ABSTRACT
Background: The objective of this study was to compare the rates of caesarean section and neonatal outcome in patients with elective induction of labor compared to patients with spontaneous onset of labor.Methods: Authors studied 200 patients with 100 in elective induction group and 100 in spontaneous onset laboring group. Two groups were compared with respect to demographic profile, basic examination, ultrasound findings, P/A, P/V findings, duration of labor, mode of delivery and neonatal outcome.Results: Various parameters like age residence, per abdominal findings were comparable in two groups. Labor was not prolonged in study group compared to control group. Rate of caesarean section remained high in induction group (21%) in comparison to spontaneous laboring group (4%). Rate of instrumental deliveries did not differ significantly between the groups. 5 min Apgar score did not vary significantly; however, the NICU admission was higher in induction group compared to spontaneous laboring group. Duration of hospital stay was longer in study group.Conclusions: Elective induction of labor has higher rates of caesarean deliveries. NICU admission was also longer in induction group.
ABSTRACT
Background: Placenta praevia is one of the serious obstetric problems with far reaching effects and a major cause of antepartum haemorrhage. The aim of the study was to evaluate the foetomaternal outcome of pregnancies with placenta praevia.Methods: The present study was a prospective case control study conducted in the Department of Obstetrics and Gynaecology, Lal Ded Hospital, Srinagar from August 2009 to October 2010.Results: Among the 100 cases of placenta praevia studied bleeding per vaginum was the most common presenting symptom. Major placenta praevia was more common (53%) than minor placenta praevia. 43% of the cases of placenta praevia delivered before 37 completed weeks as compared to only 6% in the control group. All cases of placenta praevia delivered by caesarean section. Maternal morbidity in terms of postpartum haemorrhage (32%), intraoperative bowel and bladder injury (2%) and intensive care unit admission (1%) was more in cases of placenta praevia. Foetal complications in terms of neonatal intensive care unit admission (19%), neonatal death (10%) and stillbirth (5%) were more in pregnancies with placenta praevia as compared to controls. 48% of patients with placenta praevia required transfusion of blood and blood products as compared to 4.5% among controls.Conclusions: There is a significant increase in maternal morbidity in pregnancies complicated with placenta praevia. Also, there is a higher incidence of foetal complications and neonatal death. Managing a case of placenta praevia is a challenge in present day obstetrics and it creates a huge burden on the health care system.
ABSTRACT
Background: Modified WHO Partograph is a simple, inexpensive pre-printed form on which labour observation are recorded. It generally comprises three sections of information: maternal condition, fetal condition and labor progress. To study on usefulness of Modified WHO Partograph in management of labour of low risk women, this indirectly improved maternal and perinatal outcome.Methods: In this study the progress of labour of 150 women with uncomplicated full term pregnancies with cephalic presentation in active labour was studied using modified WHO partograph. 150 historical matched controls comprising of low risk women who delivered without the use of partograph were identified from the labour register and their course of labour studied. The hospital records were studied to obtain the demographic variables. Maternal and perinatal outcome was analyzed for both cases and controls.Results: The emergency cesarean section rate was reduced from 38.7% in controls to 24.7% in cases and both are significant statistically. None of the cases had labour beyond 16 hours, thus indicating significant reduction in prolonged labour. Neonatal intensive care admissions decreased from 18.6% in controls to 6% in cases indicating an improved maternal and neonatal outcome.Conclusions: Modified WHO Partograph work as “early alarming warning system” which help in detecting delayed progress of labour which improves maternal as well as perinatal outcome.