ABSTRACT
Splenic rupture is a very rare entity during pregnancy and puerperium. It has a very high maternal mortality if not diagnosed and managed in time. Here we are presenting a very rare case of splenic haemorrhage on day 5 lower segment caeserian section which was diagnosed and managed at RIMS, Ranchi, Jharkhand, India.
ABSTRACT
Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions:Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions: Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.
ABSTRACT
Background: Pre eclampsia is responsible for significant maternal and perinatal morbidity and mortality worldwide .Serum LDH level is a useful biomarker for cellular injury which may reflect the severity of pre eclampsia and its level might be a guideline for management of patients. The aim of study was to find out the role of serum LDH in prediction of adverse outcome of pre eclampsia, severity of disease and occurrence of complications.Methods: This prospective observational study was conducted in the department of Obstetrics and Gynecolog, RIMS, Ranchi, Jharkhand, India. A total of 300 cases were studied.150 cases were non severe preeclamptic and 150 cases were severe pre eclamptic patients. Serum LDH was done in both non severe and severe eclamptic patients .Data entry was done in Microsoft excel 2007. Results were analysed by chi square test.Results: Higher LDH levels had significant correlation with high blood pressure as well as poor maternal and perinatal outcome.Conclusions: High serum LDH level correlate well with the severity of disease and poor outcome in patients of pre eclampsia. Detection of high risk patients with increased levels of LDH mandate close monitoring and management to prevent maternal and fetal morbidity and mortality.