RESUMEN
Caesarean scar ectopic is one of the rarest of all ectopic pregnancies. The incidence of caesarean scar ectopic has increased due to increase in number of caesarean deliveries. A 31-year-old woman (G4P3003) presented from an outside facility to Sola Civil Hospital with vaginal bleeding and discharge with no abdominal pain or any discomfort. The gestational sac was located in an anterior position toward the anterior lower uterine segment at the level of prior caesarean scar with little visible myometrium noted anterior to the gestational sac in the lower uterine segment and Tissue was sent for histopathological examination and diagnosis of caesarean scar ectopic pregnancy was confirmed. Reports found that It is life threatening condition, causes excessive hemorrhage and risk of uterine rupture. The diagnosis of this type of ectopic pregnancy is very difficult and false negative diagnosis can lead to major complications.
RESUMEN
Anomalies of the reproductive tract are common and are seen in approximately 3-5% of the general population. These are usually asymptomatic, but are sometimes associated with recurrent pregnancy loss or infertility. Among these anomalies, septate uterus is the most common anomaly to be associated with obstetric complications and infertility. A 27 years old female patient P0A2L0 with first spontaneous abortion at 3 months and second spontaneous abortion at 4 months came to OPD with complaint of recurrent pregnancy loss. She was advised USG of pelvic region which shows septate uterus with normal cervix, fallopian tubes and ovaries. Patient prepared for DHL complete septum present normal B/L ostium and Jone's metroplasty done in which wedge shaped incision kept on uterine fundus, common cavity created by un roofing septum myometrium closed and AT the end Copper T 375 placed in intrauterine cavity for 6 months. 1 year after surgery patient came with UPT positive for antenatal visit at sola civil. Patient is now with 30 weeks of pregnancy with normal single intrauterine live cephalic fetus, metroplasty is an accepted method of treatment in women with recurrent abortions and septate uterus and it significantly improves the subsequent reproductive outcome. combined data from several published series and reported that the incidence of spontaneous abortion and preterm delivery rate decreases significantly after metroplasty, whereas, the incidence of term delivery rate increases.
RESUMEN
Background: Abruptio placentae is very frequently seen in our population. Few studies have reported maternal and fetal morbidity and mortality associated with this condition. No work has been done on abruptio placentae in our setup. The data generated will help to improve maternal and fetal morbidity and mortality by planning prompt management of future cases of placental abruption. Objective of this study was to study possible etiological factors of abruptio placentae, analyse maternal outcome, perinatal outcome in the form of maternal morbidity and mortality and discuss possible preventive measures and future management optionMethods: The retrospective observational study it was included all cases presenting with ante partum haemorrhage during the study period. Subjects selected for the study were all cases diagnosed as having abruptio placentae. All other causes of APH like placenta previa and other extraplacental causes were excluded.Results: In the present study incidence of abruptio placentae is higher in 25-30 year that were 42.5% and more in 2nd gravida patient. PIH was accounting for 50%, most of the patients (95%) were anaemic at admission and majority of them required blood transfusion.one maternal mortality (2.5%) occurred, perinatal mortality was 75%.Conclusions: Abruptio placentae serious condition with manifestation of significant maternal and perinatal morbidity and mortality. Complications can be reduced by provisional antenatal care to every woman and with improvement in medical facilities, availability of blood transfusion, proper management of shock. With liberalization of caesarean section, the rate of maternal morbidity and mortality is gradually on the decline.
RESUMEN
Background: Bleeding per vaginum in the first trimester is a common obstetric entity. Four major causes of pathological bleeding in 1st trimester are miscarriage, ectopic pregnancy, implantation bleeding of pregnancy and cervical pathology. The purpose of this study was to investigate and understand the effect of first trimester vaginal bleeding on maternal and perinatal outcomes in the local population to which our hospital serves. Objective of this study was to estimate the degree of association between first-trimester bleeding and miscarriage, pregnancy outcomes in women with threatened abortion, various maternal complications and outcome of labor in pregnancy complicated by first-trimester bleeding and adverse fetal outcomes affected with first trimester bleeding.Methods: This prospective observational study was carried out on 110 women attending hospital with history of first trimester vaginal bleeding at a tertiary health center - sola civil hospital Ahmedabad for a period of twelve months.Results: Majority (69%) of first trimester bleeding occurs in age group of 21-30 years and majority of patients were primigravida constituting 53% out of 110 patients, 48 patients presented with abortions, out of which 26 had threatened abortion and 22 had other abortions. Primi para with previous history of bleeding per vaginum had more chances to go in full term in present pregnancy.Conclusions: Patients presenting with heavy bleeding per vaginum ended up in pregnancy loss and thus a poor outcome. In the presence of sub-chorionic hematoma, the prognosis of pregnancy is greatly affected as the risk of pre-term, IUGR and especially miscarriages increase significantly.
RESUMEN
Background: Pre labor Rupture of membranes is a common obstetrical problem, significant event as it transforms an ordinary pregnancy into a high risk one. Majority of cases of PROM - of about 60% occur after 37 completed weeks Induction of labour is artificial. Misoprostol is receiving attention as a cervical modifier and labour induction agent. This study compares the safety and efficacy of Misoprostol with Oxytocin in labour induction in term pre labour rupture of membranes. Objective of this study was to compare the safety and efficacy of Misoprostol with that of Oxytocin in labour induction in PROM. The effects were compared between primipara and multipara in a selected sample.Methods: General condition is assessed by pulse rate, blood pressure, height, weight with particular attention to pedal odema, anemia. Cardiovascular and respiratory systems were examined, rule out cephalo pelvic disproportion and for Bishop’s scoring. USG for foetal maturity, Liquor status and for foetal well-being. Admission CTG.Results: There is no significant difference was observed between two groups either in vaginal delivery or in incidence of LSCS. Mean induction delivery interval in misoprostol group for nullipara is 8.5 hours. For multipara it is 6.6 hours. And in oxytocin group for nullipara is 10:4 hours. In multipara it is 6.5 for primipara it was significantly reduced in misoprostol group compared to syntocinon group.Conclusions: Misoprostol is an effective, cheap, safe, stable at room temperature and easy to use if it is used in appropriate dosage for induction of labour in pre-labour rupture of membranes at term.
RESUMEN
Background: Primary amenorrhea is absence of menstruation and secondary sexual characters by age of 14 years primary amenorrhea is < 1%. Development of female genital organs takes place from mullerian DUCT (paramesonephric duct). The objective of this study was to note the various causes, complete clinical picture and the management in 25 such cases of primary amenorrhea.Methods: This is a prospective study done in 25 cases. They were investigated, managed and patients were called up for follow up for their response to treatment.Results: Out of 25 cases studied, maximum cases presented at 14-16 years of age, with chief complaint of primary amenorrhea, out of which 8% were married, 44% cases were of MRKH syndrome which was the most common cause of primary amenorrhea.Conclusions: Amenorrhea has got multi factorial etiology. For patients with amenorrhea physical examination should focus on pubertal development and possible genital out flow obstruction.