ABSTRACT
Background: Objectives: To compare misoprostol 600 mcg, oral with carboprost 125 mcg, i.m., in the active management of third stage of labour. Methods: A total of 200 pregnant women of 38-42 weeks of gestation delivering vaginally in the Shivamogga institute of medical sciences, Shivamogga, Karnataka, India were selected for study. 100 women received misoprostol 600 mcg, orally and 100 women received carboprost 125 mcg, i.m. immediately after delivery of baby and cord clamping by the method of randomisation. Results: In the misoprostol group, mean blood loss is 134.9 ml, mean duration of the third stage of labour is 4.07 min and mean fall in hemoglobin is 0.34 g/dl. In the carboprost group, mean blood loss is 123.7 ml, mean duration of the third stage of labour is 3.73 min and mean fall in hemoglobin is 0.28 g/dl. There was no significant difference between the two groups with regard to the above mentioned factors. There were 5 cases of PPH in the misoprostol group and 3 cases in the carboprost group. 21 cases in the misoprostol group and 14 cases in the carboprost group required additional oxytocics. Unpleasant side effects like diarrhoea and vomiting were more in carboprost group. Conclusion: Oral misoprostol is as effective as carboprost in AMTSL and can be used safely in vaginal deliveries for prevention of PPH, especially in non-institutional deliveries and in places of low resource settings.
ABSTRACT
Background: Acute appendicitis is an infrequent, yet one of the commonest surgical emergency encountered in pregnancy. Recorded incidence is about 1:1500 pregnancies. The aim of this study was to determine the risk factors associated with prenatal outcome in acute appendicitis during second and third trimester pregnancies. Open access surgery was done due to non-availability of laparoscopy. Methods: A total of 10 pregnant women who were diagnosed with acute appendicitis between Jan 2011 to Jan 2013 were presented and 7 of them operated by open access surgery. Results: Seven pregnant women who were diagnosed with acute appendicitis were operated upon during late pregnancy. The interval between symptom onset and surgery was the only predictive variable. A longer interval between symptom onset and surgery was associated with appendix perforation than with no appendix perforation. There was a significant difference in the rate of preterm labor (5.1% vs. 1.3%) and the rate of fetal mortality (25% vs. 1.7%) between patients with and without a perforated appendix. Conclusion: Delaying surgery correlates to more advanced disease with an increased risk of perforation. This contributes to an increased risk of further complications, including premature labor or abortion, and to higher maternal complication rates. Prompt diagnosis may improve the prenatal outcome.