ABSTRACT
Introduction: Labour induction is a clinical intervention thathas the potential to confer major benefits to the mother andnew-born. Study aimed to compare the safety and efficacyof sublingual versus vaginal misoprostol and to evaluatematernal and foetal outcomes after sublingual and vaginalroutes of administration.Material and methods: We conducted a study on inductionof labor with misoprostol on antenatal patients with medicalor obstetric indication who presented in the Department ofObstetrics and Gynaecology, RMCH.Result: There was no significant difference in the demographiccharacteristics between the two groups. The main indicationfor induction in both groups was pregnancy induced HT.Incidence of caesarean section was not significantly differentin the two groups. There was no significant difference inmaternal complications between the two groups.Conclusion: Sublingual misoprostol is as effective and safe asvaginal misoprostol for induction of labor at term.
ABSTRACT
Introduction: The strength of the uterine scar and its capacityto withstand the stress of subsequent pregnancy and laborcannot be completely assessed or guaranteed in advance.Hence the present study was undertaken to analyse factorsstated by Flamm and Geiger admission scoring system andother plausible factors for successful TOLAC.Material and methods: A total of 265 cases of a previous CSwere selected. Booked cases were regularly followed up inthe antenatal clinic and the unbooked patients, who reporteddirectly for labor, were then assessed for a trial of vaginaldelivery.Result: A total of 265 cases were eligible for trial of scar usingFlamm and Geiger Admission scoring system. 135 had VBACwhereas in 130 cases trial was terminated and had ERCS.Out of 130 ERCS, 73.4% were because of scar tenderness,whereas 16.4% had non reassuring fetal heart rate. Remaininghad unsuccessful progress of labor.Conclusion: Flamm and Geiger admission scoring systemcan be used to successfully predict the likelihood of vaginaldelivery after a trial of scar, thereby reducing maternal andfetal morbidity and rate of caesarean section. Decisionregarding trial should also include factors like eventfulprevious pregnancy, interpregnancy interval, gestational ageand estimated fetal weight. Successful trial can be increasedby regular antenatal visits, general health promotion, earlydetection and management of high risk factors. Adequate interpregnancy interval should be encouraged by promoting andoffering contraception.
ABSTRACT
Introduction: Ketamine is dissociative anaesthesia- acombination of profound analgesia with superficial sleep.This state is characterized by spontaneous ventilation, relativepreservation of airway reflexes and hemodynamic stability.The present study was designed to evaluate the efficacy ofprogrammed labour protocol in proving shorter, safer andrelatively pain free deliveries.Material and methods: This study was a randomised controltrial done in The Department of Obstetrics and Gynaecology,Rohailkhand Medical College and Hospital for a span of oneyear (October 2016 to September 2017).Result: In our study, the duration of labour, induction deliveryinterval was significantly reduced. Pain relief was excellent instudy group.Conclusion: Ketamine’s site of action appears to be primarilyin the thalamus and limbic systems, acting as N- methyl Daspartate receptor non- competitive antagonist. It does notsuppress respiratory drive unless high dosage are used, orsmall dosage given rapidly. Intravenous ketamine in low doseappears to be safe laternative to epidural analgesia.
ABSTRACT
Necrotizing fasciitis, NF, is also known as the flesh eating disease. The incidence is rare. Infection. Mortality is a high as 40%. Very few cases have been reported in English literature and also very few cases of necrotizing fasciitis of female perineum in India have been reported. Here we report a case in India who recovered well with repeated debridement and dressing.
ABSTRACT
Verrucous carcinoma of uterine cervix associated with uterovaginal prolapse is a rare entity. The etiology of verrucous carcinoma is uncertain. HPV profiling of cervical carcinomas may have prognostic value. A case of longstanding uterovaginal prolapsed with verrucous carcinoma is discussed accompanied with a brief review.