ABSTRACT
Background: Preeclampsia is a complex clinical syndrome which involves multiple organ systems and remains the principle cause of maternal and perinatal morbidity and mortality. Preeclampsia is a disease of trophoblastic tissue. Placental abnormality is one of the initial events in patients who are destined to develop pregnancy induced hypertension subsequently. Objective of this study was to evaluate the association of laterally located placenta on ultrasound with development of preeclampsia.Methods: This prospective observational study was conducted on 200 antenatal women with singleton pregnancy at 18-24 weeks of gestation who attended antenatal clinic of obstetrics and gynaecology, PGIMS Rohtak from October 2017 to October 2018. Detailed antenatal transabdominal ultrasound along with placental location was done between 18-24 weeks of gestation in women who fitted into inclusion criteria. All the antenatal women belonged to 18-24 weeks of gestation were included in the study except those women with chronic hypertension, diabetes mellitus, renal disease, severe anaemia, thyrotoxicosis, low lying placenta, previous history of preeclampsia or eclampsia.Results: Out of 200 antenatal women, 84 had lateral placenta while 116 had central placenta. Out of these 84 women who had lateral placenta, 55 women (65.5%) developed preeclampsia and out of 116 (58%) women who had central placenta, 28 women (24.1%) developed preeclampsia.Conclusions: From the above study, we concluded that women with laterally located placenta by ultrasound at 18-24 weeks of gestation have greater risk of developing preeclampsia.
ABSTRACT
Background: Major degree placenta praevia is a serioushealth issue and is associated with high fetal-maternalmorbidity and mortality. Especially the central placenta praeviais one of the most dangerous states in obstetrics.Objective: The objective of the study is to investigate theoutcome of central placenta praevia and to determine area ofconcern which requires maximum focus to decrease theincidence.Materials and Methods: This cross sectional study wasconducted over a period of two years (from January 2018 toDecember 2019) in the department of Obstetrics andGynaecology at HFRCMCH, Dhaka, Bangladesh.Results: A total numbers of 2479 antenatal patients had beenexamined in this study. Out of 2479 antenatal patient1380(55.67%) were caesarean section delivery. Among them53(2.14%) were suffering placenta praevia. Out of 53 placentapraevia, 47 were central placenta praevia. In percentageanalysis it is 88.68%, which is too high. All the placenta praeviapatients were delivered by caesarean section. 37 weredelivered by elective caesarean section16 were delivered byemergency caesarean section. Among 16 emergencydeliveries, 8 were due to Severe P/V bleeding and rest 8 forlabour pain & fetal distress. Regarding the maternal outcome,no mortality occurred but 5 patients needed ICU care, 6patients needed hysterectomy and 5 patients had bladderinjury for which they needed bladder repair. Regarding theneonatal outcome, 16 babies needed NICU support. Amongthem 5 babies died.Conclusion: Placenta praevia, especially central placentapraevia is a major cause of both maternal and fetal morbidityand mortality. If the patient has previous H/O caesareansection it becomes more serious. By observing the outcome ofthese patients in our hospital, we can also correlate it withother studies. By this way we can also take measure todecrease the incidence of maternal and fetal morbidity andmortality.
ABSTRACT
Background: Preeclampsia occurs in presence of placenta. Blood supply distribution within the uterus is not similar in central versus lateral sites implicating that, the site of placenta is likely to have a profound effect on the pregnancy outcome. In the light of these observations, a prospective study was designed to find out if the lateral location of placenta as seen by ultrasound between 18-24 weeks of gestation can be used to predict the development of preeclampsia.Methods: This prospective study was conducted in the department of Obstetrics and Gynaecology in IGGMC, Nagpur between January 2017 and June 2018. Pregnant women, with singleton pregnancy and without any risk factor, attending the antenatal clinic were subjected to USG between 18-24 weeks of gestation. Accordingly, patients were divided into 2 groups, 51 with lateral placenta and 51 with central placenta. All 102 women were followed till term. The end point of the study was development of preeclampsia i.e. BP >140/90 and urine albumin >300 mg in 24 hours sample. The data obtained was analysed using appropriate statistical tests.Results: Out of 102 patients, 80.9% were from lateral placenta group and only 19.1% were from central placenta. Sensitivity of this as screening test for preeclampsia was 80.9% while specificity was 58%, Odds ratio being 5.875. In predicting preeclampsia, lateral placenta had a meaningful effect with p value <0.001.Conclusions: Placental laterality, as determined by USG between 18-24 weeks of gestation, is a simple and cost-effective screening test for development of preeclampsia.
ABSTRACT
Objective To discuss and validate which method is more effectiveness for central placenta previa through analysing the clinical outcomes of the management of hemorrhage between uterine packing and stitching hemo-stasis during cesarean section.Methods 48 pregnant women with central placenta previa was conducted in this ret-rospective study,which were all cesarean section delivery.These patients were divided into two groups.24 patients with uterine packing with gauze in the control of massive hemorrhage during cesarean section were indetified,other-wise,the other 24 patients were conducted with sewing and ligation uterine.And then,the effectiveness and outcomes were compared.Results These all patients were alive and keep the uterus.The average estimated blood loss of the stiching group was (554 ±327)mL,obviously less than the uterine packing group,which was (828 ±584)mL,and the difference was statisatically significant (t =6.689,P0.05).Conclusion The uterine stiching is an effective,rapid and simple technique in the control of hemorrhage of central placenta previa.
ABSTRACT
From January 1987 to April 1991, we used the ultrasonography in the diagnosis of placenta previa of 197 cases. The diagosis of placenta previa is made to assess the relationship of the lower margins of the placenta and the internal os. There were total 74 eases of placenta previa (37.6%), 37 cases of (18.8%) partial placenta previa, 46 cases of low-lying placenta (23.4%), and 40 cases of "relative low-lying placenta" (20.2%). The high ratio diagnosis of the total placenta previa was made at 28-36 weeks.(P