ABSTRACT
Although obstructed labor in vanished from the western world where the destructive operations are obsolete and not needed, in developing countries like India obstructed labor with dead fetus and severe infection is a sad reality, and destructive operations are an essential part of obstetric practice and cannot be wished away. In many situations they should be a preferred option to cesarean delivery which needs much better facilities and greater morbidity. Here authors present a case series of three patients who reported with obstructed labour and IUFD. Fetal craniotomy was done and thus maternal morbidity reduced. Craniotomy offers less postpartum morbidity, lesser expertise and resources and therefore better in cases presenting with obstructed labour and dead baby in developing countries.
ABSTRACT
MMR being an important index for evaluation of obstetric care of that area has a little information regarding actions to be taken to negotiate the maternal health issues of that area. Hence more number of cases who were moribund and critical but fortunately escaped death grouped as near miss was being studied to find out the shadowed causes of maternal mortality. Methods: All 312 near miss cases women were evaluated out of total 6040 admissions in obstetric ward of this institute during a period of one year from April 2017 to March 2018 to know the steps to be taken for improvement of maternal health in tribal and low resource newly started medical college. Result: Hypertensive disorders of pregnancy are the main culprit of maternal mortality whereas hemorrhage and its aftereffects are proved to be the most important cause of near miss. Incomplete abortion is the most common cause of hemorrhage and over the counter sell and misuse of Mifegest is found mainly responsible for incomplete abortion. Conclusion: To improve the obstetric care we have to educate the public for proper antenatal checkup. It will help health workers to identify the high risk pregnancies and their timely management. Apart from public awareness program there is necessity of well-equipped government health set ups where the poor tribal and also the other needy ones can report easily with all faith and confidence. Scarcity of skilled staff is also a subject to be noticed.