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Background: Insomnia is a typical complaint during pregnancy. Hormonal alterations, physiological changes during early pregnancy, and the enlargement of the foetus during late pregnancy contribute to disrupted sleep. Nursing interventions to identify sleep deficits and promote sleep are required at all stages of the maternity cycle. Methods: Insomnia, related problems and coping strategies were assessed using a structured Questionnaire of purposive sample of 50 Primigravida and 50 Multigravida Mothers attending OBG unit at HSK hospital and research centre, Bagalkot, Karnataka. Data were analyzed using descriptive and inferential statistics. Results: The result depicts that the majority of primigravida mothers (92%) experienced moderate and 8% experienced severe insomnia, 94% moderate, 4% mild and 2% experienced severe insomnia-related problems, 84% followed average, 12% good and 4% followed poor coping strategies, whereas, majority of Multigravida mothers (90%) experienced mild and 10% experienced moderate insomnia, 82% moderate and 18% experienced mild degree insomnia related problems, 92% followed average, 6% good and 2% followed poor coping strategies. There is a significant difference between primigravida mothers' insomnia, related problems and coping strategies and that of multigravida mothers. There was an irrelevant association found between insomnia scores of Primigravida and Multigravida mothers with socio-demographic variables. Conclusion: The overall study findings depicted that the mean percentage scores of insomnia of primigravida mothers (49.33%) was comparatively higher than the mean percentage scores of multigravida mothers (16.33%). Hence it was concluded that primigravida mothers has experienced more insomnia than compared to multigravida mothers.
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Dissociative trance and possession disorder is common in clinical settings and is dif?cult to differentiate from psychotic disorder by clinicians. It has also been associated with non-suicidal self-injurious behaviours. A case of 24-year-old married female who is 4 months ANC was diagnosed with a case of trance and possession disorder with a bad obstetric history. She received treatment on OPD basis.
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Background: Caesarean delivery is one of the commonly performed surgical procedures in obstetrics in today's practice. The objective of this study was to estimate the overall incidence and indications of primary caesarean delivery among multiparous women and to study the immediate maternal and perinatal outcome.Methods: It was a prospective observational study done in Sikkim Manipal Institute of Medical Science, Sikkim, India. It included all pregnant women after 28 weeks of gestation who had normal vaginal delivery in previous pregnancy but underwent caesarean delivery during current pregnancy (n=120) from January 2016 to December 2016. Authors collected data using a pro forma. Relevant history including demographic details, relevant clinical, laboratory and radiological examination, indication for caesarean delivery, details of delivery and neonate, and duration of hospital stay were noted. Data was described using descriptive data like mean and percentages.Results: Out of 1646 deliveries conducted, 49% were by caesarean section. It included 7.29% primary caesarean delivery in multigravida. Majority of women (27%) were in the age group 25-29. Maternal request was the commonest indication for caesarean delivery (21.66%). Atonic PPH was the commonest intraoperative complication (2.5%). Surgical site infection was the commonest post-operative morbidity (3.33%). There were 51 perinatal morbidity and 2 perinatal mortality. There was no maternal mortality.Conclusions: Caesarean section rates in this study was higher than WHO recommendation (15% versus 49.69%). This shift in trend can be attributed to higher number of maternal request for caesarean delivery which can be avoided by good analgesic facility and good counselling.
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Background: Breastmilk is considered the most complete source of nutrition for the new-born as it contains all necessary components such as proteins, carbohydrates and fats, water, vitamins and minerals and immunological factors required for the new-born in appropriate amounts. Breastfeeding is advantageous to the infant as well as the nursing mother in many ways. There are various benefits to the new-born both immediate as well as in the long run.Methods: A multiple-choice questionnaire was used to interview the participants during data collection.Results: Using the IBM SPSS version 20 software, descriptive analysis of the categorical variables has been presented using frequency and percentage tables.Conclusions: Though the knowledge about exclusive breast feeding was not extraordinary among the participants, they had a very favourable attitude towards the same. Almost all patients were also extremely receptive and inquisitive during the session for discussion about the same.
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Background: MTP Act no 34 of 1971 has been defined as Legal termination of pregnancy before the age of viability of fetus that is 20 weeks of gestation. There is a need to find a medical agent which can help in the process of abortion by speeding it up, with minimal side effects. The objective of this study was to compare the efficacy of I.M carboprost and intravaginal Misoprostol and to evaluate the safety profile of I.M carboprost and Intravaginal Misoprostol. To compare the cervical dilatation caused by I.M carboprost and intravaginal Misoprostol and to compare the blood loss and adverse effects of I.M carboprost and Intravaginal Misoprostol.Methods: Prospective randomized experimental study including pregnant women up to 12 weeks of gestation opting for M.T.P. Study conducted on 200 patients selected from patients admitted in MGM Medical College and M.Y. Hospital, Indore and Kalyanmal Hospital, Indore during the period July 2014 to March 2015. They were randomly divided into 2 groups. Group A who received intramuscular injection of 250 mcg of caboprost or Group B,which received 400 mcg of vaginal Misoprostol 4 hours prior to suction evacuation.Results: Intravaginal misoprostol achieves better cervical dilatation compared I.M carboprost which is statistically significant. Misoprostol is associated with higher blood loss as compared to I.M carboprost which is associated with nausea/vomiting & more likelihood of loose stools and abdominal cramps which is proved statistically.Conclusions: Intravaginal misoprostol is associated with higher blood loss as compared to I.M carboprost which is significant but intravaginal misoprostol achieves more cervical dilatation and causes less adverse events than I.M carboprost which is statistically more significant and therefore intravaginal misoprostol is the drug of choice for cervical priming prior to surgical abortion in terms of both efficacy and safety.
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Background: Breastmilk is considered as one of the healthiest, nutrition-rich yet least expensive method of infant feeding. It is a universally accepted fact that breastmilk meets all the nutritional demands of the new-born. There are extensive benefits of breastfeeding for the new-born as well as for the nursing mother which have been documented from time to time.Methods: A multiple-choice questionnaire was used to interview the participants during data collection.Results: Using the IBM SPSS version 20 software, descriptive analysis of the categorical variables has been presented using frequency and percentage tables. Regarding the practices about breast feeding in primigravidas, their concepts about the same have been captured in this study.Conclusions: Though the knowledge about exclusive breast feeding was not extraordinary among the participants, they had a very favourable attitude towards the same. Almost all patients were also extremely receptive and inquisitive during the session for discussion about the same.
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Background: An alarming increase in Gestational diabetes mellitus (GDM) cases worldwide elevates concern regarding the consequences including fetal macrosomia, preeclampsia and many more. Plasma homocysteine levels which has direct impact on to endothelial function of blood vessels. The relationship of homocysteine and GDM is yet to be clarified.Methods: This single centre prospective observational study was conducted in Department of Obstetrics and Gynaecology of Thanjavur medical college hospital among 50 pregnant primi and multi gravida patients with normal pregnancy and gestational diabetes mellitus to assess the association and comparison of serum homocysteine levels in both groups.Results: The mean value of homocysteine in control group was 3.8 ± 0.95 and in gestational diabetes patients was 16.30±6.09. On comparison, found that there was hyperhomocysteinemia among GDM patients with normal pregnancy and results were statistically significant (T= -9.024 Df=48.000 <0.05).Conclusions: In this comparative and correlative study, we found that patients with gestational diabetes mellitus have higher serum homocysteine levels in comparison with normal pregnant women. Hyperhomocysteinemia is found to be an independent risk factor for gestational diabetes mellitus patients. Further investigations are needed to follow up for these patients in the postpartum period and later in their life.
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Background: the objective of this study was to study the utility of partogram in both primi and multi gravida and evaluate its role in preventing prolonged labour; assess the rate of cervical dilatation on admission, and to evaluate the maternal and perinatal outcome by comparing their partogram in labour.Methods: This observational prospective clinical study involved randomly selected 200 patients in labor divided into 2 groups of 100 each admitted in Khaja Banda Nawaz Institute of Medical Sciences, Gulbarga. Modified WHO partogram was used. Statistical analysis done by Chi square test.Results: Mean age group in primi was 22.05 years with standard deviation of 2.38 years and in multi mean age group was 25.19 years with standard deviation of 3.09 years. Mean duration of active phase of labor in primi was 2 hrs 12 mins and in multi was 1 hours and 35 mins from time of admission into hospital. Mean duration of second stage of labor in primi was 57 mins and in multi was 35 mins. Out of 100 primi gravida 68% had NVD, 1% had outlet forceps. 13% had vacuum application and 18% underwent LSCS. Out of 100 multigravida 86% had NVD, 1% had outlet forceps, 7% had vacuum application and 6% underwent LSCS. In group A in primi 75% had NVD, 0% had forceps, 5% had vacuum application and 0% LSCS whereas in multi 93% had NVD and 7% had vaccum, NO forceps /LSCS. In group B, in primi 20% had NVD, 4% had forceps, 33% had vacuum application and 43% had LSCS whereas in multi 34% had NVD, 8% had forceps, 8% had vacuum application and 50% LSCS. In group C, in primi 100% had LSCS whereas in multi there were no NVD/Vaccum/ forceps/ LSCS cases. In primi 100% and in multi 96% had no maternal complications. In primi 96% and in multi 97% had no neonatal complications.Conclusions: The partogram is used to assess the labor progress and identify when intervention is necessary. This study showed that it can be highly effective in reducing complications from prolonged labor for both mother & neonate, in reducing operative intervention and improving their outcome.
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Background: Polyhydramnios is the term for abnormal increase in the amniotic fluid. It has been shown that AFI is quite reliable in determining normal or elevated volumes. The aim of this study to evaluated the perinatal and maternal outcome in pregnant women with polyhydramnios. Material & Methods: This analytical study was conducted on 300 unselected pregnancies attending in Mahatma Gandhi Hospital, Bhilwara, Rajasthan. Most of the cases of polyhydramnios were admitted in the hospital till they delivered, other patients were followed up as outpatient and they were admitted to the hospital for delivery. Pregnancy outcome were recorded for the patients who were classified as having an excess amount of amniotic fluid. Results: In our study showed that out 0f 300 patients, 168 (56%) were in the age group of 21-25 yrs, 62.3% cases were multigravida in our study. In our study 73% of the cases were delivered vaginally. Out of which 15% were induced and 58% were delivered spontaneously. 27% of the cases were delivered by LSCS, out of which 16% were emergency LSCS and 11% were elective LSCS. In our study there were many perinatal complications. Out of them preterm birth was the most common complication. Conclusion: The conclusion of this prospective study was occurrence of polyhydramnios is directly related to advanced maternal age with multigravida. Caesarean section as a mode of delivery was found to be higher in cases of polyhydramnios.
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Background: In women at low risk of PPH, recent studies have suggested that active pharmacological management does not reduce blood loss when compared with physiological management and routine use of oxytocic drugs benefits only seven women per hundred. The aim of study is to study the effect of prolonged duration of third stage labour on risk of hemorrhage Methods: This was a hospital based prospective randomized controlled trial study. Institutional Ethics Committee permission was obtained. Informed consent was taken from each and every woman who participated in the study. A total of 500 women in third stage of labour were divided into two groups of 250 each. The outcome was measured in terms of blood loss and hemoglobin percentage. Results: It is observed that the duration of III stage labour was more among control group where the cord was clamped compared to study group where the cord was drained. Similarly it was also observed that the blood loss was also more among control group compared to study group, both in multigravida and primigravida. It is seen that there was a fall of 1.1% of hemoglobin in primigravida in study group compared to 1% among control group in primigravida. Similar result was seen for multigravida women. Conclusion: Routine drug administration is unnecessary for all low risk women.
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Twenty women in labor were allocated to receive either a continuous epidural infusion of 0.125% bupivacaine at a rate of 8-10 ml/hr or hourly intermittent injections of bupivacaine 0.125%. Both groups received an initial bolus dose of 8-10 ml bupivacaine 0.125%. Supplementary top-up doses of 4-5 ml bupivacaine 0.15% were given when the pain scores failed to change in the subsequent hour. Results showed that both groups attained comparable best pain scores (p0.37), but more patients from the intermittent injection group suffered worst pain scores (p=0.07904). The infusion group has a significant shortened active stage of labor (p0.1) and used less total volume of bupivacaine 0.125% (p0.001). Sixty percent of the intermittent injection group required top-up doses. Likewise there was a greater incidence of motor block in this group (p
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PURPOSE: To solving the problems of unbalanced sex ratio through the last 10 year's and future problems. METHOD: This study was reviewed in last 10year's period in nulligravida, multigravida, cesarean section, season, year(odd, even), and month(odd, even), it's depend on the 11568 cases during the last 10 year's and average of yearly delivery is almost 1000 cases. RESULT: The following results were obtained, The total sex ratio in last 10 years were 100: 108. 5(female: male). The total monthly sex ratio in last 10 years were following. Febraury sex ratio was 100: 115.2(female:male), may sex ratio was 100: 97.0(female:male), Even month sex ratio 100: 112.1(female: male), odd month sex ratio 100: 104(female: male), seasonal sex ratio were following. Spring(100: 102.7), summer(100: 115.6), fall(100: 106.4), winter(100: 109.4). The total Normal Spontaneous Vaginal Delivery in nulligravida and multigravida were followed, nulligravida(which is one delivery only) was 100: 112.4(f: m), multigravida(which is more than one delivery, but not inclued abortion) was 100: 107.6(f: m). The total c/sec(Cesarean section) in 1st c/sec and 2nd and above c/sec were followed. 1st c/sec was 100: 113.6(female: male), 2nd and above c/sec was 100: 103(female: male). CONCLUSION: Our results suggest that the unbalance of newbom baby boy sex ratio in nulligravida is higher then multigravida and is problem in this contry. We will be concerned social problem in early 21th centry.