ABSTRACT
Background: Placenta is a dynamic tissue synthesized physiologically to serve as a nutrient source for developing fetus it is exposed to several changes in reaction to many toxemic conditions associated with pregnancies. Studies had proved that placental changes observed on histomorphology is directly proportional to reaction to hemodynamic compensatory mechanisms, thereby aiding the obstetricians to manage the sequelae of complications. Objective of this study was to study the placental histomorphology in pregnancies associated with pre-eclampsia and to quantitate the observed placental changes.Methods: The study comprised on 101 placental specimens obtained from department of obstetrics and gynecology, Mahatma Gandhi Medical College and Research Institute, Pondicherry. Toxemia of pregnancies were divided into mild, severe preeclampsia and eclampsia based on blood pressure. The 101 cases were divided as 4 groups: Group 1 (control group); Group 2 (mild preeclampsia); Group 3 (severe preeclampsia); Group 4 (eclampsia).Results: Among the 101 cases, 38 placentas were from uncomplicated full-term deliveries which constitutes the control group. The rest 63 placenta were from toxemia of pregnancies which constitutes the study group.Conclusions: The incidence of toxemic pregnancies and pre-eclamptic cases are on higher margin than assumed. Histomorphology examination of placenta plays a vital role in assessing etiopathogenesis and mechanism of toxemic pregnancies. This aids the obstetrician to further manage subsequent sequelae and fix the complication to significant proportion.
ABSTRACT
Background: This study aimed to investigate whether perineal massage during second stage of labour could decrease perineal trauma in the form of episiotomy and perineal tears.Methods: One hundred and fifty term antenatal women in labour were randomly assigned to two groups, one of which received perineal massage and the other received routine care during the second stage. Frequency of episiotomies, perineal tears, intact perineums, degrees of perineal tears, duration of second stage of labour and perineal pain after 24 hours was compared.Results: Perineal massage was efficient in reducing incidence of episiotomy, duration of second stage of labour and perineal pain assessed 24 hours after delivery. The frequency of perineal tears and intact perineums did not differ significantly. Perineal massage was protective against severe form of third degree perineal tears.Conclusions: Authors suggest that perineal massage can be routinely practiced by health professionals to improve quality of life in women post vaginal delivery.
ABSTRACT
A genital fistula is an abnormal communication between uterus with either urinary tract or gastrointestinal tract. Although genitourinary fistula is a common entity, rectovaginal or even uterorectal fistula is relatively uncommon. The etiology of fistula is usually due to an obstetric cause in a developing country, whereas, it is gynecological in the developing country. Whether etiology is obstetrical or gynecological, this develops following days of the procedure. Here, we present the case of a 17-year-old girl, who underwent vaginoplasty for cervical atresia and develop uterorectal fistula one and a half year following the first surgery. She was finally managed with hysterectomy