ABSTRACT
To measure maternal serum beta human chorionic gonadotropin during 13-24 weeks of pregnancy and compare the same between those who develop pregnancy induced hypertension with those who do not. In a prospective study βhCG levels were estimated in 75 antenatal women in the second trimester (12-24 weeks) by ELISA technique. Results were noted in terms of development of preeclampsia, mean serum levels of the marker, mode of delivery and complications. During the course of study, a total of 8 (10.7%) patients developed hypertension. Thus incidence of pregnancy induced hypertension was 10.7%. A significant rise of mean serum βhCG level (32022MIU/ml, mean)was present in those who developed preeclampsia.The marker can prove an important role in early recognition of a pregnancy related complication and provides the obstetrician ample opportunity to guide the management during pregnancy.
ABSTRACT
Uterine cervical prolapse with pregnancy is rare, the threat to preterm labour and close observation needed. Here we present a case of gravid 2 para 0 abortion 1 and live 0 with 38 weeks of pregnancy with third degree cervical descent with labour pains.Pt on her previous visit was kept ring pessary and advice for follow up. Patient underwent emergency lower segment caesarean section on 21/9/2016 with cupperT insertion after observation. She delivered female baby of weight 2.8 kg and apgar score 8 & 9.The patient cervix remain prolapsed in early postpartum period. The patient was discharged and scheduled for further follow up in gynaecology clinic. Genital prolapse may develop before or during the pregnancy. Prolapse occurs due to tearing down of support structure of uterus. Pre- existing prolapse has been associated with infertility and spontaneous abortion. Women during late pregnancy encountered the complication of cervical dystocia due to non- retractable oedematous cervix. Management depends on the degree of prolapse and gestational age. Conservative management with bed rest, vaginal pessary, tocolysis to prevent pre-term labour and to achieve near term gestation, with few delivery complication and at last caesarean section.
ABSTRACT
Background: Prolongation of labor is one such dilemma that every obstetrician tries to avoid. The ultimate aim of the obstetrician is to accomplish the delivery in the shortest possible time without compromising maternal and fetal safety. Prolonged labor often ends up in great suffering to the parturient because of dehydration, confusion, and infection. This study aims to compare the efficacy of drotaverine hydrochloride with hyoscine butyl bromide for increasing the rate of cervical dilatation and to compare their duration of labor. Methods: This was a prospective interventional study conducted on 60 women who were randomly allocated to Group I, which was control group, women in Group II were injected hyoscine butylbromide one ampoule (20 mg) and the women in Group III were injected drotaverine hydrochloride one ampoule (40 mg) intramuscular at 3 cm dilatation of cervix. The data collected was statistically analyzed using SPSS version 15. Results: When compared to Group I (control group), Group II and Group III took lower time for all the three stages of labor. However, intergroup difference was significant only for Stage I (p<0.001). However, no significant difference was observed between Groups II and III (p=0.964). A significant difference among group was observed in total duration of labor too (p<0.001). Between group comparisons for Stage II and Stage III did not show a statistically significant intergroup difference for any of the comparisons (p>0.05). Conclusions: The finding in this study suggested a significant impact of both the drugs in first stage as well as total duration of labor as compared to control group. However, no significant difference between two study groups was observed. Thus, both drotaverine hydrochloride and hyoscine butylbromide could effectively reduce first stage as well as total duration of labor.
ABSTRACT
To find out the incidence of self-extubation in intensive care, to evaluate the factors responsible for it and to identify the predictors of need for re-intubation, a retrospective analysis was conducted among 350 patients who were admitted to the intensive care unit over a two-year period and required ventilatory therapy for more than 48 hours. In all patients who self-extubated, the demographic data, ventilatory parameters before self-extubation (mode of ventilation, inspired oxygen concentration, positive end-expiratory pressure), partial pressure of oxygen in arterial blood and inspired oxygen fraction ration (PaO2/FiO2), and the event of re-intubation were noted. These values were compared among patients who were re-intubated and those who were not. Twelve patients out of 350 self-extubated. Of these 12 patients, 7 required re-intubation while 5 did not. Of these 7 patients, 3 died within 48 hours of the episode of self-extubation and one patient's death was directly attributable to self-extubation. Of the remaining 4 patients, 3 died within a span of 7 days. Re-intubation after self-extubation should not be considered mandatory. Patients who required re-intubation had lower PaO2/FiO2 than patients who did not.