ABSTRACT
Objective: to determine the effect of dexamethasone administration to women between 37 to 39 weeks of gestation on neonatal outcome in terms of respiratory morbidity and the need for NICU admission
Study Design: an experimental study
Place and Duration of Study: department of Obstetrics and Department of Neonatology, Military Hospital, Rawalpindi, Pakistan, from February to July 2017
Methodology: women with singleton pregnancies, undergoing elective cesarean section between 37-39 weeks. Neonates were evaluated for any respiratory morbidity and need for NICU admission as well as need of mechanical ventilation, length of hospital stay and final outcome
Results: out of 535 patients, 240 [44.8%] patients received steroid cover before their elective cesarean section [group 1]. Two hundred and ninety-five [55.2%] patients who did not receive steroid cover, were allocated group 2. Mean age of mother's in-group 1 was 29.20 +4.50 years and in-group 2, it was 29.34 +4.50 years. The mean gestational ages were 37.56 +0.66 weeks and 38.11 +0.79 weeks in groups 1 and 2, respectively. In-group 2, 14 [4.74%] newborns developed transient tachypnea of newborn [TTN], which was higher than the newborns in-group 1 [04 [1.66%], p = 0.049]. Also the number of neonates being admitted to NICU was greater in group 2 than in group 1 [23 [7.79%] vs. 06 [2.5%] respectively, p = 0.007].However, there was no statistically significant difference between the two groups with regard to final outcome, requirement for mechanical ventilation, length of hospital stay and APGAR scores at one and five minutes
Conclusion: steroid cover significantly reduced the risk of respiratory morbidity in babies delivered by elective cesarean section between 37-39 weeks
ABSTRACT
Objective: To evaluate the quality of the observed mini-CEX scores by estimating reliability coefficients and standard errors
Study Design: Quasi-experimental, co relational study
Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi from Sep 2016 to Oct 2017
Material and Methods: This Quasi-experimental, correlational study was conducted with the OBGYN residents through non probability convenience sampling at Pak Emirates Military Hospital with sample size of 40. Twenty residents underwent Mini CEX [in addition to the existing teaching] while 20 had training through existing traditional teaching methods [lectures, SGDs, OPD, ward rounds, journal clubs, CPCs]. Before commencing the study both faculty and Resident trainees were introduced to Mini-CEX. The faculty [CPSP accredited supervisors], were given face to face training in conducting and rating Mini-CEX by a workshop. Each of the 20 trainees took four Mini-CEX sessions over a period of one year. The clinical skills were rated on a standard adapted Mini-CEX proforma. The trainees were given immediate feedback. Action plan was made and documented on the proformas
Results: The Trainees were assessed for improvement in clinical skills over the period of 12 months; and a trend of increased performance was obsessed amongst the trainees with each subsequent evaluation, supporting the construct validity of the instruments
Conclusions: The study showed that the mini-CEX is a potentially powerful tool to provide high-quality, interactive feedback that could contribute to improvement in trainees' clinical skills
ABSTRACT
Gestational trophoblastic neoplasia [GTN] is an uncommon complication of pregnancy which can follow any gestational event, molar pregnancy, normal pregnancy, miscarriage or even ectopic pregnancy. Its incidence is high in the region of South East Asia. The curability of GTD is a milestone of success in the history of medicine however we still face challenges in diagnosis and treatment due to myriad of its clinical presentations. The case under discussion is of a patient who presented with unusual symptoms of GTD which posed a diagnostic dilemma but was effectively managed in a tertiary care setting conserving her future fertility and quality of life
ABSTRACT
Objective: To assess and document safety, efficacy and patient acceptability of Manual vacuum aspiration [MVA] in the management of early pregnancy loss [EPL], performed in the treatment room setting
Study Design: Quasi-experimental, [clinical trial]
Place and Duration of Study: Treatment Room, OBGYN department, PNS Shifa from Nov 2010 to 31[st] Mar 2013
Material and Methods: Single centre prospective study conducted at Obstetric and Gynecology department, PNS Shifa from Nov 2010 to Mar 2013. A total of 414 women with EPL consented for MVA in the treatment room under local anesthesia, out of which 400 women underwent MVA
Results: Overall MVA was 94.5% effective in treating pregnancies through 13 weeks of gestation. There were no major complications. Minor complications: retained products of conception and endometeritis were treated easily
Conclusion: MVA is safe, effective and economical alternative to conventional dilatation and curettage for the treatment of EPL. Treatment in the outpatient setting allows better post-procedure physical and emotional quality of life; avoids general anesthesia, has immense potential in primary health care setting
Subject(s)
Humans , Female , Adult , Middle Aged , Pregnancy Complications , Pregnancy, High-Risk , Pregnancy , Prospective Studies , Safety Management , Vacuum CurettageABSTRACT
A strong relationship between maternal weight and birth weight has been demonstrated consistently and low maternal weight is considered as a preventable risk factor for low birth weight. To determine the frequency of preterm labour and fetal outcome in terms of low birth weight in pregnant women with low body mass index<19. Descriptive case series. Setting: Outpatient Department of Obstetrics and Gynaecology, Combined Military Hospital, Quetta, a tertiary care hospital. Duration of study: Six months from 01-05-2009 to 01-11-2009. Subjects and Total 114 pregnant women at 16 weeks of gestational age with singleton pregnancy reporting to obstetrics and Gynaecology Department Combined Military Hospital, Quetta were selected. Mean age was observed 27.6 +/- 3.9 year. Out of total 114 patients, 15 [13.1%] belonged to<37 weeks of gestation while 99 [86.9%] patients had>37 weeks gestation. Mean gestational age observed 38.5 +/- 4.1. Out of 15 preterm deliveries, 10 [66.7%] had uterine contractions>4/10 min 5 and [33.3%] patients had Cervical dilatation>2cm. Out of 114 patients, 12 [10.5%] cases had fetal weight<2.5 kg and while remaining 102 cases [89.5%] had fetal weight 2.5-4 Kg. In conclusion, this study demonstrates that low BMI is associated with preterm delivery and low birth weight babies
ABSTRACT
To evaluate neonatal outcome in terms of Apgar score after forceps and ventouse delivery in pregnant ladies indicated to have instrumental deliveries. Randomized control trial. This study was conducted at Labor ward of department of obstetrics and gynecology, PNS SHIFA Karachi, between Dec 2007 to Mar 2008. The target population were all pregnant subjects who visited labor room for delivery. Out of these patients, subjects who were indicated an assisted vaginal delivery for necessary management of labor were formally requested to participate in the study after various exclusions. Instrumentation was done in only those patients with singleton term pregnancy with cephalic presentation and vertex at + 1 to +3 stations. Patients with an indication for assisted vaginal delivery [n=105], were randomized for ventouse [n=53] and forceps delivery [n=52]. Instruments used were Wrigley's outlet forceps and vacuum extractor [V.E] with silicone cups. Data was recorded on specially designed Proforma. Post delivery neonatal outcome in terms of Apgar score at one minute and five minutes were compared between two modalities. The subjects undergoing forceps delivery had a significantly higher Apgar score [8.36 +/- 1.27] at 1 minute in comparison to those subjected to vacuum delivery [7.53 +/- 1.56]. The differences in Apgar score at 5-minutes [forceps delivery: 9.136 + 1.01 vs vacuum delivery 9.00 + 1.19], were not statistically significant. Outlet forceps assisted vaginal deliveries had better neonatal outcome in terms of Apgar score in comparison to ventouse