ABSTRACT
Trial of labour is a clinical test to assess the adequacy of pelvis and ability of fetus and mother to withstand labour. If progressive changes in dilation and station do not occur, a cesarean delivery is performed. Feto-maternal outcome after trial of labour in women with gestational age b/w 37 to 42 weeks. Cross sectional study. Department of Obs/ Gyn unit-I Liaquat University Hospital Hyderabad. One year from 01-02-2009 to 31-01-2010. 100 pregnant women, with gestational age between 37-42 weeks, who underwent trial of labour at labour ward, Obs/Gyn Unit-1 Liaquat University Hospital, after fulfilling the inclusion criteria were included in the study. Detailed history and examination including abdominal and pelvic examination as well as Ultrasound for fetal well being was performed. Fetal monitoring was done by auscultation and CTG. Partogram was maintained to observe the progress of labour. Those who progressed with trial either delivered normally or with the help of instruments and those who did not progress were delivered by C-section. After delivery, mothers were watched for any postpartum complication and condition of neonates was assessed by APGAR score. Out of 100 women included in this study 58% delivered vaginally, 31% delivered by cesarean section and 11% had instrumental deliveries. Labour was induced in 34%, augmented in 34% and 32% had spontaneous labour. 77.0% babies had apgar score > 5[7.1 +/- 0.72], 16% < 5[3.68 +/- 2.18] and 6% were still birth. 81% mothers had no complication during or after delivery, whereas 19 developed complications and these were 12 Genital tract traumas, 5 postpartum haemorrhage, one uterine rupture and one retained placenta. There was no statistically significant difference [P=0.42] when mode of delivery was compared with the trial of labour. However augmentation of labour was associated with increased rate of maternal complications when maternal outcome was compared with the type of labour [P=0.03]. Trial of labour in carefully selected women with high probability to deliver their babies vaginally decreases the rate of LSCS, thereby reducing the maternal morbidity and mortality associated with it. However augmentation of labour is associated with increased rate of maternal complications as compared to spontaneous or induced labour
ABSTRACT
To determine the number of hospitalized patients at risk for developing venous thromboembolism [VTE] / deep vein thrombosis [DVT], identifying the most common risk factor and to document the use of thromboprophylaxis. Observational and cross-sectional study. Chandka Medical College Hospital, Larkana, from October to December 2011. A total of 170 patients underwent this study and these included 51 [30%] from general medical, and 119 [70%] from surgical units. Inclusion and exclusion criteria were defined and data was collected on printed format. VTE risk assessment was done according to Caprini Model and criteria defined by the American College of Chest Physicians- ACCP. Out of 170 patients, 91 were male and 79 female with mean age of 39 +/- 16 years. According to ACCP criteria for VTE risk assessment, 20% [n=34] patients were identified to be at low risk, 20% [n=34] at moderate risk, 47.65% [n=81] at high risk and 12.35% [n=21] at very high risk of developing VTE. The commonest risk factor significantly identified was immobility [54.7%, p < 0.005], followed by advancing age [41.17%, p < 0.005] and obesity [18.23%]. The most common risk factor in all types of surgical patients was anaesthesia for more than 45 minutes 82.35% [n=98/119] and in medical patients advancing age 45% [n=23/51]. Only 6 [3.5%] patients received thromboprophylaxis, all were surgical patients of very high-risk category. Majority of studied hospitalized patients were at high risk of developing VTE. Immobility was the commonest risk factor for developing VTE, followed by advancing age and obesity. Very few hospitalized patients actually received thromboprophylaxis
ABSTRACT
To determine the frequency of anemia and need for blood transfusion in patients of placental abruption. This prospective cross sectional study was conducted at Department of Obstetrics and Gynecology for a period of 15 months from September 2010 to December 2011. All pregnant ladies who presented with Abruptio Placentae were included by completing a proforma for each patient After confirming the diagnosis, the blood of these patients was sent to laboratory for hemoglobin level, blood group and other routine investigations. According to hemoglobin level and the amount of bleeding, the number of blood units required by each patient was analyzed on SPSS v 15. 100 patients suffering from placental abruption were studied. 83% ladies were anemic and 61 were moderate to severely anemic. 98% received blood transfusion and 91% received 1-4 units of blood. Majority of patients presenting with placental abruption were found to be anemic and required multiple blood transfusions. The association between anemia and placental abruption is well documented, however, it needs to be established whether anemia leads to abruption or anemia is the consequence of abruption