Programmed Labor For Optimizing Labor And Delivery.

To evaluate the efficacy of Programmed Labor protocol in providing shorter, safer and a relatively pain free delivery.The study was conducted in Obstetrics & Gynecology deptt of Christian Medical College & Hospital, Ludhiana. 30 primigravidae were included into the study and treated as per protocol. Labor outcome was analyzed in terms of mean rate of cervical dilatation, mean duration of first, second and third stages of labor, average blood loss, mode of delivery, maternal and neonatal morbidity. 50 primigravidae as controls were also included in the study and analyzed for the same parameters. The mean rate of cervical dilatation in the study group was 2.3cm/hr, which was almost double of the control group. There was marked shortening of all the stages of labor. Average blood loss was comparatively less in the study group. 70% of women in the study group had significant pain relief. Majority of women in the study group delivered vaginally. 2 (6.7%) babies born to these mothers had an Apgar Score < 7 but there was no perinatal mortality. Programmed labor protocol can safely lead to shorter labors and significant pain relief without any major increase in maternal or neonatal morbidity.

Alarmingly High Maternal Mortality in 21st Century.

The study was conducted to determine the maternal mortality rate (MMR), various factors affecting it and possible prevention of maternal deaths in Christian Medical College & Hospital, a tertiary care institute during the past five years (2001- 2005). The individual record of maternal deaths was studied regarding their socio-demographic features, causes, modes of management and ultimate outcome. The Maternal Mortality rate was 1470 per lac live births. The major obstetrical complications accounted for more than three fourth of maternal deaths with hemorrhage (33%), sepsis (21.7%) and eclampsia (7.5%) playing an important role. Anemia (44.3%) and jaundice (16.0%) were two important indirect causes of maternal deaths. Un-booked cases accounted for majority of maternal deaths. Only two maternal mortality patients were showing regularly in our institute, rest all of the patients either had no antenatal check-up or were having ANC in private clinics and were referred as an emergency in critical condition. More than 90% of maternal deaths hailed from rural and urban slum areas. 61 (57.8%) cases received primary care from untrained birth attendants and 11 (10.4%) did not receive primary care in any form. There was delayed referral by the untrained personnel, 49 (46.2%) patients were referred after more than 48 hours of acute emergency, 51 (48.1%) died between 24 to 48 hours and 25 (23.6%) died within 24 hours of admission in spite of all resuscitative measures. It is concluded that providing good antenatal care, finding appropriate ways of preventing and dealing with the consequences of unwanted pregnancies, and improving the way society looks after pregnant women are three most important ways to reduce maternal mortality.

Broad Ligament Fibroid - An Unusual Presentation

Giant fibroids are known to arise from the uterus, but occasionally from the broad ligament also. This is a case report of a giant broad ligament fibroid, reported for its rarity, and the diagnostic difficulties.