (ultra-low dose) supplements in hysterectomised surgically menopaused women.Methods: The present study was prospective and retrospective study. For retrospective study authors records of 100 hysterectomised women up to 45years of age with severe post-menopausal symptoms treated in authors Medicine Department of Hospital with once weekly MALA-D tablets were studied. For prospective study, all consecutive hysterectomised patients with severe post-menopausal symptoms attending medicine OPD were given once weekly MALA-D which contains ethinylestradiol 0.03mg and levonorgestrel 0.15mg tablets and followed up monthly with outcomes measured by Modified Kuppermann Index, visual analogue scale, and women’s health questionnaires.Results: Present retrospective study showed moderate degree of postmenopausal symptoms as indicated by Modified Kuppermann index of 19.57. Prospective study showed significant improvement in postmenopausal symptoms with weekly intermittent hormone replacement therapy as indicated by outcomes measured by Modified Kupperman index and Visual analogue scale. Women’s health questionnaire also showed statistically significant improvement in 6 out of 8 dimensions.Conclusions: Authors concluded that weekly estrogen progesterone hormone replacement therapy with mala-D tablet (ultra-low dose therapy) was 100% effective in relieving vasomotor symptoms and it is very effective in improving psychosomatic symptoms, urinary symptoms and quality of life with no obvious side effects and greater adherence.